No abstract

Background: Blood stream infections are amongst the most important causes of morbidity and mortality throughout the world. Septicemia is a serious bloodstream infection and a biggest challenge for the clinicians in selection of appropriate antimicrobial agents. Presence of intravascular catheters, immunosuppression and use of cytotoxic drugs are some precipitating factors for antibiotic resistance which is a global problem. Reports of multi-resistant bacteria causing septicemia in developing countries are increasing. Extended-spectrum beta-lactamases (ESBL) and Carbapenemase-producing Enterobacteriaceae (CRE) has caused a major public health concern. Aim and Objectives: To determine the bacteriological profile of septicemia and their antibiotic susceptibility profile with special references to β-lactamase and carbapemase productionin gram negative bacilli. Material and Method: During the 3 month period of study total 100 blood samples from suspected cases of septicaemia are collected. Isolates were processed and identified by standard protocols. Detection of extended spectrum β-lactamase (ESBL), inducible AmpC and MBL (Metallo β-lactamases) was done by using screening test and then confirmatory tests. Results: Out of 100 samples 68 gram negative organisms were isolated. Maximum growth was of Pseudomonas aeruginosa i.e. 34, followed by Klebsiella pnemoniae i.e. 19 and Acinetobacter sps and E.coli. From all isolates 4.4% were ESBL, Metallo –beta-lactamases (MBL) production were seen in 5.9 %. 40% and 10.5% were MBL-E.coli and MBL-Klebseilla pnuemoniae respectively. Conclusion: Many of the isolates from cases of septicaemia were resistant to most of the recently used antibiotics. So, Detection of the etiological agents and their antibiotic sensitivity will definitely help in effective prophylactic measures, prompt and accurate diagnosis of septicaemia. Simple methods like disc potentiation test for ESBL, disk antagonism test for inducible AmpC producers and Combined disk potentiation test for MBL production are relatively inexpensive and less cumbersome, so it can also be performed as a part of routine sensitivity testing. High degree of antibiotic resistance is an alarming sign for development of antibiotic policies and protocols for treatment of septicaemia.

Background: Infections of the bloodstream are a leading source of illness and mortality in all types of communities. Bacteremia is the presence of bacteria in the bloodstream for long or short periods. Aim and Objectives: Dissemination of the bacteria throughout the body with evidence of systemic responses toward microorganisms is septicemia. Many organisms including Gram positive such as Coagulase negative staphylococci, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, and Enterococcus faecium can cause septicemia. Many precipitating factors such as presence of intravenous catheters, immunocompromised state, and use of cytotoxic drugs may lead to increase in cases of septicemia. Isolation of the offending pathogens and knowledge about sensitivity and resistance pattern of the isolates remain the mainstay of the diagnosis. This study was conducted to cite the bacteriological etiology of septicemia in adults as well as in neonates and to decide the strategy for the cure of septicemia cases along with their antibiotic susceptibility profile. Materials and Methods: Duration of this study was 3 months. In this duration, 100 blood samples from suspected cases of septicemia were processed. Results: Gram positive organisms isolated from the specimens were collected and identified by standard protocols. Antibiotic sensitivity and detection of methicillin resistant Staphylococcus aureus were done by using Kirby Bauer disc diffusion method. Conclusion: Various causative agents were isolated from blood samples. Some of them are resistant to the drugs that are commonly used for the treatment of septicemia. Hence, isolation of the etiological agent along with the detection of its antibiogram pattern is important for early diagnosis and treatment of cases of septicemia.