Evaluation of Clinico-epidemiology Profile and Susceptibility Pattern of Bacterial Isolates of Purulent Samples in a University Hospital, India

Background: Patients suffering from trauma, burns or those who have undergone surgical interventions are susceptible to pyogenic infections caused by commensal as well as exogenously acquired pathogens. This study helps us recognize and characterize aerobic bacteria isolated from pyogenic samples and establish antibiotic resistance for clinicians to devise an empirical treatment for patients suffering from similar disease.

Methods: This observational study was carried out from November 2019 to May 2020 in the Department of Microbiology at a teaching hospital in northern India and included all patients who presented with suppurative infections during the study period.

Results: Total 201 culture positive samples were included in our study of which 80 (40%) samples were of sterile body fluids, 51 (25%) samples were of pus aspirates and the other samples included wound pus and surgical site infection samples. Escherichia coli was the most common pathogen (30.34%) followed by Klebsiella pneumoniae (17.91%) and Pseudomonas spp (13.43%).Sixty eight (33.83%) isolates were multidrug resistant. Enterobacter spp was completely resistant to ciprofloxacin, ceftazidime and ceftriaxone, and 25% sensitive to Cefoperazone-Sulbactam, thus showing the presence of extended spectrum beta lactamase (ESBL) character. We studied the association of multidrug resistance to certain risk factors like previous antibiotic therapy, days of wound before admission, increased length of hospital stay, patient comorbidities like diabetes mellitus, heart disease, chronic liver disease and immunosupression.

Conclusions: This study reveals Gram negative bacilli to be more commonly causing pyogenic infections in our patients. Local antibiotic susceptibility profile of these pathogens is essential for empirical treatment.