Antimicrobial resistance surveillance, intensive care units of a tertiary care hospital, Islamabad

Abstract

Abstract Background Hospital Acquired Infections (HAIs) are the emerging threat in the health care facilities around the globe. Most of Intensive Care Unit(ICU)patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. Objective was to study the occurrence of different types of HAIs in patients admitted to various ICUs of and the AMR pattern of the bacterial pathogens isolated from them. Methods It was a retrospective descriptive study based on culture reports of the patients admitted to surgical, Medical ICU of tertiary care hospital during period from March 2019 to October 2019. Results Most common culture positive clinical specimen received was tracheal aspirate(35.3%) followed by exudate(22.7%).Pseudomonas from blood specimens were the most common organisms isolated; whereas Escherichia coli was the predominant organism found in urine, exudate and sterile fluid specimens. About 25% infections were HAIs, out of which pneumonia(7.24%)was the most common. Analysis of antimicrobial susceptibility pattern revealed that most of Gram-Negative Bacilli(GNB) was Multi Drug Resistant(MDR) resistant to three or more class of antibiotics such as cephalosporins, aminoglycosides, tetracyclines and fluoroquinolones. Conclusions Increasing trend of AMR among hospital acquired pathogens such as MDR-GNBs,MRSA and VRE pose a great threat to critically ill patients of ICUs. Study on AMR surveillance is the need of the hour as it helps the centers to generate local antibiogram which further helps in formulating the national data. Hence, such studies will be a stepping stone in establishing antimicrobial stewardship and regulate the antimicrobial resistance in future Key messages Study on AMR surveillance is the need of the hour. such studies will be a stepping stone in establishing antimicrobial stewardship and regulate the antimicrobial resistance in future.