Publication:

Antibiotic sensitivity and resistance in nosocomial infection in medical and surgical intensive care units of a tertiary care hospital in north India

Background Antibiotic resistance threatens the health of many throughout the world. It is a common problem in the ICU patients who acquire nosocomial infections. Critically ill ICU patients are most vulnerable for developing multidrug resistant nosocomial infections.

Methods Hospital based, cross sectional, descriptive type of observational study involving 311 patients admitted in ICU who were studied for development of nosocomial infections.

Results In this study, the nosocomial infection rate among ICU patients was 32.79%. The commonest organism isolated from all samples were E. coli., Acinetobacter spp., Pseudomonas sp., CONS and Staph. aureus. In these samples, it was found that E. coli was most commonly resistant to Imipenem (93.8%) and Meropenem (93.8%). Majority of CONS was resistant to Nitrofurantoin (81.0%). Klebsiella sp. was most commonly resistant to Ceftriaxone (94.4%). Pseudomonas was commonly resistant to Imipenem (94.1%) and Meropenem (94.1%). Acinetobacter sp. was resistant commonly to Amikacin (90%) and Gentamicin (90%). Staph. Aureus was mostly resistant to Amikacin (90%), Gentamicin (90%) and Cotrimoxazole (90%).

Conclusions Nosocomial infections affect about 1/3rd of the patients in ICUs. Development of antibiotic resistance to commonly used drugs becomes a major deterrent to patient outcome, increasing duration of patient stay as well as expense. Strict infection control measures like universal precautions and stringent adherence to hand washing practices; formulation of antibiotic policy; Surveillance activities, appointment of infection control practitioners; might be required for the same for which further research is advocated.