Emergence of Antibiotic-Resistant Infections in ICU Patients

Md. Tahsin Salam¹, Kaniz Fatima Bari², Md Mostafizur Rahman³, Dewan Muhammad Mahmudul Gafur¹, Md. Omar Faruk4, Khurshida Akter⁵, Farhana Irin⁶, Md Rahatul Ashakin⁷, Tanim Ahmed shaikat⁸, Ashik Chandra Das⁹, Tufael¹⁰, Mahmudul Hasan Mithun¹¹, Atiqur Rahman Sunny¹⁰

Resistance-strain infections in ICU patients significantly increase morbidity and mortality, necessitating revised antibiotic policies for effective treatment.

Abstract

The fate of critically ill patients with infections in intensive care units (ICUs) is significantly influenced by antimicrobial resistance, which has become a serious concern in developing nations. This observational study, conducted over a 12-month period from January 2021 to December 2021, aimed to track the pattern of antibiotic resistance among patients admitted to the ICU. Among the 200 patients, the most common main diagnoses were aspiration pneumonia (29%) and diabetes mellitus (24%). Out of 250 samples, 65 samples (26%) yielded 85 bacterial isolates. The most frequently found sites of infection were tracheal aspirate (64.71%) and urine (14.12%). From the tracheal aspirate samples, the most frequently isolated microorganisms were Pseudomonas spp. (30.59%), Escherichia coli (24.71%), Acinetobacter spp. (20%), and Klebsiella spp. (14.12%). The antibiotics with the highest overall resistance patterns were levofloxacin (68.24%), amikacin (64.71%), meropenem (49.41%), ceftazidime (75.29%), ciprofloxacin (78.82%), and gentamicin (82.35%). The most effective antibiotic against Klebsiella species was meropenem (64.61%), while Acinetobacter species were mostly susceptible to cotrimoxazole (64.67%) and piperacillin + tazobactam (60.50%). Escherichia coli showed the highest susceptibility to netilmicin (70.48%) and meropenem (49.32%), whereas Pseudomonas spp. were mostly responsive to colistin (55.14%) and netilmicin (52.25%). Antibiotic resistance is common among ICU patients, with most isolated microbes showing resistance to traditional antibiotics.

Keywords: Antibiotic resistance, Nosocomial infections, ICU morbidity, Multidrug-resistant bacteria, Empirical antibiotic therapy

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