Bacterial profile and their antibiotic resistance patterns from blood culture in Intensive Care Unit patients at the University Of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

Abstract Background: The burden of bloodstream infection and antibiotic resistance in intensive care unit (ICU) is high when compared with other settings. The data on the changing antibiotic resistance trends are important for infection control activities. There is no sufficient data in the intensive care units of this hospital. Objective: The aims of this study were to assess the magnitude and risk factors of bacterial pathogens and their antibiotic resistance patterns of blood culture isolates from ICU patients at the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. Materials and Methods: A cross-sectional study was conducted from February to May 2018.Blood specimen were collected from 384 patients and inoculated on appropriate culture media. Identification of bacterial pathogens and antibiotic susceptibility tests were performed using bacteriological standard methods. Presence of Extended Spectrum Beta Lactamase (ESBL) enzymes was confirmed by combined disk diffusion method. Data were analyzed using SPSS version 20. Result: Of the total 384 study participants, 96(25%) were culture positive. Majority of bacteria isolates 67(69.8%) were Gram negative. The commonly isolated bacterial species were K.pneumoniae 18(18.8%), Coagulase negative Staphylococcus 13(13.5%), K.ozanae 10(10.4%), K.rhinose 8(8.3%) and E.coli, E.cloacae, Citrobacter species, S.aureus each accounts 7(7.3%). Gram negative isolates were found to be resistant to ampicillin 66(98%), amoxicillin/clavulanate 64(95%) and ceftriaxone 52(77.6%). However, amikacin 64(95.5%), meropenem 58(87%) and Ciprofloxacin 56(83.6%) were relatively effective drugs. Gram positive isolates were found to be resistant to Penicillin 28(96.5%), amoxicillin/clavulanate27 (93.1%) and erythromycin 26(90%). They were sensitive to ciprofloxacin 22(79%) and clindamycin 24(83%). Methicillin resistant S.aureus accounted 4(57.1%) and ESBL enzyme producing Gram negative isolates accounted 41(78.8%). Conclusion: Klebsiella species were the predominant bacterial isolates in ICU settings. Antibiotic resistance due to ESBL enzyme production is alarmingly high. This result might be a reflection of inappropriate use of antibiotics and poor infection prevention control practice in these settings. Key words: Antibiotic resistance, ICU, ESBL, Gondar Ethiopia.