Resistance of Gram-negative bacilli isolated from patients in ICU

Abstract

Objective: to determine the spectrum of pathogens associated with nosocomial infections among ICU patients, to summarize the level of antimicrobial resistance of common pathogens and provide an overview of strategies to prevent the spread of resistance. Methods: A prospective microbiologic study of 781 strains isolated from adult patients after cardiac surgery at ICU was conducted, during the period 2010-2014. Results. The results of the study, 52.3% of the isolated strains (409) were Gram-negative, among which the share of non-fermenting Gram-negative bacteria accounted for 34.4% of the isolates (269), of which most frequently was Acinetobacter baumannii - 20,9% (164) and Pseudomonas aeruginosa - 13,4% (105). A. baumannii showed a high level of resistance to the III generation cephalosporins (ceftazidime - 96.9%, cefotaxime - 97.6%, ceftriaxone - 93.5%), to carbapenems at the level of 88%. Resistant strains of Pseudomonas aeruginosa to carbapenems was 63%. Among the representatives of the family Enterobacteriaceae, the highest resistance was observed in strains of Klebsiella pneumoniae, 100% resistance to cephalosporins III generation (ceftriaxone, ceftazidime), the lowest resistance to carbapenems observed (4.2% of meropenem, imipenem 11.1%). Conclusion: In order to reduce the emergence and spread of drug-resistant strains in the ICU, it is strongly recommended to carry out microbiological monitoring and optimization of the use of antibiotics in each hospital. Therefore local resistance surveillance programs have the greatest value in the development of appropriate therapeutic recommendations for specific types of patients and infections.

Keywords

• antimicrobial resistance
• microbiologic monitoring
• Acinetobacter baumannii
• Pseudomonas aeruginosa
• Klebsiella pneumoniae