ABSTRACT
Introducation: Multi-drug resistant nosocomial infections are one of the leading causes of mortality and morbidity amongst hospitalized patients throughout the world, accounting a major burden on the patients and public health system of any country Method :To determine the prevalence of aerobic bacterial in different clinical specimens received from various Intensive Care Units (MICU, SICU, CCU, PICU, and NICU) and their antibiotic susceptibility pattern in the isolated organisms in a tertiary care hospital in Jaipur, Rajasthan. Result : Out of 500 samples, 213 (43%) samples showed growth while 287 (57%) did not show any growth. In the 213 positive samples 183 (85.92%) were Gram Negative bacilli while 25(1.74%) were Gram Positive Cocci and 5 (2.34%) were candida spp.Out of Gram Negative Isolates Acinetobacter Spp. was found to be maximum 35.2% followed by E.coli 19.7% , Klebsiella spp.19.2%, Pseudomonas 12.2%, Citrobacter 0.93% and Proteus Spp. 0.93%. Among Gram Positive Isolates Staphylococcus aureus was maximum 6.5% followed by Enterococcus 3.75%, CONS 0.93% and streptococcus spp.0. 46%. Candida spp. contributes 2.34% of all positive culture. Conclusion: Isolates are sensitive to combination drugs while more resistant to single drug. Among gram negative bacteria most common isolate was Acinetobacter spp. 75 (35.2%) which were resistant to most of the antibiotics like amoxycillin- clavulanic acid (83%) , cefotaxime (76%), imipenem (71%), piperacillin- tazobactam (53%),cefepime (57%) while sensitive to aztreonam (64%) and cotrimoxazole (64%).
ABSTRACT
OBJECTIVE: To analyse the prevalent microorganisms and their antimicrobial resistance among intensive care unit patients in a tertiary care centre in New Delhi. METHODS: A retrospective study of all consecutive blood cultures from various intensive care unit patients in the hospital during four years (January 2008 to December 2011). Antibiotic consumption data in the intensive care units were also analysed during the same period. RESULTS: Out of the total 22,491 blood cultures processed, 2846 samples were positive and 3771 microorganisms were isolated. The blood culture positivity was estimated as 12.7% of which 67.5% were monomicrobial and 32.5% polymicrobial infections. Gram negative bacilli, Gram positive cocci, and fungi were isolated in 49%, 33%, and 18% cases, respectively. Coagulase negative staphylococcus was the commonest single isolate followed by Candida spp. A drastic shift in the distribution of Candida spp. towards nonalbicans along with high resistance to azole group of antifungals suggest echinocandins for the empiric therapy of candidemia. High penicillin resistance in Gram positive isolates suggest vancomycin, linezolid and tigecycline as the options for empiric therapy, whereas tigecycline and colistin are the only options remaining for highly resistant Gram negative isolates. Aminoglycosides were observed to have better sensitivity and reduced usage when compared with cephalosporins and ß-lactam + ß-lactam inhibitor combinations. CONCLUSIONS: High frequencies of multidrug resistant organisms were observed in intensive care units which is a warning as to use the only few effective antimicrobials wisely to reduce selective pressure on sensitive strains. .