Analysis of Intensive Care Units (ICUs) Blood stream Infections (BSI) in Kafkas University Health Research and Application Hospital

Objectives: Sepsis is one of the most important cause of admission in Intensive Care Units, probably due to the more severe illnesses of hospitalized patients and to the persistently high incidence of nosocomial infections. However, despite the availability of potential antibiotics and refined supportive care the mortality of septic patients remains high, with overall estimates of about 30% and increasing to 50% when associated with shock. In this study, our aim is to determine retrospectively the epidemiology of blood stream infections occurred in Intensive Care Units of Kafkas University Health Research and Application Hospital and to present the first data from this university hospital. Materials and Methods: Total 1004 blood culture bottle were sent to Microbiology Laboratory of Kafkas University Health Research and Application Hospital between January 2013 to January 2015. All bottles were placed into Automated BACTEC 9050 Blood Culture System. After the positive bottles were detected by machine, the bacteria were identified and antibiotic susceptibility test were performed by using both BD Phoneix Microorganism Identification System and Kirby- Bauer Disk Diffusion method. Results: Total 202 positive samples were detected and the biggest part of total positive samples (n:164, 81.2%) were sent by Internal Intensive Care Unit. The identified bacteria were MRCNS (n:67, 33.2%), MSCNS (n:42, 20.8%), MRSA (n:29, 14.3%), E.coli (n:23, 11.3%), MSSA (n:16, 7.9%), P.aeruginosa (n:9, 4.5%), Enterococcus spp (n:9, 4.5%), K.pneumoniae (n:4, 1.9%), A.baumannii (n:1, 0.5%), Proteus mirabilis (n:1, 0.5%), Stenotrophomonas maltophilia (n:1, 0.5%), respectively. Additionally Extended-Spectrum Beta-Lactamase (ESBL) were detected as positive in 7 E.coli. Conclusions: Gram negative bacteria are still important. However; in recent years, coagulase negative staphylococci are the most detected bacteria in Intensive Care Units. For this reason, increased MRCNS rate may restrict antibiotic options and lead increasing the usage of glyco- peptides prophylactically. It is necessary to perform active surveillance studies, obey standard infection control measures and develop an appropriate antibiotic policy for decreasing the frequency of resistant microorganisms, due to the changes in microorganism types in ICUs and their antibiotic susceptibilities.