Volume 10, Issue 3 (2024)
IEM 2024, 10(3): 213-221 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Erfani S, Zare Bidaki M, Alemzadeh E, Ebrahimzadeh A. Bacterial Spectrum and Antimicrobial Susceptibility Patterns in Septicemia Suspected Patients. IEM 2024; 10 (3) :213-221
URL: http://iem.modares.ac.ir/article-4-72999-en.html
URL: http://iem.modares.ac.ir/article-4-72999-en.html
1- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
3- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran ,alemzadeheffat@bums.ac.ir
2- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
3- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran ,
Abstract: (875 Views)
Background: In this comprehensive study, the prevalence of sepsis, a potentially life-threatening condition, was investigated among 477 patients displaying sepsis symptoms.
Materials & Methods: A detailed questionnaire was used to capture the patients' demographic information and clinical treatment outcomes.The E-test method was employed to determine the susceptibility of Gram-positive bacteria to vancomycin and Gram-negative bacteria to cefepime, ceftriaxone, and imipenem.
Findings: Among the participants, 40 patients (8.6%) were diagnosed with septicemia, a condition whose prevalence significantly increased with age (p= .001). Out of 40 patients with positive blood cultures, 14 (35%) were infected by Gram-positive bacteria, while 26 (65%) were infected by Gram-negative bacteria. Acinetobacter lwoffii and Staphylococcus epidermidis were identified as the most common causes of sepsis among Gram-negative (30.7%) and Gram-positive (57.1%) bacteria, respectively Gram-negative bacteria exhibited the highest resistance to ceftriaxone (38.4%) and the highest susceptibility to imipenem (84.6%) in both laboratory and clinical settings. Gram-positive bacteria demonstrated the high susceptibility to vancomycin (78.5%), with only four patients exhibiting resistance to vancomycin in both laboratory and clinical settings. Encouragingly, there was a 77.5% concordance between laboratory and clinical antibiotic susceptibility testing results.
Conclusion: Based on these findings, vancomycin and imipenem are recommended as the preferred antibiotics for Gram-positive and Gram-negative bacteria, respectively. Given the high concordance (77.5%) between laboratory and clinical results, it is suggested to perform antibiogram test using E-test method on blood culture isolates in septicemia cases to guide appropriate antibiotic treatment.
Materials & Methods: A detailed questionnaire was used to capture the patients' demographic information and clinical treatment outcomes.The E-test method was employed to determine the susceptibility of Gram-positive bacteria to vancomycin and Gram-negative bacteria to cefepime, ceftriaxone, and imipenem.
Findings: Among the participants, 40 patients (8.6%) were diagnosed with septicemia, a condition whose prevalence significantly increased with age (p= .001). Out of 40 patients with positive blood cultures, 14 (35%) were infected by Gram-positive bacteria, while 26 (65%) were infected by Gram-negative bacteria. Acinetobacter lwoffii and Staphylococcus epidermidis were identified as the most common causes of sepsis among Gram-negative (30.7%) and Gram-positive (57.1%) bacteria, respectively Gram-negative bacteria exhibited the highest resistance to ceftriaxone (38.4%) and the highest susceptibility to imipenem (84.6%) in both laboratory and clinical settings. Gram-positive bacteria demonstrated the high susceptibility to vancomycin (78.5%), with only four patients exhibiting resistance to vancomycin in both laboratory and clinical settings. Encouragingly, there was a 77.5% concordance between laboratory and clinical antibiotic susceptibility testing results.
Conclusion: Based on these findings, vancomycin and imipenem are recommended as the preferred antibiotics for Gram-positive and Gram-negative bacteria, respectively. Given the high concordance (77.5%) between laboratory and clinical results, it is suggested to perform antibiogram test using E-test method on blood culture isolates in septicemia cases to guide appropriate antibiotic treatment.
Article Type: Original Research |
Subject:
Bacteriology
Received: 2023/12/18 | Accepted: 2024/06/25 | Published: 2024/08/20
Received: 2023/12/18 | Accepted: 2024/06/25 | Published: 2024/08/20
References
1. [1] Weinstein MP, Towns ML, Quartey SM, Mirrett S, Reimer LG, Parmigiani G, et al. The clinical significance of positive blood cultures in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology, and outcome of bacteremia and fungemia in adults. Clin. Infect. Dis. 1997;24(4):584-602. [DOI:10.1093/clind/24.4.584] [PMID]
2. [2] Ahmed D, Nahid MA, Sami AB, Halim F, Akter N, Sadique T, et al. Bacterial etiology of bloodstream infections and antimicrobial resistance in Dhaka, Bangladesh, 2005-2014. Antimicrob. Resist. Infect. Control. 2017;6(1):1-11. [DOI:10.1186/s13756-016-0162-z] [PMID] []
3. [3] Birru M, Woldemariam M, Manilal A, Aklilu A, Tsalla T, Mitiku A, et al. Bacterial profile, antimicrobial susceptibility patterns, and associated factors among bloodstream infection suspected patients attending Arba Minch General Hospital, Ethiopia. Sci. Rep. 2021;11(1):1-13. [DOI:10.1038/s41598-021-95314-x] [PMID] []
4. [4] Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546-54. [DOI:10.1056/NEJMoa022139] [PMID]
5. [5] Jones AE, Heffner AC, Horton JM, Marchick MR. Etiology of illness in patients with severe sepsis admitted to the hospital from the emergency department. Clin. Infect. Dis. 2010; 50(6):814-20. [DOI:10.1086/650580] [PMID] []
6. [6] Orsini J, Mainardi C, Muzylo E, Karki N, Cohen N, Sakoulas G. Microbiological profile of organisms causing bloodstream infection in critically ill patients. J. Clin. Med. Res. 2012;4(6):371. [DOI:10.4021/jocmr1099w]
7. [7] Kumalo A, Kassa T, Mariam ZS, Daka D, Tadesse AH. Bacterial profile of adult sepsis and their antimicrobial susceptibility pattern at Jimma University specialized hospital, south West Ethiopia. Health Sci. J. 2016;10(2):1.
8. [8] Aung AK, Skinner MJ, Lee FJ, Cheng AC. Changing epidemiology of bloodstream infection pathogens over time in adult nonspecialty patients at an Australian tertiary hospital. Commun Dis Intell Q Rep. 2012;36(4): E333-41.
9. [9] Christaki E, Giamarellos-Bourboulis EJ. The complex pathogenesis of bacteremia: from antimicrobial clearance mechanisms to the genetic background of the host. Virulence. 2014;5(1):57-65. [DOI:10.4161/viru.26514] [PMID] []
10. [10] Wilson J, Elgohari S, Livermore D, Cookson B, Johnson A, Lamagni T, et al. Trends among pathogens reported as causing bacteraemia in England, 2004-2008. Clin. Microbiol. Infect. 2011; 17: 451-458 [DOI:10.1111/j.1469-0691.2010.03262.x] [PMID]
11. [11] Obeng-Nkrumah N, Labi A-K, Addison NO, Labi JEM, Awuah-Mensah G. Trends in paediatric and adult bloodstream infections at a Ghanaian referral hospital: a retrospective study. Ann. Clin. Microbiol. 2016; 15(1): 10-11. [DOI:10.1186/s12941-016-0163-z] [PMID] []
12. [12] Rhee C, Dantes R, Epstein L, Murphy DJ, Seymour CW, Iwashyna TJ, et al. Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014. Jama. 2017;318(13):1241-9. [DOI:10.1001/jama.2017.13836] [PMID] []
13. [13] Marchello CS, Dale AP, Pisharody S, Rubach MP, Crump JA. A systematic review and meta-analysis of the prevalence of community-onset bloodstream infections among hospitalized patients in Africa and Asia. Antimicrob. Agents Chemother. 2019;64(1):e01974-19. [DOI:10.1128/AAC.01974-19] [PMID] []
14. [14] Reddy EA, Shaw AV, Crump JA. Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis. Lancet Infect. Dis.. 2010;10(6):417-32. [DOI:10.1016/S1473-3099(10)70072-4] [PMID]
15. [15] Tadesse BT, Ashley EA, Ongarello S, Havumaki J, Wijegoonewardena M, González IJ, et al. Antimicrobial resistance in Africa: a systematic review. BMC Infect. Dis. 2017;17(1):1-17. [DOI:10.1186/s12879-017-2713-1] [PMID] []
16. [16] Zenebe T, Kannan S, Yilma D, Beyene G. Invasive bacterial pathogens and their antibiotic susceptibility patterns in Jimma University specialized hospital, Jimma, Southwest Ethiopia. Ethiop J Health Sci. 2011;21(1):1-8. [DOI:10.4314/ejhs.v21i1.69038] [PMID] []
17. [17] Abayneh M, HaileMariam S, Asnake M. Bacterial profile and multi-drug resistance pattern of bacterial isolates among septicemia suspected cases: A meta-analysis report in Ethiopia. J. Lab. Med.. 2021;45(3):167-78. [DOI:10.1515/labmed-2020-0124]
18. [18] Jacob ST, Moore CC, Banura P, Pinkerton R, Meya D, Opendi P, et al. Severe sepsis in two Ugandan hospitals: a prospective observational study of management and outcomes in a predominantly HIV-1 infected population. PloS one. 2009;4(11):e7782. [DOI:10.1371/journal.pone.0007782] [PMID] []
19. [19] Kingsley OC, Ifeanyi AO, Edet AE, Smart OC. Bacteriologic profile and antibiotic susceptibility pattern of suspected septicaemic patients in Uyo, Nigeria. Res J Med Sci. 2013;7:35-9.
20. [20] Walsh TR, Bolmström A, Qwärnström A, Ho P, Wootton M, Howe RA, et al. Evaluation of current methods for detection of staphylococci with reduced susceptibility to glycopeptides. J. Clin. Microbiol. 2001;39(7):2439-44. [DOI:10.1128/JCM.39.7.2439-2444.2001] [PMID] []
21. [21] Angele MK, Pratschke S, Hubbard WJ, Chaudry IH. Gender differences in sepsis: cardiovascular and immunological aspects. Virulence. 2014;5(1):12-9. [DOI:10.4161/viru.26982] [PMID] []
22. [22] Liu V, Escobar GJ, Greene JD, Soule J, Whippy A, Angus DC, et al. Hospital deaths in patients with sepsis from 2 independent cohorts. Jama. 2014;312(1):9-20. [DOI:10.1001/jama.2014.5804] [PMID]
23. [23] Finfer S, Machado FR. The global epidemiology of sepsis. Does it matter that we know so little? : Am J Respir Crit Care Med. 2016; 193(3):228-30. [DOI:10.1164/rccm.201510-1976ED] [PMID]
24. [24] Pradipta IS, Sandiana AT, Halimah E, Diantini A, Lestari K, Abdulah R. Microbial and resistance profile in isolate from adult sepsis patients: An observational study at an Indonesian private hospital during 2009-2012. age. 2009;2012.
25. [25] Dandoy C, Ardura M, Papanicolaou G, Auletta J. Bacterial bloodstream infections in the allogeneic hematopoietic cell transplant patient: new considerations for a persistent nemesis. Bone marrow transplant. 2017;52(8):1091-106. [DOI:10.1038/bmt.2017.14] [PMID]
26. [26] Lamy B, Dargère S, Arendrup MC, Parienti J-J, Tattevin P. How to optimize the use of blood cultures for the diagnosis of bloodstream infections? A state-of-the art. Front. Microbiol. 2016;7:697. [DOI:10.3389/fmicb.2016.00697]
27. [27] Laupland K. Incidence of bloodstream infection: a review of population-based studies. Clin. Microbiol. Infect. 2013;19(6):492-500. [DOI:10.1111/1469-0691.12144] [PMID]
28. [28] Liao X, Du B, Lu M, Wu M, Kang Y. Current epidemiology of sepsis in mainland China. Ann. Transl. Med. 2016; 4(17):324 [DOI:10.21037/atm.2016.08.51] [PMID] []
29. [29] Aku FY, Akweongo P, Nyarko K, Sackey S, Wurapa F, Afari EA, et al. Bacteriological profile and antibiotic susceptibility pattern of common isolates of neonatal sepsis, Ho Municipality, Ghana-2016. Matern. health neonatol. perinatol. 2018;4(1):1-8. [DOI:10.1186/s40748-017-0071-z] [PMID] []
30. [30] Bos M, Smeets L, Dumay I, De Jonge E. Bloodstream infections in patients with or without cancer in a large community hospital. Infection. 2013;41(5): 949-958. [DOI:10.1007/s15010-013-0468-1] [PMID]
31. [31] Munita J, Arias C. Mechanisms of antibiotic resistance. Virulence mechanisms of bacterial pathogens. 2016; 481-511. [DOI:10.1128/9781555819286.ch17]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |