Abstract
Objective: To evaluate occurrence of nosocomial infections and antibiotic susceptibility patterns of bacterial pathogens isolated from Intensive Care Units (IC-Us) in a tertiary care hospital of Karachi-Pakistan.Methods and Results: One thousand and fifty clinical isolates were identified following standard proto-cols. Their antibiograms were evaluated and a clinical correlation was made to measure their pathogenic status and method of acquisition of infection. Fifty-six percent isolates were identified as Acinetobacter baumannii, 13.2% as Pseudomonas aeruginosa, 11.2% as Staphylococcus aureus (MRSA), 8.8% as Klebsiella pneumoniae, 4.1% as Vancomycin resistant Enterococci (VRE), 2.7% as Escherichia coli (ESBL), 1.2% as Klebsiella spp, 1.1% as coagulase negative staphylococcus, 0.7% as Salmonella typhi and 0.2% as salmonella spp. All the isolates exhibited different resistance patterns against conventional antibiotics. Majority of them were Multi Drug Resistant (MDR).Conclusions: In this study, Acinetobacter baumannii isolates revealed a pathogenic potential of around 56% were identified by antimicrobial susceptibility patterns. In our study, majority of Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella pneumoniae, Vancomycin resistant Enterococci, E.coli, and Klebsiella spp were found to be multi drug resistant. High antimicrobial resistance in the ICU is an alarming situation, and calls for imperative measures leading to careful selection/use of antimicrobials while treating different infections. This study is expected to help infection control agencies to take robust steps to control nosocomial infections in developing countries.
Highlights
Nosocomial infections are defined as the infections that are not present at the time of the admission to hospital and appear within 48 to 72 hours after admission or within 10 days after discharge.[1]
A variety of clinical samples were collected from individuals, a higher frequency of bacterial isolates was recovered from catheters and other devices used in the Intensive Care Units (ICUs)
The most frequently isolated pathogen was E.coli which was isolated 420/630 .Klebsiella pneumoniae was 73/630, Pseudomonas aeruginosa was revealed as 62/630, Klebsiella spp isolated as 43/630 and Coagulase negative staph aureus was 32/630.all samples were first confirmed as nosocomial infections
Summary
Nosocomial infections are defined as the infections that are not present at the time of the admission to hospital and appear within 48 to 72 hours after admission or within 10 days after discharge.[1] The World Health Organization (WHO) has reported that, globally, the highest frequency of nosocomial infections occurs in Intensive Care Units (ICUs) of hospitals. Infection rates are higher among patients with risk-factors, such as, very young/old age, underlying disease, compromised immune system and prolong use of different medical devices.[2] Prolong hospitalization associated with nosocomial infections leads to increased morbidity and mortality.[3,4] Patient in the intensive care unit (ICU) has a 5 to 7 fold higher chance of acquiring nosocomial infection.[5]. Hospitals of both large and small cities of Pakistan are facing multi facet
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