Objective: To determine the frequency of micro-organisms causing sepsis as well as to determine the antibiotic susceptibility and resistance of microorganisms isolated in intensive care unit.
Study Design: Descriptive case series study.
Place and Duration of Study: Intensive Care Unit, National Hospital & Medical Center, Lahore. Study was conducted over period of 1 year, from Jan 2016 to Dec 2016.
Patients and Methods: Culture reports of 882 patients were collected from the intensive care unit of National Hospital and Medical Center, Lahore, Pakistan via non-probability consecutive sampling. Reports collected were of blood, urine, endotracheal secretions and cerebrospinal fluid. All bacteria had been identified by standard microbiological methods, and antibiotic susceptibility had been performed using the disk diffusion technique, according to Clinical and Laboratory Standards Institute guidelines and for Colistin, MIC determination was done by using broth dilution method. Data was collected using a critical care unit electronic database and data analysis was done by using the Statistical Package for Social Sciences (SPSS), version 20.
Results: Gram-negative bacteria were more frequent as compared to gram-positive bacteria. The most frequent isolated gram negative bacteria was Escherichia coli 168 (19%), followed by Klebsiella pneumonia 132 (14.9%), Escherichia faecalis 108 (12.2%), Pseudomonas Aeregenoa 84 (9.5%) and Acinetobacter spp (8.1%), whereas among Gram-positive isolates Staphylococcus epidermidis was the most common followed by 42 (4.7%), Methicillin-resistant Staphylococcus aureus (MRSA) 42 (4.7%) and Methicillin-sensitive Staphylococcus aureus (MSSA) 12 (1.3%). For Klebsiella pneumoniae, high sensitivity was seen for meropenem 96/132 (72.7%) followed by amikacin 96/132 (72.7%). For Escherichia coli, carbapenems were 100% sensitive while amikacin was 156/168 (92.9%) and fosfomycin 138/168 (82.1%). Pseudomonas aeruginosa was sensitive for piperacillin-tazobactum 78/84 (92.9%), cefipime 60/84 (71.4%) and amikacin 60/84 (71.4%). For Acinetobacter spp, doxycycline was the most sensitive antibiotic 66/72 (91.7% sensitive), followed by tobramycin 48/72 (66.7%).
Conclusion: Gram-negative infections, especially by multidrug-resistant organisms, are more prevalent in the ICU. Empirical antibiotics should be used according to the local unit specific data.
Keywords : Antibiogram, bacteria, resistance.