http://dx.doi.org/10.4314/tjpr.v11i6.17
Abstract
Purpose:
To undertake an audit of the antimicrobial (AM)
sensitivity pattern of bacterial isolates in the
intensive care units (ICU) of a tertiary
hospital of
Bhavnagar, India.
Methods:
Retrospective analysis of the indoor case papers of ICUs from
January 2010 to 31st March 2011 was carried out at
Department of Pharmacology, Govt. Medical College and
Sir Takhtsinhji General Hospital, Bhavnagar, India.
Information collected include demographic data of the
patient, admission unit, duration of hospital stay,
diagnosis, type of infection, empirical treatment,
indication of the use of the antimicrobials (AMs).
Others include collected specimen, causative agent,
sensitivity pattern, and treatment changes based on the
sensitivity pattern in a case record form. AM
sensitivity testing was performed by the modified Kirby
Baur method as recommended by clinical and laboratory
standard institute (CLSI). Internal and external quality
control were maintained for culture and sensitivity
method.
Results:
The most commonly isolated organisms were Klebsiella
pneumoniae (28.6 %) and Pseudomonas aeruginosa (16.3 %).
Lower respiratory tract infection (LRTI) was the most
common infection. Imipenem, meropenem and levofloxacin
were the most effective antimicrobials for Gram-negative
isolates (GNIs) while vancomycin ciprofloxacin, and
gentamicin were the most efficacious antimicrobials for
Gram-positive isolates (GPIs). Widespread resistance to
third generation cephalosporins and cloxacillin was
noted for GNIs and GPIs, respectively. Meropenem (100 %)
> levofloxacin (100 %) > sparfloxacin (94.4 %) >
gentamicin (83.3 %) was the rank order of antimicrobial
activity against LRTI.
Conclusion:
GNIs were the predominant cause of infection in ICUs.
Third generation cephalosporins-resistant GNIs were the
predominant resistant organisms. The study showed that
fluoroquinolones and aminoglycosides could be used as
first line AMs for the effective management of LRTI in a
hospital setting.
Keywords:
Antibiotic sensitivity,
Bacterial resistance, Intensive care unit, Tertiary
hospital