Fighting Resistance with Evidence: Antibiogram-Based Stewardship Insights from Mayo Hospital Lahore
DOI:
https://doi.org/10.66344/jpad.v36i2.3371Keywords:
Antimicrobial resistance, Antibiogram, Antimicrobial stewardship, Antimicrobial susceptibility testing, Multidrug resistanceAbstract
Background Antimicrobial resistance threatens patient outcomes in resource-limited healthcare settings such as hospitals in Pakistan, where unregulated antibiotic access and inadequate surveillance contribute to the accelerated emergence of antibiotic resistance. Institutional antibiograms provide practical surveillance and guide empiric therapy, yet published data from Punjab’s public-sector teaching hospitals remain sparse.
Objective To determine antimicrobial susceptibility patterns of bacterial pathogens from diverse clinical specimens at a tertiary care hospital in Lahore and generate actionable stewardship data.
Methods This descriptive cross-sectional study was conducted at the Microbiology Section, Department of Pathology, King Edward Medical University/Mayo Hospital, Lahore, from July to December 2025. A total of 4,000 non-duplicate, clinically significant bacterial isolates met the eligibility criteria and were included in the analysis. Non-duplicate isolates from pus, wound swabs, blood, urine, body fluids, respiratory samples, tissue, and catheter tips were identified by standard methods. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disc diffusion method and interpreted according to the Clinical and Laboratory Standards Institute (CLSI) document M100, 35th edition (2025).
Results Methicillin-sensitive and methicillin-resistant Staphylococcus aureus showed 100% susceptibility to vancomycin and linezolid but low susceptibility to erythromycin and clindamycin (10-53%). Enterococcus species exhibited ampicillin susceptibility of 66-76%. Escherichia coli displayed extensive cephalosporin (0-25%) and fluoroquinolone resistance (ciprofloxacin 0-52%) but retained colistin efficacy (100%). Klebsiella pneumoniae showed cephalosporin susceptibility below 33% and carbapenem susceptibility of 22-82%. Acinetobacter baumannii exhibited critical pan-resistance with carbapenem susceptibility of 0-45%; only colistin remained effective. Pseudomonas species retained better susceptibility to ceftazidime (14-75%) and piperacillin-tazobactam (21-73%).
Conclusion The high resistance observed against cephalosporins, fluoroquinolones, and carbapenems highlights an urgent need for structured antimicrobial stewardship and routine antibiogram surveillance in public-sector hospitals across Pakistan.
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