2018JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCHOpen access

Trends in Septicaemic Patients Admitted in Tertiary Care Teaching Hospital in Andhra Pradesh, India

Uma Mylandlahalli Anandkumar, Nagarajan Natarajan, Revathi Jeripiti

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Abstract

Introduction: Septicaemia is one of the significant causes of morbidity and mortality in Intensive Care Units (ICUs). The rate of antimicrobial resistance in ICU is very high compared to general hospital setting. Aim: To enumerate common bacterial pathogens causing sepsis and to identify their antimicrobial susceptibility pattern. Materials and Methods: This was a retrospective descriptive study done in patients with sepsis during January 2016 to December 2017. The Institutional Ethical Committee clearance was obtained. Data were collected from inpatient case files regarding clinical history, laboratory parameters with special reference to causative organisms and antibiotic sensitivity pattern. Data were entered in Microsoft Excel sheet and analysed using strata 14.0. Results: Among 216 subjects of sepsis admitted to ICU during study period, 130 (60.1%) were males, with mean age of 52.83 year (±16.6 SD). Pneumonia (31.94%) was the major cause of sepsis followed by urosepsis. Gram negative organisms were the major cause of sepsis accounting for 76.25% of organisms isolated. Escherichia coli was the most common organism isolated in urine (65.9%) and blood cultures (32%). All Gram negative bacteria had high level of resistance to Amoxicillin Clavulunic Acid (Amoxyclav) (85.9%), ampicillin sulbactum (66.7%) and third generation cephalosporins (70%). Conclusion: Gram negative organisms were the principal causes of septicaemia. Cephalosporin resistance was more than 70%. Acinetobacter species was resistant to most antibiotics. The knowledge of bacterial profile of sepsis and antibiotic susceptibility pattern not only helps in improving outcome but also prevents emergence of drug resistance strains.

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Introduction: Septicaemia is one of the significant causes of morbidity and mortality in Intensive Care Units (ICUs). The rate of antimicrobial resistance in ICU is very high compared to general hospital setting. Aim: To enumerate common bacterial pathogens causing sepsis and to identify their antimicrobial susceptibility pattern. Materials and Methods: This was a retrospective descriptive study done in patients with sepsis during January 2016 to December 2017. The Institutional Ethical Committee clearance was obtained. Data were collected from inpatient case files regarding clinical history, laboratory parameters with special reference to causative organisms and antibiotic sensitivity pattern. Data were entered in Microsoft Excel sheet and analysed using strata 14.0. Results: Among 216 subjects of sepsis admitted to ICU during study period, 130 (60.1%) were males, with mean age of 52.83 year (±16.6 SD). Pneumonia (31.94%) was the major cause of sepsis followed by urosepsis. Gram negative organisms were the major cause of sepsis accounting for 76.25% of organisms isolated. Escherichia coli was the most common organism isolated in urine (65.9%) and blood cultures (32%). All Gram negative bacteria had high level of resistance to Amoxicillin Clavulunic Acid (Amoxyclav) (85.9%), ampicillin sulbactum (66.7%) and third generation cephalosporins (70%). Conclusion: Gram negative organisms were the principal causes of septicaemia. Cephalosporin resistance was more than 70%. Acinetobacter species was resistant to most antibiotics. The knowledge of bacterial profile of sepsis and antibiotic susceptibility pattern not only helps in improving outcome but also prevents emergence of drug resistance strains.

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Available abstract

Introduction: Septicaemia is one of the significant causes of morbidity and mortality in Intensive Care Units (ICUs). The rate of antimicrobial resistance in ICU is very high compared to general hospital setting. Aim: To enumerate common bacterial pathogens causing sepsis and to identify their antimicrobial susceptibility pattern. Materials and Methods: This was a retrospective descriptive study done in patients with sepsis during January 2016 to December 2017. The Institutional Ethical Committee clearance was obtained. Data were collected from inpatient case files regarding clinical history, laboratory parameters with special reference to causative organisms and antibiotic sensitivity pattern. Data were entered in Microsoft Excel sheet and analysed using strata 14.0. Results: Among 216 subjects of sepsis admitted to ICU during study period, 130 (60.1%) were males, with mean age of 52.83 year (±16.6 SD). Pneumonia (31.94%) was the major cause of sepsis followed by urosepsis. Gram negative organisms were the major cause of sepsis accounting for 76.25% of organisms isolated. Escherichia coli was the most common organism isolated in urine (65.9%) and blood cultures (32%). All Gram negative bacteria had high level of resistance to Amoxicillin Clavulunic Acid (Amoxyclav) (85.9%), ampicillin sulbactum (66.7%) and third generation cephalosporins (70%). Conclusion: Gram negative organisms were the principal causes of septicaemia. Cephalosporin resistance was more than 70%. Acinetobacter species was resistant to most antibiotics. The knowledge of bacterial profile of sepsis and antibiotic susceptibility pattern not only helps in improving outcome but also prevents emergence of drug resistance strains.

Key concepts: Tertiary care, Teaching hospital, Medicine, Socioeconomics, Geography, Family medicine, Sociology

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