Sensitivity and Resistant Pattern of Commonly Used Drugs and Outcome of Culture Positive Patients - A Study in Bangladesh Shishu Hospital and Institute

Abstract

Introduction:Antimicrobials are the most commonly prescribed group of drugs in general practice and hospitals.Infectious diseases remain a priority in public health problems, where widespread use of different antimicrobials against bacterial, fungal, viral, and parasitic infections is required. This study aimed to analyze the outcome of blood culture-positive patients. Methods: This prospective cross-sectional observational studywas conducted at the Critical Care Department in Bangladesh Shishu Hospital and Institute. The study duration was 2 years; from January 2020 to January 2022. Blood samples were drawn by a clinician at the bedside after cleaningthe skin with 70% isopropyl alcohol and applying 10% povidone-iodine for 1 min. The blood samples were deposited in the BACTEC 9050 blood culture instrument after being inoculated into BACTEC Peds Plus/F at a volume of 1 to 5 ml. All test bottles underwent a 7-day incubation period. The detection time was recorded each time there was evidence of microbial expansion. The Gram stain was applied and stained onto the bottles that exhibited a positive signal. blood-based subcultures. Plates of Mac Conkey and chocolate agar were finished. Subcultures were incubated for 48 hours at 35 °C. After the

7-day treatment, Gram-stained and subcultured bottles that tested instrument-negative to confirm negatives. False-positive cultures are ones that the instrument reported as positive but in which Gram staining and culturing had found no bacteria. Each and every isolation was seen as having clinical significance. All data were kept confidential and used only for this study purpose. Ethical clearance was obtained from the respective institute. Statistical analysis of the results was obtained by using Statistical Packages for Social Sciences (SPSS-25) software.Result:In this study, most of the (81, 40.0%) belonged to the age group of >1 year, followed by (44, 21.0%) 1-5 months. Most of them (107, 51.0) reside in urban areas, and 51.0% of the patients' parents had a monthly income of >15000 BDT.In this study, most of the subjects (100, 48.30%) were infected by Klebsiella, followed by Acinetobacter (78, 37.68%), Pseudomonas (10, 4.83%), Streptococcus (4, 1.93%), Staphylococcus, E.Coli, SerratiaMarcescens (6, 2.89%).Among the patients who were culture positive, 102 (49.27%) patients improved with treatment, followed by 92 (44.44%) patients who died, and the rest 13 (6.28%) took DORB.Regarding sex distribution, 138 (67%) patients were male and the rest 69 (33%) patients were female.Concerning the distribution of respondents according to sensitivity to antimicrobial agents, most of the patients (202, 97.58%) were resistant to amoxicillin, followed by, 96 (46.37%) who were resistant and 5 (2.41%) patients who were sensitive to piperacillin, 55 (26.57%) were sensitive and 25 (12.07%) were resistant to ceftriaxone, 65 (31.40%) patients were resistant and 51 (24.63%) patients were sensitive to chloramphenicol.Conclusion:This study concluded that, among the patients who were culture positive, most of the patients (49.27%) improved with treatment, followed by 44.44% of patients who died, and the rest6.28% took DORB. Moreover, it was also seen in this study that, the most common micro-organism among the infected respondents was Klebsiella, followed by, Acinetobacter. Amoxycillin was the most resistant antimicrobial agent among the study population.