Bloodstream infections and trends of antimicrobial sensitivity patterns at Port Blair

Amit Banik; Sanjeev H. Bhat; Abhay Kumar; Agnijeet Palit; Kandregula Snehaa

doi:10.4103/JLP.JLP_50_18

Journal of Laboratory Physicians, Table of Contents

CC BY-NC-ND 4.0 · J Lab Physicians 2018; 10(03): 332-337
DOI: 10.4103/JLP.JLP_50_18

Original Article

Bloodstream infections and trends of antimicrobial sensitivity patterns at Port Blair

Authors

Amit Banik

Department of Microbiology, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India,
Sanjeev H. Bhat

Department of Microbiology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands
Abhay Kumar

Department of Microbiology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands
Agnijeet Palit

Department of Microbiology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands
Kandregula Snehaa

Department of Microbiology, Andaman and Nicobar Islands Institute of Medical Sciences, Port Blair, Andaman and Nicobar Islands

Abstract

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ABSTRACT

PURPOSE: Bloodstream infection can range from inapparent bacteremia until fulminant septic shock with high mortality. Microorganisms present in circulating blood whether continuously, intermittently, or transiently are a threat to every organ in the body. Culture of blood is a vital tool to diagnose such infections. Drug susceptibility patterns help in rationalizing therapy.

OBJECTIVE: The objective of this study was to perform bacteriological analysis and assess drug sensitivity patterns of isolates from blood stream infections.

DESIGN: Retrospective observational study was conducted from May 2015 to February 2017 at a tertiary care hospital, Port Blair, India. Blood samples were collected with aseptic guidelines and cultured for 7 days. Growths were identified using standard biochemical tests and subjected to sensitivity testing according to Modified Kirby–Bauer’s disk diffusion method. Data for the source of blood collection and duration of incubation were noted and compared.

RESULTS: A total of 270 (14.24%) pathogens were isolated from 1895 bacteremia suspect patient blood specimens. Contamination was observed at a rate of 1.63%. Gram-positive cocci (60.37%) were predominant organisms recovered followed by Gram-negative Bacilli (36.29%) and Yeasts (3.33%). Staphylococcus aureus, CoNS, and Acinetobacter spp. were the primary pathogens isolated. Aminoglycosides, carbapenems, and glycopeptides were the most effective drugs for treating bacteremia.

CONCLUSIONS: Successful treatment of sepsis depends on early diagnosis and proper antimicrobial therapy. Local knowledge of bacteriological profile and antimicrobial sensitivity patterns helps rationalize empiric treatment strategies.

Keywords

Andaman and Nicobar Islands - antimicrobial sensitivity - blood culture - bloodstream infection - empiric therapy

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References

REFERENCES
1 Vasudeva N, Nirwan PS, Shrivastava P. Bloodstream infections and antimicrobial sensitivity patterns in a tertiary care hospital of India. Ther Adv Infect Dis 2016;3:119-27.
2 Seifert H, Wisplinghoff H. Bloodstream infection and endocarditis. In: Borriello SP, Murray PR, Funke G, editors. Topley and Wilson's Microbiology and Microbial Infections, Bacteriology. 10th ed., Vol. 1. Ch. 4.1. London: Hodder Arnold ASM Press; 2005. p. 1181-235.
3 CLSI. Principles and Procedures for Blood Cultures; approved Guideline. CLSI Document M47-A. Wayne, PA: Clinical and Laboratory Standards Institute; 2017.
4 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Twenty- Fourth Informational Supplement. CLSI Document M100-S27. Wayne, PA: Clinical and Laboratory Standards Institute; 2017.
5 Clinical and Laboratory Standards Institute. Method for Antifungal disc Diffusion Susceptibility Testing of Yeast; approved Guideline. CLSI Document M44-A2. 2^nd ed. Wayne, PA: Clinical and Laboratory Standards Institute; 2008.
6 Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev 2006;19:788-802.
7 Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006;34:1589-96.
8 Wattal C, Raveendran R, Goel N, Oberoi JK, Rao BK. Ecology of blood stream infection and antibiotic resistance in Intensive Care Unit at a tertiary care hospital in North India. Braz J Infect Dis 2014;18:245-51.
9 Rajeevan S, Ahmed SM, Jasmin PT. Study of prevalence and antimicrobial susceptibility pattern in blood isolates from a tertiary care hospital in North Kerala, India. Int J Curr Microbiol Appl Sci 2014;3:655-62.
10 Sharma R, Sharma R, Gupta S. Bacteriological analysis of blood culture isolates with their antibiogram from a tertiary care hospital. Int J Pharm Sci Res 2015;6:4847-51.
11 Gupta S, Kashyap B. Bacteriological profile and antibiogram of blood culture isolates from a tertiary care hospital of North India. Trop J Med Res 2016;19:94-9.
12 Tariq TM. Bacteriologic profile and antibiogram of blood culture isolates from a children's hospital in Kabul. J Coll Physicians Surg Pak 2014;24:396-9.
13 Iregbu KC, Elegba OY, Babaniyi IB. Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria. Afr Health Sci 2006;6:151-4.
14 Mehdinejad M, Khosravi AD, Morvaridi A. Study of prevalence and antimicrobial susceptibility pattern of bacteria isolated from blood cultures. J Biol Sci 2009;9:249-53.
15 Sharma M, Goel N, Chaudhary U, Aggarwal R, Arora DR. Bacteraemia in children. Indian J Pediatr 2002;69:1029-32.
16 Lee A, Mirrett S, Reller LB, Weinstein MP. Detection of bloodstream infections in adults: How many blood cultures are needed? J Clin Microbiol 2007;45:3546-8.
17 Archibald LK, Pallangyo K, Kazembe P, Reller LB. Blood culture contamination in Tanzania, Malawi, and the United States: A microbiological tale of three cities. J Clin Microbiol 2006;44:4425-9.
18 Weinstein MP. Blood culture contamination: Persisting problems and partial progress. J Clin Microbiol 2003;41:2275-8.
19 Prabhu K, Bhat S, Rao S. Bacteriologic profile and antibiogram of blood culture isolates in a pediatric care unit. J Lab Physicians 2010;2:85-8.
20 Diekema DJ, Beekmann SE, Chapin KC, Morel KA, Munson E, Doern GV, et al. Epidemiology and outcome of nosocomial and community-onset bloodstream infection. J Clin Microbiol 2003;41:3655-60.
21 Onipede AO, Onayade AA, Elusiyan JB, Obiajunwa PO, Ogundare EO, Olaniran OO, et al. Invasive bacteria isolates from children with severe infections in a Nigerian hospital. J Infect Dev Ctries 2009;3:429-36.
22 Karlowsky JA, Jones ME, Draghi DC, Thornsberry C, Sahm DF, Volturo GA, et al. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002. Ann Clin Microbiol Antimicrob 2004;3:7.
23 Vanitha RN, Kannan G, Venkata NM, Vishwanath D, Nagesh VR, Yogitha M. A retrospective study on blood stream infections and antibiotic susceptibility patterns in a tertiary care teaching hospital. Int J Pharm Pharm Sci 2012;4:543-8.
24 Chhina D, Gupta V. Bacteriological profile and antimicrobial susceptibility pattern of blood isolates from a tertiary care hospital in North India. Int J Pharm Res Bio Sci 2013;2:24-35.
25 Karunakaran R, Raja NS, Ng KP, Navaratnam P. Etiology of blood culture isolates among patients in a multidisciplinary teaching hospital in Kuala Lumpur. J Microbiol Immunol Infect 2007;40:432-7.
26 Kohli-Kochhar R, Omuse G, Revathi G. A ten-year review of neonatal bloodstream infections in a tertiary private hospital in Kenya. J Infect Dev Ctries 2011;5:799-803.