BACTERIOLOGICAL PROFILE OF BLOODSTREAM INFECTIONS AND THEIR RESISTANCE PATTERN WITH DETECTION OF mecA GENE AT A TERTIARY CARE HOSPITAL IN ASSAM
Prof. (Dr.) Samrat Biswas and *Dr. Subarna Devi
ABSTRACT
Background- Blood stream infections (BSIs) are the major cause of morbidity & mortality among patients
admitted in intensive care unit and surveillance of etiological agents in these infections are important for their
prevention and treatment. Despite significant advances in antimicrobial therapy, concerns about increasing
antimicrobial resistance among the blood isolates have been noted, especially due to organisms with finite
treatment options, such as extended spectrum beta-lactamase producing Gram-negative bacilli and methicillin
resistant Staphylococcus aureus. Early identification of bloodstream pathogens and their antibiotic resistance
profile is necessary to improve clinical outcome. Materials and Methods- The study was conducted in the
Department of Microbiology, TMCH over a period of one year. 240 clinically suspected cases of septicaemia was
included in the study. The phenotypic identification of bacterial pathogen was done based on microscopic
morphology, staining characteristics, cultural and biochemical properties using standard laboratory techniques.
The antimicrobial susceptibility testing of the bacterial isolates were performed using Kirby-Bauer disc diffusion
method. Results- In this study, culture positivity rate was found to be 44.16%. Maximum number of GPC which
were isolated by the BacT/ALERT 3D blood culture system was Staphylococcus aureus 62 (78.5%). Predominant
Gram-negative isolate was Klebsiella pneumoniae. AST testing showed that all the Gram-positive isolates were
100% sensitive to vancomycin and linezolid. All MSSA species were moderately sensitive to Gentamicin (64%)
and Amoxicilin/clavulanate. Detection of mecA gene is considered the gold standard for MRSA confirmation. Out
of 62 Staphylococcal isolates in our study, 37 (48%) Staphylococcal isolates were found to be MRSA by Cefoxitin
disc diffusion method. Conclusion - From the results of the study we conclude that culture positivity was high in
Bloodstream infections and were caused by both gram-positive and gram-negative bacteria. High prevalence of
MRSA was found among the Staphylococcus aureus isolates. The antimicrobial susceptibility pattern showed that
the isolates are increasingly becoming resistant with only few options left to treat the patients.
Keywords: Blood Stream Infection, Antimicrobial sensitivity Test, MRSA, mecA gene.
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