The landscape of bacterial antibiotic susceptibility in a multi-tier ophthalmology network in India: an electronic medical record driven analytics report

Abstract

Introduction. Injudicious use of antibiotics often leads to antibiotic resistance which contributes to significant morbidity and mortality. Knowledge of local antibiogram is important in informing appropriate empiric antimicrobial therapy. Hypothesis / Gap. It is the first and largest study that examines bacterial isolates from multiple ocular infections across South India and provides a overview of susceptibility patterns for each individual bacteria in the detailed interactive dashboard. Aim. To study the landscape of bacterial antibiotic susceptibility patterns of ocular infections in patients undergoing microbiological investigations across a multi-tier ophthalmology network in India. Methodology. This cross-sectional hospital-based study included 15 822 patients in whom microbiology samples were analysed between September 2013 and December 2021. Ocular tissue of patients in whom a microbiology sample was processed in at least one eye were included as cases. The data were collected using an indigenously developed electronic medical record (EMR) system. Results. Among the 15 822 patients, bacteria (51.06 %) was the most common aetiology, followed by fungus (38.27 %). The majority of the patients were male (68.10 %) and the majority were adults (90.01 %). The most common age group was during the sixth decade with 2914 (18.42 %) patients. The patients were more commonly from the lower socio-economic status (51.61 %) and rural geography (46.82 %). The majority of the specimens sent for microbiological analysis were corneal scraping (68.61 %). Gram-positive cocci and Gram-positive bacilli were most sensitive towards vancomycin (86.83 and 92.89% respectively) followed by cefazolin (80.88 %) and amikacin, while Gram-negative bacilli were most sensitive towards ofloxacin (65.24%). Conclusion. The most common aetiology of infection in ocular disease is bacterial and the majority of the patients presented from the rural geography and from lower socio-economic status. While vancomycin continues to be the drug of choice for Gram-positive organisms, increasing resistance to fluoroquinolones and ceftazidime was observed. Adoption of this model will enable access to antimicrobial susceptibility data, leading to reliable decisions and better clinical outcomes.