Increasing trend of carbapenem resistant gram negative bacteria in an intensive care unit

2016-06-24T08-39-20Z
Source: International Journal of Medical Science and Public Health
Richa Agrawal, Arnaw Kishore, Sumana MN, Madhuri Kulkarni.
Background: Ventilator-associated pneumonia (VAP) has been associated with morbidity, mortality, prolonged hospitalization and extra health-care costs, requires rapid diagnosis and initiation of the appropriate antibiotic treatment. Objective: To analyse the microbiological profile of ventilator associated pneumonia in a tertiary care hospital. Material and Methods: This is a crosssectional study conducted in Intensive Care Units with hundred VAP patients who satisfied the Clinical Pulmonary Infection Score (CPIS) > 6. Results: Acinetobacter baumannii (46.61%) was the most common isolate followed by Klebsiella pneumoniae (26.31%) and Pseudomonas aeruginosa (17.29%). Metallo-betalactamases was produced by 64.70% of non-fermenters and extended spectrum beta lactamases (ESBL) was produced by 54.28% of Klebsiella pneumoniae. AmpC β-lactamases were produced by 17.07% and 4.70% of the members of Enterobacteriaceae and non-fermenters, respectively. Conclusion: Malpractice of antibiotics usage has led to emergence of new broad spectrum β-lactamase. The emergence of carbapenemase-producing multidrug resistant (MDR) gram-negative bacteria is major public health problem particularly in the hospital settings. Infections due to these organisms lead to life-threatening illness which is difficult to manage as there are limited treatment options. Prevention of VAP may be carried out by early isolation and decreasing the length of stay along with proper knowledge of the MDR organisms.


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