Antimicrobial Susceptibility Patterns of Bacterial Isolates among Intensive Care Unit Patients at A Tertiary Care Hospital in Bangladesh
Keywords:
Bloodstream infection, ICU, Antimicrobial resistance, MRSA, ESBL, Colistin, BangladeshAbstract
Background: Bloodstream infections (BSIs) that are multi-drug resistant (MDR) represent a significant source of illness and death in intensive care units (ICUs), especially in low- and middle-income nations where antimicrobial resistance is escalating quickly. Ongoing monitoring of causative agents and their resistance patterns is crucial for directing empirical antibiotic treatment and updating hospital antibiotic guidelines.
Objective: To determine the bacterial profile and antimicrobial susceptibility pattern of bloodstream isolates among ICU patients
admitted to Gazi Medical College Hospital, Khulna, Bangladesh. Methods: This cross-sectional study was conducted in the ICU of Gazi Medical College
Hospital from July 2025 to April 2026. Blood samples from clinically suspected cases of infection were collected and processed using standard microbiological methods, including culture, isolation, identification, and antimicrobial susceptibility testing by the disc diffusion method. Interpretation was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed using SPSS version 26.0 and expressed as frequencies and percentages.
Results: A total of 200 blood samples were analyzed, of which 81
(40.5%) yielded microbial growth. Gram-negative bacteria predominated, with Escherichia coli being the most common isolate (31, 15.5%), followed by Staphylococcus aureus (24, 12.0%) and Klebsiella spp. (15, 7.5%). Among S. aureus, high resistance to cefoxitin (70.8%) and cloxacillin (66.7%) suggested a high prevalence of MRSA, while linezolid (70.9%) and vancomycin (75.0%) remained the most effective agents. Among Gram-negative isolates, E. coli showed the highest susceptibility to colistin (100.0%), amikacin (83.9%), and gentamicin (80.6%), but high resistance to nalidixic acid (96.8%), ceftazidime (93.5%), and ceftriaxone (83.9%), indicating probable ESBL production. Klebsiella spp. demonstrated 100% resistance to third-generation cephalosporins and low susceptibility to meropenem (20.0%). Colistin remained the most effective drug across Gram-negative organisms.
Conclusion: The study revealed a high burden of bloodstream infections in ICU patients with predominance of MDR Gram-negative bacteria and a substantial prevalence of MRSA. Due to the startlingly high level of resistance to carbapenems and third-generation cephalosporins, colistin and a small number of other drugs were the only viable treatments. Strict infection control procedures, antimicrobial stewardship, and routine ICU antibiogram updates are desperately needed to stop the spread of resistant microorganisms and enhance clinical results.
Mediscope 2026;13(2): 89-96
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Copyright (c) 2026 Shantanu Sen, Md Zaber, Md Shahariar Ahmed Sourav, Md Aslam Hossain, Shaikh Salman Salam, Aiwasharia Ghosh, Md Akter Uzzaman, Susmita Ghosh
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