Abstract
Background: The aim of our study was to evaluate the antimicrobial resistance rates among pathogen microorganisms especially colistin resistant rates of Acinetobacter baumannii in intensive care unit (ICU)-acquired infections and to determine infection-specific correct treatment strategies.
 Methods: The data of adult and newborn infant patients diagnosed with ICU-acquired infection in a tertiary education and research hospital in Bursa in 2014 and 2016 were analyzed, retrospectively.
 Results: Acinetobacter baumannii was the most frequent pathogen of ICU-acquired infections in 2014 and 2016. There was a significant increase in colistin (CO) resistance rates in A. baumanii (0.0%-6.8%). A significant increase in CO, cefepime (FEP), ciprofloxacin (CIP) resistance rates was established in all gram negative bacteria (0.0%-7.9%, 50.0%-91.9%, 54.7%-74.6%), respectively. A significant increase in the rate of detection of A. baumanii as the pathogen microorganism in respiratory tract infection (RTI) was established (53.9% -79.5%). In addition, the average ventilator-associated pneumonia (VIP) infection rate also increased in 2016 compared to 2014 (VIP rate 2014: 7.12, 2016: 7.45, per 1000 ventilator days). A significant decrease in the rate of detection of all gram negative microorganisms in the surgical site infection (SSI), and a significant increase in the rate of detection of all gram positive microorganisms in the SSI was determined.
 Conclusion: Increased antimicrobial resistance, especially increased colistin resistance rates in ICU-acquired infections, necessitates the creation of new strategies in empirical therapy. Detection of antimicrobial resistance profiles of local and infectious pathogen microorganisms in ICUs is a good guide for correct antimicrobial management.
Highlights
The frequent use of broad spectrum antibiotics in intensive care unit (ICU), leads to increased rates of antimicrobial resistance and more frequent occurrence of multidrug-resistant microorganisms [13]
Nowadays colistin is frequently used as an effective antibiotic in ICUacquired infections caused by multiresistant gramnegative bacteria, but colistin resistance is observed to be increasing in recent years [7,8,9]
ICU-acquired infections were categorized according to Centers for Disease Control and Prevention (CDC) criteria as blood stream infection (BSI), respiratory tract infection (RTI), urinary tract infection (UTI), surgical site infection (SSI), skin and soft tissue infection (SSTI) and central nervous system infection (CNSI)
Summary
The frequent use of broad spectrum antibiotics in intensive care unit (ICU), leads to increased rates of antimicrobial resistance and more frequent occurrence of multidrug-resistant microorganisms [13]. In the management of antimicrobial resistance in ICUs; it is necessary to optimize specific diagnosis and treatment of infections. Strategies for selection of antibiotics, optimization of dose and duration, prevention of the passage of resistant pathogenic microorganisms to the patient through correct infection control measures need to be developed [10]. Microbiologists, clinicians, and infection control staff must work together to identify specific common bacteria and antibiotic resistance profiles in ICUs to select the right antibiotics for treatment [4, 11]. The aim of our study was to evaluate the antimicrobial resistance rates among pathogen microorganisms especially colistin resistant rates of Acinetobacter baumannii in intensive care unit (ICU)-acquired infections and to determine infection-specific correct treatment strategies
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