Etiology and Antibiotic Susceptibility Pattern of Community-Acquired Sepsis in Isfahan, Iran: Impact on Empiric Antibiotic Treatment

Abstract

Background: Sepsis is a significant cause of morbidity and mortality in humans. Understanding the common pathogens and the antibacterial susceptibility patterns of infections in each region is invaluable for effectively treating this life-threatening condition. Objectives: We studied the etiology and antibiotic susceptibility patterns of community-acquired sepsis in 3 large hospitals in Isfahan, Iran. Methods: Clinical data were extracted from patients' medical files. Bacteria were identified by standard tests, and the data on antimicrobial susceptibility patterns were obtained from the WHONET database software. Results: Among 480 patients, Escherichia coli (26.3%), Klebsiella species (22.7%), and Staphylococcus aureus (14.8%) were the most frequent isolates. The susceptibility patterns of gram-negative isolates to various antibiotics were as follows: imipenem (92.4%), meropenem (78.6%), amikacin (76.4%), gentamicin (72.2%), and ciprofloxacin (66.5%). The sensitivity of these isolates to meropenem, amikacin, and cefepime was more remarkable in females. The sensitivity patterns of gram-positive organisms were as follows: linezolid (100%), amikacin (100%), rifampin (100%), teicoplanin (90%), vancomycin (87.5%), gentamicin (81.7%), and trimethoprim-sulfamethoxazole (71.2%). The susceptibility of these organisms to vancomycin was significantly higher in males. Conclusions: Our data suggested that a combination of a carbapenem with linezolid, teicoplanin, or vancomycin is an appropriate empiric therapy in septicemic patients in the area. Besides, in females, linezolid or teicoplanin would be better than vancomycin for inclusion in the initial treatment.