Pattern of Antimicrobial Sensitivity and Resistance in Large Series of Indoor Patients at a Tertiary Care Hospital
Objective: In the era of increasing antibiotic resistance, associated with increasing hospital stay and morbidity, the purpose was to define guidelines for antibiotics in different clinical situations.
Patients and Methods: This study was conducted at Khan Research Laboratories Hospital, Islamabad, Pakistan, from July 2014 to December 2016. 3277 patients admitted in Medical, Surgical, Gynaecology & Obstetrics, ENT, Eye and Dental departments were included. Positive cultures from different sources including blood, urine, pus, central venous lines, bronchial washings and cervical swabs were taken. Age, gender, common pathogens, their sensitivity and resistance to 27 antimicrobial drugs were taken into account. Statistical Package for Social Sciences (SPSS) version 20 was used for data analysis.
Results: 53.1% (n=1738) were females while 46.9% (n=1539) were males.2800 samples were available for analysis. Majority of the patients belonged to Medical ward, 56.9% (n=1864). Major source of culture was urine, 38.3% (n=1073). Escherichia coli (E. coli) was the most common isolate 51.3% (n=1436) followed by Staphylococcus aureus 19.9% (n=558). E. coli showed maximum sensitivity to Imipenem i.e. 94% (n=1349) followed by Amikacin, 93% (n=1335). It was resistant to ceftriaxone (77%).Staphylococcus aureus showed maximum sensitivity to Linezolid and Vancomycin i.e. 98% (n=548) followed by Chloramphenicol 84% (n=470), while being resistant to ciprofloxacin and levofloxacin (54%). Klebsiella pneumoniae showed maximum sensitivity to Imipenem i.e. 75%, while showing resistance to Amoxicillin/Clavulanic Acid (95%) and Ceftriaxone (80%).Staphylococcus epidermidis showed maximum sensitivity to Linezolid i.e.99%. Pseudomonas aeruginosa showed maximum sensitivity to Piperacillin and Tazobactam i.e. 76% . Acinetobacter baumannii showed maximum sensitivity to Colistin i.e. 91%.Salmonella typhi showed maximum sensitivity to Ceftriaxone i.e. 99% while resistance to Ciprofloxacin (94%).Enterococcus faecalis showed maximum sensitivity to Linezolid i.e.100% and Salmonella Paratyphi A showed maximum sensitivities to Cefixime and Ceftriaxone i.e 100%
Conclusion: Antibiotic resistance is emerging. Rationale use of antibiotics is required to curtail the surge of antibiotic resistance. There is also a need to modify treatment guidelines in different clinical situations based on local sensitivity and resistance patterns in order to reduce hospital stay, morbidity and mortality.
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