Septicemia Due to MDR Isolates in ICU: A Therapeutic Challenge

Emergence of multidrug resistant bacterial sepsis is one of the important cause of morbidity and mortality in ICU patients. An attempt was made to determine the profile and antimicrobial resistance pattern of aerobic bacterial isolates from blood cultures of ICU patients. This was a one year prospective study in the department of Microbiology, PIMS Jalandhar. A total of 850 blood samples obtained from patients suspected of sepsis were processed aerobically and antibiotic susceptibility testing was performed by Kirby Bauer disc diffusion method. The drug resistant strains were screened by Double disc synergy test for ESBL and oxacillin and cefoxitin disk diffusion method for MRSA. Blood cultures were positive in 7.64 %( 65/850) samples. Gram negative organisms were isolated in 38(58.46%) of 65 samples, with Enterobacteriaceae accounted for 84.21%(Escherichia coli 53.12%, Klebsiella pneumoniae 31.25%,Salmonella typhi 9.37% and Proteusmirabilis 6.25%) and Acinetobacter baumannii 15.80%. Stahylococcus aureus (64%) followed by Enterococcus sp. (28%) were the major Gram positive isolates and 3.08% (2/65) isolates were fungi. High level of resistance to various antibiotics was seen among Gram negative bacteria with 81.57% (31/38) of the isolates showing multi-drug resistance. MRSAisolates were 68.75%) (11/16) and ESBL producers were 73.68 % ( 28/38). Owing to increased prevalence of multi-drug resistant isolates in ICU, this study stresses the need for the continuous screening for antibiotic resistance in intensive care unit.