Shahla Latif, Saeed Anwar, Ishtiaq Ahmad.
Bacterial pathogens responsible for blood stream infection (BSI) and pattern of drug resistance in a tertiary care hospital of Lahore.
Biomedica Jan ;25(2):101-5.

The present retrospective analysis was carried out to determine the pattern of bacterial agents responsible for blood stream infection (BSI) in a tertiary care hospital of Lahore and to get an updated knowledge about their antibiotic resistance pattern. It is a cross sectional descriptive study, carried out in the Microbiology Section, Department of Pathology, Services Institute of Medical Sciences (SIMS), Lahore during the period April, 2006 to December, 2006. Among the 1814 blood cultures 1382 (76%) were received from pediatrics/ neonatology wards and 432 (24%) from adult patients. In a total of 508 (27.9%) blood cultures, 465 yielded monomicrobial growth and 43 polymicrobial growth. A total of 454 (97.6%) of the monomicrobial growths were bacterial isolates and 11(2.4%) were Candida Spp. Gram negative bacteria (Enterobacteriaceae + nonfermenter bacteria) comprised the majority of bacterial isolates. Amongst the gram-negative bacteria the most common organism was Klebsiella Spp. while amongst the gram-positive organisms Staph. aureus was the most common isolate. It was seen that 31.25% Staph. aureus isolates were resistant to Oxacillin, 93.7% of Klebsiella Spp. and E. coli isolates were resistant to 3rd generation Cephalosporins and 6.49% of Pseudomonas Spp. and Acinetobacter Spp. whereas resistant to Carbapenems in the present study. As BSI is an emergency, for appropriate management of these cases an updated knowledge about the causative agents and their susceptibility pattern to antibiotics is required to start appropriate empirical antibiotic therapy till the results of the microbiology report are available. The alarming finding is the high resistance seen amongst Enterobacteriaceae against 3rd generation cephalosporins (93.7%), oxacillin resistance among Staph aureus (31.25%) and increasing resistance against Carbepenems among Pseudomonas and Acinetobacter isolates (6.49%). In conclusion there are grave implications of these findings for our already strained health care system as the presence of these multidrug resistant organisms leads to longer hospital stay, more expensive/ toxic drugs and higher mortality.

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