Antibiogram Analysis and Altering Antimicrobial Susceptibility Pattern of Multidrug Resistant Pathogens
Introduction: In the current situation of escalating antibiotic resistance it is essential to identify and report sensitivity pattern of these MDR bacteria in order to tailor empirical therapy and hygienic measures. Because there will be hardly any new antibiotics in the near future, a better understanding is needed on the how to optimize the use of existing antibiotics, alone and in combination with other drugs. To achieve this, periodic monitoring and surveillance of hospital antibiogram is mandatory. Materials & Methods: Antibiogram surveillance was done for a five year period from Jan-2008 to December 2012 .The report generated was as per CLSI guidelines. A longitudinal analysis of prevalent rates of MDR pathogens-ESBL Enterobactericiae, MRSA, Imipenem resistant Gram negative bacilli isolated from all clinical samples and their sensitivity pattern was done. Results: The most prevalent MDR gram negatives at our centre were ESBL E.coli & ESBL Klebsiella pneumonia (73% & 61% respectively) and MRSA among Gram positives at 24.5%. Pseudomonas was the most predominant Imipenem resistant gram negative bacilli. Uropathogenic E.coli strains had better sensitivity to Nitrofurantoin at 63%. Imipenem showed 90- 100% sensitivity to E.coli & Klebsiella and 70-80 % to Pseudomonas. MRSA was predominantly from soft tissue infection showing 100% sensitivity to Linezolid & 99% to Vancomycin. Conclusion: During the study period a narrow spectrum of sensitivity was observed for commonly used antibiotics. An empirical antimicrobial Guideline was drafted following the Antibiogram Surveillance. Infection control measures & antimicrobial stewardship had proven to be modestly effective in our study.
