Susceptibility of Ciprofloxacin and Ceftriaxone in Colonial War Memorial Hospital from 2014-2018

Bloodstream infections are an important cause of serious morbidity and mortality. Antibiotics play a major role in treating such infections. However, over the past few years, bacteria have developed resistance which has made treating infections difficult. It is important to test the bacterial culture for susceptibility to antibiotics and to treat with the antibiotics that are active in vitro against the infecting organism. There has been an increase in the resistance to ciprofloxacin and ceftriaxone over the years. This study investigates the trends of susceptibility of Ciprofloxacin and Ceftriaxone in bloodstream infections at the Colonial War
Memorial Hospital from 2014 to 2018. A descriptive cross-sectional study was conducted in June 2019 at Colonial War Memorial Hospital Suva. All positive blood cultures of bloodstream infections were included in the study. Data was obtained from the blood culture registers from the year 2014 to 2018. Descriptive statistics were used to analyse the responses.Resistance of Ciprofloxacin was relatively consistent from 2014(20%) — 2016(21%) and slightly increased to 27% in 2017 and 2018. Similarly, resistance to Ceftriaxone has been steadily increasing from 30% in 2015 to 53% in 2018. Microorganisms commonly resistant to Ciprofloxacin included: Klebsiella pneumoniae (24%), Acinetobacter baumannii (18%), Enterobacter cloacae (3%) and Acinetobacter Iwoffii (2%). Microorganisms resistant to Ceftriaxone included: Klebsiella pneumoniae (41%), Acinetobacter baumannii (25%) Escherichia coli (17%), Enterobacter cloacae (4%) and Acinetobacter Iwoffìi (3%). Males of 38 and people aged 51 — 60 years of participants were found to be resistant to ciprofloxacin and ceftriaxone.
Resistance to the second line antibiotics Ciprofloxacin and Ceftriaxone has been increasing in this hospital in Fiji over the past 5 years. This indicates the need for use of stronger antibiotics such as the third-line antibiotics Meropenem and Amikacin.