Prevalence of Gram-negative Septicemia in a Tertiary Care Center

• Published in: Journal of medical sciences and health (Online) 2019-06, Vol.5 (1), p.36-41
• Main Authors: Bajaj, Ashish, Mishra, Bibhabati, Loomba, Poonam S, Thakur, Archana, Sharma, Abha, Rathod, Prachala G, Das, Madhusmita, Bhasin, Ashna
• Format: Article
• Language: English
• Subjects: gram-negative bacteremia; loodstream infection; sepsis
• ISSN: 2394-9481; 2394-949X
• DOI: 10.46347/JMSH.2019.v05i01.007

Introduction: Increased mortality due to sepsis and bacteremia impacts health-care activities severely. Administration of broad-spectrum antibiotics empirically may lead to failure of treatment. Toxic effects of non-susceptible drugs can be harmful for the patients and lead to the development of resistance. Aim: The aim is to study the prevalence of multidrug-resistant Gram-negative bacteria causing bloodstream infections in a tertiary care center. Materials and Methods: A total of 6265 blood samples were received in the Microbiology Department of GB Pant Hospital from January 1, 2018, to December 31, 2018. The samples were processed as per standard techniques. Identification and antimicrobial susceptibility testing were done by VITEK-2 Compact automated system and Kirby–Bauer disc diffusion method as per the Clinical and Laboratory Standards Institute guidelines. Results:Of total 6265 blood culture samples received in laboratory, 480 (7.66%) were culture positive. The Gram-negative bacteria 316 (65.83%) were isolated in majority followed by Gram-positive bacteria 148 (30.83%) and Candida spp. 16 (3.33%). Klebsiella pneumoniae (31.01%) was most common isolate among the Enterobacteriaceae. Whereas among the non-fermenting Gram-negative bacterial isolates, Pseudomonas spp. (17.72%) was most common. Gram-negative bacteria were resistant to commonly used antibiotics. 50–70% resistance was observed against carbapenems. Least resistance was seen to last resort antibiotics, i.e., tigecycline and colistin. Conclusions:The increased isolation of multidrug-resistant Gram-negative bacteria is distressing, and further studies are advocated to help in the formulation of treatment and preventive strategies so as to curb such emergence.