Clinicomicrobiological study of bacteraemia caused by coliforms in adults

Introduction: Bacteraemia due to gram-negative bacilli is a huge challenge to the clinicians because of the rapidly emerging multidrug resistance among these microorganisms. Aim: To study the associated infections and risk factors, antibiotic resistance in coliforms by phenotypic and genotypic methods, to evaluate antibiotic treatment and outcome in coliform bacteraemia. Materials and Methods: The study was carried out in the Microbiology laboratory of a tertiary care centre. Blood samples were cultured using BacT ALERT. Antibiotic susceptibility pattern was noted by Vitek 2 Compact system. Phenotypic tests were performed for Amp C beta lactamase, Carbapenemase and MBL.bla_NDM-1 &bla_KPC gene in carbapenem resistant strains of Coliforms were detected by conventional PCR. The statistical methods used were Chi-square test and Odd’s ratio. Results: Urinary Tract Infection (UTI), skin and soft tissue infections and pneumonia were associated with bacteraemia. Risk factors were invasive procedures, previous hospital and ICU admission. Penicillins, Fluoroquinolones, 3^rd generation cephalosporins showed high resistance. Of the 25 Carbapenem resistant isolates, Modified Hodge Test (MHT) positive were 11. MBL production by E-test detected 14 of the 25. Of 68 isolates resistant to 3^rd generation Cephalosporins, 35 were Amp C producers. Sixteen isolates harbored bla_NDM-1, none had bla_KPC. Mortality rate was 11.4%. Conclusion: ESBLs and Carbapenem resistant strains are spreading fast in community and pose therapeutic challenges. There is a dire need for us to initiate regional surveillance, carry out more effectual antibiotic stewardship and infection control measures to prevent further spread.