Bacterial profile and their antibiotic resistance patterns from blood culture in Intensive Care Unit patients at the University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Abstract

Background: The burden of bloodstream infection and antibiotic resistance in intensive care unit (ICU) is high when compared with other settings. The data on the changing antibiotic resistance trends are important for infection control activities. There is no sufficient data in the intensive care units of this hospital. Objective: The aims of this study were to assess the magnitude and risk factors of bacterial pathogens and their antibiotic resistance patterns of blood culture isolates from ICU patients at the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. Materials and Methods: A cross-sectional study was conducted from February to May 2018.Blood specimen were collected from 384 patients and inoculated on appropriate culture media. Identification of bacterial pathogens and antibiotic susceptibility tests were performed using bacteriological standard methods. Presence of Extended Spectrum Beta Lactamase (ESBL) enzymes was confirmed by combined disk diffusion method. Data were analyzed using SPSS version 20. Result: Of the total 384 study participants, 96(25%) were culture positive. Majority of bacteria isolates 67(69.8%) were Gram negative. The commonly isolated bacterial species were K.pneumoniae 18(18.8%), Coagulase negative Staphylococcus 13(13.5%), K.ozanae 10(10.4%), K.rhinose 8(8.3%) and E.coli, E.cloacae, Citrobacter species, S.aureus each accounts 7(7.3%). Gram negative isolates were found to be resistant to ampicillin 66(98%), amoxicillin/clavulanate 64(95%) and ceftriaxone 52(77.6%). However, amikacin 64(95.5%), meropenem 58(87%) and Ciprofloxacin 56(83.6%) were relatively effective drugs. Gram positive isolates were found to be resistant to Penicillin 28(96.5%), amoxicillin/clavulanate27 (93.1%) and erythromycin 26(90%). They were sensitive to ciprofloxacin 22(79%) and clindamycin 24(83%). Methicillin resistant S.aureus accounted 4(57.1%) and ESBL enzyme producing Gram negative isolates accounted 41(78.8%). Conclusion: Klebsiella species were the predominant bacterial isolates in ICU settings. Antibiotic resistance due to ESBL enzyme production is alarmingly high. This result might be a reflection of inappropriate use of antibiotics and poor infection prevention control practice in these settings. Key words: Antibiotic resistance, ICU, ESBL, Gondar Ethiopia.

Bacterial Profile and Their Antimicrobial Susceptibility Pattern of Isolates Recovered from Intensive Care Unit Environments at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Southern Ethiopia

“…Also, K. pneumoniae (28.6%) was the second reported GNB, and it is relatively similar to the fnding of a previous study conducted in Zimbabwe 20.3% [42]. But, it is higher than those of the studies carried out in Uganda 13% [35], Hiwot Fana 12.4% [41], Mizan-Tepi 14.8% [36], Namibia 3% [30], Northern Nigeria 2.4% [40], Mekelle 8% [27], and Gondar 4.08% [34]. Tis potential variation might be due to the dissemination of K. pneumoniae throughout the ICU environments during cleaning and recontamination of HCP hands with isolates during patient's examinations, handcontact made with patients or inanimate surfaces, and handwashing.…”

“…Te results of our study showed that varied groups of bacteria, including both Gram-positive (56%) and Gramnegative (44%) bacteria contaminated the ICU environments. Comparable to our results, the frequency of Grampositive bacteria constituted the leading inhabited bacteria compared to Gram-negative bacteria in diferent countries, for example, in Iran (60.7% vs. 39.3%) [33], Nigeria (52.2% vs. 47.8%) [28], and Gondar in Ethiopia (60.5% vs. 39.5%) [34]. Te dominance of Gram-positive over Gram-negative bacteria could be described by the fact that Gram-positive bacteria, being free of lipid-dominant drying up prone outer membrane, have concerning nature ability to keep their viability on diferent hospital environments for several time periods [33].…”

“…Tis recognized prevalence of GPB might be due to the bacterial resistance ability to dry conditions of the hospital environment and transmission from skin, nasal, and hands of health care providers and patients, and also the presence of underlying clinical conditions and immunocompromised patients admitted to intensive care. From Gram-negative isolates, E. coli 41 (39%) was highly isolates from the all study groups in these output, but it contradicts with the fndings of the study in Namibia 24% [30], Gondar 16.3%, [34], Madda-Walabu 20.9% [39], Mizan-Tepi 11.4% [36], Gondar [34], Northern Nigeria 8.0% [40], Mekelle 0.8%, [27] and Hiwot Fana 7.3% [41]. Tis could be explained by existence of colonized/infected patients in the ICU environments of the hospital, or failure of routine cleaning and disinfection practices.…”

Bacterial Profile among Patients with Suspected Bloodstream Infections in Ethiopia: A Systematic Review and Meta-Analysis

“…The included studies were conducted in four regions (Amhara, Tigray, Oromia, and Southern Nations, Nationalities, and Peoples' Region (SNNPR)) and from the two self-administrative cities (Addis Ababa and Dire Dawa). Of the 26 studies that fulfilled the review inclusion criteria [ 7 , 11 , 14 , 16 , 35 , 36 , 38 – 52 , 55 ], eleven studies were conducted in Amhara region [ 7 , 8 , 11 , 14 , 36 , 40 , 44 , 45 , 52 – 54 ], nine in Addis Ababa [ 16 , 41 , 43 , 46 , 48 – 50 , 55 , 56 ], three in Oromia region [ 35 , 38 , 42 ], and a single study from Tigray [ 39 ], Dire Dawa [ 51 ], and SNNPR [ 47 ]. The sample size of individual studies ranged from 83 [ 53 ] to 856 [ 36 ].…”

Antibiotic Resistance Profile of Common Bacteria Isolated from Blood Stream, Lower Respiratory Tract and Urinary Infections in Intensive Care Unit in Saudi Arabia: A Retrospective Study

“…Intensive care units (ICUs) are the most life-saving facilities in hospitals, with highly specialized clinicians and nurses caring for severely ill patients. Most conditions treated in ICU are life-threatening, severe injuries and illnesses that necessitate regular monitoring and support from specialist technology and pharmaceuticals to ensure normal body processes ( 1 , 2 ).…”