Study Of Drug Resistance In Isolates From ICU Infections In A Tertiary Care Hospital
Study Of Drug Resistance In Isolates From ICU Infections In A Tertiary Care Hospital
Keywords:
ICU infections, multidrug resistanceAbstract
Background: Nosocomial Infections are an important cause of morbidity, mortality and economic
problems especially in intensive care units (ICUs). Aim: This study was conducted to estimate the clinical and
bacteriological profile and their antibiotic sensitivity testing in ICU infected patient. Materials and methods:
245 patients clinically diagnosed to have infections in ICU were studied prospectively in the Department of
Microbiology, Indira Gandhi Govt. Medical College from Sep. 2009- Dec. 2011. Depending on sites of infections
various samples were collected and processed as per the standard guidelines. The isolates were subjected to
antimicrobial susceptibility testing by Kirby Bauer disc diffusion method as per CLSI 2012 guideline. Results:
The incidence of pneumonia, blood stream infection and urinary tract infections was 61.6%, 20.1% and 11%
respectively. P. aeruginosa (16.3%) was the commonest isolate in ICU infection followed by A. baumannii
(13.5%) and K. pneumoniae (11.8%) with maximum sensitivity to imipenem, piperacillin tazobactum and
amikacin. All Staphylococcus and Enterococcus species were sensitive to vancomycin and linezolid. Gramnegative
pathogens acquired from ICU patients in our settings show high resistance to antibiotics. Conclusion:
Regular monitoring of the pattern of resistance of common pathogens in the ICUs is critical in planning the
best routines for empirical treatment of infectious patients. [ Kombade S NJIRM 2014; 5(2) :60-65]Background: Nosocomial Infections are an important cause of morbidity, mortality and economic
problems especially in intensive care units (ICUs). Aim: This study was conducted to estimate the clinical and
bacteriological profile and their antibiotic sensitivity testing in ICU infected patient. Materials and methods:
245 patients clinically diagnosed to have infections in ICU were studied prospectively in the Department of
Microbiology, Indira Gandhi Govt. Medical College from Sep. 2009- Dec. 2011. Depending on sites of infections
various samples were collected and processed as per the standard guidelines. The isolates were subjected to
antimicrobial susceptibility testing by Kirby Bauer disc diffusion method as per CLSI 2012 guideline. Results:
The incidence of pneumonia, blood stream infection and urinary tract infections was 61.6%, 20.1% and 11%
respectively. P. aeruginosa (16.3%) was the commonest isolate in ICU infection followed by A. baumannii
(13.5%) and K. pneumoniae (11.8%) with maximum sensitivity to imipenem, piperacillin tazobactum and
amikacin. All Staphylococcus and Enterococcus species were sensitive to vancomycin and linezolid. Gramnegative
pathogens acquired from ICU patients in our settings show high resistance to antibiotics. Conclusion:
Regular monitoring of the pattern of resistance of common pathogens in the ICUs is critical in planning the
best routines for empirical treatment of infectious patients.
References
2.antibiotic resistance patterns among Jordanian
3.intensive care patients. East Mediterr Health J,
4.1996;2(3):515-20.
5.Hassanzadeh P, Mohammad M, Nahal H.
Prevalent bacterial infections in intensive care
units of Shiraz university of medical sciences
teaching hospitals, Shiraz, Iran. Jpn J Infect Dis
2009; 62:249-53.
6.Kaul S, Brahmadathan KN, Jagannati M,
Sudarsanam TD, Pitchamuthu K, Abraham OC,
John G. One year trends in the gram negative
bacterial antibiotic susceptibility patterns in a
medical intensive care unit in South India.
Indian J Med Microbiol 2007;25:230-5.
7.Horan TC, Andrus ML, Dudeck MA. CDC/NHSN
surveillance definition of healthcare-associated
infection and criteria for specific types of
infections in the acute care setting. Am J Infect
Control 2008;36:309-32.
8.Collee JG, Duguid JP, Fraser AG, Marmion BP,
Simmons A. laboratory strategy in the diagnosis
of infective syndromes. In: Collee JG, Marmion
BP, Fraser AG, Simmons A, editors. Mackie and
Mc Cartney`s Practical Medical Microbiology.
14th ed. New Delhi: Reed Elsevier India Private
Limited; 1996. p 53-94.
9.Clinical and Laboratory Standards Institute.
Performance standards for antimicrobial
susceptibility testing; Sixteenth informational
supplement. CLSI document M100-S16. Clinical
and laboratory standards institute, Wayne
2012.
10. Yong D, Lee K, Yum JH, Shin HB, Rossolini GB,
Chong Y. Imipenem-EDTA disk method for
differentiation of metallo-β-lactamaseproducing
clinical isolates of Pseudomonas spp.
and Acinetobacter spp. J Clin Microbiol 2002;40:
3798-801.
11. Shanthi M, Sekar U. Multi-drug resistant
Pseudomonas aeruginosa and Acinetobacter
baumannii infections among hospitalized
patients: risk factors and outcomes. J Assoc
Physician India 2009;57(636):638-45.
12. Alberti C, Brun-Buisson C, Burchardi H, Martin C,
Goodman S, Artigas A, Sicignano A, et al.
Epidemiology of sepsis and infection in ICU
patients from an international multicentre
cohort study. Intensive Care Med
2002;28(2):108-21.
13. Meric M, Willke A, Calayan C, Toker K. Intensive
care unit- acquired infections: Incidence, risk
factors and associated mortality in a Turkishuniversity hospital. Jpn J Infect Dis 2005;58:297-302.
14. Hughes AJ, Ariffin N, Huat TL, Abdul Molok H, Hashim S, Sarijo J, Abd Latif NH, Abu Hanifah Y, Kamarulzaman A. Prevalence of nosocomial infection and antibiotic use at a university medical centre in Malaysia. Infect Control Hosp Epidemiol 2005;26:100-4.
15. Yehia Nasser AA, Haifaa H, El Sayed M, Al Asar. Nosocomial Infections in a Medical-Surgical Intensive Care Unit. Med Princ Pract 2008;17:373–7.
16. Shaikh JM, Devrajani DB, Ali Shah SZ, Akhund T, Bibi I. Frequency, pattern and etiology of nosocomial infection in intensive care unit: an experience at a tertiary care hospital. J Ayub Med Coll Abbottabad 2008;20:37-40.
17. Jamshidi M, Javadpour S, Eftekhari TE, Moradi N, Jomehpour F. Antimicrobial resistance pattern among intensive care unit patients. African J Microbiol Res 2009;3:590-4.
18. Criticare Frontires [online]. 2009. Available from: URL:http://www.expresshealthcare.in.
19. Wattal C, Goel N, Oberoi JK, Raveendran R, Datta S, Prasad KJ. Surveillance of multidrug resistant organisms in a tertiary care hospital in Delhi, India. J Assoc Physician India 2010;58:32-6.
20. Kucukates E. Antimicrobial resistance among gram-negative bacteria isolated from intensive care units in a Cardiology Institute in Istanbul, Turkey. Jpn J Inf Dis, 2005;58(4):228-31.
21. Singhal S, Mathur T, Upadhayay DJ, Chug S, Gaind R, Rattan A. Evaluation of methods for Amp C β lactamase in gram negative clinical isolates from tertiary care. Indian J Med Microbiol 2005;23(2):120-4.
22. Joseph NM, Sistla S, Dutta TK, Badhe AS, Rasitha D, Parija SC. Ventilator-associated pneumonia in a tertiary care hospital in India: role of multi-drug resistant pathogens. J Infect Dev Ctries 2010;4(4):218-25.
23. John S, Balagurunathan R. Metallo beta lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii. Indian J Med Microbiol 2011;29(3):302-4.
24. Gopalkrishnan R, Dorairajan S. Changing trends in antimicrobial susceptibility and hospital acquired infections over an 8 year period in a tertiary care hospital in relation to introduction
of an infection control programme. J Assoc Physician India, 2010;58:25-31.
25. Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, Linda K. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 2006;355:666-7
