Bacteriological profile and antibiogram of blood culture isolates from a tertiary care hospital of Western India

Introduction: Clinical manifestations of blood stream infections (BSIs) range from transient bacteremia to fulminant septic shock with high mortality. Regular surveillance of BSI etiology is important in monitoring the spectrum of bacterial pathogens and their sensitivity pattern in a particular area and thus helps in rationalizing therapy. Objective: The present study was undertaken to know the bacteriological etiology of BSIs and the antibiotic susceptibility pattern of the isolated strains to formulate effective empirical treatment. Materials and Methods: During the 1-year study, 5588 blood samples from patients with a clinical diagnosis of sepsis were processed at Microbiology Laboratory of a 1200–bedded tertiary care hospital of Western India. Bacteriological identification and antimicrobial susceptibility testing were performed for all bacterial isolates by following the standard protocol. Results: A culture positivity was seen in 10.73% of the septicemic cases. Contamination was observed at a rate of 1.96%. Of the total 600 bacterial isolates gram-negative Enterobacteriaceae, Gram-negative nonfermenters and Gram-positive cocci contributed to 38%, 31%, and 31%, respectively. The predominant organisms were Acinetobacter spp followed by Klebsiella spp. and Staphylococcus aureus. All Gram-negative bacteria showed low sensitivity to fluoroquinolones and beta lactam drugs such as ampicillin and cephalosporins. Aminoglycosides, carbapenems, chloramphenicol, βeta lactam-β lactamase inhibitor combinations such as Piperacillin tazobactam were effective in treating Gram-negative bacteremia. Chloramphenicol, glycopeptides, and linezolid were effective in treating Gram-positive bacteremia. All Gram-positive isolates showed low sensitivity to fluoroquinolones. Conclusions: This study stresses the need for the continuous screening and surveillance for antibiotic resistance in septicemic cases.