Antibiotic Susceptibility Pattern of Bacterial Isolates in the Intensive Care Unit of a Tertiary Care Center in South India.

BACKGROUND AND AIMS: There is an increase in the prevalence of antibiotic resistance noted in our intensive care units (ICU). The objective of this study is to evaluate the antibiotic susceptibility and resistance pattern in an ICU of a tertiary care hospital in India.

MATERIALS AND

METHODS

This was a hospital-based prospective observational study done in a respiratory ICU of a tertiary care hospital in Kerala in South India. The study population included all subjects aged ≥ 18 years who were admitted to the ICU and required antibiotic treatment. Details of the culture and sensitivity pattern of the clinical isolates from sputum, blood, urine, endotracheal tube (ET) aspirate, and bronchoscopy specimens of the patients admitted to the ICU and requiring antibiotics were noted. Only the first isolate per patient was included while preparing the antibiogram.

RESULTS

Out of the 154 patients enrolled, chronic obstructive pulmonary disease (COPD) was the most common diagnosis seen in 52 patients. The sputum culture positivity rate was 42%. Blood and urine culture positivity rates were 4% and 5%, respectively. ET aspirate had a positive culture report in 67% of the cases. Most of the organisms isolated were Gram-negative isolates such as Klebsiella, Escherichia coli, Pseudomonas, and Acinetobacter. Klebsiella was sensitive to colistin, tigecycline in 70%, meropenem in 66%, piperacillin-tazobactam in 60%, and cefoperazone-sulbactam in 58% of the isolates. Escherichia coli was sensitive to tigecycline (75%), colistin (70%), meropenem (68%), minocycline (65%), and piperacillin-tazobactam (64%). Pseudomonas aeruginosa was sensitive to colistin (74%), meropenem (71%), piperacillin-tazobactam (68%), and cefoperazone-sulbactam (64%). Acinetobacter baumannii was sensitive to tigecycline in 62%, meropenem in 54%, and piperacillin-tazobactam in 50%.

CONCLUSION

Gram-negative-resistant infections are increasing in our ICUs, leading to increased morbidity and mortality. Hence, timely antibiogram and antibiotic stewardship programs have to be implemented in our hospitals.