Antibiotic Resistance Pattern and Stewardship Programme in Critical Care Settings
Keywords:Isolate, Antibiotic resistance, Urine, Stewardship
AbstractSensitivity pattern of isolates from patients’ specimens associated with infection, admitted to the critical care centers with empiric or prophylactic antibiotic use were assessed. Till identification of the organism and resultant sensitivity awaited; and compared with sensitive antibiotic to the isolates which could be used for management. This analytical cross sectional study carried out during the period of April 2016 to July 2016 in the Critical Care Centre (CCC) of Combined Military Hospital, Dhaka Cantonment. Urine and other specimens including wound swab, pus, sputum, tracheal aspirate, catheter tip, nasal swab, high vaginal swab, broncheoalveolar lavage, blood, urethral discharge were collected from the patients following aseptic precautions. Isolate identification was done using standard procedures at the Armed Forces Institute of Pathology (AFIP). Sensitivity was tested using antibiotic disc diffusion technique. A total of one thousand six hundred and seventy patients were dealt with in the study, and positive yield obtained in 190 (11.38%) cases. Of those, 116 were urine specimens which constituted 69 (57.76%) female and 47(42.24%) male patients. A total of 1088 discs of antibiotics were used on an average 9 discs per isolate. Six hundred and forty nine (59.65%) showed resistance to the antibiotic used against them, while four hundred and thirty nine (40.35%) showed sensitive response. The study population was of 2-80 years age group. Other specimens included 74 isolates, fifty (67.57%) were males and twenty four (32.43%) were females. A total of eight hundred and twenty seven (11.18 discs per isolate) antibiotic doses were used 479 (57.92%), showed resistant and 348 (42.08%) sensitive result. Enteric gram negative bacilli (GNB) were the majority of isolates in both types of specimens. The study indicated that, newer antimicrobials have a substantial impact in decreasing human morbidity and mortality rates. It encourages to expand surveillance of antibiotic resistance determinants and to exercise caution in dispensing antibiotics to maximize their continued efficacy. Excess or injudicious use is causing increase in cost as well as inducing drug resistance among the common bacterial isolates. A work on the clinical presentation with trends of antimicrobials used in the CCC setup right now in tertiary care hospital would be of supplemental value for the study.
563 ONLINE VIEW
How to Cite
Authors who publish with this journal agree to the following terms.
Authors retain copyright and grant the journal right of first publication.
Articles in the Bangladesh Medical Research Council Bulletin are licensed under a Creative Commons Attribution 4.0 International License (CC-BY) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).