Rehman Zia U, Hassan Shah Mohammad, Afridi Muhammad Nauman Shah, Sardar Hafsa, Shiraz Ahmad
Nephrology and Kidney Transplant Unit, Rehman Medical Institute, Peshawar, PAK.
Internal Medicine, Rehman Medical Institute, Peshawar, PAK.
Cureus. 2021 May 18;13(5):e15082. doi: 10.7759/cureus.15082.
Objective The aim of this study was to determine common microorganisms causing septicemia and their antimicrobial sensitivities in patients admitted to a tertiary care hospital. Methods A cross-sectional study was conducted using clinical criteria to diagnose patients as having septicemia where blood for culture and sensitivity (CS) was sent to the laboratory of a tertiary care hospital, Rehman Medical Institute, (Peshawar), Pakistan, during 2019. All patients diagnosed with septicemia regardless of age and gender were included in the study. The blood CS report was collected after 7-14 days of inoculation. Data were recorded on structured performa and analyzed using SPSS Version 20 (IBM Corp.). Results A total of 176 patients, with a mean age of 2.92±1.32 years, fulfilled the criteria for sepsis with a mean age of 2.92±1.32 years. Among them, 61.9% were male and 38.1% were female. Among common bacterial isolates, was found in 37.5% of samples followed by skin contaminants (18.2%), methicillin-resistant (MRSA) (14.8%), and in (11.4% cases). None of the antibiotics had susceptibility of more than 60%. Susceptibility to piperacillin/tazobactam and ampicillin/sulbactam was found in 21.5% and 14.6% of the samples, respectively, while in cephalosporins, cefoxitin's susceptibility was 28.5%, whereas both ceftriaxone and cephazolin were equally effective in 19.4% cases. Furthermore, 38.9% of the samples were susceptible to ciprofloxacin and 24.3% to levofloxacin. The susceptibilities of amikacin and gentamicin in aminoglycosides were 56.3% and 47.2%, respectively, while that of imipenem and meropenem were 59.7% and 22.9%, respectively. Lastly, clindamycin had an efficacy in 42.4% of samples. Conclusion The susceptibility of bacterial isolates in septicemia to common antibiotics was low, thus risking therapeutic failure in septic patients. Widespread resistance may be due to the excessive use along with over-the-counter availability of antibiotics, which therefore requires regulation as it is an alarming situation.
目的 本研究旨在确定一家三级医院收治患者中引起败血症的常见微生物及其抗菌药敏情况。方法 采用临床标准进行横断面研究，以诊断败血症患者，2019年期间将血培养及药敏（CS）样本送至巴基斯坦白沙瓦雷曼医学院的一家三级医院实验室。所有诊断为败血症的患者，无论年龄和性别，均纳入研究。接种7 - 14天后收集血CS报告。数据记录在结构化表格上，并使用SPSS 20版（IBM公司）进行分析。结果 共有176例患者符合败血症标准，平均年龄为2.92±1.32岁。其中，男性占61.9%，女性占38.1%。在常见细菌分离株中，37.5%的样本中发现了[具体细菌名称缺失]，其次是皮肤污染物（18.2%）、耐甲氧西林[具体细菌名称缺失]（MRSA）（14.8%），以及[具体细菌名称缺失]（11.4%的病例）。没有一种抗生素的药敏率超过60%。哌拉西林/他唑巴坦和氨苄西林/舒巴坦的药敏率分别为21.5%和14.6%，而在头孢菌素中，头孢西丁的药敏率为28.5%，头孢曲松和头孢唑林在19.4%的病例中效果相同。此外，38.9%的样本对环丙沙星敏感，24.3%对左氧氟沙星敏感。氨基糖苷类中阿米卡星和庆大霉素的药敏率分别为56.3%和47.2%，亚胺培南和美罗培南的药敏率分别为59.7%和22.9%。最后，克林霉素在42.4%的样本中有疗效。结论 败血症中细菌分离株对常见抗生素的药敏率较低，因此败血症患者存在治疗失败的风险。广泛耐药可能是由于抗生素的过度使用以及非处方可得性，因此鉴于这种令人担忧的情况，需要进行监管。
