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Aerobic bacteria study, clinical spectrum, and outcome of patients with community-acquired multidrug-resistant
Chandra Sekhar Talari Sree1, Ravi Shankar Calerappa1, Geethanjali Anke2
1Critical Care Medicine, KIMS SAVEERA Hospital, Anantapur, Andhra Pradesh, India.
Context:
Infectious diseases are the leading cause of death in developing countries like India. Hence, even small relative increases in the mortality rate for infections due to multidrug-resistant pathogens would lead to substantial increases in the number of deaths as a result of infections worldwide.
Aims:
The aim of the study was to study the microbiological data of community-acquired pathogens and the corresponding outcomes due to antibiotic-resistant versus antibiotic-susceptible bacterial microorganisms.
Settings And Design:
A single-center prospective cohort study for two years undertaken during the study period of March 2022 to 31 October 2023.
Materials And Methods:
All clinical samples of 402 patients diagnosed microbiologically as community-acquired infections were included. Culture samples were collected and processed according to standard operating procedures and clinical details were recorded.
Statistical Analysis Used:
Categorical variables were expressed as counts and percentages. Fisher's exact test was used for testing differences in proportions. Two-sided distribution P values of <0.05 were considered significant.
Results:
Among Gram-positive organisms, Staphylococcus aureus and Streptococcus pyogenes were predominant isolates. Escherichia coli and Klebsiella species were the majority of the pathogens among Gram-negative isolates. Mortality rates observed in community-acquired respiratory tract infections (CA-RTIs), community-acquired urinary tract infections (CA-UTIs), community-acquired skin and soft tissue infections (CA-SSTIs), and community-acquired bloodstream infections (CA-BSIs) were 13.6%, 6.56%, 4.5%, and 31.5%, respectively. The length of hospital stay of more than three days was found as 56.06%, 36.2%, 40.9%, and 73.6% in CA-RTIs, CA-UTIs, CA-SSTIs, and CA-BSIs, respectively.
Conclusions:
Performing cultures earlier during hospitalization and determining the timing of colonization can allow more targeted choices and reduce morbidity and mortality rates among infected patients.
Insights
This study analyzed community-acquired infections in India, finding significant mortality rates, especially for bloodstream infections. Early cultures and targeted treatments can reduce deaths from antibiotic-resistant pathogens.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Public Health
Background:
- Infectious diseases are a leading cause of death in developing nations.
- Multidrug-resistant pathogens pose a growing global health threat, increasing mortality.
- Understanding local pathogen data is crucial for effective treatment.
Purpose of the Study:
- To investigate microbiological data of community-acquired pathogens.
- To compare outcomes of antibiotic-resistant versus antibiotic-susceptible infections.
- To inform strategies for reducing infection-related morbidity and mortality.
Main Methods:
- A prospective cohort study conducted over two years (March 2022 - October 2023).
- Inclusion of 402 patients with microbiologically diagnosed community-acquired infections.
- Standard microbiological processing of culture samples and clinical data collection.
Main Results:
- Predominant Gram-positive isolates: *Staphylococcus aureus*, *Streptococcus pyogenes*. Predominant Gram-negative isolates: *Escherichia coli*, *Klebsiella* species.
- Observed mortality rates: CA-RTIs (13.6%), CA-UTIs (6.56%), CA-SSTIs (4.5%), CA-BSIs (31.5%).
- Prolonged hospital stay (>3 days) was frequent, particularly in CA-BSIs (73.6%).
Conclusions:
- Early microbiological cultures and timely identification of pathogens are essential.
- Targeted antibiotic selection based on susceptibility data can improve patient outcomes.
- Interventions to reduce morbidity and mortality in community-acquired infections are needed.
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