ANTIMICROBIAL RESISTANCE (AMR) SURVEILLANCE IN RURAL MEDICAL COLLEGE IN MAHARASHTRA: NEED OF HOUR

A.G. JADHAV¹*, S.L. NILEKAR^2
1Department of Microbiology, SRT Rural Govt Medical College, Ambajogai, 431517 Maharashtra University of Health Sciences, Nashik, 422004, Maharashtra, India
²Department of Microbiology, SRT Rural Govt Medical College, Ambajogai, 431517 Maharashtra University of Health Sciences, Nashik, 422004, Maharashtra, India
* Corresponding Author : dr.arjunjadhav28@gmail.com

Received : 01-04-2019     Accepted : 17-04-2019     Published : 30-04-2019
Volume : 11     Issue : 4       Pages : 1534 - 1537
Int J Microbiol Res 11.4 (2019):1534-1537

Keywords : AMR, β lactamase, Rural, Surveillance, Infection control
Academic Editor : Dr Sourabh Chakraborty
Conflict of Interest : None declared
Acknowledgements/Funding : Authors are thankful to SRT Rural Govt Medical College, Ambajogai, 431517, Maharashtra University of Health Sciences, Nashik, 422004, Maharashtra, India
Author Contribution : All authors equally contributed

Introduction: Antimicrobial resistance Surveillance (AMR) of frequently isolated bacterial pathogens causing severe infections is of great importance. Thus, this study aims to identify the prevalence of common bacterial isolates and β lactamases producing resistant strains and their antimicrobial susceptibility pattern of these isolates from patients attending Rural medical college and hospital which will help in framing institutional policy and better patient management. Material and methods: This study includes a total of 3675 bacterial isolates from urinary tract infections (UTIs), Lower respiratory tract infections (LRTIs), Blood stream infections (BSIs), Skin and soft tissue infections (SSIs) from January 2018 to December 2018. All the study isolates were characterised up to species level, antibiotic susceptibility pattern was determined. Gram negative bacteria were screened for β lactamases production. Results: Among 3675 isolates collected, E.coli (n= 1062) and Klebsiella spp(n= 745) are most common followed by S.aureus (n= 645), Pseudomonas spp (n= 511), Acinetobacter spp (n= 197) and other bacteria s(n= 515). E.coli and Klebsiella spp. were predominant pathogen isolated from UTI and LRTI respectively. Staphylococcus aureus was predominant pathogen isolated in BSI and SSI. Among the antimicrobials tested against Gram negative organisms, Colistin and Imipenem were the most active, followed by Amikacin and Piperacillin- Tazobactam. Moderate activity was noted for fluoroquinolones. Resistance to cephalosporins was high. ESBL Production is highest in Klebsiella spp(65%) and E.coli(60%) followed by Pseudomonas spp(37%) and Acinetobacter spp(30%) whereas Acinetobacter spp (51%) shows highest Ampc production followed by E.coli (40%), Klebsiella spp,(30%) and Pseudomonas spp(25%).The major MBL producer were Acinetobacter spp (28%) and Klebsiella spp(25%) followed by Pseudomonas spp(20%) and E.coli(12%). Among the antimicrobials tested against S.aureus, Vancomycin and Linezolid having no resistance, followed by Clindamycin and Gentamycin having Moderate activity. Resistance to fluoroquinolones and Cotrimoxazole was relatively high. The prevalence of Methicillin resistant Staphylococcus aureus(MRSA) was 39%. Conclusion: Increasing rates of β lactamases producers emphasizes the need for their early detection which can help in providing an appropriate antimicrobial therapy and in avoiding the development and the dissemination of these multidrug resistant strains. Need of hour is that every health care institute must have own AMR Surveillance data which will helps to develop antimicrobial stewardship program. Antimicrobial stewardship program along with Preventive measures like continuous surveillance of wards/ICUs and strict implementation of infection control practices can go long way in containing the menace of drug resistance.

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