Bloodstream infections (BSIs), also known as septicemia or bacteremia, occur when bacteria or other microorganisms enter the bloodstream and cause an infection1.  The most common bacteria genera responsible for BSIs are Klebsiella, Escherichia, and Staphylococcus.2,3 Factors contributing to BSI: Immunosupression,  excessive use of broad spectrum antibiotic can suppress the normal flora, thus allowing the emergence of resistant strains of bacteria.4

Diagnosis of BSIs involves blood cultures, where a sample of blood is collected and cultured to identify the presence of microorganisms.5,6 Prevention of BSIs is crucial, especially in healthcare settings.1,Timely identification and appropriate treatment of infections in other parts of the body can also prevent the spread of infection to the bloodstream.5 It's important to consult a healthcare professional for a proper diagnosis and treatment if you suspect a bloodstream infection or have any concerns about your health.

Continuous oversightof bloodstream infections (BSIs) etiology is an indispensable drillin healthcare settings to monitor the types of pathogens causing infections and their antibiotic resistance patterns.7,8 Scrutiny helps healthcare facilities to identify thetendencies, executesuitable infection control measures, and make informed decisions regarding antimicrobial therapy.9,10

MATERIALS AND METHODS

Study design

• This was retrospective descriptive record based study.
• Duration of study: Two year (January 2023–December 2024).
• Place of Study: This study was conducted at Microbiology Department of ESIC Medical College, Jaipur Rajasthan.

Study population

The study included blood samples of all inpatients of the tertiary care hospital in the department of microbiology during January 2023–December 2024. In the study, contaminants and mixed bacterial growths were not included.

METHODS: 

This prospective study was conducted in the Department of Microbiology during the period from JAN. 2023 - DEC 2024. Two ml of venous blood was taken from each neonate &  five 5ml blood from adult cultured by automated BacT/Alert & BD phoenix method for rapid isolation & sensitivity test11,12.

Processing of samples

Blood cultures: Blood samples bottles were collected from the patients as suggested the physician and earlier the administration of any antibiotic. The details of the patients were recorded in registers. Samples from neonates and adult were processed were loaded in BACT/ALERT3D Automated System11,12. For negative samples blood culture bottle remains loaded in automated system and after 5 days sample is reported negative. For positive samples, the blood culture bottle is taken out from the system and then conventionally blood was inoculated with the sample were incubated at 37°C aerobically.

Laboratory identification: The growth obtained was identified by colony morphology, gram stain and standard biochemical identification tests. the BD PhoenixTM M50 AST13 system with priority given to critically important antibiotics, including NMIC/ID-421,  PMIC/ID-70, and NMIC-500  panels,  which  contain 15  antimicrobials  for GN bacteria, 11 antimicrobials for non-Streptococcus GP bacteria and 5 antimicrobials for Streptococcus, respectively. M50 AST not only provides AST (Sensitive: S/Resistant: R) results but alsoautomatically detects MIC. Updated annually according to the standard guidelines (CLSI, EUCAST)14.

RESULT AND DISCUSSION: 

Amongst the total samples processed, 282(32.8%) became culture positive among which gram positive bacteria were the most predominant (65.8%). Out of all the gram positive pathogens, Staph.aureus was isolated from  (35%)were the most common isolates Among the total culture positive pathogenic isolates the CoNS  (18%)were reported S. epidermidis  (14.6%) a), S. haemolyticus (8 %)aEscherchia coli.  (17%) and Salmonella typhi (15%).  cases whereas candida spp. were isolated (8%). The age group varied from 2 days told to 82-year-old patient, and both genders were taken into the study.

Figure 1

Gender wise ratio of male to female was 1.59:1 our study which matches with other similar studies. Neonates with low-birth-weight are highly prone to BSIs15.

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Figure 2

Figure 3

Figure 4

Antibiogram:Gram-positive and Gram-negative bacteria showed very high resistance to most the antibiotics tested, and the statistical analysis clearly suggest that the drug resistance is undeniably significant and poses threat more-so to high-risk patients having blood culture positive.

BSIs are the most common nosocomial infections. Studies15,16 including ours revealed that ICU patients are at higher risk of nosocomial BSIs than those admitted to other types of units. The reason for high infectious incidence in ICU patient is self-explanatory. The causative agents are affected by underlying comorbidities such as chronic disease conditions, immunodeficiency, age, socioeconomic and environmental factors.

CONCLUSION:

Prevention is most effective cure in BSIs. Proper implementation of hospital infection control15,16, well trained staff and strictly imposing the rules of infection control in hospital, reducing footfall in ICUs and wards,proper use of PPE in infection prone areas and including hand hygiene practices in routine .Periodically, training the hospital staff to practice infection control and hand hygiene17.

Financial support and sponsorship: Nil.

Conflicts of interest: There are no conflicts of interest.

REFERENCE:

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12. Jungkind D, et al. Workflow evaluation of the BD Phoenix™ AP Compared to the MicroScan Walkaway overnight system for identification and susceptibility testing of bacteria. As presented at the 110th General Meeting of the American Society of Microbiology. May 2010. – Study was a supported grant from BD Diagnostic Systems.
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14. AM Minassian R Newnham E Kalimeris P Bejon BL Atkins ICJW Bowler Use of an automated blood culture system (BD BACTECTM) for diagnosis of prosthetic joint infections: Easy and fastBMC Infect Dis2014141233.
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