RESUMEN
Hospital-acquired infections encompass almost all clinically evident infections that do not originate from a patient's original admitting diagnosis. Nosocomial infections are one of the major causes of morbidity and mortality in Pakistan. This study was conducted to determine the frequency of hospital-acquired infections and its causative organisms in patients admitted to a surgical intensive care unit. A prospective observational study was carried out at Holy Family Hospital, Rawalpindi from July 2007 to April 2008. Clinical samples of tracheal aspirates, sputum, urine, blood, body fluids, pus and others were collected from patients admitted to intensive care unit and cultured. Bacterial isolates were identified along with their antimicrobial susceptibility. A total of 156 samples were collected. Bacteria or candida species were isolated in 89[57.1%] samples. Highest infection was seen in respiratory tract followed by surgical sites. Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli and candida spp. were the commonest organisms. The isolation rate of gram-positive bacteria was relatively low. Resistance pattern of gram-negative isolates was: ampicillin, 67[90.5%]; co-trimoxazole, 67[90.5%]; cefaclor, 66[89.2%]; co-amoxyclav, 64[86.5%]; tetracycline, 61[82.4%]; rifampicin, 59[79.7%] cephradine, 58[78.4%]; ceftriaxone, 58[78.4%], ceftazidime, 57[77.0%], lincomicin, 53[71.6%]; ofloxacin, 50[67.6%]; ciprofloxacin, 50[67.6%]; cefotaxime, 49[66.2%]; gentamicin, 47[63.5%]; chloramphenicol, 45[60.8%]; levofloxacin, 41[55.4%]; fosfomycin, 37[50%];sparfloxacin, 35[47.3%]; enoxacin, 29[39.2%]; imipenem, 27[36.5%]; moxifloxacin, 21[28.4%], amikacin, 21[28.4%]; and aztreonam, 14[18.9%]. The high frequency of hospital acquired infections suggests that infection control practices are not strictly observed along with indiscriminate prescription of antibiotics that are causing emergence of antimicrobial resistant organisms. Guide lines to control facility based transmission of infections should be strictly followed