Antimicrobial sensitivity patterns among the sepsis patients in the intensive care unit of Dhaka Medical College Hospital, Bangladesh

2017 ◽  
Vol 2 (1) ◽  
pp. 80-87
Author(s):  
A. M. Khan ◽  
F. T. Jannat ◽  
M. F. Ahasan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
Antimicrobial Sensitivity

scholarly journals Patterns of Antimicrobial Resistance Among Intensive Care Unit Patients of A Private Medical College Hospital in Dhaka

2015 ◽  
Vol 25 (2) ◽  
pp. 47-51 ◽  
Author(s):  
Quazi Tarikul Islam ◽  
Md Mahmudur Rahman Siddiqui ◽  
Farhana Raz ◽  
Mohammad Asrafuzzaman ◽  
Md Robed Amin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Aspirate ◽  
College Hospital ◽  
Icu Patients ◽  
Gram Negative ◽  
Pseudomonas Spp ◽  
Medical College ◽  
Acinetobacter Spp ◽  
Klebsiella Spp

Because of importance of Hospital acquired infections (HAIs), it is critical to conduct surveillance studies to obtain the required data about the regional microorganisms and their susceptibility to antibiotics. This study to investigate antimicrobial resistance pattern among Intensive Care Unit (ICU) patients in a private medical college hospital setup. In a cross sectional study, 100 specimens from patients admitted in the ICU who had signs or symptoms of nosocomial infection were collected from 2012 - 2013. For each patient, samples of blood, urine, tracheal aspirate, sputum, wound swab, pus, and endotracheal tubes were obtained, cultured and analyzed with antibiogram. The most common primary diagnosis were aspiration pneumonia (49%) and UTI (20%) respectively. The most common locations for infection were tracheal aspirate (54%). The most frequent gram negative microorganisms derived from samples were Acinetobacter spp (29%), Klebsiella spp (26%) and Pseudomonas spp (18%). Klebsiella spp, Acinetobacter spp and Pseudomonas spp were most common resistant organisms among all. Klebsiella spp were resistant against Ceftriaxone (84.6%), Ceftazidime (82.6%), Amikacin (46.1%), Gentamicin (66.6%) and Quinolones (65-66.6%) respectively. Acinetobacter spp were resistant against Ceftriaxone (85%), Ceftazidime (88.8%), Cefotaxime (85.7%), Meropenem (79.3%),Amikacin (86.2%), Gentamicin (84.5%) and Quinolons (86.2-89.2%) respectively. Pseudomonas spp were resistant against Ceftriaxone (70.5%), Ceftazidime (66.6%), Amikacin (68.7%), Gentamicin (58.8%), Meropenem (52.9%) and Quinolones (81.2-86.6%) respectively. Meropenem was the most sensitive antibiotic against Klebsiella spp (84.6%) but Cotrimoxazole in case of Acinetobacter spp (60%) respectively. Escherichia coli were mostly isolated from urine, which was sensitive to Amikacin (73.3%) and Meropenem (86.6%) respectively. Gram-negative pathogens obtained from ICU patients in our settings show high resistance to antibiotics. Regular monitoring of the pattern of resistance of common pathogens in the ICUs is essential to up-to-date the use of rational antibiotics regiments.Bangladesh J Medicine Jul 2014; 25 (2) : 47-51

scholarly journals Profile of Intensive Care Unit admission and Outcomes of Medical and Surgical patients at A Tertiary Government Hospital: A 5 Year Trend Analysis

2018 ◽  
Vol 29 (2) ◽  
pp. 59-62
Author(s):  
Shakera Ahmed ◽  
Omar Faruque Yusuf ◽  
AKM Shamsul Alam ◽  
Anisul Awal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Ventilatory Support ◽  
Surgical Patients ◽  
College Hospital ◽  
Medical College ◽  
Advanced Airway ◽  
Medical Discipline ◽  
Record Review

Background: The intensive care unit (ICU) is that part of the hospital where critically ill patients that require advanced airway, respiratory and haemodynamic supports are usually admitted. Intensive care unit admissions which aim at achieving an outcome better than if the patients were admitted into other parts of the hospital however come at a huge cost to the hospital, the personnel and patients’ relations.Objective: To audit the 5 year bed occupancy rate and outcome of medicine and surgical patients admitted into the ICU of the Chittagong Medical College Hospital, Chittagong, Bangladesh.Design: A 5 years retrospective study (Record review) from January 2012 to December 2016. Method: Data were extracted from the ICU records of the patient and analyzed.Results: During this study period, the frequency of admission into ICU was significantly more (p<0.001) from medical discipline (55.20%) than surgical disciplines (44.80%). The incidence of survival was significantly lower (p<0.001) from medical discipline (37.68%), than from surgical disciplines (49.05%). Occurrence of total ventilatory support provided in all disciplines was 60.32% and it was significantly higher for the surgical patients. Overall mortality rate was 57.23%.Conclusion: During prioritizing the patients for ICU admission surgical cases should get preference. It is primarily necessary to optimize patient to doctor ratio and patient to nurse ratio and providing the service by critical care physicians (“intensivists”) to reduce the mortality rate of ICU.Bangladesh J Medicine Jul 2018; 29(2) : 59-62

scholarly journals Acute Kidney Injury in Patients of Intensive Care Unit

2017 ◽  
Vol 8 (1) ◽  
pp. 38-44
Author(s):  
Nazneen Mahmood ◽  
Md Fazlur Rahman ◽  
Md Mostafizur Rahman ◽  
SM Hossain Shahid ◽  
Md Mahmudur Ahman Siddiqui
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Type I ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Failure Group ◽  
Medical College

Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44

Tracheostomy in Intensive Care Unit: Indications, Benefits and Complications

2015 ◽  
Vol 21 (1) ◽  
pp. 28-32
Author(s):  
Muddassir Mahmud ◽  
Md Abul Hossain ◽  
Md Zakaria Sarkar ◽  
HS Mubarak Hossain ◽  
Md Obaidul Islam ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Endotracheal Intubation ◽  
Cervical Spinal Cord ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Cord Injury

Objectives: To see the common indications of tracheostomy in ICU in this country, to compare the benefits over endotracheal intubation and to find out the pattern of complication of tracheostomy in the ICU to enrich the ideas for minimizing the complications.Methods: This is a cross sectional study was carried out at the Department of Otolaryngology and Head-Neck Surgery and Intensive Care Unit of Bangabandhu Sheikh Mujib Medical University & Dhaka Medical college Hospital, Dhaka from October 2012 to march 2013.This study includes all ICU patients, irrespective of age and sex, whose tracheostomy has done after admission in Intensive Care Unit.Results: The study revealed that the commonest indication of tracheostomy in the ICU was head injury with history of RTA (27.5%), followed by post operative case of Intracranial space occupying lesion (25%). Next common indications were Guillain-Barre syndrome (15%), cerebrovascular accident (12.5%), Maxillofacial trauma (5%), RTA with cervical spinal cord injury (5%), and post operative pneumonia (5%)., Regarding benefits of tracheostomy over endotracheal intubation in ICU we found that 100% patient had greater comfort.The rate of complication of tracheostomy in ICU was 10% in this study. Surgical emphysema was the commonest complications (5%) followed by haemorrhage(2.5%) and tube displacement(2.5%).Bangladesh J Otorhinolaryngol; April 2015; 21(1): 28-32

scholarly journals Antimicrobial Resistance Pattern of Bacterial Isolates from Intensive Care Unit of a Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 8 (1) ◽  
pp. 7-11
Author(s):  
Taslima Akter ◽  
Mohammad Murshed ◽  
Taslima Begum ◽  
Kamrun Nahar ◽  
Syeda Sharmin Duza ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Care Hospital ◽  
College Hospital ◽  
Antibiotic Susceptibility Pattern ◽  
Medical College ◽  
Highly Active ◽  
The Common

Infections with resistant strain are one of the leading causes of morbidity and mortality in hospitalized patients especially the critically ill patients in intensive care unit (ICU). The present study was conducted to know the changing pattern of antibiotic resistance of the common isolates from blood, urine, respiratory secretions and pus/ wound swab of patients admitted in ICU at Holy Family Red Crescent Medical College hospital over a two years period from January 2012 to December 2013. A total of 1282 samples were analyzed. Out of which 301 (23.5%) samples were positive for growth of organisms. The predominant isolates were E.coli (28%), Klebsiella (27%), Acinetobacter (17.3%), Pseudomonas (9.6%), Staphylococcus aureus (5.3%) & candida (6%). Majority isolates were resistant to Cephalosporin and Amoxycillin, (>70-90%). Carbapenem were still highly active against E.coli. However, Klebsiella, Pseudomonas and Acinetobacter were showing alarming resistance (55-60%) towards those drugs. Aminoglycosides resistance has also increased for Pseudomonas and Klebsiella. The percentage of Cloxacillin resistant for staphylococcus was near about 40%. The most active drug against Pseudomonas was piperacillin/Tazobactam. The positive result from this study was that organisms showed decreased resistance towards Tetracycline, Cotrimoxazole and Ciprofloxacin. The sensitivity of Nitrofurantoin for urinary isolates was good. Regular surveillance of antibiotic susceptibility pattern & judicious use of antibiotics is very important for reducing the infection rate and antimicrobial resistance.Bangladesh J Med Microbiol 2014; 08 (01): 07-11

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