Open Access Open Access  Restricted Access Subscription Access
Cover Image

Study of drug resistance in isolates from ICU infections in a tertiary care hospital

S. Kombade, G. Agrawal


Background, Nosocomial Infections are an important cause of morbidity, mortality and economic problems especially in intensive care units (ICUs). Aim, This study was conducted to estimate the clinical and bacteriological profile and their antibiotic sensitivity testing in ICU infected patient.Materials and methods, 245 patients clinically diagnosed to have infections in ICU were studied prospectively in the Department of Microbiology, Indira Gandhi Govt. Medical College from Sep. 2009- Dec. 2011. Depending on sites of infections various samples were collected and processed as per the standard guidelines. The isolates were subjected to antimicrobial susceptibility testing by Kirby Bauer disc diffusion method as per CLSI 2012 guideline. Results, The incidence of pneumonia, blood stream infection and urinary tract infections was 61.6%, 20.1% and 11% respectively. P. aeruginosa (16.3%) was the commonest isolate in ICU infection followed by A. baumannii (13.5%) and K. pneumoniae (11.8%) with maximum sensitivity to imipenem, piperacillin tazobactum and amikacin. All Staphylococcus and Enterococcus species were sensitive to vancomycin and linezolid. Gram-negative pathogens acquired from ICU patients in our settings show high resistance to antibiotics. Conclusion, Regular monitoring of the pattern of resistance of common pathogens in the ICUs is critical in planning the best routines for empirical treatment of infectious patients.


Alberti, C., Brun-Buisson, C., Burchardi, H., Martin, C., Goodman, S., Artigas, A., Sicignano, A., et al., 2002. Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care. Med., 28(2),108-21.

Clinical and Laboratory Standards Institute. 2012. Performance standards for antimicrobial susceptibility testing; Sixteenth informational supplement. CLSI document M100-S16. Clinical and laboratory standards institute, Wayne .

Collee, J.G., Duguid, J.P., Fraser, A.G., Marmion, B.P., Simmons, A., laboratory strategy in the diagnosis of infective syndromes. In, Collee JG, Marmion BP, Fraser AG, Simmons A, 1996. editors. Mackie and Mc Cartney`s Practical Medical Microbiology. 14th ed. New Delhi, Reed Elsevier India Private Limited., p 53-94.

Criticare Frontires [online]., 2009. Available from, URL,http,//

Gopalkrishnan, R., Dorairajan, S., 2010. Changing trends in antimicrobial susceptibility and hospital acquired infections over an 8 year period in a tertiary care hospital in relation to introduction of an infection control programme. J. Assoc. Physic. India, 58, 25-31 Hassanzadeh, P., Mohammad, M., Nahal, H., 2009. Prevalent bacterial infections in intensive care units of Shiraz university of medical sciences teaching hospitals, Shiraz, Iran. Jpn. J. Infect. Dis., 62,249-53.

Horan, T.C., Andrus, M.L., Dudeck, M.A., 2008. CDC/NHSN surveillance definition of healthcare-associated infection and criteria for specific types of infections in the acute care setting. Am. J. Infect. Control., 36,309-32.

Hughes, A.J., Ariffin, N., Huat, T.L., Abdul, M.H., Hashim, S., Sarijo, J., Abd Latif, N.H., Abu, H.Y., Kamarulzaman, A., 2005. Prevalence of nosocomial infection and antibiotic use at a university medical centre in Malaysia. Infect Cont. Hosp Epidemiol., 26,100-4.

Jamshidi, M., Javadpour, S., Eftekhari, T.E., Moradi, N., Jomehpour, F., 2009. Antimicrobial resistance pattern among intensive care unit patients. African J. Microbiol Res., 3, 590-4.

John, S., Balagurunathan, R., 2011. Metallo beta lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii. Indian J. Med. Microbiol., 29(3), 302-4.

Joseph, N.M., Sistla, S., Dutta, T.K., Badhe, A.S., Rasitha, D., Parija, S.C., 2010. Ventilator-associated pneumonia in a tertiary care hospital in India, role of multi-drug resistant pathogens. J. Infect. Dev. Ctries., 4(4),218-25.

Kaul, S., Brahmadathan, K.N., Jagannati, M., Sudarsanam, T.D., Pitchamuthu, K., Abraham, O.C., John, G., 2007. One year trends in the gram negative bacterial antibiotic susceptibility patterns in a medical intensive care unit in South India. Indian J. Med. Microbiol., 25,230-5.

Kucukates, E., 2005. Antimicrobial resistance among gram-negative bacteria isolated from intensive care units in a Cardiology Institute in Istanbul, Turkey. Jpn. J. Inf. Dis., 58(4), 228-31.

Meric, M., Willke, A., Calayan, C., Toker, K., 2005. Intensive care unit- acquired infections, Incidence, risk factors and associated mortality in a Turkish university hospital. Jpn. J. Infect. Dis., 58, 297-302.

Moran, G.J., Krishnadasan, A., Gorwitz, R.J., Fosheim, G.E., Linda, K., 2006. Methicillin-resistant S. aureus infections among patients in the emergency department. N. Engl. J. Med., 355, 666-7.

Shaikh, J.M., Devrajani, D.B., Ali Shah, S.Z., Akhund, T., Bibi, I., 2008. Frequency, pattern and etiology of nosocomial infection in intensive care unit, an experience at a tertiary care hospital. J. Ayub. Med. Coll. Abbottabad., 20, 37-40.

Shanthi, M., Sekar, U., 2009. Multi-drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii infections among hospitalized patients, risk factors and outcomes. J Assoc Physic. India., 57(636),638-45.

Shehabi, A.A., Baadran, I., 1996. Microbial infection and antibiotic resistance patterns among Jordanian intensive care patients. East Mediterr Health J., 2(3), 515-20.

Singhal, S., Mathur, T., Upadhayay, D.J., Chug, S., Gaind, R., Rattan, A., 2005. Evaluation of methods for Amp C β lactamase in gram negative clinical isolates from tertiary care. Indian J. Med. Microbiol., 23(2), 120-4.

Wattal, C., Goel, N., Oberoi, J.K., Raveendran, R., Datta, S., Prasad, K.J., 2010. Surveillance of multidrug resistant organisms in a tertiary care hospital in Delhi, India. J. Assoc. Physician India.,58, 32-6.

Yehia Nasser, A.A., Haifaa, H., El Sayed, M., 2008. Al Asar. Nosocomial Infections in a Medical-Surgical Intensive Care Unit. Med. Princ. Pract., 17, 373–7.

Yong, D., Lee, K., Yum, J.H., Shin, H.B., Rossolini, G.B., Chong, Y., 2002. Imipenem-EDTA disk method for differentiation of metallo-β-lactamase-producing clinical isolates of Pseudomonas spp. and Acinetobacter spp. J. Clin. Microbiol., 40, 3798-801.

Full Text: PDF


  • There are currently no refbacks.