Assessment of Antibiotic Use and Resistance Patterns in ICU Patient

Abstract

Intensive care units (ICUs), deliver advanced medical interventions to severely ill patients. These patients face heightened vulnerability to nosocomial infections stemming from multiple contributing elements, including underlying immunosuppression, extended hospitalizations, frequent exposure to invasive procedures, and the routine empirical administration of broad-spectrum antibiotics.

To assess antibiotic use and characterize the antimicrobial resistance patterns of bacterial and fungal isolates among patients admitted to the intensive care unit.

The study included 100 patients admitted in intensive care unit during the study period. At the time of sample collection, all patients were receiving prescribed antibiotic therapy, including cephalosporin’s, imipenem, meropenem, and vancomycin. Clinical specimens including tracheal aspirates, blood and urine samples were collected from these patients and submitted to the microbiology laboratory for culture and antimicrobial susceptibility testing. The antimicrobial susceptibility test and the identification of the isolated microorganisms were done using the VITEK® 2 Compact System (bioMérieux, France).

Pseudomonas aeruginosa was the most common isolates 37.5% followed by Acinetobacter baumannii 31.3%, Klebsiella pneumoniae and Staphylococcus aureus each were 8.3% of the isolates, Escherichia coli and Candida albicans were each detected in 6.3% of isolates, whereas Proteus mirabilis was the least frequently isolated organism, representing 2%. The high level of antimicrobial resistance observed in A. baumannii. Among the 41 Gram-negative bacterial isolates, 8 (19.5%) were identified as MDR, whereas 24 (58.5%) were classified as XDR.

The high proportion of MDR and XDR isolates observed in this study highlights the therapeutic challenges associated with bacterial infections in the ICU.