DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20191567

Antibiotic sensitivity profile and resistance of microorganisms isolated from south Indian population, a hospital based study at Velappanchavady, Chennai, India

Brethis C. S., Mahender G., Thamizharasan S., Suresh Kumar K., Sudharson T.

Abstract


Background: Increasing rates of antibiotic drug resistance has been noted in recent times and this adversely affects the prognosis and outcomes of patients. There is a greater need for local resistance prevalence data in order to guide empirical prescription and to identify areas in which medical need for newer antimicrobial agents is greater.

Methods: A prospective hospital based observational study was carried out to determine antibiotic sensitivity profile and resistance pattern of microorganisms. Samples were collected from urinary tract infections, while cultures from blood stream infections, sputum samples and Serology. Antibiotic susceptibility was determined by the standard disc diffusion method. Data interpretation was based on CLSI, 2017 guidelines for antimicrobial susceptibility testing.

Results: The predominant isolates from the samples were, Staphylococcus aureus (16.7%) 67, K. pneumoniae (11.5%) 46, E. coli (29.4%) 118, P. aeruginosa (6%) 24. Escherichia coli, the most common causative organism showed high resistance to commonly used drugs such as Ampicillin (60.1%) 71, Amoxicillin (53.4%) 63, Amoxicillin-clavulanic acid (44.1%) 52 and Nalidixic acid (53.4%) 63. E. coli was found to be most sensitive to Amikacin (51.7%) 61, Piperacillin (69.5%) 82, Norfloxacin (61.9%) 73, Meropenem (76.3%) 90 and Imipenem (68.6%) 81. Klebsiella was most sensitive to 30 (65.2%) ofloxacin, 31 (67.4%) ciprofloxacin followed by 24 (52.2%) ceftriaxone and least sensitive to 7 (15.2%) Amoxicillin and 12 (26.1%) Ampicillin.

Conclusions: Among commonly used antibiotics resistance to Penicillins (Ampicillin, Amoxicillin) was highest. Resistance to Fluoroquinolones (Ciprofloxacin) was seen in majority of the patients. Among broad spectrum antibiotics Imipenem, Meropenem resistance was seen in lesser proportion of the patients.


Keywords


Antibiotic sensitivity, Microorganisms, Resistance

Full Text:

PDF

References


Alpuche C, Garau J, and Lim V. Global and local variations in antimicrobial susceptibilities and resistance development in the major respiratory pathogens. Int J Antimicrob Agents. 2007;30(2):135-8.

Pfaller MA, Jones RN, Doren GV, Kugler K, The SENTRY Participants Group. Bacterial Pathogens Isolated from Patients with Bloodstream Infection: Frequencies of Occurrence and Antimicrobial Susceptibility Patterns from the SENTRY Antimicrobial Surveillance Program (United States and Canada, 1997). Antimicrob Agents Chemother 1998;42:1762-70. (PMid: 9661018 PMCid: PMC105680).

Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis and Prevention of Chronic Obstructive Pulmonary Disease. Updated; 2009.

Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al. Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia in Adults. Clin Infect Dis. 2007;44(2):S27-72. (PMid:17278083).

Garcı´a-Rey C, Aguilar L, Baquero F, Casal J, Dal-Ré R. Importance of Local Variations in Antibiotic Consumption and Geographical Differences of Erythromycin and Penicillin Resistance in Streptococcus pneumoniae. J Clin Microbiol. 2002;40:159-64. (PMCid:PMC120130).

Lakshmi V. Need for national/regional guidelines and policies in India to combat antibiotic resistance. Indian J of Med Microbiol. 2008;26:105-7.

Kulpati DDS, Kumar A. Flexible fibreoptic bronchoscopy in lower respiratory tract infections. Ind J Chest Dis Allied Sci. 1980;22:39-46.

Kulpati DDS, Khastgir T. Reappraisal of pneumonias. JAPI. 1988;36(ii);660-64.

Sharma BK, Manjunatha S, Varma S. Profile of pneumonias in hospitalized medical patients. Ind J Chest Dis Allied Sci. 1988;30:199-204.

Barlett JG. Bacteriological diagnosis of pulmonary infections. In Sackner MA (Ed:) Diagnostic techniques in pulmonary disease, part 1 New York, Marcel Dekker Inc.; 1980:707-745.

Wollschlager C, Khan F. The contribution of blood cultures to the diagnosis and management of community acquired pneumonia. Am Rev Resp Dis. 1985;131:80.

Mackie TJ, McCartney JE. Practical medical microbiology. 14th Ed. New York: Churchill Livingstone; 1996.

Louie L, Goodfellow J, Mathieu P, Glatt A, Louie M, Simor AE. Rapid detection of methicillin-resistant staphylococci from blood culture bottles by using a multiplex PCR assay. J Clin Microbiol. 2002;40:2786-90.

Sundaram V, Kumar P, Dutta S, Mukhopadhay K, Ray P, Gautam V, et al. Blood culture confirmed bacterial sepsis in neonates in a North Indian tertiary care center: Changes over the last decade. Jpn J Infect Dis. 2009;62:46-50.

Mathur M, Shah H, Dixit K, Khambadkone S, Chakrapni A, Irani S. Bacteriological profile of neonatal septicemic cases (for the year 1990-91) J. Post Grad. Med. 1994;40(1):18-20.

Wasfy MO, Pimentel G, Abdel-Maksoud M, Russell KL, Barrozo CP, Klena JD, et al. Antimicrobial susceptibility and serotype distribution of Streptococcus pneumoniae causing meningitis in Egypt, 1998-2003. J Antimicrob Chemother. 2005;55:958-64. (PMid:15820983).

Borg MA, Tiemersma E, Scicluna E, van de Sande-Bruinsma N, de Kraker M, Monen J, et al. Prevalence of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae isolates reported by laboratories in the southern and eastern Mediterranean region. Clin Microbiol Infect. 2009;15:232-7.

Mathur M, Shah H, Dixit K, Khambadkone S, Chakrapni A, Irani S. Bacteriological profile of neonatal septicemic cases (for the year 1990-91) J. Post Grad Med. 1994;40(1):18-20.

Palikhe N. Prescribing pattern of antibiotics in pediatric hospital of Kathmandu Valley. Kathmandu Univ Med J. 2004;2:6-12.

Zargar AH, Masoodi SR, Laway BA, Wani AI, Bashir MI. Ciprofloxacin in the management of soft tissue infections in diabetes mellitus. J Assoc Phys India. 2000;48:757-8.

Sader HS, Jones RN, Silva JB. Skin and soft tissue infections in Latin American medical centers: four-year assessment of the pathogen frequency and antimicrobial susceptibility patterns. Diagn Microbiol Infect Dis. 2002;44:281-8.

Rennie RP, Jones RN, Mutnick AH, and the SENTRY Program Study Group (North America). Occurrence and antimicrobial susceptibility patterns of pathogens isolated from skin and soft tissue infections: report from the SENTRY Antimicrobial Surveillance Program (United States and Canada, 2000) Diagn Microbiol Infect Dis. 2003;45:287-93.

Sanghvi KP, Tudehope DI. Neonatal bacterial sepsis in a neonatal intensive care unit: a 5 year analysis. J Paediatr Child Health. 1996;32:333-8.

Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Changes in pathogens causing early-onset sepsis in very-low-birth-weight infants. N Engl J Med. 2002;347:240-7.

Kaistha N, Mehta M, Singla N, Garg R, Chander J. Neonatal septicemia isolates and resistance patterns in a tertiary care hospital of North India. J Infect Dev Ctries. 2009;4:55-7.

Anderson-Berry AL, Bellig LL, Ohning BL. Neonatal sepsis. emedicine Pediatrics: Cardiac Disease and Critical Care Medicine 2010;978352. (Updated 2010 Feb 23; Cited 2010 Sep 22).

Iregbu KC, Elegba OY, Babaniyi IB. Bacteriological profile of neonatal septicaemia in a tertiary hospital in Nigeria. Afr Health Sci. 2006;6:151-4.

Kuruvilla KA, Pillai S, Jesudason M, Jana AK. Bacterial profile of sepsis in a neonatal unit in south India. Indian Pediatr. 1998;35:851-8.

Chacko B, Sohi I. Early onset neonatal sepsis. Indian J Pediatr. 2005;72:23-6.

Ailani RK, Agastya G, Ailani R, Mukunda BN, Shekar R. Doxycycline is a cost - effective therapy for hospitalized patients with community - acquired pneumonia. Arch Intern Med. 1999;159:266-70.

Almirall J, Morato I, Riera F, Verdaguer A, Priu R, Coll P, et al. Incidence of community-acquired pneumonia and Chlamydia pneumoniae infection: a prospective multicentre study. Eur Respr J. 1993 Jan 1;6(1):14-8.

Amsden GW. Pneumococcal Macrolide resistance: myth or reality? J Antimicrob Chemother. 1999;44:1-6.

Berntsson E, Lagergard T, Strannegard O, Trollfors B. Etiology of community- acquired pneumonia in out patients. Eur J Clin Microbiol. 1986;5:446-7.

Park DC, Lee SK, Cha CI, Lee SO, Lee MS, Yeo SG. Antimicrobial resistance of Staphylococcus from otorrhea in chronic suppurative otitis media and comparison with results of all isolated Staphylococci. Eur J Clin Microbiol Infecti Dis. 2008 Jul 1;27(7):571.

Pollock M. Special role pseudomonas aeruginosa in CSOM: Workshop on CSOM etiology and management. An Otorhinolaryng. 1996;17(6).

Tahnkiwale SS, Roy S, Jalgaonkar SV. Methicillins resistance among isolates of Staphylococcus aureus: antibiotic sensitivity pattern and phage typing. Ind J Med Sci. 2002;56:330-4.

Pulimood TB, Lalitha MK, Jesdason MV, Pandian R, Selwyn J, John TJ. The spectrum of antimicrobial resistance among Methicillin resistant Staphylococcus aureus (MRSA) in a tertiary care centre in India. Indian J Med Res. 1996;103:212-5.

Pitout JDD, Sanders CC, Sanders WE Jr. Antimicrobial resistance with focus on β-lactam resistance in Gram negative bacilli. Am J Med. 1997;103:51-9.