Antimicrobial resistance among nosocomial isolates in a teaching hospital in Goa

Abstract

Background:Emergence of polyantimicrobial resistant strains of hospital pathogens has presented a challenge in the provision of good quality in-patient care. Inappropriate use of antibiotics in the hospital is largely responsible for this catastrophe. Bacteriological surveillance of the cases of nosocomial infections is crucial for framing an evidence-based antimicrobial policy for a hospital.Materials and Methods:A prospective study was undertaken among 498 patients from medicine and surgery wards in a tertiary teaching hospital in Goa. The patients were followed up clinico-bacteriologically for the occurrence of nosocomial infections (NI). Antibiotic susceptibility testing was done using Kirby-Bauer disc diffusion method.Results:The overall infection rate was 33.93 ± 4.16 infections per 100 patients. Urinary tract infection was the most common NI (26.63%), followed by surgical site infection (23.67%), wound infection (23%) and nosocomial pneumonia (18.34%). Ninety-seven percent of the isolates were bacterial, while the others were fungal. More than 80% of the NIs were caused by Gram-negative bacteria, predominantly Pseudomonas aeruginosa, Escherichia coli and Aceinetobacter baumanii. Almost 70% of the isolates were resistant to all the antibiotics for which susceptibility was tested; the rest were sensitive to amikacin, cefoperazone-sulbactam and other antibiotics including methicillin, co-trimoxazole, teicoplenin, vancomycin and rifampicin, either singly or in combination. The proportion of MRSA was 71.4%. Resistance to a particular antibiotic was found to be directly proportional to the antibiotic usage in the study setting.Conclusion:Surveillance of nosocomial infections with emphasis on the microbiologic surveillance and frequent antimicrobial audit are critical towards curbing the evil of polyantimicrobial resistant nosocomial infections in a hospital.

Epidemiology and risk factors of healthcare associated infections from intensive care unit of a tertiary care hospital

“…The result of this study is in agreement with previous studies. 9,11 Our findings confirm the results of another study from northern India. Agarwal et al found majority of infections with gramnegative bacilli in respiratory ICU.…”

Risk Factor Analysis and Microbial Etiology of Surgical Site Infections following Lower Segment Caesarean Section

“…Surgical site infection is an important outcome indicator after surgery. The situation is worsened by the emergence of polymicrobial resistant strains of nosocomial pathogens [5]. The infection rate in the present study was 24.2% including postdischarge surveillance and compares favorably with other reported rates ranging from 2.5 to 41.9% [6][7][8][9][10].…”

Hospital Acquired Infections Among Patients Admitted in the Medical and Surgical Wards of a Non-Teaching Secondary Care Hospital in Northern India

“…The incidence of NI was higher among the patients of medical (28%) ward than surgical (24.5%) ward, however, the difference was statistically insignificant (p=0.58). Similar finding was seen by Kamat et al, [11], which is higher than the previous studies in which Infection rate were 16.4% [12] and 13% [13] and lower than following studies where NI rate was 27.4% [14].…”