Profile of Infections in Intensive Care Unit (Icu) in a Central Nigeria Tertiary Hospital

Abstract

Background: Intensive Care Units (ICUs) accommodate the most seriously ill patients in a relatively confined environment. Increased duration of stay, increased number of indwelling and invasive devices and prolonged or inappropriate use of antibiotics are common features of ICUs, with consequent or associated increase in selection of multi-resistant  pathogens, morbidity and mortality.
Objectives: To determine the identity and antimicrobial resistance pattern of organisms commonly associated with infections in the ICU of the hospital.
Method: A retrospective study of Intensive Care Units (ICU) infections in NHA over a three-year period January 1st, 2010 to December 31st, 2012 was conducted through review and analysis of laboratory data.
Results: Data for 79specimens were fully analysed; 35(44%) from urine, 17 (22%) from blood, 6 (8%) from tracheal specimens and 8 (10%) from wound. Forty-one (52%)of the specimens yielded growth;16 (20%) from urine, 8 (10%) from wound, 6 (8%) from tracheal specimens,3(4%) from blood and others 8(10%). 14(34%) out of the 41 isolates were Escherichia coli, 8 (20%) Pseudomonas aeruginosa, 6 (15%) were Staphylococcus aureus and 6 (15%) Klebsiella pneumoniae. Three (4%) of the specimens
yielded mixed growths while another 3 (4%) yielded Candida species. Sensitivity of E. coli to third generation cephalosporins ranged from 62-72%and 90% to imipenem. For Klebsiella pneumoniae it was 67-75% to third generation cephalosporins and 100% to imipenem. Pseudomonas aeruginosa was 71% and 83% sensitive to ceftazidime and imipenem respectively. Staphylococcus aureus was 67% and 83% sensitive to amoxicillin-clavulanate and imipenem respectively. Susceptibility of all
these isolates to fluoroquinolones and aminoglycosides remained poor.
Conclusion: The isolates from the ICU were same as common in clinical specimens. There was wide variability in resistance with a tendency to increase over time. This trend needs to be monitored while antibiotic stewardship should be emphasised.

Key words: Intensive care units (ICU), nosocomial Infections, antibiotic susceptibility.