Study of Bacteriological Profile and Antibiotic Sensitivity Pattern in Samples Received From Patients Attending Tertiary Care Hospital in Mumbai

Abstract

BACKGROUND Bacterial infections are important cause of morbidity and mortality among patients and antimicrobial resistance is a significant growing global threat. In this era of multidrug resistance, it is mandatory to know the bacteriological profile and antimicrobial sensitivity pattern of one's own institute. Hence, the following study was conducted to document the common bacteria isolated from various clinical specimens from patients of our institute and describe their antibiotic susceptibility. MATERIALS AND METHODSThe study was carried out in the Department of Microbiology from January 2016 to December 2016 in our institute. The study included 12,429 clinical samples comprising urine, blood, sputum, stool, pus, wound swabs, catheter tips, nasal swabs, throat swabs, vaginal swabs, sterile body fluids and tissue which were processed for culture, identification and antibiotic susceptibility testing as per standard recommended procedures. RESULTSSamples received were urine 55%, blood 21%, sputum 12%, wound swabs 3%, pus 2.5%, stool 2%, catheter tips 1%, body fluids 1% followed by others. Sample received from males and females were 47% and 53%, respectively. Samples received from 13 -65 years' age group, geriatric age group, paediatric age group and neonates were 69.4%, 24%, 6% and 0.6% respectively. Samples received from Outpatient Department (OPD), Inpatient Department (IPD) and Intensive Care Unit (ICU) were 54%, 43% and 3% respectively. 3,014 different bacterial pathogens were isolated. The prevalence of Gram negative bacilli was 90% and that of Gram positive bacilli was 10%. Out of all isolates 60% were from OPD samples, 37% from IPD samples and 3% from ICU samples. Among the pathogens isolated, Escherichia coli was 40% followed by Klebsiella pneumoniae 27%, Pseudomonas aeruginosa 13.4% and Staphylococcus aureus 8% followed by others. Most of the Gram-negative isolates were sensitive to carbapenems, aminoglycosides and beta lactam -beta lactamase inhibitor combinations. Approximately, half of them were sensitive to third and fourth generation cephalosporins and fluoroquinolones. Most of the Gram-positive isolates were sensitive to tetracycline, clindamycin, nitrofurantoin, glycopeptides and vancomycin, but resistant to erythromycin, trimethoprim/ sulfamethoxazole and fluoroquinolones. CONCLUSIONIn general, most of our Gram-negative isolates showed good sensitivity to carbapenems, aminoglycosides and beta lactam -beta lactamase inhibitor combinations. Sensitivity to cephalosporins and fluoroquinolones prevailed amongst half of them. High resistance to fluoroquinolones was seen among Gram positive isolates also. Methicillin resistant Staphylococcus aureus (MRSA) prevalence was not very high. Such type of surveillance done regularly can help in optimising antibiotic use and thus help to curb antimicrobial resistance.

Prevalence and distribution of etiological agent from open wound drainage

“…In support of our results, Barai et al, 2021 [18] also reported 30.2% wound/pus swab from the samples collected between the 2001 to 2021. Whereas study of Jangla and Naidu (2018) [17] reported only 5.5% of wound swab and pus samples. The results of the prevalence analysis among the bacterial and fungal isolates indicates the incredible prevalence of the Staphyloccus auerus (306), followed by the Escherichia coli ( 137 The study of Biswas et al, 2021 [19] on prevalence of methicillin resistant Staphylococcus aureus in pus samples in a tertiary care hospital of eastern India reported the 4.6% to 54.4% prevalence of methicillin resistant Staphylococcus aureus.…”