The problem of antimicrobial resistance in nosocomial medical and surgical intensive care units infections in a university hospital; a two-year prospective study

摘要: Aim: To determine the frequency of nosocomial infections (NIs) and antimicrobial resistance pathogens isolated from patients admitted to 4 intensive care units (ICUs) at a university hospital. Materials Methods: The were prospectively followed over 2 years in medical, surgical, reanimation ICUs. isolates collected with NI determined by Center for Diseases Control Prevention criteria. identification was performed susceptibility antibiotics an automated system Sceptor (Becton Dickinson) as described CCLS. Results: Among 3962 ICUs, total incidence 6.9%, highest rate ICU (14.7%) lowest surgical (2.5%). In all, 492 episodes diagnosed 272 patients. NIs 13.1 per 1000 patient days. urinary tract (32%), primary blood stream (24%), pneumonia (20%), surgical-site (13%), other (11%). Pneumonia most common (54%). 39% gram-positive bacteria, 52% gram-negative 9% Candida species. S. aureus (18%) frequently P. aeruginosa (16%), Acinetobacter spp. (10%), coagulase negative staphylococcus (CNS) Klebsiella (9%), E. coli Enterococcus (9%). Resistance methicillin 90% 95% CNS isolates; no detected vancomycin isolates. Eight percent resistant vancomycin. Against bacteria carbapenems active, amikacin ciprofloxacin. Five 15% all antibiotics. active agents against imipenem (73%) tobramycin (46%); Pseudomonas ticarcillin/clavulanate (56%), piperacillin (44%), (33%); (92%); (94%), ciprofloxacin (74%); Enterobacter (89%) (78%). Conclusions: high rates responsible ICUs suggest that infection preventive procedures should be implemented must used appropriately.