scholarly journals Antibiotic resistance pattern in intensive care unit of a tertiary care teaching hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 906
Author(s):  
Amit Bhatia ◽  
Juhi Kalra ◽  
Saurabh Kohli ◽  
Barnali Kakati ◽  
Reshma Kaushik
Keyword(s):  
Intensive Care Unit ◽  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents. 

Predictive Factors for the Development of Central Line–Associated Bloodstream Infection Due to Gram-Negative Bacteria in Intensive Care Unit Patients After Surgery

2008 ◽  
Vol 29 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Pranavi V. Sreeramoju ◽  
Jocelyn Tolentino ◽  
Sylvia Garcia-Houchins ◽  
Stephen G. Weber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Predictive Factors ◽  
Tertiary Care ◽  
Central Line ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Objectives.To examine the relative proportions of central line-associated bloodstream infection (BSI) due to gram-negative bacteria and due to gram-positive bacteria among patients who had undergone surgery and patients who had not. The study also evaluated clinical predictive factors and unadjusted outcomes associated with central line-associated BSI caused by gram-negative bacteria in the postoperative period.Design.Observational, case-control study based on a retrospective review of medical records.Setting.University of Chicago Medical Center, a 500-bed tertiary care center located on Chicago's south side.Patients.Adult intensive care unit (ICU) patients who developed central line-associated BSI.Results.There were a total of 142 adult patients who met the Centers for Disease Control and Prevention National Nosocomial Infection Surveillance System definition for central line-associated BSI. Of those, 66 patients (46.5%) had infections due to gram-positive bacteria, 49 patients (34.5%) had infections due to gram-negative bacteria, 23 patients (16.2%) had infections due to yeast, and 4 patients (2.8%) had mixed infections. Patients who underwent surgery were more likely to develop central line-associated BSI due to gram-negative bacteria within 28 days of the surgery, compared with patients who had not had surgery recently (57.6% vs 27.3%; P = .002). On multivariable logistic regression analysis, diabetes mellitus (adjusted odds ratio [OR], 4.6 [95% CI, 1.2-18.1]; P = .03) and the presence of hypotension at the time of the first blood culture positive for a pathogen (adjusted OR, 9.8 [95% CI, 2.5-39.1]; P = .001 ) were found to be independently predictive of central line-associated BSI caused by gram-negative bacteria. Unadjusted outcomes were not different in the group with BSI due to gram-negative pathogens, compared to the group with BSI due to gram-positive pathogens.Conclusions.Clinicians caring for critically ill patients after surgery should be especially concerned about the possibility of central line-associated BSI caused by gram-negative pathogens. The presence of diabetes and hypotension appear to be significant associated factors.

scholarly journals COLONIZATION AND ANTIBIOTIC RESISTANCE DYNAMICS OF PATIENTS AT INTENSIVE CARE UNIT (ICU)-OUR EXPERIENCE

2017 ◽  
Vol 10 (4) ◽  
pp. 417
Author(s):  
Mahesh Chandra Sahu ◽  
Ishwar Chandra Behera ◽  
Santosh Kumar Swain
Keyword(s):  
Intensive Care Unit ◽  
Drug Resistance ◽  
Intensive Care ◽  
Liver Abscess ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Specific Medium

introduction: Multidrug resistant strains are developed day by day due to empirical therapy in intensive care unit (ICU). Both gram positive and gram negative strains are found in ICU are drug resistant bacteria. In this study, the prevalence of drug resistance bacteria in ICU were determined.Materials and Methods: The clinical samples; ascitic fluid, blood, central line tip, ET aspiration  pleural fluid, pus from liver abscess, sputum, tracheal aspiration, urine and wound swabs were collected from ICU patients and cultured in specific medium. Subsequently antibiotic sensitivity pattern of isolated bacteria were carried out with disc diffusion methods.Results: A total number of 794 clinical samples were cultured in specific medium and it revealed 191 of single colonies, 145 were double colonies and 87 were 3 or multy-colonies. A total of 963 bacteria were isolated among them 180 were gram positive bacteria, BYC were 135 and rest were gram negative bacteria. There was no significantly difference in growth of microorganisms with respect to clinical samples as t test revealed P= 0.87. Among the gram negative bacteria; Klebsiela pneumonia were predominant and Proteous mirabilis was lowest. Tigecycline and colistin were most effective antibiotics agonist all bacteria. Conclusions: Urine samples of the patient’s revealed higher number of organisms where as pus from liver abscess found only one number of growths. The antibiotic stewardship programs must lead to significant decrease in all antibiotic used in the ICU setting. However, this result may be required further work to determine the fruitful necessary for success.Key words: Antibiotics, Intensive Care Unit, Bacterial infections, Drug resistance.

scholarly journals Five-year period evaluation of isolated agents and their resistance profiles in intensive care unit patients with malignancy

2020 ◽  
Vol 14 (08) ◽  
pp. 918-923
Author(s):  
Duygu Mert ◽  
Selda Muslu ◽  
Alparslan Merdin ◽  
Arif Timuroğlu ◽  
Ece Dirim ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Hospital Infections ◽  
Gram Positive ◽  
Icu Patients ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Acinetobacter Spp

Introduction: Patients treated in the intensive care unit (ICU) are usually patients who deteriorated health condition and could have longer hospital stay compared to other patients. Hospital infections are more common in ICU patients. The aim of this study was to evaluate the bacteria and treatment resistance profiles isolated from clinical specimens sent for hospital infections in ICU patients between January 1, 2014 and December 31, 2018. Methodology: Bacteria isolated from various clinical samples sent for hospital infections in hospitalized patients in the Anesthesia and Reanimation Intensive Care Unit were retrospectively analyzed. Results: Culture positivity was detected in 547 of the sent clinical samples. Eighty Gram-positive bacteria, 389 Gram-negative bacteria and 78 fungi infection were identified in a total of 547 positive cultures. In Gram-positive bacteria, 4 MRSA, 6 VRE and 30 MRCoNS were identified as resistant strains. In Gram-negative bacteria, Acinetobacter spp. was the most culture positive strain with the number of 223. Carbapenem resistance was found in 258 of the Gram-negative bacteria and ESBL positivity was found in 44 of the Gram-negative bacteria strains. Conclusions: Gram-negative bacteria were the most frequently isolated strain in samples. Recently, colistin resistance has been increasing in Acinetobacter spp. and the increase in carbapenemase enzyme in Escherichia coli, Pseudomonas and Klebsiella species has increased resistance to carbapenems. Knowing the microorganisms that grow in ICUs and their antibiotic resistance patterns may help to prevent contamination of resistant microorganisms by both appropriate empirical antibiotic treatment and more isolation as well as general hygiene standard precautions.

scholarly journals A study of infections in neonatal intensive care unit at a tertiary care hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 1349 ◽  
Author(s):  
Hemangi D Ingale ◽  
Vaishali A. Kongre ◽  
Renu S. Bharadwaj
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: As infection is a major cause of morbidity and mortality in neonates, early diagnosis and prompt treatment can prevent its serious consequences. The present study was conducted to determine the prevalence of infections in neonatal intensive care unit (NICU) of a tertiary care hospital and to study their risk factors, causative organisms and antimicrobial susceptibility pattern.Methods: Appropriate samples were collected from all neonates with clinical signs and symptoms of infections. Isolation of microorganisms, their identification and antimicrobial susceptibility was done according to standard microbiological techniques.Results: Among 1210 neonates admitted in the NICU, 393 (32.4%) were clinically suspected infections. The prevalence of Septicemia, Pneumonia, and Meningitis were 6%, 1.5%, 0.7% respectively. The predominant organisms causing neonatal infection were Gram negative bacteria followed by fungi and Gram positive bacteria. Among Gram negative bacteria, the antimicrobial resistance was highest for third generation Cephalosporins [Ceftazidime (81.1%), Cefotaxime (60.3%)]. In Gram positive bacteria highest resistance was observed for Penicillin and Ampicillin (91.3%). Methicillin resistance was observed in 91.6% of Coagulase negative Staphylococci (CoNS). All isolates of Candida parapsilosis were sensitive to Fluconazole, Voriconazole but resistant to Amphotericin B. Predominant risk factors were low birth weight (87.7%) and prematurity (75%). Maternal risk factors were pregnancy induced hypertension (13.4%) and premature rupture of membranes (PROM) (10.1%). The case fatality rate was 20.7%.Conclusions: There is a need of strict infection control measures and rational antibiotic policy to reduce the economic burden of hospital and community due to neonatal infections. 

scholarly journals Determination of Antibiotic Resistance Pattern of Organisms Isolated from Endotracheal Tube Cultures of Patients Admitted to Intensive Care Unit

2020 ◽  
Author(s):  
Masoum Khoshfetrat ◽  
Aliakbar Keykha ◽  
Morteza Sedaghatkia ◽  
Reza Farahmandrad ◽  
Mohammad Behnampour
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Icu Patients ◽  
Gram Negative ◽  
Antibiotic Resistance Pattern

Background: It is widely accepted that increased prevalence of antibiotic resistance of pathogens grown in the respiratory system in intensive care unit (ICU) patients is a very serious problem causing expansion of mortality. The most important strategy to prevent the occurrence and appropriate solution to control the antibiotic resistance is to thoroughly investigate the pattern of resistance in the studied ward. Therefore, the purpose of this study was to determine the antibiotic resistance pattern of organisms isolated from endotracheal tube secretions of patients admitted to ICU of Khatam-Al-Anbia Hospital at Zahedan in Iran. Methods: In the present retrospective and descriptive cross-sectional study, the medical records of patients hospitalized during 2013-2018 were included by census method and then selected based on inclusion criteria (n=1387). The required data, including age, gender, type of microorganism isolated from endotracheal tube cultures, antibiotic resistance and sensitivity, duration of intubation and cause of hospitalization, were recorded for each patient. Finally, the data were analyzed by descriptive statistics using SPSS 16 software. Results: Mean age of patients was 44.66 ± 21.39 years and mean duration of intubation was 17.96 ± 10.99 days. Stroke was the most common cause of hospitalization with a prevalence of 553 patients (49%). The prevalence of positive culture of endotracheal tube secretions was 1128 (81.3%) of which 71.5% were male (n=807) and 28.5% were female (n=321). The cultures of endotracheal tube secretions resulted in 933 (82.7%) gram-negative bacteria, 191 (16.9%) grampositive bacteria and 4 (0.4%) mixed isolates. The most prevalent gram-negative bacterium was Acinetobacter baumannii (37.2%) with the highest and lowest antibiotic resistance to Meropenem (95.1% resistance) and colistin (99.5% sensitivity), respectively. In addition, the most prevalent gram-positive bacterium was Staphylococcus epidermidis (50.3%) with the highest and lowest antibiotic resistance to Meropenem (85.7% resistance) and Vancomycin (92.2% sensitivity). Conclusion: The findings of the present study illustrate that there was widespread bacterial resistance to respiratory tract infections in our ICU patients. Due to the high sensitivity of gram-negative bacteria to colistin, the use of antibiotic combination with colistin in the control of pulmonary infections caused by these organisms can be a good choice. In addition, in the case of gram-positive bacteria, the highest sensitivity was to vancomycin; therefore, it can be the selective antibiotic to control infections caused by these bacteria.

scholarly journals THE STUDY OF MULTIDRUG-RESISTANCE IN NEONATAL INTENSIVE CARE UNIT AT THE CENTRAL JAVA HOSPITAL

2017 ◽  
Vol 10 (14) ◽  
pp. 80 ◽  
Author(s):  
Ika Puspita Sari ◽  
Titik Nuryastuti ◽  
Djoko Wahyono
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistance ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Central Java ◽  
Culture And Sensitivity

Objective: Multidrug-resistance (MDR) is defined as an acquired non-susceptibility to at least one agent in three or more antimicrobial categories. MDR can be caused by several factors, including the misuse of antibiotics.  Resistance to antibiotics still poses a global challenge, especially in Indonesia. This study aimed to identify patterns of MDR in Neonatal Intensive Care Unit (NICU) at the Central Java Hospital, during the period of January 2014 to December 2015.Methods: The study was conducted using a descriptive retrospective design. The research population comprised of 225 patients. Patient inclusion criteria were neonatal patients treated in NICU ward with infection diagnosis. All patients had culture and sensitivity examinations on their bloods. The culture and sensitivity examinations were performed by microbiology clinicians.Results: The most common infection type was sepsis (60%). The most common bacteria found in the blood specimen of patients in the NICU ward was Gram-negative bacteria with a 72% rate, the other was Gram-positive bacteria. Bacteria which infected patients include; Klebsiellapneumoniaessppneumoniae, Pseudomonas aeruginosa, Bulkholderiacepacia, Acinetobacterbaumannii, Enterobactercloacae ssp cloacae, Serratiamarcescens, Staphylococcus haemolyticusand Staphylococcus epidermidis. The research result showed that 97.8% MDR cases were reported in the NICU ward. Antibiotics which were still potent for all bacteria found in NICU patients were tigecycline, meropenem and ciprofloxacin (for Gram-negative bacteria) and tigecycline, linezolid, nitrofurantoin, moxifloksacin and vancomycin (for Gram-positive bacteria).Conclusion: A high percentage of MDR occurred in NICU patients. Sepsis is the most common diagnosis in NICU patients. The usage of third generation antibiotics should be limited and regulated systematically.   

scholarly journals PATIENTS' MICROFLORA COMPARATIVE CHARACTERISTICS OF DIFFERENT DEPARTMENTS AT THE NATIONAL HOSPITAL OF PEDIATRICS IN HANOI, VIETNAM

2019 ◽  
pp. 43-48
Author(s):  
L.V. Kataeva ◽  
A.P. Rebeshchenko ◽  
T.F. Stepanova ◽  
O.V. Posoiuznykh ◽  
Le Thanh Hai ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infectious Diseases ◽  
Hospital Environment ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
National Hospital ◽  
Statistical Research ◽  
Gram Positive ◽  
Gram Negative

We studied the microflora structure and resistance gathered from the biomaterial of patients and the environment objects of various departments at the National hospital of Pediatrics in Hanoi. 140 clinical samples of biomaterials from 74 patients treated in the intensive care unit, the infectious diseases and the gastroenterology departments were studied. A systematic approach including microbiological, epidemiological and statistical research methods was used in carrying out the study. Bacteria of the Enterobacteriaceae family (38.5 per cent) prevailed in the biomaterial of intensive care unit patients. Nonfermentative Gram-negative bacteria (46.5 per cent) occupied the leading positions in the infectious diseases department and Gram-positive bacteria (39.3 per cent) were in the gastroenterology department. Gram-positive flora (60.2 per cent in the intensive care unit and 50.7 per cent in the infectious diseases department) prevailed in the microflora structure gathered from hospital environment objects. We identified the prevalence of bacteria of the genus Enterobacteriaceae and non-fermentative Gram-negative bacteria with a wide spectrum of resistance in the departments of the National Hospital of Pediatrics.

scholarly journals CHARACTERISTICS OF ANTIBIOTIC RESISTANCE OF BACTERIA ISOLATED FROM INFANTS – PATIENTS OF NATIONAL HOSPITAL PEDIATRICS HANOI, VIETNAM

2017 ◽  
pp. 51-53
Author(s):  
T.F. Stepanova ◽  
L.V. Kataeva ◽  
A.P. Rebeshchenko ◽  
Le Thanh Hai ◽  
Khu Thi Khanh Dung ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
High Resistance ◽  
Gram Negative Bacteria ◽  
National Hospital ◽  
Gram Negative ◽  
Resistance To Antibiotics ◽  
Pure Block ◽  
Carbapenem Antibiotic

The results of studies of resistance to antibiotics microflora isolated from mucous pharynx and rectum of patients intensive care unit newborns of National Hospital of Pediatrics, Hanoi are presented. It is shown that gram-negative bacteria isolated from children have a high resistance to penicillins, cephalosporins and carbapenem. Antibiotic resistance of bacteria isolated from children receiving treatment in «pure» block did not differ from sustainability of the strains, selected from children in «dirty» block.

scholarly journals Frequency and predictors of colonization of the respiratory tract by VIM-2-producing Pseudomonas aeruginosa in patients of a newly established intensive care unit

2006 ◽  
Vol 55 (10) ◽  
pp. 1435-1439 ◽  
Author(s):  
Maria Horianopoulou ◽  
Nicholas J. Legakis ◽  
Maria Kanellopoulou ◽  
Sotiris Lambropoulos ◽  
Athanassios Tsakris ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Respiratory Tract ◽  
Tertiary Care ◽  
Nucleotide Sequencing ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Icu Stay

The aim of this study was to examine the frequency and predictors of colonization of the respiratory tract by metallo-β-lactamase (MBL)-producing Gram-negative bacteria in patients admitted to a newly established intensive care unit (ICU) of a tertiary care hospital. Specimens of tracheobronchial aspirates for microbiological studies were obtained every day for the first 3 days of the ICU stay and subsequently every third day for the rest of the ICU stay. PCR analysis and nucleotide sequencing were performed to identify bacteria that had MBL genes. Thirty-five patients (20 male, 15 female) were hospitalized during the initial 3 month period of functioning of the ICU. Colonization of the lower respiratory tract by Gram-negative bacteria was found in 29 of 35 patients (83 %) during the first 6–20 days (median 13 days) following admission to the ICU (13 patients with Acinetobacter baumannii, ten with Pseudomonas aeruginosa, three with Enterobacter aerogenes, two with Klebsiella pneumoniae and one with Stenotrophomonas maltophilia). Six of 29 patients (21 %) colonized with Gram-negative bacteria had bla VIM-2-positive P. aeruginosa isolates; one of these patients developed clinical infection due to this micro-organism. Previous use of carbapenems (P=0.01) or other β-lactams (P=0.03), as well as a stay in the ICU of >20 days (P<0.001), were associated with colonization with bla VIM-2-producing P. aeruginosa. In conclusion, colonization by Gram-negative bacteria of the respiratory tract of patients in this newly established ICU was common (83 %). Use of β-lactams, including carbapenems, was associated with subsequent colonization of the respiratory tract with MBL-positive P. aeruginosa.

scholarly journals Bacteriological Profile and their Susceptibility Pattern in Neonatal Intensive Care Unit at Tertiary Care Hospital in Wah

2020 ◽  
Vol 24 (3) ◽  
pp. 219-224
Author(s):  
Saba Mushtaq ◽  
Sohail Ashraf ◽  
Lubna Ghazal ◽  
Rida Zahid ◽  
Basharat Hussain ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Blood Samples ◽  
Gram Negative ◽  
Gram Positive Cocci

Introduction: Neonatal sepsis is a clinical syndrome characterized by multiple symptoms and signs of infection during the first month of life. The objective of this study is to determine the frequency of commonly isolated bacteria from patients of neonatal sepsis and their susceptibility patterns in POF hospital at Wah. Methods: This cross-sectional study was carried out in POF Hospital Neonatal intensive care unit and Microbiology laboratory from January 2018 to December 2019. The blood samples of patients suspected with neonatal sepsis were processed as per standard methodology. Results: Out of ninety blood samples, fifty-one (56.7%) yielded the growth of Gram-negative rods and thirty-nine (43.3%) yielded Gram-positive cocci. Among Gram-positive bacteria, coagulase-negative staphylococci were the most common pathogen isolated from 53.8% cases followed by methicillin-resistant Staphylococcus aureus (15.3%). Among Gram-negative bacteria, Klebsiella pneumoniae (54.90%) was the most frequently identified bacteria followed by Serratia marcescens (27.45%). The Gram-positive cocci were the most susceptible to linezolid (100%) followed by vancomycin (87.2%). The Gram-negative rods depict remarkable resistance to ciprofloxacin (92.2%), gentamicin (100%), and meropenem (54.9%). Conclusions: The study concluded a predominance of Gram-negative bacteria as a causative agent of neonatal sepsis in our setup. The bacterial isolates are highly resistant to commonly prescribed oral as well as injectable antibiotics. Implementation of infection control policies is a dire need to combat the grave situation of increasing antibiotic resistance.

Sign in / Sign up

Export Citation Format

Share Document