Multidrug resistant pathogens and their antibiotic susceptibility profile isolated from blood stream infections in a tertiary care hospital

Abstract

Background: Increasing burden of hospital-acquired BSI caused by multidrug-resistant (MDR) pathogens are associated with poor patient outcome compared to susceptible bacteria. Objectives: The aim is to isolate and identify multidrug resistant (MDR) pathogens from positive blood cultures and to study their antibiotic resistant pattern. Methods: A cross sectional study was done on blood samples sent for culture and sensitivity. Identification and antibiotic susceptibility of isolated pathogens were done as per guidelines and Gram-negative bacteria resistance to at least one antibiotic in three or more antimicrobial classes was taken as MDR pathogen and further studied. Results: Out of 4770 blood samples were cultured, 78.3% were sterile and 7.2% were proven culture positive for pathogen. Among 342 positive blood culture, 88(25.7%) were MDR, 146 (42.7%) were ESBL producers and 76(22.2%) were carbapenem resistant isolates. Gram negative bacteria was predominantly isolated (83%) of which 67% of Klebsiella pneumoniae (K. pneumoniae), 57% of Acinetobacter baumanni (A. baumannii) were MDR pathogens. 75% of Klebsiella pneumoniae, 69% of Escherichia coli (E. coli), 50% of A. baumanni were screened positive for ESBL producers. Resistance to carbapenems were 64%, 50%, 31% and 6% for K. pneumoniae, A. baumannii, Pseudomonas aeruginosa and E. coli respectively. Conclusion: In our study, among 342 positive blood culture, 25.7% were MDR, 42.7% were ESBL producers and 22.2% were carbapenem resistant isolates. Measures to curtail the spread of MDR pathogen in the community settings and policies to adopt appropriate use of antibiotics in the hospital as well in the community need to be emphasized.