Bacterial Isolates and Drug Susceptibility Pattern of Sterile Body Fluids at a Tertiary Care Hospital in Northern India

Background: Body fluids obtained from sterile body sites are expected to be devoid of any pathogenic or commensal microorganisms. The cause of infected body fluids could be any pathological agents or skin contaminants harbored from intensive care units. This study identifies commonly isolated bacteria from the body fluid samples and their antibiotic sensitivity pattern.

Methods: All body fluid samples (except blood, cerebrospinal fluid and contaminated samples) received in Bacteriology section of Department of Microbiology in tertiary care centre in Northern India from November 2019 to May 2020 were included in the study. All microorganisms obtained on bacterial culture were subjected to identification by standard biochemical tests or MALDI-TOF-MS assay and antibiotic sensitivity testing by Kirby Bauer disc diffusion test.

Results: Out of 363 samples of body fluids, 113 (31.12%) showed bacterial growth on culture. Male predominance among patients with liver disease was deemed statistically significant in comparison to those without liver disease. Comorbidities like hypertension and encephalopathy among the patients with liver disease was statistically significant in comparison to those without liver disease. Escherichia coli was the most commonly isolated bacteria (20.35%) which was followed by Pseudomonas spp (15.92%) and Klebsiella pneumoniae (11.50%). Fifty one (45.13%) isolates were multidrug resistant. The isolation of MDR microorganisms from body fluid samples is statistically significant in cancer patients. Among MDR microorganisms, Klebsiella pneumoniae was deemed most resistant with presence of Extended spectrum beta lactamase (ESBL) character and also showed complete resistance to Carbapenems but all isolates were susceptible to Colistin.

Conclusion: This study shows spectrum of bacterial isolates observed from body fluid samples received in our laboratory and helps in empirical treatment of patients based on antibiotic susceptibility patterns. It also highlights importance of adhering to antibiotic sensitivity results and infection control practices to prevent spread of multidrug resistant infection in hospital environment.