PP15 -A REVIEW OF THE PATTERN OF ANTIMICROBIAL RESISTANCE AT TEACHING HOSPITAL BATTICALOA DURING 2021 – 2024
Abstract
Introduction
Antimicrobial resistance (AMR) is a global concern. Appropriate AMR surveillance is an essential strategy to combat it. Teaching Hospital Batticaloa (THB) is the largest tertiary care hospital in the Eastern province. Therefore, we analyzed the AMR pattern of the selected clinical isolates of THB during the past four years from 2021 to 2024.
Objectives
To analyze the rate of isolation of selected pathogens and their AMR pattern at Teaching Hospital Batticaloa during 2021 – 2024.
Design, setting, and methods
This is a laboratory-based, cross-sectional, descriptive study where data were collected from WHONET and analyzed using Microsoft Excel.
Results
A total of 22664 blood samples, 22374 urine samples, and 582 pus samples were processed during this period. Around 10% (2194/22664) of blood, 16% (3599/22374) of urine, and 25% (145/582) of pus samples revealed a significant growth of a pathogen, and 23% (5216/22374) of urine samples and 8.6% (1947/22664) of blood samples revealed contamination. Coliforms are the predominant pathogens in all three samples, contributing to 35% (769/2194), 70% (2509/3599), and 48% (71/145) of the significant positive blood, urine, and pus samples, respectively. Third-generation cephalosporin susceptibility data were available for approximately 60% (2037/3349) of the total coliforms, out of which 49.8% (1015/2037) revealed resistance. Carbapenem susceptibility data was available for 55% (1866/3349)) of the total coliforms, out of which 5.4% (100/1866) revealed carbapenem resistance. Around 59% of (2008/3349) of total coliforms were tested against Ciprofloxacin, and 55% (1109/2008) revealed resistance to it. Fifty-one percent (1693/3349) of coliforms were tested against Amikacin, and 23% (387/1693) revealed resistance to it. Cefoxitin susceptibility data were available for 88.4% (313/354) of Staphylococcus aureus isolates, out of which 65.8% (206/313) were identified as MRSA.
Conclusions
Nearly half of the coliforms for which 3rd generation cephalosporin susceptibility data was available were resistant to 3rd generation cephalosporins, which are one of the significant classes of antibacterials used in Sri Lanka. Nearly two-thirds of Staphylococcus aureus isolates, for which cefoxitin susceptibility data were available, were MRSA, indicating the possibility of treatment failure with the common empiric therapy of flucloxacillin. Continuous monitoring is essential to detect the AMR trends of common clinical isolates and to implement effective measures to rationalize antimicrobial usage.
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