Abstract
Intensive care units are complex environments favoring high resistance in microorganisms. This study evaluated the resistance and the distribution dynamics of resistant Gram-negative bacteria (GNB) in patients admitted to intensive care units. This retrospective, record-based, cross-sectional study analyzed all of the antibiograms of patients admitted to the ICUs. The BD Phoenix system (BD Diagnostics, Sparks, MD, USA) was used for bacterial identification and antimicrobial testing. Clinical and Laboratory Standard Institute recommendations were used for antimicrobial testing. Frequencies and percentages of multidrug and pan-drug resistance were calculated. A total of 570 bacterial growths were observed, out of which 437 (76.7%) were of GNB. K. pneumoniae (21.0%), P. aeruginosa (11.8%), and Staphylococcus aureus (13.2%) were the most frequent disease-causing bacteria in intensive care patients. Resistance rates of 73.2% and 70.1% were observed for third- and fourth-generation cephalosporins, respectively, while 48.2% carbapenem and > 65% fluoroquinolones resistance rates were observed. Amikacin was the most effective antibiotic, with a sensitivity rate of 69.5%. A total of 372 (85.1%) of GNB were multidrug resistant. The majority of infections in intensive care patients are caused by multidrug-resistant (MDR) Gram-negative bacteria. Female gender and advancing age are factors favoring MDR. Enhanced surveillance and strengthening of the antimicrobial stewardship program are warranted.
Highlights
We evaluated the resistance patterns—especially the MDR patterns—and the distribution dynamics of the resistant Gram-negative bacteria in patients admitted to intensive care units
Bacteria were frequently isolated from blood (28.8%) and urine
ICU patients are increasingly subjected to invasive procedures such as central venous catheterization, arterial catheterization, intra-aortic balloon pump (IABP), tracheostomy, etc
Summary
Antimicrobial resistance is being increasingly recognized throughout the world, and is offsetting the success story of antibiotics. The world is encountering a grave threat of resistant bacterial infections, which have emerged as a significant public health problem. Microorganisms are developing new resistance mechanisms that increase their capacity to spread globally and cause prolonged illness, disability, and death. In the absence of efficacious antimicrobials, medical procedures are becoming increasingly risky, and result in more extended hospital stays, often requiring intensive care [1]. Emanation of antimicrobial resistance is considered to be a natural phenomenon, it may be driven by the use of antimicrobial agents in healthcare settings, agriculture, and the environment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
