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Category: Volume 07 Issue 06 June 2019
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Title: Cumulative Antibiogram for a Period of one year and its Analysis in a Tertiary Care Hospital

Authors: Pilli Hema Prakash Kumari, Ratna Harika Dusi, I. Jyothi Padmaja, Nitin Mohan, P. Vijaya Lakshmi

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.166

Abstract

Hospital antibiogram is a periodic summary of antimicrobial susceptibilities of local bacterial strains given to the hospital’s clinical microbiology laboratory. It not only helps the clinicians to select the most appropriate empiric therapy, but also in monitoring resistance trends within an institution, thereby optimizing treatment. The current study is mainly designed to know the susceptibility rates and resistance trends of microorganisms isolated from various clinical samples. To monitor antimicrobial resistance trends in this period with emphasis on inpatient and outpatient data.

To prepare a cumulative antibiogram of our institution as a part of antibiotic stewardship program. It is a Tertiary care health institution which delivers its services to the rural and urban population with departments like Medicine, Pulmonary medicine, Surgery, Orthopedics, and Obstetrics and Gynecology. Data was gathered from all outpatient and inpatient specimens received for Culture and sensitivity.  The organisms and their susceptibility patterns isolated in the Department of Microbiology were collected and cumulative antibiogram is prepared and from the 6239 specimens received in the Microbiology laboratory during this one year period, most of them from urine followed by sputum, pus and blood. Urine samples (36.5%) from OPD (19.1%) and IPD (80.9%) showed a culture positivity of 46.7% and 42.6% respectively.  E.coli (40.4%) was the predominant isolate in urine samples from OPD and Klebsiella species (38.2%) from IPD. Blood samples from OPD (10.4%) showed a culture positivity of 29.2% and IPD (89.6%) about 16%. Blood samples from both OPD and IPD frequently grew Klebsiella species with 45.9% and 45.2% respectively. Sputum (34.2%) samples from OPD (35.2%) showed a culture positivity of 43.2% and IPD   (66.8%) with a positivity of 33.2%. Klebsiella species was the predominant isolate in the sputum specimens from both OPD (40%) and IPD (43.3%). Pus samples (16.7%) from OPD (29%) gave a culture positivity of 56.9% and IPD (71%) of 38.1%. Klebsiella species was frequently isolated from both OPD (38.4%) and IPD (42%) pus specimens. Resistance to commonly used antibiotics in institutions is alarmingly high requiring continuous surveillance to assess the sensitivity and resistance pattern at a certain levels. The antibiogram prepared from Hospital diagnostic laboratories are readily accessible and inexpensive tool to monitor antimicrobial resistance patterns in communities and regions.

Keywords: Antibiogram, Gram-negative organisms, Gram-positive organisms.

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Corresponding Author

Dr D. Ratna Harika

Assistant Professor, Department of Microbiology, GIMSR, GITAM (Deemed to be University)