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Determine variation of antimicrobial susceptibility patterns according to five years in intensive care unit of a university hospital

Abstract number: r1944

Koksal  I., Yilmaz  G., Aydin  K., Sucu  N., Caylan  R., Senel  A.C.

Background: 

Antimicrobial resistance is a significant problem in the intensive care unit (ICU). There are many factors that contribute to the high rate of antibiotic resistance in the ICU, but one factor having major impact is the ecological pressure exerted by high usage of antibiotics in critically ill patients.

Methods: 

We conducted a five-years prospective study of the hospital-acquired infections and colonization causative microorganisms and antimicrobial resistance in a 11-bed medical and surgical ICU of a Karadeniz Technical University Hospital, Trabzon, Türkiye. From 2000 to 2004 all patients staying in ICU more than 48 h were consecutively enrolled and followed prospectively until discharge or death. From every patient, common specimens were sent for bacteriologic culture and sensitivity analysis.

Results: 

A total of 1400 bacterial pathogens were obtained from 728 patients in ICU during the study period. Of these, 1306 (93.3%) were single isolates and 94 (6.7%) were polymicrobial isolates. The isolates consisted of 797 (56.9%) Gram-negative strains, 495 (35.4%) Gram-positive strains and 108 (7.7%) Candida spp. The most common isolates were Pseudomonasaeruginosa (277; 19.8%), methicillin resistant Staphylococcus aureus (MRSA) (174; 12.4%), Acinetobacter spp (166; 11.9%), methicillin resistant coagulase-negative staphylococci (MRCNS) (122; 8.7%), Enterobacter spp (92; 6.6%). The most active agents were ticarcillin/clavulanate and amikacin against P. aeruginosa, imipenem against Acinetobacter spp, imipenem-cefoperazone/sulbactam-ciprofloxacin and amikacin against Enterobacter spp, Klebsiella spp and E. coli, trimetoprim/sulfamethoxazole against S. maltophilia, vancomycin against S. aureus , CNS and Enterococcus spp.

Conclusions: 

In determine variation of microorganisms according to five years, P. aeruginosa was the most prevalant microorganism, while MRSA and Acinetobacter spp remained to be less frequent. An increasing rathe of Gr( + ) microorganisms has been overemphasised in recent years. We observed the presence of multiple antimicrobial resistant microorganisms, which play an important roll in massive colonization of patients and in the aetiology of nosocomial infections. In approach to empirical treatment, such microorganisms and their susceptibilities were primarily considered. This fact is very worrisome, exception a few therapeutic options are failure to treat infections caused by this multidrug-resistant microorganisms.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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