Clinical outcome, microbiological spectrum and antibiotic susceptibility of clinical isolates from adult intensive care unit in a tertiary care hospital in India
CCCF ePoster library. Sardar A. Oct 3, 2017; 198137; 76
Arijit Sardar
Arijit Sardar
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Clinical outcome, microbiological spectrum and antibiotic susceptibility of clinical isolates from adult intensive care unit in a tertiary care hospital in India

Sardar Arijit1, Arora Mahesh Kumar1, Kashyap Lokesh1, Darlong V1, Khanna Puneet1

1 Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India



 


Abstract:
Introduction:
Nosocomial infection in the hospitals especially in the intensive care units (ICUs) is gradually emerging as a serious health hazard.(1) It is defined by infection occurring after 48hrs of hospital admission and affects almost one in every ten hospital admission.(2) Among all hospital acquired infections ICU acquired infections are the most notorious and carry highest mortality rate.(2) Study based on the antibiotic sensitivity pattern from Indian sub continental tertiary care ICUs are lacking in the literature
Objective:
To find out microbiological spectrum of the ICU and antibiotic susceptibility of the organisms and to determine the cause of ICU mortality, clinical outcome & organ dysfunction due to nosocomial infection.
Methods:
The study was conducted in one of the ICUs (known as AB8ICU) of the hospital, All India Institute of medical Sciences, which is a tertiary care super speciality teaching hospital in the capital of India, New Delhi. It is a 12 bedded mixed medical and surgical ICU which is the referral centre for critically ill adult patient from all parts of the hospital. A cross sectional retrospective analysis were carried out based on ICU chart review of microbiological data of all the patients whose clinical sample’s culture came out to be positive during the ICU stay from 1st May 2015 to 30th April 2016. Apart from microbiological data, detailed history, demographic parameter, operative status, clinical parameters, laboratory values, antibiotic usage, presence or absence of risk factors for infection, organ dysfunction of the patients were recorded. Strict confidentiality was maintained for all data collected from the patients’ ICU chart.
Results:
Total 487 patients were admitted in the specific time period. Out of which 86 patients were found to be microbiological culture positive of their clinical samples and included in the analysis. 50 patients were discharged alive from the ICU and 36 patients were succumbed to death due to the overwhelming infection. Patients with diabetes mellitus, chronic liver disease and connective tissue disorder were found to have worse outcome due to infection where as chronic airway diseases were found to be protective.(table 1) The dead patients required multiple extensive organ support and had multiple risk factors present for their infection.(table1, 2) Sputum/tracheal aspirate, blood, drain fluid, pus, urine and catheter tip were the most common samples from which organisms were isolated. Only 10 patients had gram positive infection where as rest 76 patients had gram negative infection. Most of the organisms were multidrug resistant. Antibiotic sensitivity pattern for most common organisms were displayed in figure 1.
Conclusions:
Most of the hospital acquired infections are fatal, multidrug resistant and carries poor prognosis to the patients.

 

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