Bacteriological Spectrum and Antimicrobial Resistance Pattern in A Multidisciplinary Intensive Care Unit

摘要

Introduction: In Intensive Care Units, the rate of infection due to multidrug resistant pathogens is high and accounts for increase in duration of hospital stay, mortality and morbidity and cost incurred to the patient as well as the hospital. The pathogens responsible for infection vary greatly from place to place.Aim: To identify the spectrum of bacterial pathogens and their anti-microbial resistance pattern in a multi-disciplinary Intensive Care Unit (ICU).Materials and Methods: A retrospective study was conducted in the Department of Microbiology from May 2013 – April 2014. All clinical samples received in the microbiology lab from the intensive care unit which were positive by culture were included in this study. They were processed according to standard microbiological methods. Antimicrobial susceptibility testing was done by Kirby Bauer’s disc diffusion method and the results were interpreted according to Clinical Laboratory Standards Institute (CLSI) guidelines. Detection of Methicillin Resistant Staphylococcus aureus (MRSA) and Extended Spectrum Beta Lactamase (ESBL) was also done as per CLSI guidelines.Results: A total of 186 samples were processed. The most frequent isolate was Acinetobacter species (21%). Endo-tracheal (ET) aspirate (45.2%) was the most common source for these isolates. Methicillin resistance was detected in 25% of the Staphylococcus isolates. Of the 88 Enterobacteriaceae isolates, 30% were found to be Extended Spectrum β-Lactamase (ESBL) producers. Klebsiella species accounted for 40.5% of the ESBL producers. The resistance rates to antimicrobials were higher for Acinetobacter species including 41% resistance to imipenem.Conclusion: Acinetobacter species was the most frequently isolated organism which showed higher resistance pattern. Multidrug resistant organisms are on the rise and strict measures are required to control infections due to these organisms.