European Journal of Biomedical and Pharmaceutical Sciences

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.