Empiric antibiotic and in-vitro susceptibility of urosepsis pathogens: do they match? The outcome of a study from south India

  • Anandhalakshmi Subramanian Department of Microbiology,College of Medicine King Khalid University Abha, Saudi Arabia
  • Sandhya Bhat Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India
  • Sudhagar Mookkappan Department of General Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
  • Patricia Anitha Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India
  • Ravichandran Kandasamy Department of Biostatistics, Pondicherry Institute of Medical Sciences, Puducherry, India
  • Reba Kanungo Department of Microbiology, Pondicherry Institute of Medical Sciences, Puducherry, India
Keywords: Urosepsis, empirical antibiotic, in-vitro antimicrobial susceptibility, risk factors

Abstract

Introduction: Urosepsis is life threatening, unless treated immediately. Empirical treatment with appropriate antibiotics lowers the risk of a poor outcome. However, with increasing resistance among common uropathogens, there is a need for continuous review of the existing protocol to determine whether there is a correlation between empirical antibiotic therapy and in-vitro susceptibility pattern of the pathogens causing urosepsis.

Methodology: A prospective study was carried out on 66 confirmed cases of urosepsis from January 2017 to December 2018 after obtaining ethical clearance. Demographic details, risk factors, length of hospital stay, bacteriological profile, empirical antibiotic given, and change in antibiotic following susceptibility report and outcome was recorded.

Results: Among the 66 urosepsis cases 63 of them were started on empiric antibiotic. The correlation between the empirical antibiotic given and the in-vitro antimicrobial susceptibility was found to be significant with a p value < 0.0001. Among the 63 for whom empiric antibiotics was started further escalation of antibiotic was done in 46 patients. The remaining 20% of cases were changed over to a different antibiotic, in line with susceptibility report. The mortality rate was (15.1%) with a confidence interval of (CI = 15 ± 3.5). The association between the risk factors for urosepsis and their effect on mortality rate was analyzed. Diabetes mellitus and chronic kidney disease were identified as important independent risk factors and had direct influence on the mortality rate with significant p value of 0.0281 and 0.0015 respectively.

Conclusions: A significant correlation was identified between the empirical antibiotic given and in-vitro antibiotic susceptibility pattern.

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Author Biography

Anandhalakshmi Subramanian, Department of Microbiology,College of Medicine King Khalid University Abha, Saudi Arabia

Department of Microbiology 

College of medicine 

King Khalid University

 

Published
2021-09-30
How to Cite
1.
Subramanian A, Bhat S, Mookkappan S, Anitha P, Kandasamy R, KanungoR (2021) Empiric antibiotic and in-vitro susceptibility of urosepsis pathogens: do they match? The outcome of a study from south India. J Infect Dev Ctries 15:1346-1350. doi: 10.3855/jidc.14589
Section
Brief Original Articles