Pattern of Antibiotic Sensitivity and Resistance in Various Cases of Sepsis in a Mixed Intensive Care Unit set up in a Tertiary Hospital

JNGMC Pub Date : 2023-09-01 DOI:10.3126/jngmc.v21i1.58296
Sagun Sharma, Milan Adhikari, Anisha Basnet, Shishir Khadka, Ram Das, Ashish Bhatta
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 Aims: To find out the common organisms responsible for sepsis in patients admitted to the Intensive Care Unit and to know the antibiotic sensitivity/resistance patterns.
 Methods: The study was done from May 2022 to April 2023 in mixed Intensive Care Units on the clinical isolates from blood, urine, sputum, endotracheal tube aspirate, central venous catheter tips and wound swabs and those were sent to microbiology department for culture and sensitivity. All the organisms were identified morphologically and biochemically and antibiotic susceptibility pattern was determined by standard laboratory procedure.
 Results: We took a total of 102 samples in which organisms were isolated. The most frequently isolated bacteria were Klebsiella (24.91%) followed by Staphylococcus aureus (24.5%), both were sensitive to Doxycycline and Tazobactam-piperacillin in most cases. Other organisms isolated were Escherichia coli (15.69%), Streptococcus (9.8%), Pseudomonas (8.82%), Acinetobacter (6.86%), Enterobacter species (3.92%) and Proteus (0.98%). Azithromycin was found to be the most resistant drug followed by Amoxycillin/clavulanic acid and Levofloxacin.
 Conclusion: Klebsiella was found to be the most prevalent cause of sepsis in ICU. Most of the frequently isolated pathogens were resistant to Beta lactamase inhibitors, Cephalosporins and Quinolones. Regular surveillance of antibiotic susceptibility pattern is very important for setting a guideline to the clinician in choosing an appropriate therapy for patients with sepsis.","PeriodicalId":476221,"journal":{"name":"JNGMC","volume":"77 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JNGMC","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3126/jngmc.v21i1.58296","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract

Introduction: Sepsis has been shown to be one of the critical reasons for Intensive Care Unit admissions of patients for which early and empirical use of antibiotics have been used. Antibiotics resistance is becoming a matter of serious concern, especially in developing countries like ours. In this study, all the cases those were diagnosed with sepsis and had culture positive results for bacteria have been evaluated. Aims: To find out the common organisms responsible for sepsis in patients admitted to the Intensive Care Unit and to know the antibiotic sensitivity/resistance patterns. Methods: The study was done from May 2022 to April 2023 in mixed Intensive Care Units on the clinical isolates from blood, urine, sputum, endotracheal tube aspirate, central venous catheter tips and wound swabs and those were sent to microbiology department for culture and sensitivity. All the organisms were identified morphologically and biochemically and antibiotic susceptibility pattern was determined by standard laboratory procedure. Results: We took a total of 102 samples in which organisms were isolated. The most frequently isolated bacteria were Klebsiella (24.91%) followed by Staphylococcus aureus (24.5%), both were sensitive to Doxycycline and Tazobactam-piperacillin in most cases. Other organisms isolated were Escherichia coli (15.69%), Streptococcus (9.8%), Pseudomonas (8.82%), Acinetobacter (6.86%), Enterobacter species (3.92%) and Proteus (0.98%). Azithromycin was found to be the most resistant drug followed by Amoxycillin/clavulanic acid and Levofloxacin. Conclusion: Klebsiella was found to be the most prevalent cause of sepsis in ICU. Most of the frequently isolated pathogens were resistant to Beta lactamase inhibitors, Cephalosporins and Quinolones. Regular surveillance of antibiotic susceptibility pattern is very important for setting a guideline to the clinician in choosing an appropriate therapy for patients with sepsis.
某三级医院混合重症监护病房不同脓毒症患者的抗生素敏感性和耐药性模式
简介:败血症已被证明是重症监护病房入院的患者早期和经验性使用抗生素的关键原因之一。抗生素耐药性正在成为一个令人严重关切的问题,特别是在像我国这样的发展中国家。在本研究中,所有被诊断为脓毒症且细菌培养结果阳性的病例都进行了评估。 目的:了解重症监护病房患者脓毒症的常见病原菌,并了解其抗生素敏感性/耐药模式。 方法:于2022年5月至2023年4月在混合重症监护病房对临床分离的血液、尿液、痰液、气管插管抽吸液、中心静脉导管针尖和创面拭子进行研究,并将其送微生物科进行培养和敏感性试验。对所有病原菌进行形态学和生化鉴定,并按标准实验室程序测定抗生素敏感性。 结果:共采集了102份分离出微生物的样品。检出最多的细菌是克雷伯菌(24.91%),其次是金黄色葡萄球菌(24.5%),多数病例对多西环素和他唑巴坦-哌拉西林敏感。其他分离出的细菌分别为大肠杆菌(15.69%)、链球菌(9.8%)、假单胞菌(8.82%)、不动杆菌(6.86%)、肠杆菌(3.92%)和变形杆菌(0.98%)。阿奇霉素是最耐药的药物,其次是阿莫西林/克拉维酸和左氧氟沙星。结论:克雷伯菌是ICU中最常见的脓毒症病因。大多数常见的分离病原体对内酰胺酶抑制剂、头孢菌素和喹诺酮类药物耐药。定期监测抗生素的药敏模式对于指导临床医生选择合适的治疗方法是非常重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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