Gram Negative Bacilli Causing Blood Stream Infection in Febrile Neutropenic Patients in a Tertiary Care Centre
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 7
Abstract
Introdoction: The alarming rise in the incidence of infections due to antibiotic-resistant gram-negative bacilli in recent years in hospital setting is of great concern, a situation compounded in neutropenic patients, as they may initially receive antibiotics that are resistant. The present study depicts the frequency of Gram negative bacteremia in neutropenic patients, burden of MDR and PDR Gram negative bacilli, antibiotic sensitivity pattern of the isolated organisms and relationship between ANC (Absolute Neutrophil Complete) and BSI in neutropenic patients. Material and methods: It is a hospital based prospective study conducted in a tertiary care centre Guwahati. Analysis of microbiological profile and Antibiotic sensitivity pattern of the FN patients admitted from September 2014 to September 2016 was done. All the isolated bacteria were tested against different antimicrobial agents by the Vitek2 as well as the standard disc diffusion method (Kirby Bauer Technique). For isolates of Gram negative Bacilli Extended-spectrum β-lactamase (ESBL) production was screened for by testing ceftazidime and cefotaxime, and confirmed with the doubledisk test. Result: The occurrence of BSI is inversely proportional to the Absolute Neutrophil count, with highest 15 (88.23%) positive Blood culture in patients with ANC < 100/μl. Gram negative bacilli is the most common isolate with a share of 58.18% (32) of the positive cases. The antibiotic sensitivity among GNB was highest for Colistin (100%) and Teigecycline (93.8%). There is an alarming increase in resistance for cephalosporins and carbepenems. 64.3% of Klebsiella pneumoniae and 37.5% of Escherichia coli were found to be Multi Drug Resistant (MDR). Conclusion: Gram negative bacilli is the predominant pathogen with a share of 58.18% (32) of the positive cases in this region causing BSI in FN patients. BSI is inversely proportional to the Absolute Neutrophil count in neutropenic patients. There is an alarming rise in MDR organisms and resistance against carbapenems. It needs to be emphasized that microbiological examination of these group of patients should be carried out routinely and periodically, so that an effective empirical antibiotic regime could be tailored for these patients against the commonly causative organisms.
Authors and Affiliations
Joydeep Mangaraj, Dipa Barkataki, Daiji Gogoi Mohan
Keywords
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