Microbiological Profile of Blood Stream Infections in a Tertiary Care Hospital, J&K. India

Abstract

Background: Worldwide, bacteremia is one of the serious infections that cause significant morbidity and mortality in hospitalized patients. A wide range of microorganisms have been implicated in the etiology of BSIs. Early detection of these pathogens along with the determination of antimicrobial susceptibility patterns have been shown to improve treatment outcomes. The present study aimed to determine the microbiological profile of BSIs in a major tertiary care hospital in North India. Materials and Methods: This is a cross-sectional study conducted in the Department of Microbiology Government Medical College Srinagar. Blood samples submitted in brain heart infusion (BHI) broth for culture and sensitivity over a period of one year from September   2021 to 30th August 2022 were included in the study and processed per standard laboratory protocol techniques for isolating and identifying pathogens causing BSI. The antimicrobial susceptibility of bacterial isolates was determined by the disc diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Out of 4260 blood samples, 1204(28.26%) isolates were obtained. Of these isolates, 575(47.75%) were Gram‑positive bacteria and 468 (38.87%) were Gram‑negative bacteria. Candida species were isolated from 161(13.7%) positive samples and 32 showed contamination. The most commonly identified organism was Coagulase‑negative Staphylococcus (CoNS) (22.59%) followed by Staphylococcus aureus(17.69%), Acinetobacter spp. (13.70%), Klebsiella spp (10.13%) and Escherichia coli (6.47%). Among the gram-positive bacteria, maximum resistance was seen with methicillin and azithromycin. No resistance was seen with vancomycin and linezolid. Most of the gram-negative bacilli were multidrug-resistant. Maximum resistance was seen with ampicillin(91.7%), amoxiclav (86.5%), ceftriaxone (88.5%), and gentamicin (60.9%). Higher prevalence of resistance was observed in Gram‑negative bacteria when compared with Gram‑positive bacteria. Conclusion: Hence, empirical treatment of BSIs should be based on the current knowledge of bacterial resistance profiles as provided by microbiology laboratory reports. The results of this study warrant continuous monitoring of antimicrobial patterns for the clinicians along with judicious antibiotic policy to mandate antimicrobial sensitivity testing against the BSIs in the hospital setup so that appropriate therapeutic measures should be taken at the earliest.