Abstract
BackgroundThe nightmare of the rising numbers of multidrug-resistant organisms (MDROs) requires the implementation of effective stewardship programs. However, this should be preceeded by making available evidence-based knowledge regarding the local antimicrobial resistance pattern, which is fundamental. The aim of the current study is to determine the prevalence of MDRO among different Ain Shams University Hospitals (ASUHs) intensive care units (ICUs) and detect the resistance profile of the common pathogens.ResultsThe 1-year records of a total of 1280 pathogens were studied. The highest number of pathogens were isolated from blood cultures (44.84%), followed by urine (41.41%) then wound swabs (13.75%). Gram-negative isolates (57.5%) were more prevalent than gram-positive ones (31.1%). The most frequently isolated pathogens were Klebsiella spp. (22.5%), Escherichia coli (13.4%), and Coagulase-negative Staphylococci (12.5%). The highest percentage of resistance among gram-positive organisms was exhibited by penicillin (89.5%) followed by erythromycin (83.98%) and then cefoxitin (76.52%). None of the isolates showed resistance to linezolid and resistance to vancomycin was minimal (2.62%). Gram-negative isolates exhibited high overall resistance to all used antibiotic classes. The least frequency of resistance was recorded against nitrofurantoin (52.5%), amikacin (58.01%), followed by imipenem (59.78%) and meropenem (61.82%). All isolates of Pseudomonas and Acinetobacter showed 100% susceptibility to colistin.ConclusionsThe prevalence of antibiotic resistance in Ain Shams University Hospitals (ASUHs) was high among both gram-negative and gram-positive organisms. This high resistance pattern foreshadows an inevitable catastrophe that requires continuous monitoring and implementation of effective antibiotic stewardship.
Highlights
The nightmare of the rising numbers of multidrug-resistant organisms (MDROs) requires the implementation of effective stewardship programs
Since the intensive care unit (ICU) patients are more prone to nosocomial infections caused by aggressive pathogens, the present study aimed to identify and obtain a comprehensive idea about the current situation in Ain Shams University Hospitals (ASUHs) regarding the spectrum of microbes and the antimicrobial resistance pattern of the most prevalent pathogens isolated from variable infection sites of ICU patients in addition to the determination of the prevalence of multiple drug resistance through a 1-year retrospective study
The records of the pathogenic organisms recovered from different microbiological samples of ICU patients sent for routine diagnosis in microbiology laboratory were retrieved from the microbiology laboratory information system at ASUHs and reviewed
Summary
The nightmare of the rising numbers of multidrug-resistant organisms (MDROs) requires the implementation of effective stewardship programs This should be preceeded by making available evidence-based knowledge regarding the local antimicrobial resistance pattern, which is fundamental. Antimicrobial resistance is rapidly becoming a global focus of attention, especially with the rising number of microorganisms resistant to available antimicrobials. It encompasses both the gram-positive and gram-negative bacteria, with global prevalence rates of 60% or more [1]. Multidrug-resistant organisms (MDROs) are described as acquired non-sensitivity to one or more agents in at least three groups of antimicrobials This kind of resistance essentially predominates in hospitals [2]. The Centers for Disease Control and Prevention (CDC) declared that worldwide increasing infection rates with resistant pathogens strikingly endanger our healthcare systems creating both negative universal economic effects and a therapeutic challenge for clinicians delaying proper antibiotic therapy and increasing mortality rates [5]
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