Publication

Abstract : Bacterial sepsis forms a major cause of mortality in the ER ICUs of referral hospitals. This study was performed to propose an antibiogram from a tertiary care centre in south east Asia by tracing out the bacterial spectrum causing sepsis, with special emphasis on body fluid culture sensitivity studies, in the background of presently used empirical antibiotics. One hundred patients with culture positive sepsis, satisfying the inclusion criteria, admitted to the ERICU over a two year period, were selected randomly. Their clinical and demographic profile on admission to the ICU including APACHE II scores, and in vitro culture and antibiotic sensitivity study results were recorded and analyzed. Primary outcome measure was hospital mortality. Out of the 100 sepsis patients admitted in ER ICU, 59 % were under sepsis category, 36% under severe sepsis and 5% under septic shock category. Gram negative bacteria predominated in all cultures. In urine cultures Escherichia coli predominated (38.98 %) over Klebsiella Pneumonia (18.64%) and Enterococcus faecalis (16.95%), blood cultures showed Escherichia coli (21.05%), Klebsiella pneumonia (18.42%) and Staphylococcus aureus (15.78%) as the major organisms. Sputum/ETaspirate/BAL/MiniBAL cultures demonstrated Klebsiella pneumonia (33.33%) as the commonest bacteria, followed by Acinetobacter baumanii (28.57%). Among the Gram negatives Klebsiella pneumonia, and among the Gram positives Staphylococcus aureus predominated. Antibiotic sensitivity profile of urosepsis revealed maximum frequency of sensitivity to Nitrofurantoin (12.87%), blood sepsis cases to Amikacin (8.715 %), and lung related sepsis cases to Colistin (10.71%). Amikacin (29.05%) have shown maximum frequency of sensitivity for covering all forms of bacterial sepsis. Gentamicin (21.28%), Cefoperazone sulbactam (19.59%), Piperacillin tazobactam (18.29%), Colistin (17.61%), Levofloxacin (17.1%), Meropenem (16.11%) and Ciprofloxacin (14.54%) also were found to be sensitive.