Antimicrobial Resistant Pattern of Isolates from Intensive Care Unit of Tertiary Care Hospital

Shehryar Ahmad, Ujala Rasheed, Iram Naz, Sajid Ali, Nasir Ali, Atif Aziz

Abstract


Background: Patients in intensive care units are more vulnerable and have a higher risk of Hospital acquire infection in comparison to non-critical patient’s wards. We determine the Microbial spectrum and their antimicrobial resistant pattern of isolates from intensive care units of tertiary care hospital in Peshawar, Pakistan.

Methods: A cross-sectional study was carried out for a period of 6 months and a total of 65 patients from the surgical intensive care unit and medical intensive care unit of tertiary care hospital were sampled for the possible pathogen. Non-probability convenient sampling techniques were used to enrolled patients and samples were transported to the pathology department for culture and anti-microbial resistant pattern. Data were analyzed on SPPS version 19 using descriptive and inferential statistical tools. Chi-square test were used for possible association and p value of < 0.05 were considered statistically significant.

Results: Both gram-positive and gram-negative isolates additional to fungi were prevalent in the intensive care unit with the most frequent isolates being Acinetobacter species followed by Enterobacteriaceae and  P. Aeruginosa respectively. Amikacin, Doxycycline, Linezolid, Tigecycline, and Vancomycin have a low resistant pattern for both Staph aureus and coagulase-negative staphylococci (CoNS) while Cephalosporin including cefepime (58%), and minocycline (35%) along with polymyxin B shows the lower resistance pattern for Acinetobacter and other gram-negative isolates. 

Conclusion: Tigecycline, vancomycin, cefepime, and polymyxin B were used as empiric therapy agents in severe conditions however a larger scale study is required for calculating optimized therapeutic regime for each agent. The physician and hospital guidelines should adhere to the monitoring of antimicrobials to limit the upsurge of resistance patterns among different pathogenic organisms.

Keywords: Anti-Microbial; Resistant; Intensive care unit; Hospital acquire Infection 


Full Text:

PDF

References


Rhomberg PR, Fritsche TR, Sader HS, Jones RN. Antimicrobial susceptibility pattern comparisons among intensive care unit and general ward Gram-negative isolates from the Meropenem Yearly Susceptibility Test Information Collection Program (USA). Diagnostic Microbiology and Infectious Disease, (2006); 56(1): 57–62.

Sligl W, Taylor G, Brindley PG. Five years of nosocomial Gram-negative bacteremia in a general intensive care unit: epidemiology, antimicrobial susceptibility patterns, and outcomes. International Journal of Infectious Diseases, (2006) 10(4): 320–5.

Akhtar N. Hospital acquired infections in a medical intensive care unit. Journal of the College of Physicians & Surgeons Pakistan, (2010); 20(6): 386–90.

Weinstein RA. Nosocomial infection update. Emerging Infectious Diseases, (1998); 4(3): 416.

Johani SM Al, Akhter J, Balkhy H, El-saed A, Younan M, Memish Z. Prevalence of antimicrobial resistance among gram-negative isolates in an adult intensive care unit at a tertiary care center in Saudi Arabia. Annals of Saudi medicine, (2010); 30(5):364-9.

Al-Ahmadey ZZ, Mohamed SA. Antimicrobial susceptibility pattern of bacterial isolates in the intensive care unit of Al-Ansar Hospital, Saudi Arabia. European journal of advanced research in biological and life Science, (2013); 1(1): 17-26.

Fridkin SK. Increasing prevalence of antimicrobial resistance in intensive care units. Critical Care Medicine, (2001); 29(4): N64–8.

Meyer E, Jonas D, Schwab F, Rueden H, Gastmeier P, Daschner FD. Design of a surveillance system of antibiotic use and bacterial resistance in German intensive care units (SARI). Infection, (2003); 31(4): 208–15.

Epidemiology ICAR. surveillance report, data summary from January 1996 through December 1997: a report from the National Nosocomial Infections Surveillance (NNIS) System. American Journal of Infection Control, (1999); 27(3): 279–84.

Ben DS, Makni S, Ben SR. Epidemiology of gram negative bacterial septicemias: data from a Tunisian hospital (1996-1998). Tunisie Medicale, (2002); 80(5): 245–8.

Harbarth S, Rohner P, Auckenthaler R, Safran E, Sudre P, Pittet D. Impact and Pattern of Gram-Negative Bacteraemia during 6 y at a Large University HospitalPresented in part at the 4th International Conference on the Prevention of Infection (CIPI), May 1996 in Nice, France and at the Annual Meeting of the Society of Heal. Infectious Diseases, (1999); 31(2): 163–8.

Gitau W, Masika M, Musyoki M, Museve B, Mutwiri T. Antimicrobial susceptibility pattern of Staphylococcus aureus isolates from clinical specimens at Kenyatta National Hospital. BMC research notes, (2018); 11(1): 1-5.

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. Journal of Clinical Microbiology, (2007); 45(10): 3352–9.

Tan R, Liu J, Li M, Huang J, Sun J, Qu H. Epidemiology and antimicrobial resistance among commonly encountered bacteria associated with infections and colonization in intensive care units in a university-affiliated hospital in Shanghai. Journal of Microbiology, Immunology and Infection, (2014); 47(2): 87-94.

Khan MA. Bacterial Spectrum and Susceptibility patterns of Pathogens in ICU and IMCU of a Secondary Care Hospital in Kingdom of Saudi Arabia, 2012; 10(2): 64–70.

Bayram A, Balci I. Patterns of antimicrobial resistance in a surgical intensive care unit of a university hospital in Turkey. 2006;6:1–6.

Japoni A, Vazin A, Hamedi M, Davarpanah MA, Alborzi A, Rafaatpour N. Multidrug-resistant bacteria isolated from intensive-care-unit patient samples . Vol. 13, Brazilian Journal of Infectious Diseases, (2009); 118–22.

Mohammadi-Mehr M, Feizabadi M. Antimicrobial resistance pattern of Gram-negative bacilli isolated from patients at ICUs of Army hospitals in Iran. Iranian Journal of Microbiology, (2011); 3(1): 26–30.


Refbacks

  • There are currently no refbacks.