STUDY OF PATHOGENS CAUSING BLOODSTREAM INFECTIONS WITH THEIR ANTIBIOGRAM IN A TERTIARY CARE HOSPITAL. Dr. Tharangini Karicheti

Dr. Tharangini Karicheti 1 , Dr. P. Ratna Kumari 2 and Dr. R.Lakshmi Kumari 3 . 1. 3-Year Postgraduate, Siddhartha Medical College, Vijayawada. 2. Professor, Department of Microbiology, Siddhartha Medical College, Vijayawada. 3. Professor and HOD, Department of Microbiology, Siddhartha Medical College, Vijayawada. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 03 October 2019 Final Accepted: 05 November 2019 Published: December 2019.

399 common health care associated infection and a significant cause of mortality and morbidity around the globe. Blood culture is the standard test for the detection of the causative bacteria and antibiotic sensitivity providing essential information for the evaluation of a variety of diseases like endocarditis, pneumonia, pyrexia of unknown origin and helpful particularly in patients with suspected sepsis allowing for successful recovery of bacteria in 99% patients with bacteremia. Early and appropriate antibiotic therapy is crucial in the treatment of bloodstream infections. In the current era of improper use of antibiotics there is a rise of antimicrobial resistance in bloodstream infections, and hence policies should be devised to control this by proper and effective use of antibiotics.

Methods:-
A total of 467 blood culture samples were received from different departments of Government General Hospital, Vijayawada, Andhra Pradesh, from October 2016 to September 2017.
Blood culture: Venous blood 5ml from adults and 2ml from children was obtained aseptically and inoculated into brain heart infusion broth. In suspected cases of enteric fever, bile broth was used and incubated at 37°C for 24 hours. Blind subculture was done on to fresh 5% sheep blood agar and Mac Conkey's agar. A negative result was followed up by examining the broth daily and doing a final subculture at the end of 7 th day or at the appearance of turbidity, gas production or the presence of microcolonies over the clot whichever was earlier. Where ever necessary second blood culture was taken. In Subacute bacterial endocarditis, 3 consecutive blood samples were taken. Organisms were identified by cultural characters, morphology and standard biochemical tests. Antibiotic susceptibility testing was performed by the by Kirby-Bauer disc diffusion methods, and results were interpreted as per Clinical and Laboratory Standards Institute (CLSI)guidelines.

Discussion:-
Bloodstream infection is a serious medical problem, and sometimes it may be life-threatening; therefore timely detection, identification, and antimicrobial susceptibility testing of blood-borne pathogens are one of the essential functions of the diagnostic microbiology laboratory.
In the present study blood culture positivity was seen in 22 % of cases which corresponds to Arora et al.

Conclusion:-
The present study indicates Staphylococcus aureus and Klebsiella species are the most common causative agents of bloodstream infections. The effective antibiotics are linezolid and vancomycin for Staphylococcus aureus and Imipenem, cefoperazone & sulbactam for Klebsiella species. The prevalence of multi drug resistant organisms among etiologic agents of bacterial sepsis is on the rise. There is a need for monitoring pathogen trends and microbial susceptibility patterns. This study emphasised the need for the development of antibiotic policies which can prevent the circulation of multi drug resistant bacteria in the hospitals as well as in the community.

Acknowledgement:-
I am thankful to all doctors , technical staff of Microbiology department, Government General Hospital, Siddhartha Medical College, Vijayawada who cooperated us in carrying out this research work.