Changing Trends in Antimicrobial Resistance Pattern in Klebsiella species Bacteremia in an Out-patient Hemodialysis Unit over 6 Years (2010–2015) in a Tertiary Care Hospital in Pakistan. (4th October 2017)

• Record Type: Journal Article
• Authors: Dodani, Sunil; Nasim, Asma
• Is Part Of: Open forum infectious diseases. Volume 4(2017)Supplement 1
• Page Start: S156
• Page End: S156
• Publication Date: 2017-10-04
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofx163.262
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Klebsiella spp. is the commonest cause of bacteremia in dialysis patients from our center. A rising trend of antimicrobial resistance among Klebsiella has been reported from Pakistan. We studied the trends of antimicrobial resistance over the years in dialysis patients. Methods: Sindh Institute of Urology and Transplantation (SIUT) is a 700 bedded tertiary care hospital in Karachi, Pakistan. Around 500 patients are offered outpatient dialysis daily. We did a retrospective data analysis of all blood cultures with isolation of Klebsiella spp. for years 2010, 2012, 2014 and 2015. The resistance pattern of ceftriaxone, piperacillin-tazobactam, ciprofloxacin, trimethoprim-sulfamethoxazole, amikacin and imipenem were compared over the 6 years period. Results: A total of 27, 852 blood cultures were received during the study years, out of which 19, 670 (70.6%) were positive for any microbial growth. Around 5, 325 (27%) were Klebsiella spp . There was an increase in percentage of Klebsiella spp. bacteremia over the years, range from 19 to 35% (Figure 1). The antimicrobial sensitivity pattern changed significantly over years (Figure 2). Resistance was lowest against imipenem in 2010 around 1% which increased to 20%. Conclusion: There is a gradual rise in Klebsiella bacteremia in dialysis unit. Resistance to broad-spectrum antimicrobials has been increased significantly with a 20-fold increase in imipenem resistance over the last 6 years. We need a robust stewardship program for judicious use of antimicrobials and better infection control measures to contain increasing resistance. Disclosures: All authors: No reported disclosures.