title: Frequency of Blood Culture Isolates and their Antibiogram in a Teaching hospital.
abstract: BACKGROUND
  Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia.
  
  
  METHODS
  Blood sample received from the patient attending Nepal Medical College and Teaching Hospital from March, 2012 - August, 2012 were subjected to culture. Isolate identification and antimicrobial susceptibility testing was done by standard microbiological method.
  
  
  RESULTS
  Out of the total 2,766 blood samples, 368 (13.3%) showed bacterial growth. The percentage of neonatal septicemia was 368 (13.3%). Staphylococcus aureus (28%) was the most common isolates followed by Salmonella enterica Serotype Typhi (22%), Coagulase negative Staphylococci (9.5%), Salmonella enterica Serotype Paratyphi ((7.6%) and Klebsiella pneumoniae (7.6%). 26.3% of the isolates of Staphylococcus aureus were oxacillin resistant. Most of the gram positive organisms were susceptible to amikacin and vancomycin and showed high level resistance to cefuroxime and cotrimoxazole. Out of 109 isolates of typhoid bacilli, 95.3% were resistant to nalidixic acid,79% to ciprofloxacin and 60.5% to ofloxacin. More than 50% of the isolates of Klebsiella pneumoniae and Escherichia coli showed resistance to cephalosporins and cotrimoxazole. Acinetobacter sp. showed high resistance (more than 60%) to ceftriaxone and ofloxacin. More than 20% of the isolates of Pseudomonas aeruginosa were resistant to ciprofloxacin and amikacin.
  
  
  CONCLUSIONS
  Ongoing surveillance for antimicrobial susceptibility remains essential, and will enhance efforts to identify resistance and attempt to limit its spread.
authors.affiliation: Department of Microbiology, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal.
authors.forename: Subha
authors.initials: S
authors.lastname: Shrestha
authors.affiliation: Department of Microbiology, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal.
authors.forename: Ritu
authors.initials: R
authors.lastname: Amatya
authors.affiliation: Department of Microbiology, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal.
authors.forename: Raj Kumari
authors.initials: RK
authors.lastname: Shrestha
authors.affiliation: Department of Microbiology, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Shrestha
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D004926:Escherichia coli / Q000302:isolation & purification / Q000502:physiology; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification / Q000502:physiology; D008297:Male; D008826:Microbial Sensitivity Tests; D009390:Nepal / Q000453:epidemiology; D010284:Paratyphoid Fever / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification / Q000502:physiology; D019779:Salmonella enterica / Q000302:isolation & purification / Q000502:physiology; D012485:Salmonella typhi / Q000302:isolation & purification / Q000502:physiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification / Q000502:physiology; D014435:Typhoid Fever / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotic; bacteria; blood stream infections.