ABSTRACT
Development of antimicrobial resistance (AMR) to different generations of common antibiotics by various organisms is rising alarmingly. A nationwide standard antibiotic policy is needed. We wanted to study the resistant organisms, the drug class to which organisms are becoming resistant and identify factors favoring the development of AMR for formulating an effective antibiotic policy. MethodsWe conducted this observational study from January 2018 to May 2019 in a tertiary care hospital in India. Sample (urine, blood from ICU patients) processing, organism identification and antibiotic susceptibility tests were carried out as per the institutional guidelines in the Microbiology Department from where data collection was done. ResultsOut of 500 samples, 145 (29%) showed significant growth of organisms exhibiting resistance to either single or multiple drugs. Acinetobacter spp. was the most common organism isolated with a total of 40 (27.58%), followed by Klebsiella spp. 23 (15.83%), MRSA 20 (13.79%), E. coli 15 (10.34%), Pseudomonas 12 (8.27%), Enterococci 12 (8.27%), and CoNS 7 (4.82%). Among GNB, Klebsiella and E. coli showed minimal resistance to polymyxins, fosfomycin, minocycline and tigecycline. Among Staphylococcus spp. maximum sensitivity was seen to teicoplanin, tobramycin, tigecycline and minocycline. Acinetobacter spp. showed high sensitivity to polymyxins, tobramycin, tetracycline, tigecycline and minocycline. ConclusionsAMR was highly prevalent with hospital acquired organisms, and against commonly used antibiotics. Variation of resistance and sensitivity pattern with time and local microflora necessitates periodic AMR monitoring and rotation of antibiotics is suggested to restrict further emergence of resistance. Focusing on the organisms causing UTI and BSI and their resistance pattern, helps in selecting proper antibiotic therapy and in strengthening general sepsis measures.
ABSTRACT
Background: Nonfermentative gram-negative bacilli (NFGB) have emerged as a major cause of nosocomial infections.This study was undertaken to know the prevalence of nonfermenters isolated from different clinical samples along with their susceptibility profile. Material and methods: Conventional bacteriological methods were used for identification and susceptibility testing of nonfermenters. Susceptibility testing was performed by methods as recommended by Clinical Laboratory Standard Institute (CLSI). Results: Out of the total 1,650 clinical samples received NFGB were found in 201 samples with an isolation rate of 12.18%. Nonfermenters isolated were Pseudomonas aeruginosa (50.24%), Acinetobacter baumannii (24.87%), Acinetobacter lowffii (5.47%), Pseudomonas fluorescens (1.49%), Pseudomonas stutzeri (1.99%), Burkholderia cepacia (6.96%), Stenotrophomonas maltophilia (2.98%), Achromobacter xylosoxidan (3.98%) and Shewanella putrefaciens (1.99%). Most of the isolated organisms were multidrugresistant (MDR). P. aerurginosa showed good sensitivity to imipenem (91.08%), cefoperazone sulbactum (68.31%) combination, amikacin (69.30%) and colistin (100%). A. baumannii showed 90% sensitivity to imipenem and 94% to colistin. Conclusion: Our study showed that prevalence of NFGB amongst different clinical isolates is significantly high especially in this part of the world and these organisms are often MDR. In this scenario, we propose all laboratory samples should be screened for NFGB even in clinically unsuspected cases. P. aeruginosa showed good sensitivity to colistin, imipenem, amikacin and cefoperazone sulbactum combination while A. baumannii showed good sensitivity to imipenem and colistin.