Latif S, Anwar Ms.
Changing Trends Of Aerobic Bacteria Isolated And Susceptability Pattern Of Acinetobacter Species In Intensive Care Unit.
Biomedica Jan ;34(1):1-5.

Background and Objectives: Microorganisms isolated in Intensive Care Unit (ICU) setting change over time and may be different in different hospitals. For empiric therapy the knowledge of commonly isolated organisms is important. Multi drug resistance is common in the Acinetobacter species isolated from patients admitted in medical intensive care unit (MICU). The presence of multi drug resistant (MDR) bacteria leads to increased morbidity and mortality, is an economic burden on the already stretched resources of our nation. Methods: In this retrospective cohort study specimens received from the patients admitted in the medical ICU of Services Hospital Lahore (SHL) during the period January 2009 to October 2009 and January 2013 to March 2014 were analyzed. The bacterial isolates obtained were identified on the basis of colony morphology, Gram staining reaction and biochemical tests. The sensitivity pattern of Acinetobacter spp. to various antibiotics was noted. Results: In 2009, 379 bacterial isolates were obtained from 640 culture specimens received from MICU. Gram-positive bacteria isolated were 111 (29%), enterobacteriacae were 122 (32%) and non-fermenters were 146 (39%). During the period from January 2013 to March 2014, 462 bacteria were isolated from 801 specimens. Gram positive bacteria were 20 (4.3%), enterobacteriacae 121 (26.3%) and non-fermenters were 321 (69.4%). Sixty-six Acinetobacter species were isolated from Jan-Oct, 2009. Imipenem resistant strains were 40(60.6%) of these 18 were found to be resistant to all antibiotics studied. Tigecyclin (TGC) sensitivity was not performed in 2009. From January 2013 to March 2014 one hundred and eighty-nine Acinetobacter species were isolated. One hundred and fifty-four Acinetobacter species were tested for imipenem/meropenen sensitivity out of these 114 (74%) were resistant. One hundred and eighty Acinetobacter species were tested for sensitivity to tigecycline and only 13 (7.2%) were resistant. Nine were resistant to all antibiotics tested including TGC. Conclusion: It is observed that the prevalence of non-fermenter bacteria is increasing while Gram positive bacteria and enterobacteriacaea are decreasing in MICU patients. This situation is alarming as not only the prevalence of the non-fermenter, Acinetobacter species increasing so is the imipenem resistance which has increased from 60.6% to 74% within two years. The presence of resistance to imipenem in bacteria indicates resistance to multiple drugs and in extreme case, to all the antibacterial drugs available. The treatment of infections caused by MDR or pan-drug resistant bacteria is not always possible. Thus it is very important to control, detect and treat these bacteria early.

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