ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN.
Intro: Antimicrobial resistance (AMR) is a major factor in patient outcomes in the intensive care unit (ICU). The majority of Intensive Care Unit (ICU) patients are on broad-spectrum antimicrobials, which induces selective antibiotic pressure leading to Antimicrobial Resistance development (AMR) amo...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-08-01
|
| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971223006215 |
| _version_ | 1797745273468878848 |
|---|---|
| author | Z. Nasir D.N. Khan D.N. Noreen |
| author_facet | Z. Nasir D.N. Khan D.N. Noreen |
| author_sort | Z. Nasir |
| collection | DOAJ |
| description | Intro: Antimicrobial resistance (AMR) is a major factor in patient outcomes in the intensive care unit (ICU). The majority of Intensive Care Unit (ICU) patients are on broad-spectrum antimicrobials, which induces selective antibiotic pressure leading to Antimicrobial Resistance development (AMR) among the microorganisms of ICUs. The aim was to study the occurrence of different types of ICU-acquired infections and the AMR pattern of the bacterial pathogens isolated from them. Methods: It was a descriptive study based on retrospective data collection including culture reports of all patients admitted to the ICUs during the period from April 2022 to June 2022. A total of 3453 isolates were obtained from the clinical specimens of 2,895 patients. Data on sociodemographic characteristics, type of ICU, site of infection, type of HAI, and AMR including co-resistance were collected and analyzed using SPSS version 24. Findings: The ICU infection rate was 62.3%. The most common culture-positive clinical specimen received was tracheal aspirate (35.6%) followed by exudate (22.7%). The most common organisms isolated were Acinetobacter spp from tracheal aspirate and Pseudomonas spp from blood specimens; whereas the predominant organism found in urine, exudate, and sterile fluid specimens were Escherichia coli. Candida species were found in 28.2%. About 17.5% of infections were HAIs, out of which pneumonia (8.43%) was the most common. The antimicrobial susceptibility pattern analysis revealed that most Gram-Negative Bacilli (GNB) were resistant to three or more classes of antibiotics such as cephalosporins, carbapenems, aminoglycosides, tetracyclines, and fluoroquinolones. Multi Drug Resistant (MDR). Conclusion: The rising trend of AMR among hospital-acquired pathogens such as MDR-GNBs, MRSA, and VRE renders an enormous threat to HCWs and other critically ill patients of the ICUs. A robust antimicrobial stewardship program along with educational intervention is critical to combat this issue. Hence, such studies will be a stepping stone in establishing antimicrobial stewardship and regulating antimicrobial use. |
| first_indexed | 2024-03-12T15:22:03Z |
| format | Article |
| id | doaj.art-a2d6cad59d1241b1b3d0a9223f93820d |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-03-12T15:22:03Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-a2d6cad59d1241b1b3d0a9223f93820d2023-08-11T05:32:20ZengElsevierInternational Journal of Infectious Diseases1201-97122023-08-01134S19ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN.Z. Nasir0D.N. Khan1D.N. Noreen2Islamabad International Airport, Islamabad, Directorate of Central Health Establishments, Islamabad, PakistanFGPC, Surgery, Islamabad, PakistanIslamabad International Airport, Islamabad, Directorate of Central Health Establishments, Islamabad, PakistanIntro: Antimicrobial resistance (AMR) is a major factor in patient outcomes in the intensive care unit (ICU). The majority of Intensive Care Unit (ICU) patients are on broad-spectrum antimicrobials, which induces selective antibiotic pressure leading to Antimicrobial Resistance development (AMR) among the microorganisms of ICUs. The aim was to study the occurrence of different types of ICU-acquired infections and the AMR pattern of the bacterial pathogens isolated from them. Methods: It was a descriptive study based on retrospective data collection including culture reports of all patients admitted to the ICUs during the period from April 2022 to June 2022. A total of 3453 isolates were obtained from the clinical specimens of 2,895 patients. Data on sociodemographic characteristics, type of ICU, site of infection, type of HAI, and AMR including co-resistance were collected and analyzed using SPSS version 24. Findings: The ICU infection rate was 62.3%. The most common culture-positive clinical specimen received was tracheal aspirate (35.6%) followed by exudate (22.7%). The most common organisms isolated were Acinetobacter spp from tracheal aspirate and Pseudomonas spp from blood specimens; whereas the predominant organism found in urine, exudate, and sterile fluid specimens were Escherichia coli. Candida species were found in 28.2%. About 17.5% of infections were HAIs, out of which pneumonia (8.43%) was the most common. The antimicrobial susceptibility pattern analysis revealed that most Gram-Negative Bacilli (GNB) were resistant to three or more classes of antibiotics such as cephalosporins, carbapenems, aminoglycosides, tetracyclines, and fluoroquinolones. Multi Drug Resistant (MDR). Conclusion: The rising trend of AMR among hospital-acquired pathogens such as MDR-GNBs, MRSA, and VRE renders an enormous threat to HCWs and other critically ill patients of the ICUs. A robust antimicrobial stewardship program along with educational intervention is critical to combat this issue. Hence, such studies will be a stepping stone in establishing antimicrobial stewardship and regulating antimicrobial use.http://www.sciencedirect.com/science/article/pii/S1201971223006215 |
| spellingShingle | Z. Nasir D.N. Khan D.N. Noreen ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN. International Journal of Infectious Diseases |
| title | ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN. |
| title_full | ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN. |
| title_fullStr | ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN. |
| title_full_unstemmed | ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN. |
| title_short | ANTIMICROBIAL RESISTANCE SURVEILLANCE AMONG INTENSIVE CARE UNITS, ISLAMABAD, PAKISTAN. |
| title_sort | antimicrobial resistance surveillance among intensive care units islamabad pakistan |
| url | http://www.sciencedirect.com/science/article/pii/S1201971223006215 |
| work_keys_str_mv | AT znasir antimicrobialresistancesurveillanceamongintensivecareunitsislamabadpakistan AT dnkhan antimicrobialresistancesurveillanceamongintensivecareunitsislamabadpakistan AT dnnoreen antimicrobialresistancesurveillanceamongintensivecareunitsislamabadpakistan |