One Year Study of Blood Culture in Adults Admitted in Intensive Respiratory Care Unit in a Tertiary Care Hospital

Sepsis in Intensive Respiratory Care Unit (IRCU) is mainly due to gram negative bacteria, followed by gram positive bacteria. A retrospective study was undertaken for a period of one year to find out the bacterial etiology of sepsis in IRCU and their antimicrobial susceptibility pattern. Ten ml of blood was collected in 100 ml of tryptic soy broth from all adults admitted in IRCU with clinical suspicion of sepsis. Blood cultures were processed as per standard techniques and all organisms were identified by standard biochemical tests. Antibiotic susceptibility test was performed on Muller Hinton Agar by Kirby Bauer Disc Diffusion method, according to CLSI guidelines. Out of total 169 blood cultures received from IRCU, males compromised 74 %. Pulmonary causes comprised 58.15 %. Out of 169, 15.98 % showed growth, of which Gram negative bacilli (GNB) predominated (77.78 %). Amongst GNB, Acinetobacter species was commonest (76.2 %). Acinetobacter species showed 93.75 % and 100 % susceptibility to tigecycline and colistin respectively. Multidrug resistant (MDR) -GNB encountered in this study was 71.4 % and carbapenem resistance was 9.5 %. All Methicillin Resistant Staphylococcus aureus were 100 % susceptible to vancomycin and linezolid. Of the culture positive cases 96.3 % were on mechanical ventilation and 7.69 % developed Acute Respiratory Distress Syndrome. Mortality amongst culture positive cases was 37.04 %. Incidence of MDR Acinetobacter species is increasingly being encountered in patients admitted with sepsis in IRCU. Therefore, prudent use of antibiotics and good infection control practices are advocated.