Antibiogram of Gram Negative Bacteria Isolated from the Skin and Soft Tissue Infections a Guide for Empirical Therapy to the Clinicians

Abstract

The antibiogram gives the periodic summary of antimicrobial susceptibilities of local bacterial isolates submitted to the hospitals microbiology laboratory. Antibiogram can be of great use in assessing the local susceptibility rates and can serve as a tool in designing the empirical antibiotic therapy and also in monitoring the resistance trends over time within in an institution. Pus samples from various clinical conditions like abscess, cellulitis, necrotizing fasciitis, wound infections; diabetic foot ulcers were included in the study. A total of 1124 positive cultures were obtained out of which 736 yielded various Gram negative organisms and 488 were Gram positive organisms. Only Gram negative organisms were considered in the study as gram negative organisms are common etiological agents of skin and soft tissue infections and pose a great challenge to the treating physician as they are known to develop a high antimicrobial resistance. The organisms isolated in our hospital were Pseudomonas aeruginosa (192), Klebsiella pneumonia (173), Escherichia coli (168), Citrobacter species (117), Acinetobacter species (47), and Proteus species (39). In our study which aims at formulating an empirical therapy for Gram negative organisms the drugs with highest sensitivity were Imipenem (51%), Amikacin (43%), Meropenem (38%), Tobramycin (36%), and Ciprofloxacin (34%) Gentamicin (34%), Netimicin (33%), Cotrimoxazole (32%), Piperacillin (28%),Tetracycline (28%), Ceftazidime (28%), Levofloxacin (26%), Ceftriaxone (26%), Colistin (22%), Carbenecillin (21%), Cefoperazone (21%), Cefoperazone +Sulbactum (21%), Azonetrem (21%), Cefipime (20%), Cefuroxime (17%), Cephaxlein (15%), Ampicillin (12%), Amoxyclav (10%). With the knowledge of most commonly isolated organisms causing SSTIs and their antimicrobial susceptibility patterns the clinicians can start the most likely antibiotic and can change accordingly once the sensitivity report is available.

Keywords

• resistance
• antibiogram
• empirical therapy
• pseudomonas aeruginosa
• klebsiella pneumonia