Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West Indies
Background. Intensive-care units (ICUs) are a source of multidrug-resistant organisms, owing to the indiscriminate usage of broad-spectrum antimicrobial drugs. In such settings, one must be aware of the spectrum of microbes and pattern of antibiotic usage.Objectives. To evaluate the spectrum, suscep...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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South African Medical Association
2017-10-01
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| Series: | Southern African Journal of Critical Care |
| Online Access: | http://www.sajcc.org.za/index.php/sajcc/article/download/284/286 |
| _version_ | 1797368730176454656 |
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| author | S Hariharan S Bidaisee D Chen |
| author_facet | S Hariharan S Bidaisee D Chen |
| author_sort | S Hariharan |
| collection | DOAJ |
| description | Background. Intensive-care units (ICUs) are a source of multidrug-resistant organisms, owing to the indiscriminate usage of broad-spectrum antimicrobial drugs. In such settings, one must be aware of the spectrum of microbes and pattern of antibiotic usage.Objectives. To evaluate the spectrum, susceptibility and resistance patterns of microbes found in ICU patients in a tertiary-care teaching hospital in Trinidad, and to quantify antimicrobial usage.Methods. All adult patients (≥15 years of age) admitted to the ICU for ≥48 h who developed nosocomial infections conforming to the Centers for Disease Control and Prevention criteria were included. Demographic data and clinical data, including specimens sent, isolates grown, antimicrobial sensitivity and resistance patterns, the usage of antimicrobials and patient outcomes, were recorded. Variables such as age, admission white blood cell count, duration of first antibiotic used, length of ICU stay, length of hospital stay, organ support and total comorbidities were analysed. Antimicrobial usage was quantified as the defined daily dosage per 1 000 patient-days.Results. A total of 153 patients with 287 microbiological specimens were studied. The mean patient age was 48.4 years, and the mean ICU length of stay was 7.9 days. The most common admitting diagnoses were sepsis and multiple trauma. Staphylococcus aureus was the most common isolate from blood and central venous lines, and Pseudomonas aeruginosa from tracheal aspirates and wound swabs. Non-survivors had significantly higher age, leucocyte count and organ support requirements, and shorter lengths of stay. Cefuroxime was the most-used antimicrobial in the unit.Conclusion. The usage pattern of antimicrobials did not correlate with susceptibility in most instances. There is a need to improve antimicrobial usage by implementing antimicrobial-stewardship programmes to establish an  antimicrobial protocol and guidelines for usage in the ICU. |
| first_indexed | 2024-03-08T17:36:53Z |
| format | Article |
| id | doaj.art-64fa4ea1c53f4fa1b45c84d495e06d8d |
| institution | Directory Open Access Journal |
| issn | 1562-8264 2078-676X |
| language | English |
| last_indexed | 2024-03-08T17:36:53Z |
| publishDate | 2017-10-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | Southern African Journal of Critical Care |
| spelling | doaj.art-64fa4ea1c53f4fa1b45c84d495e06d8d2024-01-02T12:00:29ZengSouth African Medical AssociationSouthern African Journal of Critical Care1562-82642078-676X2017-10-01332394510.7196/284Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West IndiesS HariharanS BidaiseeD ChenBackground. Intensive-care units (ICUs) are a source of multidrug-resistant organisms, owing to the indiscriminate usage of broad-spectrum antimicrobial drugs. In such settings, one must be aware of the spectrum of microbes and pattern of antibiotic usage.Objectives. To evaluate the spectrum, susceptibility and resistance patterns of microbes found in ICU patients in a tertiary-care teaching hospital in Trinidad, and to quantify antimicrobial usage.Methods. All adult patients (≥15 years of age) admitted to the ICU for ≥48 h who developed nosocomial infections conforming to the Centers for Disease Control and Prevention criteria were included. Demographic data and clinical data, including specimens sent, isolates grown, antimicrobial sensitivity and resistance patterns, the usage of antimicrobials and patient outcomes, were recorded. Variables such as age, admission white blood cell count, duration of first antibiotic used, length of ICU stay, length of hospital stay, organ support and total comorbidities were analysed. Antimicrobial usage was quantified as the defined daily dosage per 1 000 patient-days.Results. A total of 153 patients with 287 microbiological specimens were studied. The mean patient age was 48.4 years, and the mean ICU length of stay was 7.9 days. The most common admitting diagnoses were sepsis and multiple trauma. Staphylococcus aureus was the most common isolate from blood and central venous lines, and Pseudomonas aeruginosa from tracheal aspirates and wound swabs. Non-survivors had significantly higher age, leucocyte count and organ support requirements, and shorter lengths of stay. Cefuroxime was the most-used antimicrobial in the unit.Conclusion. The usage pattern of antimicrobials did not correlate with susceptibility in most instances. There is a need to improve antimicrobial usage by implementing antimicrobial-stewardship programmes to establish an  antimicrobial protocol and guidelines for usage in the ICU.http://www.sajcc.org.za/index.php/sajcc/article/download/284/286 |
| spellingShingle | S Hariharan S Bidaisee D Chen Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West Indies Southern African Journal of Critical Care |
| title | Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West Indies |
| title_full | Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West Indies |
| title_fullStr | Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West Indies |
| title_full_unstemmed | Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West Indies |
| title_short | Spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in Trinidad West Indies |
| title_sort | spectrum of microbial growth and antimicrobial usage in an intensivecare unit of a tertiarycare hospital in trinidad west indies |
| url | http://www.sajcc.org.za/index.php/sajcc/article/download/284/286 |
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