Multidrug Resistance in an Emerging Group of Enterobacteriaceae: A Retrospective Analysis at a Tertiary Hospital in Haryana, India
Dr. Shalini Upadhyay,
Department of Microbiology and Infection Control, Medanta-The Medicity, Gurgaon, Haryana, India.
Introduction: The SPICE group of Enterobacteriaceae (Serratia, Providencia, â€˜Indole positiveâ€™ Proteus and other common species of Proteus, Citrobacter, and Enterobacter species) have emerged as causes of infection in otherwise healthy patients, and are especially concerning due to their intrinsic resistance to several last-resort antibiotics.
Aim:To estimate the trend of incidence and resistance pattern among SPICE group organisms and its association with the increased use of antibiotics.
Materials and Methods: This was a single center, retrospective study conducted over a period of five years (January 2011 to December 2015). Clinical specimens from patients were collected and bacterial organisms were identified and tested for antibiotic susceptibility. The level of antibiotic usage was also analysed throughout the study period.
Results: Levels of all SPICE group organisms has increased over the course of the study, with several genera exhibiting notable increases when each year of the study period and was compared to the baseline year. Most of the SPICE organisms exhibited decreased sensitivity to each of nine tested antibiotics. Usage of several antibiotics was also found to increase over the study period.
Conclusion: This study demonstrates the rising incidence of SPICE group Enterobacteriaceae, which coincided with increased dispensing of antibiotics at our institution. In institutions with limited resources, the monitoring of antibiotic usage is especially important in curtailing the emergence of drug resistant infections.