Trend of Antimicrobial Resistance among Bacterial Pathogens using Cumulative Antibiogram in a Tertiary Care Centre in Ahmedabad, Gujarat, India

Abstract

Introduction: A rising incidence of Multidrug Resistance Organisms (MDRO) have become a major challenge to human health infections due to MDRO results in higher mortality rates, longer durations of hospital stays, and higher healthcare costs. MDRO contribute to over 50% of Healthcare Associated Infections (HAIs). Aim: To monitor the trends of Antimicrobial Resistance (AMR) among bacterial pathogens over a period of three years by using Cumulative Antibiogram (CA). Materials and Methods: A retrospective study was done to measure the trends of AMR among gram positive and gram negative organisms over a period of three years. CA capturing the susceptibility data was prepared for Enterobacteriacae, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp. and Enterococcus spp. once in every three year (2017, 2018 and 2019) in the month of January. Results: A total of 1032 isolates, of 10 medically important bacteria were analysed. Total of 21.49%, 30.38% and 54.55% isolates were Extended Spectrum β Lactamase (ESBL) producer in 2017, 2018 and 2019, respectively. There was a rising carbapenem resistance in 2019 (15.5% in E.coli, 26% in Klebsiella pneumonaie an 21% in P. aeruginosa). Among isolates of S. aureus identified in 2019, 56% were Methicillin Resistant Staphylococcus aureus (MRSA). Conclusion: CA helps in monitoring resistance trends among clinical isolates which helps in preparation of antibiotic policy. There is rising incidence of ESBL and carbapenem resistance among gram negative bacilli.

Keywords

• antimicrobial resistance
• cumulative antibiogram
• extended spectrum beta lactamase
• methicillin resistant staphylococcus aureus