Introduction: The treatment of bacterial infections has become increasingly intricate due to the ability of the microorganisms to develop resistance to the current regimen of antibiotics. Carbapenems provide enhanced anaerobic and gram negative coverage as compared with other beta lactams. Due to their stability against extended spectrum beta-lactamases, they have proven to be an effective antimicrobial agent. This study looks at the impact of carbapenem resistance on the inpatient outcomes at our center.
Methods: This is a retrospective study which includes all in-patient admissions at our institute, Aga Khan University Hospital, Karachi between the years 2015 and 2019. All the patients who had their antibiotic sensitivity cultures done were included in the sample. Fifty shortlisted patients were then divided into two groups. Group A: those who were carbapenem resistant and Group B: those with an ESBL infection sensitive to Carbapenem (B).
Results: The mean age of the sample was 56.54±16.93 years with 31 (62%) of the patients being male, 30 (60%) diabetic, 29 (58%) hypertensive and 26 (52%) having renal dysfunction. The most common presenting complaint pertained to the genito-urinary system (32%), followed by disorder of the pulmonary system (26%). There were 31 (62%) patients in group A and 19 (38%) in Group B. Patients in Group A had a significantly longer inpatient stay than those in group B (Mean: 15.12 vs 7.68 days). A total of 24 (77.42%) patients developed complications during inpatient stay as opposed to 9 (47.4%) patients in Group B. There was a significantly higher mortality rate in Group A patients as opposed to group B patients (38.7% vs 21.05%).
Conclusion: With an increased resistance being developed against antimicrobials around the world, judicious use of antibiotics is recommended in light of the data presented in the paper.