Prevalence and Antibiotic Sensitivity of Nosocomial Bloodstream Infections: An Analysis of Medical Wards in a Tertiary Care Hospital

Abstract

Nosocomial bloodstream infections (BSIs) are a significant cause of morbidity and mortality in tertiary care hospitals, especially with the rising burden of multidrug-resistant (MDR) organisms. Understanding local epidemiology and antibiotic susceptibility patterns is essential for guiding empirical therapy and strengthening infection-control practices. Objective: To determine the prevalence, microbial distribution, and antibiotic sensitivity patterns of nosocomial bloodstream infections among hospitalized patients in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 420 hospitalized patients. Nosocomial BSIs were identified in patients who developed clinical symptoms after 48 hours of admission. Blood samples were collected under aseptic conditions and processed using automated blood culture systems. Microorganisms were identified using standard biochemical and morphological methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method according to CLSI guidelines. Data were analyzed using descriptive statistics. Results: Of the 420 patients screened, 71 (16.9 percent) had confirmed nosocomial BSIs. Most infected patients were urban residents (77.46 percent), and UTIs were the leading primary source of bacteremia (45.05 percent). Gender-wise differences were notable: Salmonella typhi was more common in males (80 percent), and Klebsiella pneumoniae was more prevalent in females (71.42 percent). ICU patients showed higher isolation rates of MDR organisms, particularly Acinetobacter baumannii and K. pneumoniae. Antibiotic susceptibility profiles revealed high resistance rates among Gram-negative isolates: E. coli showed 90 percent resistance to Ampicillin, K. pneumoniae exhibited complete resistance to Ampicillin and Augmentin, and A. baumannii demonstrated 85.7 percent resistance to Ampicillin. Glycopeptides such as Vancomycin and Teicoplanin retained 100 percent sensitivity against Enterococcus spp. and Streptococcus pneumoniae. Conclusion: Nosocomial BSIs remain a significant concern, with a high prevalence of MDR Gram-negative pathogens and substantial variability in susceptibility patterns. The preserved efficacy of glycopeptides underscores their continued role in treating resistant Gram-positive infections. Strengthening antimicrobial stewardship, improving infection-control measures, and adopting evidence-based prescribing practices are essential to mitigate the burden of BSIs in tertiary care hospitals.