Microbial Profile of Infections in Various Surgical and Non-Surgical Intensive Care Units

Abstract

Background : Intensive care units(ICUs) are specialized departments that provide life-sustaining treatment to critically ill patients. ICUs can be broadly categorized into two types: Surgical ICUs(SICUs) and Non-surgical ICUs (NSICUs). Infections with resistant strains in the ICUs leads to increased mortality, morbidity and health care cost. The microbiological profile of ICUs plays a critical role in guiding antimicrobial therapy, infection control measures, and patient outcomes.

Aims and objective : To study the isolates causing infections in various surgical and non-surgical ICUs and their antimicrobial susceptibility pattern.

Materials and Methods : A cross sectional study was conducted in various ICUs (MICU,PICU,NICU,SICU,TICU) . Samples like blood , Endotracheal aspirate, sputum/BAL, CSF, pleural fluid, ascitic fluid, peritoneal fluid, urine, pus were collected from the patients admitted in various ICUs. These samples were transported immediately to Department of Microbiology laboratory .All samples were processed by Standard bacteriological techniques  and the Antimicrobial susceptibility testing was done  by Kirby-Bauer disk diffusion method and results were interpreted in accordance with CLSI 2023 guidelines.

Results: Respiratory infections were more common in both non-surgical and surgical ICUs(46.07% and 62.92% respectively ) , followed by blood stream infection, skin and soft tissue and urinary infections. Gram negative pathogens were predominant which include Klebsiella pneumoniae(32.30%),Acinetobacter baumannii (15.17%), Pseudomonas aeruginosa (14.05%), Escherichia coli (10.67%). Among these, 30.16% were ESBL producers, 14% were MBL producers, and 6.44% were Amp C producers. Gram-positive cocci, primarily Staphylococcus aureus, constituted 17.13% of isolates, with 60% of Staphylococcus aureus isolates being methicillin-resistant.

Conclusion: High prevalence of gram-negative bacterial infections and multi-drug resistant isolates was noted in Indian ICUs.

Keywords: Intensive care units, Klebsiella pneumoniae, Acinetobacter baumannii, drug resistance