Antibiotic Susceptibility Profiling of Gram-Positive and Gram-Negative Bacterial Isolates in a Tertiary Care Hospital: Establishment of an Antibiogram

Abstract

Introduction Antimicrobial resistance poses a significant global healthcare challenge in the management of bacterial infections, which is frequently attributed to rapid bacterial adaptations. This study aims to develop an antibiogram for a tertiary care hospital, providing comprehensive antibiotic sensitivity profiles for Gram-positive and Gram-negative bacteria. It informs healthcare providers of antibiotic resistance trends, enabling informed treatment decisions and enhanced infection control measures. Methods We conducted a six-month prospective observational study, during which we gathered and analyzed data from the microbiology laboratory to identify patterns of antimicrobial sensitivity. Subsequently, the data underwent analysis and interpretation using the respected WHONET software, a readily available tool designed for this specific task. Our methodology adhered to the guidelines established by the Clinical & Laboratory Standards Institute for the standardization of antibiogram generation procedures, and these guidelines are easily integrated into the WHONET software for analytical purposes. Results There were a total of 357 isolates across various hospital departments, comprising 13 distinct bacterial species. Among them, nine were identified as Gram-negative bacteria, accounting for 262 (73.3%) isolates. Escherichia coli accounted for 131 (36.6%) isolates, while Klebsiella accounted for 62 (17.3%), emerging as the predominant species among them. The remaining four bacterial species were identified as Gram-positive bacteria, totaling 95 (26.6%) isolates, with Staphylococcus aureus being the most frequently isolated species at 51 (14.2%), followed by Enterococcus at 26 (7.2%). Subsequent analysis using the WHONET software facilitated the creation of an antibiogram. Among the Gram-negative bacteria, E. coli displayed high sensitivity (100%) to aztreonam and clindamycin, followed by nitrofurantoin (98%), imipenem (94%), and meropenem (95%). However, it exhibited decreased sensitivity to ampicillin (25%), cefuroxime (34%), and ceftriaxone (39%). Conversely, among the Gram-positive bacteria, S. aureus demonstrated 100% sensitivity to ampicillin, amoxiclav, cefazolin, teicoplanin, linezolid, rifampicin, nitrofurantoin, and cefotaxime. However, it exhibited zero sensitivity to vancomycin and only 6% sensitivity to cotrimoxazole. Conclusion This study advances the understanding of antibiotic susceptibility in a tertiary care setting and provides an invaluable tool for optimizing treatment strategies, enhancing infection control measures, and combating antibiotic resistance.