Frequency of Blood Culture Isolates and their Antibiogram in a Teaching Hospital

Abstract

Introduction: Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia.Methods: Blood sample received from the patient attending Nepal Medical College and Teaching Hospital from March 2013 – August, 2013 were subjected to for culture. Isolate identification and antimicrobial susceptibility testing was done by standard microbiological methodResults: Out of the total 2,766 blood samples, 13.3% showed bacterial growth. The percentage of neonatal septicemia was 13.3%. Staphylococcus aureus (28%) was the most common isolates followed by Salmonella enterica Serotype Typhi (22%), Coagulase negative Staphylococci (9.5%), Salmonella enterica Serotype Paratyphi ((7.6%) and Klebsiella pneumoniae (7.6%). 26.3% of the isolates of Staphylococcus aureus were oxacillin resistant. Most of the gram positive organisms were susceptible to amikacin and vancomycin and showed high level resistance to cefuroxime and cotrimoxazole. Out of 109 isolates of typhoid bacilli, 95.3% were resistant to nalidixic acid ,79% to ciprofloxacin and 60.5% to ofloxacin. More than 50% of the isolates of Klebsiella pneumoniae and Escherichia coli showed resistance to cephalosporins and cotrimoxazole. Acinetobacter spp showed high resistance (more than 60%) to ceftriaxone and ofloxacin. More than 20% of the isolates of Pseudomonas aeruginosa were resistant to ciprofloxacin and amikacin.Conclusions: Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread.Keywords: antibiotic; bacteria; blood stream infections.

Multi-Drug Resistant, Extended Spectrum beta-Lactamase and Carbapenemase Producing Bacterial Isolates among Septicemia Suspected under Five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia: Cross-sectional study

“…The second most predominant GNB isolates in our study were Acinitobacter species resistance to most tested antimicrobials ceftazidime100%, cefepime 90.9% gentamycin 81.8%, torbomycin 81.8% ciprofloxacin 72.7%, meropenem 72.7% was comparable with other previous studies where high resistance of Acinitobacterspecies was published [52,53]. However our result was high rate of resistance compared to the study conducted in South India by Zakariya et al, [54] in which meropenem 100% sensitive, while 67% were sensitive to gentamicin, ceftriaxone, ciprofloxacin, ceftazidime and Amikacin reported.…”

“…Among the total isolates 54% gram negative bacteria were causing blood stream infection in children which is in line with the previous study done in Addis Ababa, Ethiopia 51.8% [23] elsewhere in India 51.8% [32] Kabul, Afghanistan 51.7% [ 33] and in Nepal 55.2%, 56% [ 34] respectively but higher compared to the study done in USA by Larru.,et al,22%[35] and in South Africa by Crichton et al, 40.7% [36], this was due to difference in socioeconomic , geographical and infection control mechanisms.…”

Multi-Drug Resistant, Extended Spectrum β-Lactamase and Carbapenemase Producing Bacterial Isolates among Septicemia Suspected under Five Children in Tikur Anbesa Specialized Hospital, Addis Ababa Ethiopia

“…The second most predominant GNB isolates in our study were Acinitobacter species resistance to most tested antimicrobials ceftazidime100%, cefepime 90.9% gentamycin 81.8%, torbomycin 81.8% ciprofloxacillin 72.7%, meropenem 72.7% was comparable with other previous studies where high resistance of Acinitobacter species was published [55,56]. However our result was high rate of resistance compared to the study conducted in South India by Zakariya et al, [57] in which meropenem 100% sensitive, while 67% were sensitive to gentamicin, ceftriaxone, ciprofloxacin, ceftazidime and Amikacin reported.…”

“…Among the total isolates 54% gram negative bacteria were causing blood stream infection in children which is in line with the previous study done in Addis Ababa, Ethiopia 51.8% [25] elsewhere in India 51.8% [ 34] Kabul, Afghanistan 51.7% [ 35] and in Nepal 55.2%, 56% [ 36] respectively but higher compared to the study done in USA by Larru.,et al,22%[37] and in South Africa by Crichton et al, 40.7% [38], this was due to difference in socioeconomic , geographical and infection control mechanisms.…”

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“…Another significant finding of the study is the isolation of Salmonella species in 15% of the cases. An increasing incidence of Salmonella species has also been reported in some recent studies 18,19 .…”