Microbial etiology and antimicrobial resistance in healthcare-associated versus community-acquired and hospital-acquired bloodstream infection in a tertiary care hospital

Abstract Background Hospital Acquired Infections (HAIs) are the emerging threat in the health care facilities around the globe. Most of Intensive Care Unit(ICU)patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. Objective was to study the occurrence of different types of HAIs in patients admitted to various ICUs of and the AMR pattern of the bacterial pathogens isolated from them. Methods It was a retrospective descriptive study based on culture reports of the patients admitted to surgical, Medical ICU of tertiary care hospital during period from March 2019 to October 2019. Results Most common culture positive clinical specimen received was tracheal aspirate(35.3%) followed by exudate(22.7%).Pseudomonas from blood specimens were the most common organisms isolated; whereas Escherichia coli was the predominant organism found in urine, exudate and sterile fluid specimens. About 25% infections were HAIs, out of which pneumonia(7.24%)was the most common. Analysis of antimicrobial susceptibility pattern revealed that most of Gram-Negative Bacilli(GNB) was Multi Drug Resistant(MDR) resistant to three or more class of antibiotics such as cephalosporins, aminoglycosides, tetracyclines and fluoroquinolones. Conclusions Increasing trend of AMR among hospital acquired pathogens such as MDR-GNBs,MRSA and VRE pose a great threat to critically ill patients of ICUs. Study on AMR surveillance is the need of the hour as it helps the centers to generate local antibiogram which further helps in formulating the national data. Hence, such studies will be a stepping stone in establishing antimicrobial stewardship and regulate the antimicrobial resistance in future Key messages Study on AMR surveillance is the need of the hour. such studies will be a stepping stone in establishing antimicrobial stewardship and regulate the antimicrobial resistance in future.

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High Prevalence and Endemicity of Multidrug Resistant Acinetobacter spp. in Intensive Care Unit of a Tertiary Care Hospital, Varanasi, India

Journal of Pathogens ◽

10.1155/2018/9129083 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Tuhina Banerjee ◽

Anwita Mishra ◽

Arghya Das ◽

Swati Sharma ◽

Hiranmay Barman ◽

...

Keyword(s):

Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Polymyxin B ◽

Multidrug Resistant ◽

North India ◽

Care Hospital ◽

High Prevalence ◽

Healthcare Associated ◽

Hospital Acquired

The increasing emergence of Acinetobacter spp. with healthcare associated infections (HCAI) in intensive care units (ICU) is alarming. This study was a laboratory-based audit to determine the prevalence of Acinetobacter spp. associated with HCAI in the adult ICU of a tertiary care hospital in Varanasi, north India, with special reference to antimicrobial resistance and resistance determinants over a period of 5 years. A total of 993 cases of HCAI were analyzed. Isolates were characterized as multidrug resistance and extended drug resistance (MDR/XDR) based on antimicrobial susceptibility records. Few (100) randomly selected isolates of Acinetobacter baumannii (A. baumannii) were tested for imipenem, meropenem, and polymyxin B susceptibility by minimum inhibitory concentration (MIC) and for the presence of class A and B carbapenemases by multiplex PCR. Active surveillance of ICU environment was also performed. High prevalence of Acinetobacter related hospital acquired pneumonia (HAP) with significant resistance to imipenem (p<0.05) and 88.02% MDR and 61.97% XDR was detected along with persistence in the ICU environment. The isolates harbored blaIMP (89%), blaVIM (51%), blaNDM-1 (34%), and blaOXA-23-like (93%) genes. Specific interventional measures should be adopted to control these imipenem resistant Acinetobacter spp. which have attained the level of endemicity in our ICU setup.

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