Comparison of Antibiotic Susceptibility Pattern among Critical and Non-Critical area of Escherichia coli and Klebsiella spp. isolated in a Tertiary Care Hospital, Greater Noida, India

Abstract

Poorna Khaneja1, Prashant Subey Nagar2

BACKGROUND

Infections still remain as one of the major cause of mortality in low and lower-middle-income countries. The two important members of Gram-negative rods (Enterobacteriaceae) are Escherichia coli and Klebsiella pneumonia, which belongs to human gastrointestinal normal flora. The objective of this study was to use a large multicenter, real-world database in Gram-negative bacteria in both critical and non-critical settings with the goal of gaining insight into common culture sources and settings for infection and key pathogens.

METHOD

It is a retrospective cross-sectional analysis of susceptibility of all the non-duplicate isolates of Gram-negative pathogens collected from January 2019 to December 2019 at Sharda Hospital, UP, India. Clinical specimens from patients were processed and isolates were identified with standard microbiological methods. AST of the isolated strains were determined according to CLSI guidelines 2019. The result was analysed statistically using chi-square test.

RESULTS

Out of 2,024 non-duplicate isolates, 944 were fermenters and 433 were non-fermenters. Among fermenters, Escherichia coli (570; 60.4 %) followed by Klebsiella spp. (217; 23 %) were the leading bacterial pathogens. 223 samples (23.6 %) belonged to critical area and 564 samples (59.7 %) belonged to non-critical area. Both Escherichia coli and Klebsiella spp. showed resistance towards cefotaxime and amoxicillin clavulanic acid. Both showed sensitivity towards polymixin B and carbapenems.  

CONCLUSIONS

This study documents the decreasing susceptibility of fluoroquinolones and carbapenems in the critical areas. Antimicrobial stewardship initiatives & infection prevention with new treatment options may be required to reduce the burden of antibiotic resistance in health care settings.