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Retrospective Analysis of Blood Stream Infections and Antibiotic Susceptibility Pattern of Gram Negative Bacteria in a Tertiary Care Cancer Hospital

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Abstract (2. Language): 
Background: Bacterial bloodstream infections are important causes of morbidity and mortality globally. The aim of the present study was to determine the bacterial profile of bloodstream infections and their antibiotic susceptibility pattern among the clinically diagnosed cases of sepsis in cancer patients. Methods: In the present study, etiological and antimicrobial susceptibility profile of blood cultures over a period of 1 year at a tertiary cancer care hospital was done. Blood culture positive isolates were identified using standard microbiological methods and by Fully automated BD Phoenix 100. The antibiotic susceptibility pattern of the organisms was performed by Kirby-Bauer disc diffusion method and MIC (Minimum inhibitory concentration) was done by Fully automated BD Phoenix 100. Results: There were 1178 blood culture samples, of which 327 (27.7%) were identified to be culture positive. Out of 327 positive cultures, 299 (91.4%) showed bacterial growth, Gram negative were 161 (53.8%) and Gram positive were 138 (46.1%). Candida species were isolated from 13 (3.97%) of positive samples and 15 samples showed contamination. The most common Gram-negative isolate was. Escherichia coli (37.80%) and Gram-positive isolate was coagulasenegative staphylococci (52.80%). Escherichia coli showed highest sensitivity to amikacin (83.60%) and sensitivity to piperacillin+ tazobactum and cefaperazone+sulbactam was 54.09% and 52.45% respectively. High degree of resistance was found to cephalosporins and levofloxacin. Conclusion: The results indicate high level of antimicrobial resistance among Gram negative bacilli in septicemic patients. The results warrant continuous monitoring of antimicrobial pattern so as to build geographical epidemiological data.
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REFERENCES

References: 

[1] Nucci, Marcio, et al. “Risk factors for death among cancer patients with fungemia.” Clinical Infectious
Diseases Vol. 27, No. 1, 1998, pp. 107-11.
[2] Bhat, Vivek, et al. “Bacteriological profile and antibiotic susceptibility patterns of clinical isolates in a tertiary
care cancer center.” Indian Journal of Medical and Paediatric Oncology: Official Journal of Indian Society of
Medical & Paediatric Oncology Vol. 37, No. 1, 2016, p. 20.
[3] Collin, Berjan A., et al. “Evolution, incidence, and susceptibility of bacterial bloodstream isolates from 519 bone
marrow transplant patients.” Clinical Infectious Diseases Vol. 33, No. 7, 2001, pp. 947-53.
[4] Krupova, I., et al. “Bacteremia and fungemia in pediatric versus adult cancer patients after chemotherapy:
comparison of etiology, risk factors and outcome.” Journal of Chemotherapy Vol. 10, No. 3, 1998, pp. 236-42.
Radha Rani, et al. Int J Med Res Health Sci 2017, 6(12): 19-26
25
[5] Krcmery, V., et al. “Bacteremia due to multiresistant gram-negative bacilli in neutropenic cancer patients: a case
controlled study.” Journal of Chemotherapy Vol. 10, No. 4, 1998, pp. 320-25.
[6] Ehni, William F., L. Barth Reller, and Richard T. Ellison III. “Bacteremia in granulocytopenic patients in a
tertiary-care general hospital.” Reviews of Infectious Diseases Vol. 13, No. 4, 1991, pp. 613-19.
[7] Venkatesh, V., and Swapna Kotian. “Bacteriological profile and antimicrobial resistance of blood culture isolates
among paediatric patients from tertiary care hospital.” Journal of International Medicine and Dentistry Vol. 3,
No. 2, 2016, pp. 80-87.
[8] Wasihun, Araya Gebreyesus, et al. “Bacteriological profile and antimicrobial susceptibility patterns of blood
culture isolates among febrile patients in Mekelle Hospital, Northern Ethiopia.” SpringerPlus Vol. 4, No. 1, 2015,
p. 314.
[9] Ali, J., and Y. Kebede. “Frequency of isolation and antimicrobial susceptibility pattern of bacterial isolates from
blood culture, Gondar University teaching hospital, Northwest Ethiopia.” Ethiopian Medical Journal Vol. 46,
No. 2, 2008, pp. 155-61.
[10] Vasudeva, Nikita, Prem Singh Nirwan, and Preeti Shrivastava. “Bloodstream infections and antimicrobial
sensitivity patterns in a tertiary care hospital of India.” Therapeutic Advances in Infectious Disease Vol. 3, No.
5, 2016, pp. 119-27.
[11] Mehta, Manjula, Priya Dutta, and Varsha Gupta. “Antimicrobial susceptibility pattern of blood isolates from a
teaching hospital in North India.” Japanese Journal of Infectious Diseases Vol. 58, No. 3, 2005, p. 174.
[12] Arora, Usha, and Pushpa Devi. “Bacterial profile of blood stream infections and antibiotic resistance pattern of
isolates.” J K Science Vol. 9, No. 4, 2007, pp. 186-90.
[13] Mehta, Manjula, Priya Dutta, and Varsha Gupta. “Antimicrobial susceptibility pattern of blood isolates from a
teaching hospital in North India.” Japanese Journal of Infectious Diseases Vol. 58, No. 3, 2005, p. 174.
[14] Shalini S, Kranthi K, Gopalkrishna BK. “The microbiological profile of nosocomial infections in the intensive
care unit.” Journal of Clinical and Diagnostic Research Vol. 4, 2010, pp. 3109-12.
[15] Ghadiri, Hamed, et al. “The antibiotic resistance profiles of bacterial strains isolated from patients with hospitalacquired
bloodstream and urinary tract infections.” Critical Care Research and Practice 2012, 2012.
[16] Gohel, Kalpesh, et al. “Bacteriological profile and drug resistance patterns of blood culture isolates in a tertiary
care nephrourology teaching institute.” BioMed Research International 2014, 2014.
[17] Zenebe, Tizazu, et al. “Invasive bacterial pathogens and their antibiotic susceptibility patterns in Jimma
University specialized hospital, Jimma, Southwest Ethiopia.” Ethiopian Journal of Health Sciences Vol. 21, No.
1, 2011, pp. 1-8.
[18] Dagnew, Mulat, et al. “Bacterial profile and antimicrobial susceptibility pattern in septicemia suspected patients
attending Gondar University Hospital, Northwest Ethiopia.” BMC Research Notes Vol. 6, 2013.
[19] Vanitha, Rani N., et al. “A retrospective study on blood stream infections and antibiotic susceptibility patterns
in a tertiary care teaching hospital.” International Journal of Pharmacy and Pharmaceutical Sciences Vol. 4, No.
1, 2012, pp. 543-48.
[20] Gupta, Shilpi, and Bineeta Kashyap. “Bacteriological profile and antibiogram of blood culture isolates from a
tertiary care hospital of North India.” Tropical Journal of Medical Research Vol. 19, No. 2, 2016, p. 94.
[21] Pal, Nidhi, and RaMaMuRthy Sujatha. “Antimicrobial resistant pattern of blood culture isolates, among
septicaemia suspected patients.” National Journal of Laboratory Medicine Vol 5, No. 1, 2016, pp. 17-21.
[22] Sonawane, Jyoti P., et al. “Bacteriological profile and antimicrobial susceptibility of blood culture isolates from
tertiary care hospital, Navi Mumbai.” Journal of Medical Science and Clinical Research Vol. 5, No. 1, 2016, pp.
17-21.
[23] Prabhash, Kumar, et al. “Blood stream infections in cancer patients: A single center experience of isolates and
sensitivity pattern.” Indian Journal of Cancer Vol. 47, No. 2, 2010, p. 184.
[24] Chen, Chien-Yuan, et al. “Trends and antimicrobial resistance of pathogens causing bloodstream infections among
febrile neutropenic adults with hematological malignancy.” Journal of the Formosan Medical Association Vol.
Radha Rani, et al. Int J Med Res Health Sci 2017, 6(12): 19-26
26
103, No. 7, 2004, pp. 526-32.
[25] Moghnieh, Rima, et al. “Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant
gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad
spectrum antibiotics use as a major risk factor, and correlation with poor prognosis.” Frontiers in Cellular and
Infection Microbiology Vol. 5, 2015.
[26] Irfan, Seema, et al. “Emergence of Carbapenem resistant Gram negative and vancomycin resistant Grampositive
organisms in bacteremic isolates of febrile neutropenic patients: a descriptive study.” BMC Infectious
Diseases Vol. 8, No. 1, 2008, p. 80.
[27] Al-Otaibi, Fawzia E., et al. “Prevalence and risk factors of Gram-negative bacilli causing blood stream infection
in patients with malignancy.” Saudi Medical Journal Vol. 37, No. 9, 2016, p. 979.
[28] Gustinetti, Giulia, and Malgorzata Mikulska. “Bloodstream infections in neutropenic cancer patients: a practical
update.” Virulence Vol. 7, No. 3, 2016, pp. 280-97.
[29] Bansal, S, and SH Advani. “Pattern of bloodstream infections in patients with hematological malignancies in a
tertiary care centre.” Indian Journal of Cancer Vol. 51, No. 4, 2014, pp. 447-449.
[30] Ahmed, N.H., F.K. Baruah, and R.K. Grover. “Letter to Editor: Staphylococcal Blood Stream Infections in
Cancer Patients.” Annals of Medical and Health Sciences Research Vol. 5, No. 3, 2015, pp. 226-27.
[31] Velasco, Eduardo, et al. “Epidemiology of bloodstream infections at a cancer center.” Sao Paulo Medical Journal
Vol. 118, No. 5, 2000, pp. 131-38.
[32] Raad, I., et al. “Serious complications of vascular catheter-related Staphylococcus aureus bacteremia in cancer
patients.” European Journal of Clinical Microbiology & Infectious Diseases Vol. 11.8 (1992): 675-682.
[33] Babu, K. Govind, et al. “Bloodstream infections in febrile neutropenic patients at a tertiary cancer institute
in South India: A timeline of clinical and microbial trends through the years.” Indian Journal of Medical and
Paediatric Oncology: Official Journal of Indian Society of Medical & Paediatric Oncology Vol. 37, No. 3, 2016,
p. 174.
[34] Kang, Cheol-In, et al. “Bloodstream infections in adult patients with cancer: clinical features and pathogenic
significance of Staphylococcus aureus bacteremia.” Supportive Care in Cancer Vol. 20, No. 10, 2012, pp. 2371-78.
[35] Taneja, Juhi, et al. “Nosocomial blood-stream infections from extended-spectrum-beta-lactamase-producing
Escherichia coli and Klebsiella pneumonia from GB Pant Hospital, New Delhi.” The Journal of Infection in
Developing Countries Vol. 4, No. 08, 2010, pp. 517-20.
[36] Mustafa, Sabir Awad. “High Prevalence and Antibiogram Pattern of Extended Spectrum Beta Lactamases
Producing Escherichia Coli and Klebsiella Pneumonia Isolated from Inpatients Units in a General Hospital in
Saudi Arabia.” EC Microbiology Vol. 5, 2017, pp. 30-35.
[37] Gedik, H. “Does antimicrobial use increase the rate of antimicrobial resistance: A one year experience.” Indian
Journal of Medical Microbiology Vol. 30, 2012, pp. 198-202.
[38] Rawat, Deepti, and Deepthi Nair. “Extended-spectrum β-lactamases in gram negative bacteria.” Journal of
Global Infectious Diseases Vol. 2, No. 3, 2010, p. 263.
[39] Singhal, T., S. Shah, and R. Naik. “The microbial etiology and antimicrobial susceptibility of bloodstream
infections in patients with cancer at a private tertiary care hospital in Mumbai, India.” Indian Journal of
Cancer Vol. 53, No. 3, 2016, p. 452.
[40] Nathisuwan, Surakit, David S. Burgess, and James S. Lewis. “Extended-spectrum β-lactamases: epidemiology,
detection, and treatment.” Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy Vol. 21,
No. 8, 2001, pp. 920-28.

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