Backgrounds & Objective:Antimicrobial resistance is a major health problem worldwide in hospitals. The main contributing factors are exposures to broad-spectrum antimicrobials and cross-infections. Understanding the extent and type of antimicrobial use in tertiary care hospitals will aid in developing national antimicrobial stewardship priorities.Methods:In this study, we have analyzed the antimicrobial agents’ usage for acquisition of multidrug resistant using retrospective, cross-sectional, single-centre study in a multidisciplinary ICU at tertiary care hospital.Results:Acinetobacter baumannii (ACB) was isolated in various specimens from 662 patients. From these, 136 patients who were diagnosed with Ventilator-associated pneumonia (VAP) caused by ACB were included into the study. In our study, MDR strain accounts for 51% of all VAP cases caused by ACB. The development of ACB VAP were 10.5 + 6.4 days for MDR strains compared to susceptible organism (7.8 + 4.5 days) and had significantly longer ICU stay.Conclusion:The study concludes that prudent use of antimicrobial agents is important to reduce acquisition of MDR ACB.

Among the group who had hypoperfusion, 94.4% were post cardiac surgery, of which 84.9% had cyanotic congenital heart disease. Treatment with peritoneal dialysis occurred in intensive care unit in 93.8% of the patients. It is associated with mechanical ventilation in 92.1%, use of two or more inotropes in 85.3% and two or more organ dysfunction in 71.2%. The indications for peritoneal dialysis were fluid overload(60.5%), uraemia and fluid overload(26.6%), uraemia(11.9%) and others(1.7%). Technique failure occurred in 1.1% of the patients and they were switched to haemodialysis. Mortality in our PD cohort was 30.5%. Age, weight, gender and primary aetiology of AKI were not significant risk factors of death. At hospital discharge, mean serum creatinine was 47.6(CI 34.3-60.9)mcmol/ L and estimated glomerular filtration rate(eGFR) was 89.7(CI 78.5-100.9) mls/min/1.73m 2. 10% of the patients had eGFR less than 60mls/min/m 2. None of the survivors developed end stage renal failure at hospital discharge. Conclusions: PD offers good patient survival and renal outcome as evidenced in our cohort. Hence, PD is a viable first line renal replacement therapy in severe AKI for young children with low body weight even if they are critically ill.

No abstract

No abstract

No abstract