Nosocomial sepsis and drug susceptibility pattern among patients admitted to adult intensive care unit of Ayder Comprehensive Specialized Hospital, Northern Ethiopia

Objective Developing nosocomial sepsis within intensive care unit (ICU) is associated with increased mortality, morbidity, and length of hospital stay. But information is scarce regarding nosocomial sepsis in intensive care units of Northern Ethiopia. Hence, this study aims to determine the incidence of nosocomial sepsis, associated factors, bacteriological profile, drug susceptibility pattern, and outcome among patients admitted to the adult ICU of Ayder Comprehensive Specialized Hospital (ACSH), which is the largest tertiary hospital in Northern Ethiopia. Method Facility-based longitudinal study was conducted by following 278 patients who were admitted for more than 48 h to adult ICU of ACSH, from October 2016 to October 2017. Data were collected from charts, electronic medical records, and microbiology registration book using a checklist. The collected data were subjected to descriptive statistics and multivariable logistic regression using SPSS version 25. Statistical significance was declared at p < 0.05. Result Of all the patients, 60 (21.6%) of them acquired nosocomial sepsis. The risk of mortality was about two times higher among adult ICU patients who acquired nosocomial sepsis (RR = 2.2; 95% CI of RR = 1.3–3.5; p = 0.003). The odds of acquiring nosocomial sepsis among those who were on a mechanical ventilator (MV) and stayed more than a week were 5.7 and 9.3 times higher, respectively, than their corresponding counterparts. Among 48 isolates, Klebsiella was the most common pathogen. The isolates had a broad antibiotic resistance pattern for cephalosporins, penicillins, and methicillin. Conclusion The incidence of nosocomial sepsis in the adult ICU patients of ACSH was higher when compared to the incidence reported from some African and Asian countries. Mortality was higher among patients who acquired nosocomial sepsis. Use of MV and longer length of ICU stay were the significant predictors of nosocomial sepsis. The isolates were resistant to several antibiotics. Therefore, strict application of infection prevention strategies and appropriate use of antibiotics is so crucial. As well, priority should be given to patients who develop nosocomial sepsis in ICU.

Study of Fungal Contamination Intensive Care Units of Arak Educational Hospitals and Determining Drug Sensitivity Profiles of Isolated Species

Background and Aim: Fungal infections are among the most critical and common issues for hospitalized patients, especially in intensive care units. This study aimed to determine the fungal contamination of indoor air and surfaces in sensitive wards of the Arak University of Medical Sciences educational hospitals and determine the drug susceptibility pattern of isolated species. Methods & Materials: In this descriptive cross-sectional study, 63 air samples were taken from sensitive hospital wards using the one-stage Anderson method, and 63 surfaces samples were taken using wet cotton swabs and cultured in saprodextrose agar medium containing chloramphenicol. Identification of the genus and, as far as possible, the species of fungi was performed using the culture method on the slide. Drug susceptibility testing was performed on isolated species by broth microdilution method (CLSI-M38A2 standard). Ethical Considerations: This study was approved by the Research Ethics Committee at Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.315). Results: From the total samples, 18 species of fungi were isolated. These included: Aspergillus niger (8), Aspergillus flavus (4), Aspergillus fumigatus (2), Rhizopus spp. (2), Mucor spp. (1) and Fusarium spp. (1). In the drug sensitivity assay, instances of resistance included: Partial sensitivity of Aspergillus fumigatus to Itraconazole (1), Partial sensitivity of Aspergillus niger to Ketoconazole (1), and Resistance of Aspergillus niger to Itraconazole (1). Conclusion: The pattern of nosocomial fungal infection with pathogenic fungi and the drug susceptibility pattern of these organisms in other regions of Iran and the world is relatively consistent with the present study results. And drugs listed in global guidelines for treating these infections, such as voriconazole and caspofungin in the treatment of invasive aspergillosis and amphotericin B in the treatment of invasive mucormycosis and Fusarium wilt, are now effective drugs. Keywords: Invasive fungal infections, Airborne fungi, Dru

Nosocomial sepsis and drug susceptibility pattern among patients admitted to adult intensive care unit of Ayder Comprehensive Specialized Hospital, Northern Ethiopia

Objective: Developing nosocomial sepsis within intensive care unit (ICU) is associated with increased mortality, morbidity, and length of hospital stay. But information is scarce regarding nosocomial sepsis in Northern Ethiopia. Hence, this study aims to determine the prevalence of nosocomial sepsis, associated factors, bacteriological profile, drug susceptibility pattern, and outcome among patients admitted to the adult intensive care unit of Ayder Comprehensive Specialized Hospital (ACSH).Method: Facility-based cross-sectional study was conducted by reviewing the medical records of 278 patients admitted for more than 48 hours to adult ICU of ACSH from October 2016 to October 2017. Data were collected from charts, electronic medical records, and microbiology laboratory data registration book using a checklist. The collected data were subjected to descriptive statistics and multivariable logistic regression using SPSS 25. Statistical significance was declared at p<0.05.Result: Of all the patients, 60(21.6%) of them acquired nosocomial sepsis. The risk of mortality was about two times higher among those who acquired nosocomial sepsis (RR=2.2; 95% CI of RR=1.3-3.5; p=0.003). The odds of acquiring nosocomial sepsis among those who were on a mechanical ventilator (MV) and stayed more than a week was 5.7 and 9.3 times higher respectively than their corresponding counterparts. Among 48 isolates, Klebsiella was the commonest. The isolated organisms had a broad antibiotic resistance pattern for cephalosporin, penicillin, and methicillin.Conclusion: Mortality due to nosocomial sepsis in adult ICU was higher. Use of MV and longer length of in-hospital stay were significant risk factors for nosocomial sepsis. The isolated organisms were resistant to several antibiotics. Therefore, strict application of infection prevention strategies and appropriate use of antibiotics is so crucial.

Bacterial Isolates and Drug Susceptibility Pattern of Sterile Body Fluids from Tertiary Hospital, Northern Ethiopia: A Four-Year Retrospective Study

This study was conducted in Ayder comprehensive specialized Hospital, Mekelle, Northern Ethiopia, to determine the bacterial profiles and drug susceptibility pattern from body fluids. A total of 218 patients were investigated, of which 146 (67%) were males. The age of the study subjects ranged from 2 days to 80 years with 96(44%) in the age group of 15 years and above. The overall bacterial infection was 44 (20.2 %) of which gram positive bacteria were prevalent, 23 (52.3%) than gram negative bacteria 21 (47.7%). The predominantly isolated bacteria wereS. pneumonia,followed byK.pneumoniae, S. aureus, andE coli.Multidrug resistance was observed in 12 (100%) of the isolated gram positive bacteria and in 6 (75%) of the isolated gram negative bacteria.