ANTIMICROBIAL RESISTANCE PATTERNS IN HOSPITAL‑ACQUIRED BACTERIAL INFECTIONS IN INTENSIVE CARE UNITS

Abstract

The danger of nosocomial infection (HAIs) which can be ascribed to the growing number of antimicrobial resistance (AMR) in bacterial pathogens is observed in intensive care units (ICUs). Knowledge of the epidemiology of AMR and its implications on clinical outcomes is crucial in the process of informing the therapeutic approach and stewardship interventions.It was a possible observational cohort study, which was followed over 24 months period in a 20-bed multidisciplinary ICU. The patients who were recruited were adult patients that had HAIs exceeding 48 hours of occupancy in the ICU. The clinical specimens were processed as recommended by normal microbiological practices and antimicrobial susceptibility testing was done according to the CLSI guidelines. The idea of multidrug resistance (MDR) was non-susceptibility to at least three groups of antimicrobials. The most important data were the ICU mortality, and the ICU length of stay. Multivariate logistic regression and Cox proportional hazards models were used to assess the relationships between the resistance patterns and clinical outcomes.The infection rate among the patients with HAIs was 287 (49.1) of the total number of patients (584) and the number of bacterial isolates which the infection belonged was 342. The gram-negative bacilli (78.9%), the most common Acinetobacter baumannii (28.7%), Klebsiella pneumoniae (24.0%), and Pseudomonas aeruginosa (17.0%), were the most common. MDR was found to be a total of 71.6 percent and carbapenem resistance prevalence was at 84.7 percent and 68.3 percent in A. baumannii and K. pneumoniae respectively. S. aureus and E. faecium were identified to have 58.5 percent and 35.0 percent of the isolates of S. aureus and E. faecium respectively with MRSA and VRE. When it was adjusted by the APACHE II score and age the mortality in the ICU was 34.8 and the only predictor of mortality was the MDR infection . The MDR infection was linked to the considerably long ICU stay . They were observed to increase resistance rates of colistin with time with 18.4% of A. baumannii being resistant.As it has been demonstrated in this paper, the list of the MDR organisms of the ICU acquired infections is simply enormous, with the carbapenem resistant Gram-negative organisms adding to it the most. MDR infection is a strong and independent negative mortality and length of stay in the ICU. These findings indicate the necessity to enhance antimicrobial stewardship, infection control, and come up with new treatment alternatives to combat the AMR crisis that is increasing in critical care units.