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| ORIGINAL RESEARCH |
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| Year : 2022 | Volume
: 11
| Issue : 4 | Page : 366-368 |
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Study of sensitivity pattern of antimicrobial agent in a tertiary care hospital in tribal area
Anjali Tarai1, Saroj Dash2, Sabitri Beshra1, Priti L Panda2
1 Department of Pharmacology, PRMMCH, Maharaj Sriramchandra Bhanja Deo University, Baripada, Odisha, India
2 Department of Microbiology, PRMMCH, Maharaj Sriramchandra Bhanja Deo University, Baripada, Odisha, India
| Date of Submission | 28-Feb-2021 |
| Date of Acceptance | 01-Jun-2021 |
| Date of Web Publication | 17-Mar-2023 |
Correspondence Address:
Dr. Anjali Tarai
Professor, Department of Pharmacology, PRM Medical College and Hospital, Rangamatia, PO Laxmiposi, Baripada, Dist., Mayurbhnja, Odisha
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdrntruhs.jdrntruhs_24_21
Background: The pharmaceutical companies are flooded with newer and numerous antimicrobial agents. At the same time, bacterial resistance is more challenging and problematic and the biggest threat to Global health of India. Therapeutic failure complicates presentation and sensitivity patterns create a dilemma for the prescriber, and sometimes, the patients respond erratically to antimicrobial agents. This problem will cause 10 million deaths per year by 2050. Culture and sensitivity reports will benefit both the doctors and patients simultaneously. It can affect anyone at any age, and in any country. Therefore, a study was conducted in the new medical college to establish own sensitivity and resistance pattern of this instituition. At the same time, it prevents inappropriate or irrational use of antibiotics, rapid emergency of resistance, adverse drug reaction, higher cost to the patient, longer hospital stays and increases mortality.
Aim and Objective: To know the sensitivity and resistance and sensitivity patterns of antimicrobial agents; regulate and promote the appropriate use of antimicrobial agents in PRMMCH, Baripada, Mayurbhanj.
Materials and Methods: This prospective study was conducted from May to October 2019 in PRMMCH, Baripada, Department of Pharmacology, in collaboration with the Department of Microbiology. The data were collected from culture sensitivity reports of all positive samples of urine, throat swab, and blood culture from the microbiology department on the prescribed format and finally be analyzed by percentage.
Result: The total number of samples with positive culture was 100. Staph aureus was positive in 60%, E. coli 10%, Enterococcus sp and Klebsiella sp 7%, Pseudomonas 6%, Acinetobacter 5%, Citrobacter sp 3%, and Corynebacterium sp 2%.
Conclusion: More studies are needed to evaluate the sensitivity and resistant pattern of the microorganisms to different antibiotics from different clinical specimens in this geographical area.
Keywords: Antimicrobial agent, observational study, sensitivity patterns
How to cite this article:
Tarai A, Dash S, Beshra S, Panda PL. Study of sensitivity pattern of antimicrobial agent in a tertiary care hospital in tribal area. J NTR Univ Health Sci 2022;11:366-8 |
How to cite this URL:
Tarai A, Dash S, Beshra S, Panda PL. Study of sensitivity pattern of antimicrobial agent in a tertiary care hospital in tribal area. J NTR Univ Health Sci [serial online] 2022 [cited 2023 Apr 1];11:366-8. Available from: https://www.jdrntruhs.org/text.asp?2022/11/4/366/371757 |
| Introduction | |  |
According to the World Health Organization's (WHO) “First Global Report on Antibiotic Resistance,” and the U.S. Centers for Disease Control and Prevention (CDC), the spread of “superbugs—bacteria that have changed in ways that render antibiotics ineffective against them—are a serious and growing threat around the world. Once common treatments for everyday intestinal and urinary tract infections, pneumonia, infections in newborns, and diseases like gonorrhea, are no longer working in people. Superbugs are bacteria-resistant to one or more antibiotics, and they make it difficult to treat or cure infections that were once easily treated. The antibiotic has lost its ability to control or kill bacterial growth. The bacteria can even grow in a sea of antibiotics because the antibiotic does not touch them. The bacteria have acquired the ability to destroy the antibiotic in order to protect themselves. They may have developed resistance to five or six antibiotics so, in treatment, we do not know which one to choose or whether it will be effective. The bacteria have accumulated resistance by developing new genes. In other words, genetics is working against us.
The pharmaceutical companies are flooded with newer and numerous antimicrobial agents. At the same time, bacterial resistance is more challenging and problematic as the biggest threat to global health.[1] Therapeutic failure complicated presentation and sensitivity pattern create a dilemma for the prescriber, and sometimes, patients respond erratically to the antimicrobial agents. It will go to ten million deaths per year by 2050. Culture and sensitivity reports will benefit both the doctors and patients simultaneously.[2] It can affect anyone at any age and any country.
Therefore, the study was conducted in the new medical college to establish their own sensitivity and resistance pattern, at the same time, it will prevent inappropriate or irrational use of antibiotics, rapid emergency of resistance, adverse drug reaction, higher cost to the patient, longer hospital stays, and increased mortality.
Objective
The present study was conducted to know the resistance and sensitivity patterns of antimicrobial agents; regulate and promote the appropriate use of antimicrobial agents in PRMMCH, Baripada, Mayurbhanj.
| Material and Method | | |
This was a prospective observational study in 100 consecutive patients. This prospective study was conducted from May to October 2019 in PRMMCH, Baripada, Department of Pharmacology in collaboration with the Department of Microbiology. The data were collected from culture sensitivity reports of all positive samples of urine, throat swab, and blood culture from the microbiology department on the prescribed format and finally it was analyzed by percentage.[3] The study was approved by the Institutional Review Board (IEC ref no-4/19/06/19, Dated on 19/06/2019), and informed consent was obtained from the patients.
Samples after collection were immediately transported to the microbiology department, and subsequently cultured. Records of identification and antibiotic sensitivity pattern of the microorganisms were maintained for all the patients. The bacteria were identified based on standard laboratory protocols.[5] All clinical specimens were inoculated on MacConkey agar and blood agar for isolation of gram-negative and gram-positive bacteria. After 18–24 h of incubation, the MacConkey agar and blood agar plates were examined for colonies.[4] More than one colony morphology may represent distinct species. Wherever there was a difference in the colony morphology, colonies of each were sub-cultured in nutrient agar media (non-selective media). Isolates were subjected to a series of biochemical tests for identification. These colonies were identified up to species level using a standard protocol. Susceptibility testing was performed by disk diffusion (Kirby–Bauer) method following central laboratory standard institute (CLSI) guidelines version 2016 [Graph 1].[5]
| Result | | |
The total number of samples with positive culture was 100. Staph aureus was positive in 60%, E. coli 10%, Enterococcus sp and Klebsiella sp 7%, Pseudomonas 6%, Acinetobacter 5%, Citrobacter sp 3%, and Corynebacterium sp 2% [Graph 1].
| Discussion | | |
The study was undertaken to evaluate the developing bacterial trends and their susceptibility patterns to understand the prevalent resistance patterns and to determine the effectiveness of prescribed drugs for the treatment of various infections from clinical specimens like urine, blood, and throat swab samples. In our study, the prevalence of various organisms was as follows: E. coli (10%), Enterococcus [7%], S. aureus [60%], and Klebsiella (7%), pseudomonas (6%), Acinetobacter (5%), Citrobacter (3%), and Corynebacterium (2%). Among the gram-negative isolates, the predominant organism in our study was E. coli (10%) followed by Klebsiella (7%). Among the gram-positive isolates, S. aureus (60%) was most commonly isolated followed by Enterococcus (7%) [Graph 1].
Among the gram-positive microorganism, Staphylococcus aureus being the predominant pathogen was mostly sensitive to Erythromycin, Azithromycin, Ceftriaxone, Gentamicin, and Amikacin followed by Cotrimoxazole, Ampicillin, and Ciprofloxacin whereas among the gram-negative pathogens, E. coli being the predominant pathogen, was diffusely sensitive to different antibiotics [Table 1]. The study also correlates with the previous study done in Puducherry.[6]
A high-resistant pattern was seen to Cotrimoxazole, Ampicillin, and Tetracycline in the case of the gram-positive organism and to Cefpodoxime, Gentamicin, Clotrimoxazole, and Amikacin in the case of the gram-negative organism [Table 1].[7]
| Conclusion | | |
Anti microbial resistance (AMR) was more with the hospital-acquired organism and against commonly used antibiotics that are available for a long period. Variation of resistance and sensitivity patterns with time and geographical location are identified.[8] More studies are needed to evaluate the sensitivity and resistant patterns of microorganisms to different antibiotics from different clinical specimens in this geographical area.[9] Periodic AMR monitoring and rotation of antibiotics are suggested to restrict further emergence of resistance.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Antibiotic resistance & Stewardship (WHODRAT 2018, GLASS 2018).  |
| 2. | STG of Odisha 2014. |
| 3. | Antibiotic resistance (NCBI 2018). |
| 4. | ECDC study 2018. |
| 5. | Antibiotic & Antimicrobial resistance threat report 2013 (Centre for disease control &). |
| 6. | Antimicrobial Stewardship (APIC, NCBJ). |
| 7. | Practical guide to antimicrobial stewardship in hospital base Org UK 2013. |
| 8. | ICMR Antibiotic Stewardship guideline. |
| 9. | JINYEO 2016 Antibiotic consumption must be cut. BMJ Nov 2014. |
[Table 1]
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