English

Abstract

Infections occurring more than 48 hours after admission in hospital are usuallyconsidered as nosocomial infections. Patients in ICUs are at a higher risk of acquiring thisinfection than those in non-critical areas. The total length of stay increased from three days tonineteen days for clinical procedures. Increased antimicrobial resistance in such cases makesincrease in mortality and morbidity. The ICU infection rates is five to ten times higher than HAIs inward patients. ICU acquired infections are major health problem globally, in developing countrieslike Pakistan. The microorganisms that are frequently isolated from intensive care units areAcinetobacter spp, P. aeruginosa, Klebsiella pneumoniae, Streptococcus spp, Staphylococcusspp, Enterococci and Enterobacteriaceae i.e E. coli, Proteus mirabilis and Serratia marcescens.Aims: The present study was aimed at to determine the frequency of causative organismsin intensive care unit (ICU) patients and antimicrobial susceptibility pattern of the isolates.Study Design: A cross-sectional study. Place and Duration of Study: Microbiology section ofPathology department Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Four months(September to December 2015). Materials and Methods: Clinical samples from patientshaving signs and syptoms of site-specific infections or fever in ICU were collected. The sampleswere cultured on suitable culture media and bacterial isolates were identified by Gram stain andstandard biochemical methods. Antimicrobial susceptibility testing to conventional and newerantibiotics was performed on Mueller Hinton agar using disc diffusion method. Frequencypercentages of all isolates were determined. Results: Out of 100 samples only 30 samples werepositive for growth and 70 samples showed no growth. The most frequent isolates were E. coli(40%), K. pneumoniae (10%) P. aeruginosa (10%) Proteus spp. (20%) Acinetobacter (17%) andS.aureus (3%). S.aureus (Gram positive bacteria) were more sensitive to imipenem, cefoxitinand resistant to ceftriaxone, nitrofurantoin azithromycin, Tetracycline, Cefotaxime and amoxicillinclavulanic acid. Other Gram negative bacteria i.e E.coli, K. Pneumoniae, P.aeruginosa, Proteusspp. and Acinetobacter spp. were sensitive to imipenem, sulzone, ceftriaxone, Ciprofloxacin,Gentamicin, Nitrofurantoin and resistant to amoxicillin clavulanic acid. Conclusion: Bacteriawere isolated from 30% clinical samples taken from patients admitted in ICU. The most frequentsite of infection was the respiratory tract followed by urinary tract and blood stream infections.E. coli, P. aeruginosa, K. pneumonia, Proteus spp., Acinetibacter and S. aureus were isolated.The high frequency of Health associated infections and elevated bacterial resistance rate in ICUpatients suggest that more strict measures regarding infection control practices can be done.