Microbial infection and antibiotic patterns among intensive care unit patients in a tertiary hospital in Central Nepal

Abstract

AimsThe present study is a fundamental effort to evaluate the bacteriological and antibiotic patterns in the Intensive Care Unit (ICU) setting in a tertiary care hospital. This study was carried out to guide the clinician in choosing the appropriate antibiotics and to prevent emergence of multidrug resistance bacteria. Materials and MethodsBetween March 2009 to Feb 2012, the samples from various ICUs that were submitted to the microbiology laboratory for culture and sensitivity were included in this study. All the organisms were identified morphologically and biochemically by standard laboratory procedure and antibiotic susceptibility pattern was determined by disc diffusion methods. ResultOf 3,780 specimens, 2,312 (61.1%) isolates were recovered. Single organisms were isolated from 1,746 (75.5%) samples while the remaining 566 (24.4%) had two or more organisms isolated. Pseudomonas aeruginosa was the most common isolate 819 (35.4%), followed by Klebsiella pneumoniae 637 (27.5%). Antibiotics sensitivity of Pseudomonas aeruginosa showed that almost all isolates were resistant to cephalexin (97.8%) and ciprofloxacin (80.3%). However (95.8%) of the isolates were sensitive to tobramycin, (92.0%) to meropenem & (74.80 %) to amikacin. ConclusionIt is concluded that Pseudomonas aeruginosa is the predominate pathogen isolated from ICUs of this Hospital. Most of the frequently isolated pathogens are resistant to cephalosporins and quinolone antibiotics as compared to aminoglycosides and carbapenem. Regular surveillance of antibiotic susceptibility pattern is very important for setting a guideline to the clinician in choosing an appropriate therapy of infected patients of ICUs.

Antimicrobial Sensitivity Pattern in the Mixed Intensive Care Unit in a Tertiary Care Hospital of Eastern Nepal

“…while in other studies percentage varied from 28% to 67%. [1][2][3][4][5][6][7] This difference may be due to This study showed that gram-negative infection is more common than gram-positive which is similar to other studies from developing country whereas gram-positive infection is more common in developed country. [1][2][3][4][5][6][7][8] The present study shows that tracheal aspirate 49(36.26%) was a common sample which is similar to other studies.…”

“…[1][2][3][4][5][6][7] This difference may be due to This study showed that gram-negative infection is more common than gram-positive which is similar to other studies from developing country whereas gram-positive infection is more common in developed country. [1][2][3][4][5][6][7][8] The present study shows that tracheal aspirate 49(36.26%) was a common sample which is similar to other studies. 1,3,7,9 Studies conducted by Raval et al 10 and Sarkar et al 11 have shown that urinary tract infection was more common than respiratory tract infection.…”

“…A combined effort of the intensivist and the clinical microbiologist is required for better clinical outcomes and a decrease in antibiotic resistance. 4,5 This study showed that culture was positive in 135(22%). while in other studies percentage varied from 28% to 67%.…”

Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

“…Findings of our study are similar to studies from Nepal and India. 18,20 Pseudomonas aeruginosa, Klebsiella species, E coli, S. aureus and Enterococcus species are the most frequent pathogens reported from ICUs of different hospitals of Asian countries. 16,18,19 In this study, Acinetobacter was the most common pathogen.…”

“…37 Many studies from ICUs have reported isolation of similar organisms. 16,20 Infections caused by ESKAPE group organisms especially among ICU patients are difficult to treat and have high morbidity and mortality. 38…”