Hospital Antibiogram- A Tool for Safe Antimicrobial Therapy

Abstract

BACKGROUND Monitoring emerging trends in antimicrobial resistance at local levels is a very important aspect for clinical decision making and infection control interventions in this era of rising superbugs. The hospital antibiogram constructed by standardized methods is a summary of antimicrobial susceptibilities of local bacterial isolates, with periodic review. METHODS This antibiogram was prepared based on the Clinical and Laboratory Standards Institute (CLSI) M39-A4 guidelines. The data was collected for a period of three years from May 2016 to April 2019. All the samples which were received in the microbiology laboratory for aerobic bacterial culture and sensitivity testing were considered. Antibiotic susceptibility data of the bacterial isolates processed by VITEK2 system was considered. A hospital antibiotic policy was formulated and implemented. RESULTS A total of 15,135 samples were analysed from different clinical departments for a period of three years, of which 5,638 were culture positive. A comparative analysis of the three years' data during the introduction of antibiotic protocol showed a gradual decrease in the rate of infection with multidrug resistant organisms. The prevalence of Methicillin Resistant Staphylococcus aureus (MRSA) showed a decrease from 15% to 7%. Extended spectrum beta-lactamase (ESBL) producing Escherichia coli in urine decreased from 42.4% to 27%. CONCLUSIONS Prompt antimicrobial therapy in case of an infection makes a lot of difference between recovery and death and most of the time prevents long term disability. Hence, antibiotic policy is one of the mandatory requirements, and making an antibiogram is the first step before framing antibiotic policy.

Analysis of Cumulative Antibiotic Sensitivity Testing Data (Antibiogram) of Anwer Khan Modern Medical College Hospital

“…The knowledge of the local antimicrobial resistance patterns is vital to introduce appropriate infection control measures to check the spread of these resistant organisms as well as to prevent the emergence of new drug resistant bugs. 12 Unfortunately, the easy availability and familiarity, affordable prices and ignorance of the impending consequences of antimicrobials, has resulted in use and misuse of antimicrobials and aided the persistent expansion of multidrug resistant microbes, leading to the loss of efficacy of these "magic drugs". Inappropriate antibiotic usage triggers the selection and rapid emergence of drug resistant bacteria like ESBLs, which in turn spread in the community by horizontal gene transfer.…”

“…Isolates were identified by standard methods and antibiotic sensitivity was performed according to CLSI guidelines by modified Kirby Bauer disk diffusion techniques. 11,12 The isolates per patient in the period was analysed irrespective of the body site from which the specimen was obtained and the antimicrobial susceptibility pattern was considered. Repeat isolates were alsoincluded as segregation was not possible.…”

Antibiogram Profile of Bacteria Associated With Bovine Endometritis and Mastitis in Andhra Pradesh

“…Currently attention has to be focused for rational use of antibiotics for treating animals as it has public health importance and it has been estimated that by 2050, 10 million humans deaths annually will be due to antimicrobial resistance (AMR), which is emerging as a major threat to public health and India is said to carry the largest burden of drugresistant pathogens worldwide. (Rai and Bhat, 2020).…”