Background: Nosocomial infections (NI) are also called hospital-associated infections that comprise almost all clinically apparent infections that are not arising as a result of patientsÂ’ original admitting diagnosis. NI defined as localized and systemic conditions that result from adverse reaction owing to the presence of an infectious agents and was not present or incubating at the time of admission to the hospital. The rate of NI varies from 2.85% to 34.6% among the hospitalized patients.
Objective: To investigate NIs among the patients admitted in intensive care unit (ICU) and to evaluate the prevalence, risk factors, the causative bacteria, and their resistance pattern to antimicrobial agents.
Materials and Methods: The study was carried out over a period of 12 months from July 2014 to June 2015. Patients admitted in the general ICU were monitored for the development of NIs. Samples were collected from suspected patients depending on the type of NI, to detect the causative organisms and their antimicrobial susceptibility. Extended spectrum beta-lactamase (ESBL)-positive isolates were tested by double disc synergy test for ESBL production.
Result: The study included 260 patients admitted into general ICU. The prevalence of NI was 19.2%. Female subjects were more affected (60%) than male subjects (40%). Risk factors identified were urinary catheterization, female sex, advanced age, mechanical ventilation, and increased hospitalization. Ventilator-associated pneumonia was the most common NI, constituting 36%, followed by urinary tract infections (26%). Esherichia coli were the predominant organisms among the Gram-negative bacteria. Imipenem was majorly used antibiotic for empirical treatment of ICU infections before getting the antibiotic sensitivity report.
Conclusion: Indiscriminate use of antibiotics should be avoided in order to curtail the emergence and the spread of drug resistance among nosocomial pathogens. This study gives insight into the incidence of NIs and in revising antibiotic policy and guiding clinicians in preventing emergence of carbapenem resistance among the patients.
Key words: Nosocomial infections, ICU, ESBL, carbapenem
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