Comparison of antimicrobial resistance pattern among clinical isolates of gram negative bacilli from intensive care units and general wards in a tertiary care hospital
Author(s): Gomathi Maniyan, Vijayalakshmi Arumugam, Nithya Gomatheswari3, Malathi Murugesan
Increasing antimicrobial resistance is a worldwide concern. The prevalence of resistance among hospitalized patients varies in different location. The right choice of antibiotic is utmost importance to initiate empirical therapy especially in critical care areas. To compare and assess the differences in the pattern of antimicrobial resistance shown by Gram Negative Bacilli (GNB) isolates from general wards and Intensive Care Unit (ICU) patients. This is a retrospective study conducted in a tertiary care hospital on 100 (50 + 50) isolates of GNB from clinical samples collected from General ward and ICU patients respectively. GNB isolates were identified by standard biochemical tests and their antimicrobial susceptibility pattern was determined as per CLSI guidelines and analyzed for both the groups. The resistant strains were identified for Extended Spectrum Beta Lactamases (ESBL) and Metallo Beta Lactamase (MBL) production. In general ward isolates, Enterobacteriaceae was the commonest (78%) and nonfermenters accounts to 22%. In ICU, Enterobacteriaceae 64% and nonfermenters 36%. In ICU maximum resistance to third generation cephalosporins and fluoroquinolones was noted among nonfermenters. In contrary, in general ward, Escherichia coli showed highest resistance to almost all the drugs except aminoglycosides. Majority of the isolates in both the groups were sensitive to aminoglycosides (80%). ESBL producer in ICU was 80% and in general ward 72%. MBL production among nonfermenters in ICU was 25%. This study provides information on antibiotic resistance in different areas of the hospital. Need of the day is that, each hospital should have a comprehensively drafted and strictly implemented antibiotic policy.
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