BACTERIAL ETIOLOGY OF HOSPITAL ACQUIRED INFECTION AMONG THE INTENSIVE CARE UNIT (ICU) PATIENTS ADMITTED AT A PRIVATE HOSPITAL IN DHAKA CITY
Journal Title: World Journal of Pharmaceutical and life sciences - Year 2017, Vol 3, Issue 4
Abstract
Context: Hospital acquired infections (HAIs) increases mortality and morbidity among Intensive Care Unit (ICU). Objectives: The Purpose of the present study was to assess the frequency of hospital acquired infection in ICU patients with their association to patients and hospital related factors. Materials and Methods: This was designed as analytical type of cross sectional study. The study population comprised of admitted ICU patients in United Hospital Ltd., Dhaka, Bangladesh who were available 48 hours after admission from March 2014 to August 2014. Blood, Tracheal Aspirate and Urine of specimens were collected from patients. The organisms were isolated from specimen by inoculation and subculture on blood agar and MacConkey agar media. Identification of the organisms was done by colony morphology, gram staining and standard biochemical tests. All the isolates were tested for sensitivity against antimicrobial agents by disc diffusing method of Kirby Bauer et al (1966). The potency of each batch of disc was standardized by the reference strain of ATCC Esch. Coli, No 25922 and Pseudomonas aeruginosa No 27853. Zone of inhibition were compared with the standard value and was considered as sensitive (S), Intermediate sensitive (IS) and resistant (R) according to the NCCLS (1998). Data were checked, verified and coded into computer by using SPSS (Statistical Package for Social Science) Programme version (16.0). Result: A total number of 134 patients from ICU having HAI were studied. Among the study population, tracheal aspirate were collected from 86, Blood from 85 and urine from 75 patients. The culture positivity was highest in tracheal aspirate of samples 86(78.2%) followed by blood 22 (25.9%) and urine 15 (20%). The predominant organisms were Acinetobacter spp. (27.6%), followed by Serratia spp. (17.9%). The antibiogram showed Acinetobacter spp. were 83% sensitive only to colistin followed by imipenem 67%. High resistances (100%) were found against amikacin, amoxyclavonic acid and ceftriaxone. K. pneumoniae were 100% sensitive to colistin followed by imipenem 80%. Increasing number of visitors was reported at more risk of HAI. Application of invasive device, use of immunosuppressive therapy, immunosuppressive condition and surgical interventions were found statistically significant association of developing HAI (p<0.05). Hospital related factors does not show any positive correlation with HAI (P>0.05). Conclusion: Study may be concluded that culture positivity was highest in tracheal aspirate and predominant organism was Acinetobacter spp. Bacteria isolated from ICU were resistant to commonly used antibiotics which makes more difficult to effective interventions. Risk factors like use of invasive device, Immunosuppressive therapy, surgical procedures are found responsible to develop HAI.
Authors and Affiliations
Dr. Al Jahidi Hasan Chowdhury
Keywords
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