Antimicrobial Resistance Pattern of Bacterial Isolates among Nosocomial Infections (Urinary Tract Infection and Blood Stream Infection) from the Intensive Care Unit of a Tertiary Care Government Hospital in India

BACKGROUND Development of antimicrobial resistance (AMR) to different generations of common antibiotics by various organisms is rising alarmingly. A nationwide standard antibiotic policy is needed. We wanted to study the resistant organisms, the drug class to which organisms are becoming resistant and identify factors favoring the development of AMR for formulating an effective antibiotic policy. METHODS We conducted this observational study from January 2018 to May 2019 in a tertiary care hospital in India. Sample (urine, blood from ICU patients) processing, organism identification and antibiotic susceptibility tests were carried out as per the institutional guidelines in the Microbiology Department from where data collection was done. RESULTS Out of 500 samples, 145 (29%) showed significant growth of organisms exhibiting resistance to either single or multiple drugs. Acinetobacter spp. was the most common organism isolated with a total of 40 (27.58%), followed by Klebsiella spp. 23 (15.83%), MRSA 20 (13.79%), E. coli 15 (10.34%), Pseudomonas 12 (8.27%), Enterococci 12 (8.27%), and CoNS 7 (4.82%). Among GNB, Klebsiella and E. coli showed minimal resistance to polymyxins, fosfomycin, minocycline and tigecycline. Among Staphylococcus spp. maximum sensitivity was seen to teicoplanin, tobramycin, tigecycline and minocycline. Acinetobacter spp. showed high sensitivity to polymyxins, tobramycin, tetracycline, tigecycline and minocycline. CONCLUSIONS AMR was highly prevalent with hospital acquired organisms, and against commonly used antibiotics. Variation of resistance and sensitivity pattern with time and local microflora necessitates periodic AMR monitoring and rotation of antibiotics is suggested to restrict further emergence of resistance. Focusing on the organisms causing UTI and BSI and their resistance pattern, helps in selecting proper antibiotic therapy and in strengthening general sepsis measures.