Prevalence and Antibiotic Susceptibility Pattern of Bacterial Pathogens in Intensive Care Unit (ICU) of a Tertiary Care Facility
DOI:
https://doi.org/10.46568/bios.v4i2-3.124Keywords:
Broad-Spectrum Antibiotics, Intensive Care Unit, Nosocomial InfectionsAbstract
Aim: To determine the prevalence and antibiotic susceptibility pattern of microorganisms in the ICU patients of a tertiary care facility in Karachi, Pakistan. Method: A retrospective study was conducted on the laboratory records of 50 patients with positive culture admitted to a tertiary care facility. A structured questionnaire was used to obtain patients’ records comprising of their name, sex, age, diagnosis, sample source, isolated pathogen culture results and antibiotic susceptibility patterns. Blood, tracheal fluid, urine, sputum, pus, peritoneal fluid and catheter tips were included as specimen sources. Total 94% patients selected had clinically suspected nosocomial infections. Results: Overall, 45% of them had traumatic brain or spinal injury followed by 35% of post-operative cases, 10% respiratory disease related patients, 6% cardiac patients, 2% renal failure and 2% with miscellaneous infections. Majority of the patients admitted to the ICU were in the age range 51- 65 years. Positive microbial growth samples included blood (30%), trachea (24%), urine (26%), sputum (10%), pus (4%), peritoneal fluids (2%) and catheter tip (4%). Amongst the samples tested, Acinetobacter spp. (22%) were predominant, followed by E. coli (14%), P. aeruginosa (10%), S. aureus (10%) and Enterococcus spp. (8%). Majority of the gram negative species were resistant to amoxiclave, cefotaxime, pipercillin and teicoplanin. Conclusions: The incidence of nosocomial infections is high in ICU patients. Thus accurate antimicrobial treatment strategies together with the development of new therapeutic regimens and risk assessment in hospitals and their ICUs is significantly required to prevent antimicrobial drug resistance among microorganisms.
References
Agaba P, Tumukunde J, Tindimwebwa JVB, Kwizera A. Nosocomial bacterial infections and their antimicrobial susceptibility patterns among patients in Ugandan intensive care units: a cross sectional study. BMC Res Notes 2017; 10(1): 349.
Khan HA, Baig FK, Mehboob R. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pacific J Tropical Biomed 2017; 7(5): 478-482.
Radji M, Fauziah S, Aribinuko N. Antibiotic sensitivity pattern of bacterial pathogens in the intensive care unit of Fatmawati Hospital, Indonesia. Asian Pacific J Trop Biomed 2011; 1(1): 39-42.
Collins AS, Hughes RG. Preventing health care–associated infections. In: Patient safety and quality: An evidence-based handbook for nurses. Agency for healthcare Research and Quality, US. Assessed in 2018.
World Health Organization. Prevention of hospital-acquired infections: a practical guide (No. WHO/CDS/CSR/EPH/2002.12). Geneva, Switzerland: World Health Organization. 2002.
Ganguly NK, Arora NK, Chandy SJ, Fairoze MN, Gill JP, Gupta U, et al. Global antibiotic resistance partnership (GARP): India Working Group. Rationalizing antibiotic use to limit antibiotic resistance in India. Ind J Med Res 2011; 134(3): 281-94.
Croda MG, Trajber Z, da Costa Lima R, Croda J. Tuberculosis control in a highly endemic indigenous community in Brazil. Transactions Royal Society Tropical Med Hygiene 2012; 106(4): 223-229.
Richards MJ, Edwards JR, Culver DH, Gaynes RP, National Nosocomial Infections Surveillance System. Nosocomial infections in combined medical-surgical intensive care units in the United States. Infect Control Hosp Epidemiol 2000; 21(8): 510-515.
Kollef MH, Fraser VJ. Antibiotic resistance in the intensive care unit. Annals Internal Med 2001; 134(4): 298-314.
Shankar PR, Partha P, Dubey AK, Mishra P, Deshpande VY. Intensive care unit drug utilization in a teaching hospital in Nepal. Kathmandu Uni Med J (KUMJ) 2005; 3(2): 130-137.
Reed II RL. Contemporary issues with bacterial infection in the intensive care unit. Surgical Clinics North America 2000; 80(3): 895-909.
Sheth KV, Patel TK, Malek SS, Tripathi CB. Antibiotic sensitivity pattern of bacterial isolates from the intensive care unit of a tertiary care hospital in India. Tropical J Pharma Res 2012; 11(6): 991-999.
Katherason SG, Naing L, Jaalam K, Ismail A. Baseline assessment of intensive care-acquired nosocomial infection surveillancein three adult intensive care units in Malaysia. J Infect Developing Countries 2008; 2(05): 364-368.
Snyder LL, Clyne KE. Wagner JC. Antibiotic sensitivity and the prescribing information sheet: assisting the prescribing physician. American J Infect Control 1990; 18(6): 399-404.
National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial disk susceptibility tests. Approved standard M2-A6. Wayne, Pa: National Committee for Clinical Laboratory Standards; 1997.
Cooper BS, Stone SP, Kibbler CC, Cookson BD, Roberts JA, Medley GF, et al. Isolation measures in the hospital management of methicillin resistant Staphylococcus aureus (MRSA): systematic review of the literature. British Med J 2004; 329(7465): 533.
Klevens RM, Edwards JR, Richards Jr CL, Horan TC, Gaynes RP, Pollock DA, Cardo DM. Estimating health care-associated infections and deaths in US hospitals, 2002. Public Health Reports, 2007; 122(2): 160-166.
Alberti C, Brun-Buisson C, Burchardi H, Martin C, Goodman S, Artigas A, et al. Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med 2002; 28(2): 108-121.
Okon KO, Osundi S, Dibal J, Ngbale T, Bello M, Akuhwa RT, ... & Uba, et al. Bacterial contamination of operating theatre and other specialized care unit in a tertiary hospital in Northeastern Nigeria. Afr J Microbiol Res 2012; 6(13): 3092-3096.
Fridkin SK. Increasing prevalence of antimicrobial resistance in intensive care units. Critical care Med 2001; 29(4): N64-N68.
Tullu MS, Deshmukh CT, Baveja SM. Bacterial profile and antimicrobial susceptibility pattern in catheter related nosocomial infections. J Postgraduate Med 1998; 44(1): 7.
Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD et al. International study of the prevalence and outcomes of infection in intensive care units. Jama 2009; 302(21): 2323-2329.
Tutuncu EE, Gurbuz Y, Sencan I, Ozturk B, Senturk GC, Kilic AU. Device-associated infection rates and bacterial resistance in the intensive care units of a Turkish referral hospital. Saudi Med J 2011; 32(5): 489-494.
Livermore DM. Minimizing antibiotic resistance. Lancet Infect Dis 2005; 5(7): 450-459.
Ray P, Manchanda V, Bajaj J, Chitnis DS, Gautam V, Goswami P, et al. Methicillin resistant Staphylococcus aureus (MRSA) in India: prevalence & susceptibility pattern. Ind J Med Res 2013; 137(2): 363.
Orrett FA. Resistance patterns among selective Gram-negative bacilli from an intensive care unit in Trinidad, West Indies. Saudi Med J 2004; 25(4): 478-483.
Corbella X, Montero A, Pujol M, Domínguez MA, Ayats J, Argerich MJ, et al. Emergence and rapid spread of carbapenem resistance during a large and sustained hospital outbreak of multiresistant Acinetobacter baumannii. J Clinical Microbiol 2000; 38(11): 4086-4095.
Forster DH, Daschner FD. Acinetobacter species as nosocomial pathogens. Eur J Clin Microbiol Infect Dis 1998; 17:73–7.
Turner PJ, Greenhalgh JM, Edwards JR, McKellar J. The MYSTIC (meropenem yearly susceptibility test information collection) programme. Int J Antimicrob Agents 1999; 13(2): 117-125.
Pattanayak C, Patanaik SK, Datta PP, Panda P. A study on antibiotic sensitivity pattern of bacterial isolates in the intensive care unit of a tertiary care hospital in Eastern India. Int J Basic Clin Pharmacol 2013; 2(2): 153-159.
Lockhart SR, Abramson MA, Beekmann SE, Gallagher G, Riedel S, Diekema DJ, et al. Antimicrobial resistance among Gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004. J Clin Microbiol 2007; 45(10): 3352-3359.
Hamishehkar H, Shadmehr P, Mahmoodpoor A, Mashayekhi SO, Entezari-Maleki T. Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran. Braz J Pharm Sci 2016; 52(3): 403-412.
Bayleyegn B, Mehari A, Damtie D, Negash M. Knowledge, Attitude and Practice on Hospital-Acquired Infection Prevention and Associated Factors Among Healthcare Workers at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. Infect Drug Resist. 2021; 14:259-266.
Harun M, Dostogir G, Anwar MMU, Sumon SA, Hassan M, Mohona TM, et al. Rationale and guidance for strengthening infection prevention and control measures and antimicrobial stewardship programs in Bangladesh: a study protocol. BMC Health Services Research. 2022; 22(1):1–11.
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