A Study on the Prevalence and Microbiological Profile of Nosocomial Infections in the ICU of a Tertiary Care Hospital in Eastern India

Chakraborty, Prithviraj; Mukherjee, Sukumar

doi:10.20546/ijcmas.2016.505.096

Cited by 1 publication

(1 citation statement)

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“…ICU settings present a higher risk of nosocomial infections such as pneumonia, UTI, catheter-associated bloodstream infection, and surgical site infection. [ 7 ] According to the Center for Disease Dynamics Economics and Policy (CDDEP) antibiotic resistance data for 2014, the prevalence of various pathogens in India was as follows: ESBL-producing Enterobacteriaceae , up to 66.5%; CRE, up to 40%; MDR Pseudomonas , up to 54.66%; MDR Acinetobacter , up to 68.8%; carbapenem-resistant Klebsiella pneumoniae , up to 55%; and CRA, up to 85%. In 55% of the ICU, CRE prevalence was up to 20% and was found to be lower as compared to above-mentioned data by the CDDEP.…”

Section: Discussionmentioning

confidence: 99%

A questionnaire-based survey of physician perceptions of the prevalence of antimicrobial resistance and their antibiotic prescribing patterns

Gupte

Gogtay

Mani

2018

Indian Journal of Critical Care Medicine

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Background:Antibiotic resistance is a serious problem being faced by physicians worldwide. This article was designed to study physician perceptions of antibiotic resistance and their prescribing patterns.Materials and Methods:A structured questionnaire was developed for reporting the prevalence of antibiotic resistance as perceived by physicians and recording their antibiotic preferences in specific contexts. A total of 539 intensivists across India participated in the study.Results:The prevalence of multidrug-resistant (MDR) Gram-negative pathogens was reported to be on the rise in Intensive Care Units. The prevalence rate of carbapenem-resistant Enterobacteriaceae was reported to be between 20% and 40% by 33% of the participants. Piperacillin-tazobactam was the preferred beta-lactam/beta-lactamase inhibitor antibiotic by the majority of intensivists (47%) in the treatment of infections caused by extended-spectrum beta-lactamase producers. Meropenem was recommended to be used at a higher dose (2 g t.i.d.) by 41% of intensivists for Pseudomonas/Acinetobacter infections with high minimum inhibitory concentration values for meropenem. De-escalation data revealed that 43% of intensivists “always” would like to de-escalate from carbapenems, based on the antibiotic susceptibility data. Minocycline was recommended by 33% for the treatment of ventilator-associated pneumonia (VAP) and by 21% for bloodstream infections caused by MDR Acinetobacter. Up to 83% of intensivists preferred the use of nebulized colistin for the management of VAP/hospital-acquired pneumonia.Conclusion:This study reveals that the prevalence of MDR Gram-negative pathogens is perceived to be on the rise. Prescription patterns indicate high levels of variability. Hence, antibiotic stewardship is essential to standardize antibiotic prescriptions not only for efficacy but also to reduce the burden of multiple drug resistance.

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Section: Discussionmentioning

confidence: 99%