Multidrug resistant infections in intensive care units

Abstract

Background: Intensive care units (ICU) are often the epicentre of development of infections caused by multidrug resistant (MDR) organisms. Purpose: The aim of our study was to determine the prevalence and types of ICU-acquired infections, pathogens associated with such infections and to determine the antibiotic resistance pattern of the presented pathogens.

Material and methods: In the study were included 130 patients hospitalized into the surgical ICU of the University Clinic for Anesthesiology and Intensive Care in Skopje in period of 2 months, April -Jun, 2017. who developed infection after at least 72 hours of their hospitalization. In all of them the pathogens and their antibiotic resistance pattern were identified. Results: Twenty of 130 (15.4%) patients developed ICU-acquired infection. Most common infections were pneumonia (50%) and surgical site (30%) infections.Gram-negative organisms were more common isolated than Gram-positive organisms (83% vs.17%). The most common isolated bacteria were Acinetobacter species (30, 41.7%) and Pseudomonas aeruginosa (15, 20.8%). All isolated species were MDR organisms resistant to the most used antibiotics like Cephalosporins, Gentamicin, Ciprofloxacin and Clindamycin. Pseudomonas aeruginosa and Acinetobacter species were sensitive to Colistin, Methicillin-resistant Staphylococcus aureus (MRSA) to Vancomycin and Linezolid and Enterococcus only to Linezolid. Klebsiella pneumoniae and Proteus mirabilis showed low resistance only to Amikacin and Carbapenems. Conclusions: Our study obtained local data about the prevalence and types of ICU-acquired infections, types of pathogens and their antibiotic resistance pattern.Based on this knowledge, clinicians can choose appropriate antibiotics, avoiding antibacterial drug overuse and MDR bacteria development.