Current pattern of bloodstream infections in a tertiary care hospital of Karachi and clinical significance of positive blood cultures

ABSTRACT

Blood stream infections [BSI] [septicemias] require prompt empirical therapy based on awareness of the drug susceptibility profiles of locally prevalent pathogens isolated. Department of Pathology Dow University of Health Sciences, Karachi, in collaboration with Dr Essa's Diagnostic Centre, from July to November 2008. A cross-sectional prospective study. 324 consecutive blood cultures from patients coming to Civil Hospital Karachi were scrutinized for bacterial isolates and their antibiotic sensitivity profiles were done. A total of 100 [30.9%] specimens were found positive, of these 78% isolates were gram negative bacteria and 22% gram positive cocci. Salmonella typhi, seen less often in adults [20.5%], was the predominant pathogen in children [82.5%]. Escherichia coli, Staphylococcus aureus, Pseudomonas and Klebsiella were isolated in neonates, and Klebsiella, Pseudomonas, Enterobacter and Acinetobacter were identified among adult patients. While all S.typhi isolates were sensitive to cefixime, ceftriaxone and the fluoroquinolones and increasingly amenable to chloramphenicol, of significance was the percentage of other multidrug resistant bacterial isolates. Methicillin resistant Staphylococcu aureus was isolated from one case. The results were analysed by applying SPSS version 16 to derive p value. Amikacin, carbapenems, cefoperazone+sulbactam, fosfomycin and pipericillin+tazobactam are currently the only available drugs still active in-vitro on blood isolates, judicious use of antibiotics focused on the compliance and formation of antibiotic policy guide lines is highly recommended