The antibiogram of Pus cultures in Federal Tertiary Care Hospital, Islamabad and its utility in antimicrobial stewardship
Abstract
Background and Objectives: Antimicrobial resistance has emerged as a significant global health threat. Infections caused by Multi Drug-Resistant (MDR) bacteria pose formidable challenges in terms of treatment options and patient outcomes. Pus cultures serve as crucial diagnostic tools in identifying the agents responsible for various infections, and their antimicrobial susceptibility patterns which help in establishment of empirical therapy guidelines. This study was conducted to determine the pathogen and its susceptibility pattern from pus cultures and to generate antibiogram in our tertiary care setting.
Materials and Methods: It was a cross-sectional study, conducted for a period of six months, from July 2022 to December 2022, in the Pathology Department of Pakistan Institute of Medical Sciences (PIMS).
Results: Out of total 2507 samples received, 1242 (49.5%) showed positive culture. Among the 1242 positive samples, 364 were Gram positive cocci (GPCs) and 878 were Gram negative rods (GNRs). Methicillin resistant Staphylococcus aureus (MRSA) was the most common isolate (23%) followed by Klebsiella pneumoniae (22.6%), Pseudomonas aeruginosa (16.9%), Enterobacter spp. (15.5%) and Escherichia coli (14.2%). Vancomycin was found to be highly effective (100%) against MRSA. GPCs were highly susceptible to linezolid (98%) while GNRs showed high level of sensitivity to colistin (96%) and tigecycline (92%).
Conclusion: The generation of a local antibiogram specific to the hospital setting is essential to effectively manage infections empirically and preserve the efficacy of existing antibiotics. By implementing antimicrobial stewardship practices based on a better understanding of antibiotic susceptibility patterns, we can contribute to the mitigation of antibiotic resistance and improve patient outcomes.
2. O'Neill J. Tackling drug-resistant infections globally: final report and recommendations. 2016. https://apo.org.au/node/63983
3. English BK, Gaur AH. The use and abuse of antibiotics and the development of antibiotic resistance. Adv Exp Med Biol 2010; 659: 73-82.
4. Mudassar S, Khan SW, Ali M, Mahmood F. Aerobic bacteriological profile and antimicrobial susceptibility pattern of pus isolates in a teaching hospital, Lahore, Pakistan. Int J Contemp Med Res 2018; 5: D1-D3.
5. Jorgensen JH, Ferraro MJ. Antimicrobial susceptibility testing: a review of general principles and contemporary practices. Clin Infect Dis 2009; 49: 1749-1755.
6. Ghazal L, Qureshi AH, Iqbal N. Antibiotic susceptibility pattern of Gram-negative Bacilli isolated from different clinical specimens in a tertiary care Hospital. JIMDC 2018; 7: 112-117.
7. Garcia LS. Clinical microbiology procedures handbook: American Society for Microbiology Press; 2010.
8. Hutchings MI, Truman AW, Wilkinson B. Antibiotics: past, present and future. Curr Opin Microbiol 2019; 51: 72-80.
9. Biradar A, Farooqui F, Prakash R, Khaqri SY, Itagi I. Aerobic bacteriological profile with antibiogram of pus isolates. Indian J Microbiol Res 2016; 3: 245-249.
10. Waheed A, Amar A, Afridi I, Rauf S, Mehran. Bacteriological profile and antibiotics susceptibility patterns of complicated skin and skin structure infections in tertiary care hospitals, Peshawar. J Pak Assoc Dermatol 2020; 30: 580-586.
11. Garoy EY, Gebreab YB, Achila OO, Tekeste DG, Kesete R, Ghirmay R, et al. Methicillin-resistant Staphylococcus aureus (MRSA): prevalence and antimicrobial sensitivity pattern among patients-a multicenter study in Asmara, Eritrea. Can J Infect Dis Med Microbiol 2019; 2019: 8321834.
12. Ali MM, Mansoor R, Zahra QA, Liangliang L, Gangguo W, Ali R, et al. Frequency and antimicrobial susceptibility pattern of Pseudomonas aeruginosa in human pus samples at holy family hospital Rawalpindi. J Microbiol Biotechnol 2021; 6: 000189.
13. Syed MA, Jamil B, Ramadan H, Rukan M, Ali S, Abbasi SA, et al. Genetic diversity of Staphylococcus aureus atrains from a tertiary care Hospital in Rawalpindi, Pakistan. Microorganisms 2021; 9: 2301.
14. Ullah A, Qasim M, Rahman H, Khan J, Haroon M, Muhammad N, et al. High frequency of methicillin-resistant Staphylococcus aureus in Peshawar Region of Pakistan. Springerplus 2016; 5: 600.
15. Khan AA, Ali A, Tharmalingam N, Mylonakis E, Zahra R. First report of mecC gene in clinical methicillin resistant S. aureus (MRSA) from tertiary care hospital Islamabad, Pakistan. J Infect Public Health 2020; 13: 1501-1507.
16. Sudhaharan S, Kanne P, Chavali P, Vemu L. Aerobic bacteriological profile and antimicrobial susceptibility pattern of pus isolates from tertiary care hospital in India. J Infect Dev Ctries 2018; 12: 842-848.
17. Rao DR, Basu R, Biswas DR. Aerobic bacterial profile and antimicrobial susceptibility pattern of pus isolates in a South Indian Tertiary Care Hospital. Surgery 2014; 36: 35-29.
18. Trojan R, Razdan L, Singh N. Antibiotic susceptibility patterns of bacterial isolates from pus samples in a tertiary care hospital of Punjab, India. Int J Microbiol 2016; 2016: 9302692.
19. Gill MK, Sharma S. Bacteriological profile and antibiotic sensitivity patterns of aerobic pus isolates: A study conducted in tertiary care hospital of North India. Int J Med Microbiol Trop Dis 2019; 5: 99-102.
20. Farooq L, Memon Z, Ismail MO, Sadiq S. Frequency and antibiogram of multi-drug resistant pseudomonas aeruginosa in a Tertiary Care Hospital of Pakistan. Pak J Med Sci 2019; 35: 1622-1626.
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Issue | Vol 16 No 1 (2024) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijm.v16i1.14871 | |
Keywords | ||
Antimicrobial drug resistance; Antimicrobial stewardship; Antibiotic resistance; Antibiotic susceptibility testing; Bacterial sensitivity test |
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