Antibiogram Profile of Bacteria Isolated from different Clinical Specimens in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka
Abstract
The danger posed by pathogenic bacteria that are resistant to antibiotics has become a global issue and developing strategies for restoring treatment options against them is inevitable. This research aimed at determining the “Antibiogram profile of bacteria isolated from different clinical specimens in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka” was carried out in the microbiology laboratory of the Hospital between December 2018 and May 2019. A total of 707 clinical samples from 500 patients attending the Hospital were examined by streaking method of microbial culture and susceptibility tests by Agar diffusion method. A total of 491 clinical specimens had positive growth and 860 bacteria were isolated. 280 male patients and 220 female patients were tested with the P-value at .08. The frequency of the isolates from different samples showed that urine had the highest number of isolates 139 (16.16%), followed by wound with 123 (14.30%) and Nasal swab recorded the number of least isolates; 38 (4.41%). The susceptibility pattern of the isolates to various antibiotics used varied as Staphylococcus aureus exhibited highest sensitivity against Ofloxacin and least sensitivity range against Erythromycin. Pseudomonas aeruginosa was sensitive to most of the antibiotics used with greatest sensitivity against Azithromycin while Proteus Spp. had the least sensitivity to most of the antibiotics. However, all the isolates had the greatest resistance against Piperacillin-tozabactam and Clindamycin. The high level of resistance observed in Piperacillin-Tozabactam, Cefixime, Erythromycin, Gentamicin and Clindamycin can be attributed to the irrational use of antibiotics in the study area and a possible high level of drug abuse. There should be continuous monitoring and periodical research on antibiogram profile of these bacteria isolated from different clinical specimens before definitive treatment of bacterial infections to reduce the burden posed by multidrug resistant bacteria.
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Introduction
Antibiotics are substances produced by microorganisms that inhibit the growth or kill other microorganisms (1). Though they are critical in modern medicine, but their widespread use or misuse has led to the evolution of microbial strains resistant to most of the commonly used antibiotics (2). Brooks (3) noted that antibiotics revolutionized medicine in the 20th Century, however, their effectiveness and easy access have also led to their overuse, prompting bacteria to develop resistance thereby putting the global health at high risk with multidrug-resistant bacteria observed globally. Presently, antimicrobial resistance poses a major threat to patient‘s treatment as it leads to increased morbidity and mortality, increased hospital stay, and severe economic loss to the patient and nation (4); (5). Due to the pacing advent of different resistance mechanisms and decrease in efficacy of antibiotics used in treating common infectious diseases, patients now endure prolonged illness, higher expenditures for health care, and an immense risk of death. Infections caused by resistant bacteria adversely affect treatment outcomes, costs, disease spread and duration of illnesses, posing a serious challenge to the future chemotherapies (6); (7).
According to Hussain (8), multidrug resistance in bacteria may be caused by any of the two mechanisms. Firstly, these bacteria may accumulate multiple genes, each coding for resistance to a single drug, within a single cell. This accumulation occurs typically on resistance (R) plasmids. Secondly, multidrug resistance may also occur by the increased expression of genes that code for multidrug efflux pumps, extruding a wide range of drugs.
Conclusion
This work on antibiogram profile of bacteria from different clinical specimens revealed that an increase in antibiotics resistance has made it necessary for the updating of information on antibiotics susceptibility pattern of bacterial isolates in order to determine appropriate empirical and definitive therapy. Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae were the predominant bacteria isolates from different clinical specimens in this study.
The relatively high number of P. aeruginosa, S. aureus and E. coli isolates is suggestive of the high level of nosocomial infections particularly in hospitalized patients making the spread of infectious agents very easy among them. This again brings up the need for strict infection control practices and good hygiene.
The high level of resistance observed with piperacillin-Tozabactam, Cefixime, Erythromycin, Gentamicin and clindamycin can be attributed to the irrational use of drug in the study area. This is also a pointer to a situation where patients indulge in antibiotic self-medication to treat all kinds of infections. Reducing the length of stay in the hospital and duration of invasive devices like catheter can equally reduce the rate of the infection since most of them can be nosocomial.
There should be continuous monitoring, periodical research on antibiotics susceptibility pattern of these bacteria implicated and isolated from different clinical samples and conducting of microscopy, culture and sensitivity (MCS) before definitive treatment of bacteria related infections.