Current Pattern of Bloodstream Infections in a Tertiary Care Hospital of Karachi and Clinical Significance of Positive Blood Cultures

Abstract

Objective: Blood stream infections (BSI) (septicemias) require prompt empirical therapy based on awarenessof the drug susceptibility profiles of locally prevalent pathogens isolated. Place and Duration of Study: Department of Pathology Dow University of Health Sciences, Karachi, incollaboration with Dr Essa™s Diagnostic Centre, from July to November 2008. Study Design: A cross-sectional prospective study. Patients and Methods: 324 consecutive blood cultures from patients coming to Civil Hospital Karachiwere scrutinized for ba c te ria l isolates and th eir antibiotic sensitivity profiles were done. Results: A total of100 (30.9%) specimens were found positive, of these 78% isolates were gram negativebacteria and 22% gram positive cocci. Salmonella typhi, seen less often in adults (20.5%), was the predominantpathogen in children (82.5%). Escherichia coli, Staphylococcus aureus, Pseudomonas and Klebsiella wereisolated in neonates, and Klebsiella, Pseudomonas, Enterobacter and Acinetobacter were identified amongadult patients. While all S.typhi isolates were sensitive to cefixime, ceftriaxone and the fluoroquinolonesand increasingly amenable to chloramphenicol, of significance was the percentage of other multidrug resistantb a cterial isolates. Methicillin resistan t Staphylococcu aureus was isolated from one case. Statistical Analysis: The results were analysed by applying SPSS version 16 to derive p value. Conclusion: Amikacin, carbapenems, cefoperazone+sulbactam, fosfomycin and pipericillin+tazobactamare currently the only available drugs still active in-vitro on blood isolates, judicious use of antibioticsfocused on the compliance and formation of antibiotic policy guide lines is highly recommended.

Keywords

• bloodstream infections
• septicemia
• gram negative bacteria
• gram positive bacteria