Emergence of High Antimicrobial Resistance among Critically Ill Patients with Hospital-Acquired Infections in a Tertiary Care Hospital

Abstract

Background and Objectives: Inappropriate antibiotic usage in hospitalized patients contributes to microbial resistance. Our study aimed to examine the incidence of clinical bacterial isolates and their antibiotic resistance burden among critically ill patients in different hospital units. Materials and Methods: A single-centered cross-sectional study was conducted in a 120-bed tertiary care hospital that included 221 critically ill patients with hospital-acquired infections. Bacterial cultures and sensitivity reports were obtained and followed by a formal analysis of the antibiogram results to explore recovered isolates’ prevalence and antibiotic susceptibility patterns. Results: Gram-negative bacteria were the most predominant pathogens among recovered isolates from the various hospital units (71%). Klebsiella sp. was the most prevalent microbe, followed by Acinetobacter sp., with an incidence level of 28% and 16.2%, respectively. Among the Gram-positive organisms, the coagulase-negative Staphylococci were the most predominant organism (11.3%), while (6.3%) methicillin-resistant Staphylococcus aureus (MRSA) isolates were recovered from different hospital units. Antibiotic sensitivity testing showed that polymyxin B was the most effective antibiotic against Gram-negative bacteria, whereas vancomycin and linezolid were the most active antibiotics against Gram-positive pathogens. Moreover, 7% of the Gram-negative bacteria isolated from different units showed positive production of extended-spectrum beta-lactamase (ESBL). Conclusions: The current study describes the high antibiotic resistance patterns in various hospital units that need extra legislation to prevent healthcare providers from misprescription and overuse of antibiotics.

The Role of COVID-19 in Antibiotic Resistance in Pediatric Population

“…Таким образом, сочетание нерационального применения антибиотиков и снижения их доступности может увеличить риск антибиотикоре-зистентности и смертности из-за вакциноуправляемых инфекций [34,48]. Частое применение антисептиков также приводит к развитию перекрестной резистентности [49].…”

“…До тех пор, пока нет проявлений бактериальной инфекции, антибиотикотерапия не предусма-тривается для лиц с легкой или среднетяжелой формами заболевания [48]. Согласно руководству по ведению COVID-19 у детей (до 18 лет) Министерства здравоохранения и благосостояния семьи Правительства Индии, антимикробные препараты не следует назначать для лечения или профилактики в бессимптомных и легких случаях; при умеренных и тяжелых формах применение не рекомендуется, если клиническая картина не свидетельствует в пользу присоединения вторичной инфекции; при септическом шоке используется эмпирическая антимикробная терапия с целью элиминации вероятных патогенных организмов на основании клинической оценки, иммунного статуса пациента, местных эпидемиологических исследований и правил применения антибиотиков в конкретной больнице [49].…”

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

“…Te surface areas of tiny objects or surfaces were approximated and the entire region was swabbed, emphasizing the frequently touched areas in two directions at right angles to each other in a close zigzag pattern at each site, rotating the swab during sampling to ensure that the full surface of the swab is utilized. Most frequently touched part in inanimate or medical device surface swab and most representative locations in each study participants (health care providers and patients) were selected to sample and the sampling sites were categorized into four groups: (1) ), and chair (sides of chair). (3) Hands of patients (fngers and palm area of the hands).…”

“…Te intensive care unit (ICU) is one of the leading units among health care settings in the percentage of the population with nosocomial infections [1] because of its patients who are susceptible to various infections due to immunodefciency, utilization of invasive medical equipment, administration of various medications, or deformation of normal fora. Health care-associated infection (HCAI) is an infection acquired recently by patients who have been admitted to a health care facility for the purpose of other health care needs.…”