Trends in antimicrobial susceptibility patterns of bacterial isolates in Lahore, Pakistan

N. Khalid, Zunaira Akbar, N. Mustafa, Jamshaid Akbar, Shanawar Saeed, Z. Saleem
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Abstract

Background Antimicrobial resistance (AMR) has provoked a global health issue. Antimicrobial stewardship programs should be implemented to overcome this issue. The aim of this study was to determine the sensitivity patterns of the WHO Access, Watch, Reserve (AWaRe) group of antibiotics that assists in the selection of appropriate empiric antibiotic therapies. Method A descriptive, cross-sectional study was conducted for 6 months, in which 422 culture sensitivity sample reports from the Ghurki Trust Teaching Hospital’s laboratory were obtained through a convenience sampling technique, and the sensitivity patterns of nine offending bacteria to the WHO AWaRe group antibiotics were determined. Descriptive statistics and differences in frequency distribution among the categorical variables were obtained using the Statistical Package for Social Sciences (SPSS) software, version 21. Results Among 422 culture sensitivity sample reports, Escherichia coli (16.1%) was the most common Gram-negative pathogen. Acinetobacter, E. coli, Klebsiella, and Pseudomonas showed 100% sensitivity to polymyxin-b and colistin. Proteus showed the highest sensitivity to meropenem (90%), Staphylococcus aureus showed a 98% sensitivity to linezolid, Staphylococcus epidermidis was 100% sensitive to vancomycin and linezolid, and Streptococcus showed the highest sensitivity to penicillin (100%) and vancomycin (94.7%). Polymyxin b and colistin were found to be the most effective antibiotics against Gram-negative bacteria (100%). Gram-positive bacteria were highly sensitive to linezolid (99.4%), vancomycin (98.2%), chloramphenicol (89.5%), and tigecycline (82.6%). Conclusion Culture sensitivity reports help to rationalize the empirical use of antibiotics in clinical practice in addressing the challenge of antimicrobial resistance. This study showed that polymyxin-b and colistin were the most effective antibiotics against Gram-negative isolates and that Gram-positive bacteria were highly susceptible to linezolid. Updated antibiograms should be used by clinicians to evaluate bacterial susceptibility patterns and rationalize antibiotic empiric therapy.
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巴基斯坦拉合尔细菌分离株的抗菌药物敏感性趋势
抗菌素耐药性(AMR)已引起全球卫生问题。应实施抗菌药物管理计划以克服这一问题。本研究的目的是确定世卫组织获取、观察和储备(AWaRe)抗生素组的敏感性模式,以帮助选择适当的经验性抗生素治疗。方法采用描述性、横断面研究方法,采用方便取样法,收集古尔克信托教学医院实验室422份培养敏感性样本报告,确定9种病原菌对WHO AWaRe组抗生素的敏感性规律。描述性统计和分类变量之间的频率分布差异使用社会科学统计软件包(SPSS)软件,版本21获得。结果在422份培养敏感样本报告中,大肠杆菌(16.1%)是最常见的革兰氏阴性病原体。不动杆菌、大肠杆菌、克雷伯菌和假单胞菌对多粘菌素-b和粘菌素的敏感性为100%。其中变形杆菌对美罗培南的敏感性最高(90%),金黄色葡萄球菌对利奈唑胺的敏感性为98%,表皮葡萄球菌对万古霉素和利奈唑胺的敏感性为100%,链球菌对青霉素和万古霉素的敏感性最高(100%)(94.7%)。多粘菌素b和粘菌素是对革兰氏阴性菌最有效的抗生素(100%)。革兰氏阳性菌对利奈唑胺(99.4%)、万古霉素(98.2%)、氯霉素(89.5%)、替加环素(82.6%)高度敏感。结论培养敏感性报告有助于在临床实践中理顺抗生素的经验性使用,以应对抗生素耐药性的挑战。本研究表明,多粘菌素-b和粘菌素是对革兰氏阴性菌株最有效的抗生素,革兰氏阳性菌对利奈唑胺高度敏感。临床医生应使用更新的抗生素图来评估细菌敏感性模式并使抗生素经验性治疗合理化。
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