Prevalence of microbial infection and strategic pattern of antimicrobial resistance among intensive care unit patients in a tertiary care teaching hospital from rural Northern India

Background: Better management of patients cannot be ensured and the antibiotic policy cannot be designed till one knows the profile of prevalent strains along with their antimicrobial resistance pattern. Objective: To assess the strategic patterns of the organisms and its resistance patterns that were isolated from the patients admitted in various ICUs in a tertiary care hospital. Material and methods: The present study was undertaken based on reports of bacterial isolates of various clinical specimens from different ICUs of a tertiary care teaching hospital, that were submitted to the Microbiology laboratory for culture and sensitivity during the period of October 2012 to September 2014. All the organisms were identified morphologically and biochemically by standard laboratory procedure and antibiotic susceptibility pattern was determined by disc diffusion methods. Results: Out of the total samples (2920) received; organisms were isolated from 66.57%. One organism was isolated in 71.19% samples whereas 2 or more organisms were obtained in 28.8% samples. The most frequently isolated bacteria were P. aeruginosa (38.17%). Among P. aeruginosa, tobramycin had the highest susceptibility rate (94.2%) followed by meropenem (93.93%), carbenecillin (79.11%), and levofloxacin (73.45%). Most of the frequently isolated organisms like K. pneumoniae, Acinetobacter anitratus, Enterobacter were highly resistant to ampicillin, cephalexin, cefepime, ciprofloxacin. Conclusion: Appropriate antibiotic utilization in ICU is crucial not only to ensure an optimal outcome, but also to prevent the emergence of multi drug resistance. Antibiotic policies and effective surveillance are needed for better management of ICU infections with resistant organisms. Alteration and rotation in antibiotic prescribing patterns would decline the antibiotic resistance.