Trend of Increased Resistance to Antibiotics in Intensive Care Unit Isolates of a Tertiary Care Hospital Over Two Years 2009 & 2010

Abstract

Objective: To asses the antibiotic resistance pattern of Intensive Care Unit bacterial isolates
over two year period; 2009 & 2010.
Material & Methods: This observational study was carried out on Intensive Care Unit isolates
of Services Hospital Lahore in the Microbiology section of Department of Pathology, Services
Institute of Medical Sciences Lahore. All samples processed for microbial cultures were tested
for anti-biotic sensitivity / resistance pattern studied and compared.
Results: In 2009,790 samples & in 2010 886 samples were submitted from ICUs to
Microbiology Section for culture. Of these, 42% and 46% were culture positive respectively.
Gram negative isolates were 294 in 2009 & 308 in 2010. Resistance to all drugs tested was
exhibited by 26 (8.78%) and 39 (12.60%) isolates in 2009, 2010. The total number of
Acinetobacter isolated increased to 102 in the year 2010 from 74 in the year 2009 with 28 more
Acinetobacters than in 2009 and the number exhibiting extensive drug resistance doubling to 28
from 14. Resistance to Imipenem, Tazobactem and Amikin drugs increased in Acinetobacters,
Klebsiella and resistance of E coli to Imipenem also increased but decreased in Pseudomonas
and E coli. ORSA and coagulase negative staphylococci with Oxacillin resistance were also on
the rise, doubling in number from 12 to 25 and 14 to 31 in 2009 & 2010.
Conclusion: Acinetobacter species are on the rise in the intensive care units as is their
extensive and multi drug resistance pattern. Increasing Carbepenem resistance is alarming
limiting our therapeutic options. Judicious use of antibiotics and curtailing nosocomial infections
would deter this upward trend