Background: The frequent use of broad-spectrum antibiotics in ICU leads to increased rates of antimicrobial resistance and occurrence of multidrug-resistant (MDR) micro-organisms. The aim of this study was to evaluate the antimicrobial resistance pattern and colistin susceptibility among bacterial isolates from ICU patients. Method: It is a prospective study with 70 nonrepetitive isolates from ICU samples. The clinical data was obtained from the department records. The gram-negative bacterial isolates were identified by conventional biochemical tests. The antimicrobial susceptibility was determined by Kirby-Bauer disc diffusion method. ESBL producers were detected by double disc diffusion test using ceftazidime, cefotaxime alone and in combination with clavulanic acid. MBL detection was done by imipenem+ EDTA combined disc diffusion test. Colistin sensitivity was determined by broth microdilution according to CLSI guidelines. Results: Out of 70 culture positive specimens. The most common gram-negative bacteria isolated from the samples was Acinetobacter spp. (41%), followed by Klebsiella spp. (20%). Among these 45% were MBL producers, 38.5% were ESBL producers and 14% were both ESBL and MBL producers. Colistin resistance was present among 5.7% isolates in ICU.          Conclusions: Non-fermenters were the most common agent causing ICU infections. An alarmingly high rate of resistance to antibiotics especially to colistin in ICU-acquired infections, necessitates new therapeutic strategies to prevent the emergence and control of antimicrobial resistance.

Pyrexia of unknown origin (PUO) is classified according to the underlying disorder. The 4 main clinical categories of PUOs are infectious, malignant, rheumatic/inflammatory, and miscellaneous disorders. Sjogren's syndrome presenting as PUO, have become uncommon in recent years because of better serologic diagnostic tests. Sjogren's syndrome may be difficult PUO diagnosis and should be considered for diagnosis if patient presents with fever, salivary glands enlargement, dry eyes and mouth.