TRENDS IN THE MICROBIOLOGICAL SPECTRUM AND ANTIMICROBIAL RESISTANCE AMONG ICU PATIENTS DIAGNOSED WITH BACTEREMIA – A RETROSPECTIVE STUDY

aditi goyal; sarvatman gupta; upasana bhumbla; kiranjeet kaur

doi:10.22159/ajpcr.2023.v16i5.46560

Authors

aditi goyal Department of Microbiology, Adesh Institute of Medical Sciences and Research, Punjab, India. https://orcid.org/0000-0003-1860-7823
sarvatman gupta Department of Microbiology, Adesh Institute of Medical Sciences and Research, Punjab, India.
upasana bhumbla Department of Microbiology, Adesh Institute of Medical Sciences and Research, Punjab, India.
kiranjeet kaur Department of Microbiology, Adesh Institute of Medical Sciences and Research, Punjab, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i5.46560

Keywords:

Bloodstream infections, ICUs, Antimicrobial resistance

Abstract

Objectives: The objectives of this study were to determine the trends of microorganisms and their antimicrobial resistance pattern among ICU patients diagnosed with bacteremia.

Methods: This retrospective study was conducted in the microbiology laboratory at a tertiary care teaching hospital from August 2021 to July 2022. A total of 2492 blood culture samples were collected from hospital ICUs from the patient with suspected septicemia. All samples were processed using the automated blood culture system BACT/ALERT 3D/60 for the recovery of pathogenic microorganisms, and antimicrobial susceptibility testing was performed using the automated VITEK 2 Compact system. A Chi-square test was done to assess the statistical significance of our results.

Results: Out of 2492 blood culture samples, 296 (11.87%) were identified as culture positive, in which 252 (85.13%) were Gram-negative isolates, 38 (12.83%) were Gram-positive isolates, and 06 (2.02%) were other organisms (contaminants). Gram-negative isolates showed maximum sensitivity to colistin 205 (81.40%), and Gram-positive isolates showed maximum sensitivity to vancomycin 35 (92.10%).

Conclusion: Early blood culture results could provide the basis for the appropriate use of antibiotics that can improve clinical prognosis and help in reducing mortality.

Downloads

Download data is not yet available.

References

Viscoli C. Bloodstream infections: The peak of the iceberg. Virulence 2016;7:248-51. doi: 10.1080/21505594.2016.1152440, PMID 26890622

Orsini J, Mainardi C, Muzylo E, Karki N, Cohen N, Sakoulas G. Microbiological profile of organisms causing bloodstream infection in critically ill patients. J Clin Med Res 2012;4:371-7. doi: 10.4021/ jocmr1099w, PMID 23226169

Kabi A, Mohanty A, Kumar SK, Singh V, Jha MK, Gupta P. Clinical spectrum and risk factors for hospital-acquired septicemia in a tertiary care center of North-East India. J Fam Med Prim Care 2020;9:3949-54. doi: 10.4103/jfmpc.jfmpc_469_20, PMID 33110792

Yang L, Lin Y, Wang J, Song J, Wei B, Zhang X, et al. Comparison of clinical characteristics and outcomes between positive and negative blood culture septic patients: A retrospective cohort study. Infect Drug Resist 2021;14:4191-205. doi: 10.2147/IDR.S334161, PMID 34675564

Clinical and Laboratory Standards Institute. CLSI Supplement M100. Wayne: Clinical and Laboratory Standards Institute; 2020.

Borg MA. Bed occupancy and overcrowding as determinant factors in the incidence of MRSA infections within general ward settings. J Hosp Infect 2003;54:316-8. doi: 10.1016/s0195-6701(03)00153-1, PMID 12919764

Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128-40. doi: 10.1016/0196-6553(88)90053-3, PMID 2841893

Ratzinger F, Eichbichler K, Schuardt M, Tsirkinidou I, Mitteregger D, Haslacher H, et al. Sepsis in standard care: Patients’ characteristics, effectiveness of antimicrobial therapy and patient outcome--a cohort study. Infection 2015;43:345-52. doi: 10.1007/s15010-015-0771-0, PMID 25840554

Dagnew M, Yismaw G, Gizachew M, Gadisa A, Abebe T, Tadesse T, et al. Bacterial profile and antimicrobial susceptibility pattern in septicemia suspected patients attending Gondar University Hospital, Northwest, Ethiopia. BMC Res Notes 2013;6:283. doi: 10.1186/1756- 0500-6-283, PMID 23875886

Ghanshyam DK, Ramachandram VC, Piyush G. Bacteriological analysis of blood culture. Malays J Microbiol 2008;4(Suppl 2):51-61.

Abe R, Oda S, Sadahiro T, Nakamura M, Hirayama Y, Tateishi Y, et al. Gram-negative bacteremia induces greater magnitude of inflammatory response than Gram-positive bacteremia. Crit Care 2010;14:R27. doi: 10.1186/cc8898, PMID 20202204

Wu HN, Yuan EY, Li WB, Peng M, Zhang QY, Xie KL. Microbiological and clinical characteristics of bloodstream infections in general intensive care unit: A retrospective study. Front Med (Lausanne). 2022;9:876207. doi: 10.3389/fmed.2022.876207, PMID 35573022

Alebachew G, Teka B, Endris M, Shiferaw Y, Tessema B. Etiologic agents of bacterial sepsis and their antibiotic susceptibility patterns among patients living with human immunodeficiency virus at Gondar University Teaching Hospital, Northwest, Ethiopia. Biomed Res Int 2016;2016:5371875. doi: 10.1155/2016/5371875, PMID 27314025

Qureshi M, Aziz F. Prevalence of microbial isolates in blood cultures and their antimicrobial susceptibility profiles. Biomedica 2011;27:136-9.

Rice LB. Progress and challenges in implementing the research on ESKAPE pathogens. Infect Control Hosp Epidemiol 2010;31(Suppl 1):S7-10. doi: 10.1086/655995, PMID 20929376

Kłos M, Jachowicz E, Pomorska-Wesołowska M, Romaniszyn D, Kandzierski G, Wójkowska-Mach J. Antimicrobial resistance of Enterobacteriaceae in bloodstream infections in hospitalized patients in Southern Poland. J Clin Med 2022;11:3927. doi: 10.3390/ jcm11143927, PMID 35887691

Xiao S, Chen T, Wang H, Zeng Q, Chen Q, Yang Z, et al. Drug susceptibility and molecular epidemiology of Klebsiella pneumoniae bloodstream infection in ICU patients in Shanghai, China. Front Med (Lausanne) 2021;8:754944. doi: 10.3389/fmed.2021.754944, PMID 34722591

Bassetti M, Righi E, Carnelutti A. Bloodstream infections in the intensive care unit. Virulence 2016;7:267-79. doi: 10.1080/21505594.2015.1134072, PMID 26760527

Chaturvedi P, Lamba M, Sharma D, Mamoria VP. Bloodstream infections and antibiotic sensitivity pattern in intensive care unit. Trop Doct 2021;51:44-8. doi: 10.1177/0049475520977043, PMID 33283677

Erdem I, Ozgultekin A, Inan AS, Engin DO, Akcay SS, Turan G, et al. Bloodstream infections in a medical-surgical intensive care unit: Incidence, aetiology, antimicrobial resistance patterns of gram-positive and gram-negative bacteria. Clin Microbiol Infect 2009;15:943-6. doi: 10.1111/j.1469-0691.2009.02863.x, PMID 19548920

Alhumaid S, Mutair AA, Alawi ZA, Alzahrani AJ, Tobaiqy M, Alresasi AM, et al. Antimicrobial susceptibility of gram-positive and gram-negative bacteria: A 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia. Ann Clin Microbiol Antimicrob 2021;20:43.

Farah SM, Alshehri MA, Alfawaz TS, Alasmeri FA, Alageel AA, Alshahrani DA. Trends in antimicrobial susceptibility patterns in King Fahad Medical City, Riyadh, Saudi Arabia. Saudi Med J 2019;40:252-9. doi: 10.15537/smj.2019.3.23947, PMID 30834420

Rajeshwari KG. Microbiological study of blood stream infections among patients admitted to critical care units at a tertiary hospital. Med Pulse Int J Microbiol 2021;18:17-21.