Antimicrobial Resistanceamong Intensive Care Unit Patients in A Tertiary Care Hospital of Bangladesh

Authors

  • Humayra Jesmin Junior Consultant, Medicine, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh
  • HAM Nazmul Ahasan Professor, Department of Medicine, Popular Medical College, Dhaka, Bangladesh
  • - Md Asaduzzaman Post-Graduate Fellow, BangabandhuSheikh Mujib Medical University, Dhaka, Bangladesh
  • AKM Monwarul Islam Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bjm.v32i1.51088

Keywords:

Antimicrobial resistance, microorganism, antibiotic, intensive care unit.

Abstract

Background: Antimicrobial resistance is a growing concern specially among the critically ill patients who are often treated by multiple antibiotics. But, the data regarding the pattern of antimicrobial resistance in this population are often insufficient.

Objective: To observe the pattern of antimicrobial resistance among the patients admitted into the intensive care unit (ICU).

Methodology: This prospective observational study was carried out in the ICU of a tertiary care hospital of Bangladesh over 6 months. Samples of blood, urine, tracheal aspirate, wound swab and pus were obtained from the patients, cultured and analyzed.

Results: Among 100 subjects, the most common primary diagnoses were aspiration pneumonia (29%) and urinary tract infection (UTI) (24%). Out of 315 samples, microorganisms were isolated from 125 samples (39.68%). The most common sample yielding positive culture was tracheal aspirate (67.2%), and the most frequently isolated microorganisms were Pseudomonas spp. (35%), Escherichia coli (28%), Acinetobacterspp. (24%) andKlebsiellaspp. (18%). Acinetobacterspp., Pseudomonasspp. and Klebsiellaspp.were the commonest resistant organisms. Overall prevalence of resistance to antibiotics were: ceftriaxone 72%, ceftazidime 78.4%, ciprofloxacin 81.6%, gentamicin 84%, meropenem 49.6% andnetilmicin 39.2%. Meropenem was the most sensitive antibiotic against Klebsiellaspp.(66.67%) but Acinetobacterspp.was still resistant to meropenem and amikacin but sensitive to cotrimoxazole (66.67%). Multidrug resistant Pseudomonas, Acinetobacter and, Klebsiella species were found; piperacillin-tazobactam combination showed <40% resistance against them. No single antibiotic showed good efficacy against Acinetobacterspp.

Conclusion: The prevalence of antibiotic resistance is high among the ICU patients, and the majority of the isolated organisms are resistant to conventional antibiotics.

Bangladesh J Medicine January 2021; 32(1) : 5-11

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Published

2021-01-04

How to Cite

Jesmin, H., Ahasan, H. N., Md Asaduzzaman, .-., & Islam, A. M. (2021). Antimicrobial Resistanceamong Intensive Care Unit Patients in A Tertiary Care Hospital of Bangladesh. Bangladesh Journal of Medicine, 32(1), 5–11. https://doi.org/10.3329/bjm.v32i1.51088

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Section

Original Articles