Prevalence and Antimicrobial Resistance Pattern of Blood Isolates in Patients of Septicemia in ICU: Single Centre Observation

Abstract

Background: Septicaemia in critically ill patients is a life threatening condition and requires rapid antimicrobial treatment. Infections caused by drug-resistant organisms are more likely to increase risk of death in these patients. The present study was aimed to study the profile of organisms causing septicaemia and their antibiotic resistance pattern in an intensive care unit (ICU) of a teaching hospital in Bangladesh.Materials and Methods: This cross-sectional study was done in a 21-beded adult ICU of Dhaka city from November 2015 to April 2016.Results: A total of 362 patients were diagnosed clinically as septicaemia during the study period of six month. 696 blood samples were analyzed and 92 blood samples yielded growth of 94 organisms, which included 89 bacteria and 5 fungal isolates. Mean age of the patients whose blood samples showed growth of organisms was 65.1 ± 9.1 years, with female preponderance (56.7%). High prevalence of diabetes, hypertension and chronic kidney disease was found in these patients. The major organisms isolated were Acinetobacter (29.7%), Pseudomonas (26.5%), Klebsiella (18.08%), Eschericia coli (11.7%) and Candida (5.3%). All the isolates were resistant (>50%) to 3rd generation cephalosporins. Acinetobacter was highly resistant (>75%) to most of the antibiotics except colistin. Isolated Pseudomonas was also resistant to aminoglycosides (>90%) and imipenem (>65%). Klebsiella was resistant to aminoglycosides and imipenem, but Eschericia coli was sensitive to these antibiotics. Among the Enterobacteriaceae, 81.8% Eschericia coli and 11.7% Klebsiella had extended spectrum ?-lactamase activity. Frequency of gram positive organisms (6.38%) was significantly low in this study (p<0.05).Conclusion: This study provides information on antibiotic resistance of blood isolates found in ICU patients with septicaemia. It will guide the intensivists to formulate the initial empiric antibiotic therapy for the critically ill patients of ICU.Bangladesh Crit Care J September 2016; 4 (2): 100-104

Bacteriological profile and antimicrobial resistance pattern among patients with sepsis: A retrospective cohort study

“…In the present study, it was observed that E coli showed >65% resistance to Ampicillin, Ciprofloxacin, Trimethoprim-sulfamethoxazole and Amoxicillin /clavulanic acid (55.6%) similar to the results obtained by Ahsan et al, 24 (>80% ) in which maximum resistance among E coli was seen for Ciprofloxacin and third-generation Cephalosporins.…”

“…In the study, Acinetobacter TA B L E 2 (Continued) baumannii showed MDR more than 55% resistance to Penicillins, Cephalosporins, Carbapenems and Fluoroquinolones. A similar study carried out somewhere else by Ahsan et al 24 and Annamalei et al, 3 also yielded the same results where they observed >75% resistance to colistin. In the present study, it was found that CONS showed the highest resistance to Benzylpenicillin (84.4%), Erythromycin (69.2%) and Oxacillin (58.8%), which was observed to be similar to the results obtained from studies carried out by Mohanty et al, 10 (75%) and Khosravi et al, 26 (70.6%) showing high resistance to Penicillin.…”

“…A similar study conducted by Sweta et al 23 also yielded the same results with maximum resistance to Amoxicillin clavulanic acid (90.32%). While another similar study performed by Ahsan et al 24 and Radji et al, 25 showed resistance to Piperacillin/Tazobactam, Ciprofloxacin (>80%), and high resistance to Cephalosporins, respectively. In the study, Acinetobacter TA B L E 2 (Continued) baumannii showed MDR more than 55% resistance to Penicillins, Cephalosporins, Carbapenems and Fluoroquinolones.…”

Antibiotic resistance in Bangladesh: A systematic review

“…Publication year 2004-2010 11 (23.9) (Arifeen et al, 2009;Brooks et al, 2005;Haque and Salam, 2010;Khan et al, 2004;Mahbubur et al, 2007;Monjur et al, 2010;Nahar et al, 2004;Rahman et al, 2005;Saha et al, 2009;Shahriar et al, 2010;Shill et al, 2010Shill et al, ) 2011Shill et al, -2014 14 (30.4) (Afroz et al, 2014;Ahmed et al, 2011Ahmed et al, , 2014Akram et al, 2014;Akter et al, 2014;Begum et al, 2013;Chiou et al, 2014;Dutta et al, 2013;Haque et al, 2011;Hossain et al, 2014;Islam et al, 2014;Khan et al, 2013;Rahman et al, 2014;Ud-Din et al, 2013-2018 21 (45.7) (Aftab et al, 2016;Ahmed et al, 2017Ahmed et al, , 2018Ahsan et al, 2016;Akter et al, 2016Akter et al, , 2017Begum et al, 2016;Chakraborty et al, 2016;Chowdhury and Parial, 2015;Haque et al, 2015;Hasan et al, 2016;Islam and Shamsuzzaman, 2015;Jobayer et al, 2017;Khanam et al, 2015;Nazme et al, 2017;…”

“…Community-acquired 5 (10.9) (Akter et al, 2014;Arifeen et al, 2009;Brooks et al, 2005;Mahbubur et al, 2007; (Aftab et al, 2016;Chiou et al, 2014;Hasan et al, 2016;Islam and Shamsuzzaman, 2015;Nahar et al, 2004;Rahman et al, 2014;Suchi et al, 2017) E-test 5 (10.9) (Arifeen et al, 2009;Begum et al, 2016;Khan et al, 2013;Mahbubur et al, 2007;Saha et al, 2009) Did not mention 5 (10.9) (Ahmed et al, 2018;Akram et al, 2014;Islam et al, 2014;Nazme et al, 2017;Shill et al, (Akter et al, 2016;Chowdhury and Parial, 2015;Haque et al, 2015;Khan et al, 2013;Nazme et al, 2017;Rahman et al, 2014;Saha et al, 2015;Shill et al, 2010;Suchi et al, 2017;Yasmeen et al, 2015) Bloodstream infection 7 (15.2) (Afroz et al, 2014;Ahmed et al, 2017Ahmed et al, , 2018Ahsan et al, 2016;Brooks et al, 2005;Khanam et al, 2015;Monjur et al, 2010) Gastroenteritis 8 (17.4) (Ahmed et al, 2011(Ahmed et al, , 2014Akter et al, 2017;Begum et al, 2016;Khan et al, 2004;…”