TITLE:
Microbiological and Antibiotic Susceptibility Patterns in Cardiothoracic and Vascular Intensive Care Unit of a Tertiary Level Hospital in Nepal
AUTHORS:
Bibhush Shrestha, Priska Bastola, Bishwas Pradhan, Arjun Gurung, Basanta Ghimire, Anil Bhattarai
KEYWORDS:
Sepsis, Antibiotics, Intensive Care Unit
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.13 No.3,
March
31,
2023
ABSTRACT: Background: Sepsis has been one of the most important conditions for morbidity and mortality
of Intensive care unit (ICU) patients. Antibiotics remain one of the major
combating factors for it. Indiscriminate antimicrobial usage and poor
prescription practices have contributed to the development of multidrug
resistant (MDR) organisms. Therefore, the current study was designed to
evaluate the spectrum, and susceptibility patterns of pathogens isolated from
patients admitted to our Cardiothoracic and Vascular Intensive care unit. Materials and
Methods: The study was conducted in Cardiothoracic and Vascular ICU of a
tertiary care teaching hospital from February 2019 to March 2021. Samples (blood, urine, wound swab, tracheal
aspirate, and central venous catheter tip) for culture were taken from all the
patients in Sepsis admitted in Cardiothoracic and Vascular ICU above 18 years
of age during the study period. The culture reports (microbiological profile
and their susceptibility pattern) were collected and data collection of
all enrolled patients was done. Results: Out of the total 128 samples
studied 75 (58.5%) were culture positive. The predominant organisms isolated
were Gram negative organisms (Klebsiella, Pseudomonas, Acinetobacter, followed by E.
coli). The highest prevalence of microbial growth was found in tracheal
aspirate (46.8%), followed by blood (21.8%). Antibiotic susceptibility results showed the
highest sensitivity of those common pathogens towards higher antibiotics only
(especially Polymyxin B and Colistin). Conclusion: The emergence of multidrug resistant organisms and lesser availability of a higher
group of antibiotics is a major concern. So there is a need for regular hospital based antibiograms,
strict infection control programs, and
implementation of antimicrobial stewardship programmes for guiding clinicians
in choosing appropriate therapy and preventing the surge of multidrug resistant organisms.