ANTIMICROBIAL RESISTANCE (AMR) SURVEILLANCE IN RURAL MEDICAL COLLEGE IN MAHARASHTRA: NEED OF HOUR

Introduction: Antimicrobial resistance Surveillance (AMR) of frequently isolated bacterial pathogens causing severe infections is of great importance. Thus, this study aims to identify the prevalence of common bacterial isolates and β lactamases producing resistant strains and their antimicrobial susceptibility pattern of these isolates from patients attending Rural medical college and hospital which will help in framing institutional policy and better patient management. Material and methods: This study includes a total of 3675 bacterial isolates from urinary tract infections (UTIs), Lower respiratory tract infections (LRTIs), Blood stream infections (BSIs), Skin and soft tissue infections (SSIs) from January 2018 to December 2018. All the study isolates were characterised up to species level, antibiotic susceptibility pattern was determined. Gram negative bacteria were screened for β lactamases production. Results: Among 3675 isolates collected, E.coli (n= 1062) and Klebsiella spp(n= 745) are most common followed by S.aureus (n= 645), Pseudomonas spp (n= 511), Acinetobacter spp (n= 197) and other bacteria s(n= 515). E.coli and Klebsiella spp. were predominant pathogen isolated from UTI and LRTI respectively. Staphylococcus aureus was predominant pathogen isolated in BSI and SSI. Among the antimicrobials tested against Gram negative organisms, Colistin and Imipenem were the most active, followed by Amikacin and Piperacillin- Tazobactam. Moderate activity was noted for fluoroquinolones. Resistance to cephalosporins was high. ESBL Production is highest in Klebsiella spp(65%) and E.coli(60%) followed by Pseudomonas spp(37%) and Acinetobacter spp(30%) whereas Acinetobacter spp (51%) shows highest Ampc production followed by E.coli (40%), Klebsiella spp,(30%) and Pseudomonas spp(25%).The major MBL producer were Acinetobacter spp (28%) and Klebsiella spp(25%) followed by Pseudomonas spp(20%) and E.coli(12%). Among the antimicrobials tested against S.aureus, Vancomycin and Linezolid having no resistance, followed by Clindamycin and Gentamycin having Moderate activity. Resistance to fluoroquinolones and Cotrimoxazole was relatively high. The prevalence of Methicillin resistant Staphylococcus aureus(MRSA) was 39%. Conclusion: Increasing rates of β lactamases producers emphasizes the need for their early detection which can help in providing an appropriate antimicrobial therapy and in avoiding the development and the dissemination of these multidrug resistant strains. Need of hour is that every health care institute must have own AMR Surveillance data which will