A pressing need to consider colistin for empirical therapy in the treatment of blood stream infections: indian scenario
Mohd Shahid, Hiba Sami, Shariq Ahmed, Fatima Khan, Asfia Sultan, Haris M Khan
Introduction: The increasing prevalence of the multidrug-resistant Gram-negative bacteria and the lack of new antibiotics to combat them have led to rekindled interest in colistin, a bactericidal antibiotic that was used in the 1960s for treatment of infections caused by Gram-negative bacilli. Colistin is used as a salvage therapy for multidrug-resistant and extremely drug-resistant Gram-negative bacterial infections. We suggest that early use of colistin as empirical therapy would decrease mortality rate in paediatric ICU patients. Materials and methods: This study was conducted in the Department of Microbiology, JNMCH, Aligarh over a period of 6 months. All samples from paediatric ICU (PICU) submitted to Bacteriology lab for blood culture were screened. All isolates were identified by standard biochemical techniques and antimicrobial sensitivity was determined by Kirby Bauer disc diffusion method as per CLSI guidelines. Few of the representative samples were confirmed by VITEK 2 system. Results: A total of 103 (39.01%) blood culture were positive out of total of 264 blood culture received from PICU over a 6 month period. 30 (29.1%) of these were Burkholderia spp, 10(9.7%) were identified as Klebsiella pneumonae, 9 (8.7%) were Pseudomonas species,12 (11.6%) were Acinetobacter species and one was identified as Enterococcus species. While the other antibiotics showed a sensitivity of less that 50% for Gram negative isolates, polymyxin B and colistin showed a sensitivity of 100%. Most of the ESBL producing strains were isolated from inpatients. Conclusion: Multi-drug resistant Gram negative isolates have emerged as important nosocomial pathogen. Antibiotic susceptibility testing is critical in the treatment of infections caused by these pathogens, particularly in those with inadequate response to antibiotic therapy. Colistin can be considered as an emperical therapy in paediatric ICU to reduce the mortality rate in these patients.
Mohd Shahid, Hiba Sami, Shariq Ahmed, Fatima Khan, Asfia Sultan, Haris M Khan. A pressing need to consider colistin for empirical therapy in the treatment of blood stream infections: indian scenario. International Journal of Medical and Health Research, Volume 5, Issue 8, 2019, Pages 193-196