STUDY OF ANTIBIOTIC-RESISTANCE AND SENSITIVITY PATTERN IN A TERTIARY CARE TEACHING HOSPITAL

Methods: It is retrospective study. Data collected from to from the culture & sensitivity records of various clinical isolates analyzed by descriptive Results: Total samples collected 2905. Only746 samples showed significant growth. Most commonly, isolated organisms were from Pus and Body fluids Staphylococcus aureus (31.16%), Klebsiella (23.02%), from blood samples Staphylococcus aureus (44%,) Klebsiella (32%), from urine samples Escherichia coli (27.31%),Staphylococcus Bacteria isolated from, and Pus & body fluid samples and urine samples Conclusion: In study, isolated and showed more to A sensitivity test following stewardship to prevent antibiotic Clavulanic acid 60% (n=60) showed high sensitivityCeftazidime + Clavulanic acid (100%). Imipenem 99%(n=99) Cefoperazone +Sulbactam 98%(n=98) Linezolid 97%(N=97).Bacteria isolated from blood, pus, and body fluidsshowed high Amoxicillin + Clavulanic acid resistance. a study et showed the same

162 gonorrhea, and foodborne diseases are becoming difficult and sometimes impossible because of antibiotic resistance. World Health Organization (WHO) has declared AMR a public health threat and has urged different countries to develop an action plan to combat the problem.
Themajor factors associated with the emergence of antibioticresistance:

Evolution & clinical/environmental practices Intrinsic factors:
Reduced entry of antibiotic into a pathogen,Enhanced export of antibiotics by efflux pumps,Release of microbial enzymes that alter or destroy the antibiotic,Alteration of target proteins, Development of alternative pathways to those inhibited by the antibiotic Social factors: Demographic changes,Deficient hygienic practices,Irrational use of antibiotics,Overcrowding, geographical variations Due to the geographical variations in antibiotic resistance and sensitivity that have been reported by manystudies, this study was undertaken with the following objectives in a tertiary care teaching hospital in Vijayawada: 1)To identify the group of organisms isolated 2) To know resistance and sensitivity patterns to various antibiotics 3)To assess the possible factors that can favor the development of antimicrobial resistance

Methodology:-
This is a retrospective observational study conducted at the Dept of Pharmacology SMC Vijayawada. Approval from the Institutional Ethics and Researchcommittee was obtained before the commencement of the study. Dataregarding culture and sensitivity of the organisms isolated from different samples such as urine, blood, pus, and body fluids were collected from June 2019 to May 2020 from culture and sensitivity records of dept of Microbiology of SMC, Vijayawada. The obtained data were subjected to descriptive statistics.   164

Discussion:-
Antibiotic resistance is one of the most common problems in the health care sector which is a challenging issue for healthcare professionals to combat infectious diseases and complications. This study is a retrospective observational study, collected data from microbiology department records from June 2019 to May 2020. The totalnumber of samples collected was2905. Clavulanic acid 60% (n=60) and showed high sensitivityCeftazidime + Clavulanic acid (100%). Imipenem 99%(n=99) Cefoperazone +Sulbactam 98%(n=98) Linezolid 97%(N=97).Bacteria isolated from blood, pus, and body fluidsshowed high Amoxicillin + Clavulanic acid resistance. a study conducted by K. V. Ramanath  In this study after amoxicillin+ clavulanic acid, for 3 rd generation, Cefalosporins bacteria showed a considerable amount of resistance. Considerable sensitivity is still retained to amikacin due to less use of these injectable antibiotics. Imipenem, Linezolid, Vancomycin-resistant bacteria and Ceftazidime+Clavulanic acid, Cefoperazone+Clavulanic acid-resistant bacteria also isolated, but very less number. This resistant pattern may be due to the inadvertent prescription of antibacterial drugs.But sensitivity to these drugs is very high.

Conclusion:-
In this retrospective observational study, among 2905 samples, only 746 (25.67%) samples showed significant growth. The most commonly isolated organisms were Staphylococcus aureus, Klebsiella, Pseudomonas from pus and body fluids and blood samples, Escherichia coli,Staphylococcus aureus, Klebsiella were the most common isolated organisms from Urine samples.
In this study, bacteria isolated from blood, pus, and body fluid samples showed more resistance to Amoxicillin + Clavulanic acid. Among bacteria isolated from urine samples showed more resistance to Fluoroquinolones like Norfloxacin and 3 rd generation Cephalosporines like Ceftriaxone, Cefotaxime. Parenterally used drugs like aminoglycosides (e.g.gentamicin and amikacin) and vancomycin have retained their sensitivity but bacteria also showed resistance to Imipenem, Vancomycin, new combinations like Cefoperazone + Sulbactam From this study understood that organisms also developed resistance to even reserve group antibiotics (4 th generation Cephalosporines, Linezolid).
Currently, we are in an antibiotic discovery void state, since 2007 there has been no new antibiotic intervention. So, it is essential to use antibiotics conservatively to prevent antibiotic resistance by following 4Ds (Right Drug, Right Dose, De-escalation to pathogen directed therapy, right Duration of therapy) and following antibiotic stewardship policies and culture sensitivity tests before prescribing Every hospital should have an antibiotic policy. Regular antibiotic audits are needed. By following the above policies can prevent antimicrobial overuse, misuse, and abuse which helps to minimize the development of resistance at the hospital and community level. Not only do physicians, veterinary, and agricultural personnel also need to participate in preventing misuse of antibiotics also need to be controlled.