Microbiological Profile and Antimicrobial Resistance Patterns of Pleural Fluid Isolates in a Tertiary Care Setting in...

Pleural fluid infections, primarily caused by a range of bacterial pathogens, present a growing challenge for healthcare professionals, particularly due to the increasing prevalence of antibiotic resistance. This study included 598 patients, of which 15.88% had culture-positive samples. A total of 18 distinct bacterial species, both individual and in combination, were identified, with 7 Gram-positive and 11 Gram-negative bacteria. Antibacterial susceptibility testing highlighted colistin as the most effective antibiotic for most Gram-negative pathogens, while vancomycin and linezolid showed increased sensitivity against Gram-positive isolates. The study calculated the Multiple Antibiotic Resistance (MAR) index for all isolates, yielding a mean value of 0.543, reflecting the high level of irrational antibiotic use. Resistance pattern analysis revealed significant variation among bacterial species and identified 61 distinct resistance profiles. The study also examined the relationship between the MAR index and factors such as gender, age, and Gram staining. Gender (p = 0.831) and age (p = 0.905) showed no significant correlation with the MAR index, while a significant negative correlation was found between Gram staining and the MAR index (ρ = - 0.434, p < 0.001). The findings highlight the increasing prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) isolates, presenting significant challenges for treatment, particularly in resource-limited settings. This underscores the urgent need for enhanced antibiotic stewardship, public awareness campaigns, and continuous monitoring to combat antibiotic resistance and improve patient outcomes. Furthermore, the study's findings contribute to global efforts in understanding and addressing the escalating problem of antibiotic resistance, offering insights relevant to international research on antimicrobial resistance.