Antimicrobial Resistanceamong Intensive Care Unit Patients in A Tertiary Care Hospital of Bangladesh

Abstract

Background: Antimicrobial resistance is a growing concern specially among the critically ill patients who are often treated by multiple antibiotics. But, the data regarding the pattern of antimicrobial resistance in this population are often insufficient.
 Objective: To observe the pattern of antimicrobial resistance among the patients admitted into the intensive care unit (ICU).
 Methodology: This prospective observational study was carried out in the ICU of a tertiary care hospital of Bangladesh over 6 months. Samples of blood, urine, tracheal aspirate, wound swab and pus were obtained from the patients, cultured and analyzed.
 Results: Among 100 subjects, the most common primary diagnoses were aspiration pneumonia (29%) and urinary tract infection (UTI) (24%). Out of 315 samples, microorganisms were isolated from 125 samples (39.68%). The most common sample yielding positive culture was tracheal aspirate (67.2%), and the most frequently isolated microorganisms were Pseudomonas spp. (35%), Escherichia coli (28%), Acinetobacterspp. (24%) andKlebsiellaspp. (18%). Acinetobacterspp., Pseudomonasspp. and Klebsiellaspp.were the commonest resistant organisms. Overall prevalence of resistance to antibiotics were: ceftriaxone 72%, ceftazidime 78.4%, ciprofloxacin 81.6%, gentamicin 84%, meropenem 49.6% andnetilmicin 39.2%. Meropenem was the most sensitive antibiotic against Klebsiellaspp.(66.67%) but Acinetobacterspp.was still resistant to meropenem and amikacin but sensitive to cotrimoxazole (66.67%). Multidrug resistant Pseudomonas, Acinetobacter and, Klebsiella species were found; piperacillin-tazobactam combination showed <40% resistance against them. No single antibiotic showed good efficacy against Acinetobacterspp.
 Conclusion: The prevalence of antibiotic resistance is high among the ICU patients, and the majority of the isolated organisms are resistant to conventional antibiotics.
 Bangladesh J Medicine January 2021; 32(1) : 5-11

Determination of multi-drug resistance (MDR) profile of isolated Gram-positive and Gram-negative bacteria from clinical pus sample in Bangladesh

“…According to our ndings, the most common isolates associated with the transmission of germs by pus samples were Pseudomonas spp., followed by Enterococcus faecalis, E. coli, and Proteus spp. These ndings have been veri ed by additional studies [18,19]. In this study, Pseudomonas spp.…”

“…In this study, Pseudomonas spp. made up 58.69% of the gram-negative bacteria, and Enterococcus faecalis made up roughly 39.02% of the gram-positive bacteria [19][20].…”

Detection of Uropathogens and their Antimicrobial Susceptibility Pattern by VITEK2 Automated System in the Intensive Care Unit

“…13,28 Our study is slightly dissimilar with the finding of Jesmin et al in Bangladesh (Amikacin 28.57%, Gentamicin 14.29%, Meropenem 50%); Khan et al India Amikacin 40%, Meropenem 48% ) respectively. 29,21 The second prevalent organism, Klebsiella pneumoniae, shows the highest sensitivity towards Colistin and Ertapenem (100%, respectively), followed by Imipenem and Meropenem (40%, respectively). These findings were nearly comparable with other studies by Fatema et 17,29 The most effective drugs for Gram-positive were Linezolid.…”

“…29,21 The second prevalent organism, Klebsiella pneumoniae, shows the highest sensitivity towards Colistin and Ertapenem (100%, respectively), followed by Imipenem and Meropenem (40%, respectively). These findings were nearly comparable with other studies by Fatema et 17,29 The most effective drugs for Gram-positive were Linezolid. Other susceptible drugs against Grampositive bacteria were Vancomycin and Tigecycline.…”

Isolation of multidrug resistance bacteria from the patients with wound infection and their antibiotics susceptibility patterns: A cross-sectional study

“…Studies conducted in many developing nations, including Africa, Ethiopia, Nigeria, and Ghana, have shown that the presence of AMR and MDR reduces the effectiveness of treatments for common wound infections [ 15 , 16 ]. Thus, the development of AMR and MDR leads to therapeutic failure, prolonged hospitalization, increased treatment cost, mortality, and the spread of MDR pathogens [ 17 ].…”