MONITORING ANTIMICROBIAL RESISTANCE AMONG INTENSIVE CARE UNIT GRAM-NEGATIVE ISOLATES: INSIGHTS FROM A RETROSPECTIVE STUDY
DOI:
https://doi.org/10.22159/ajpcr.2025v18i9.55898Keywords:
Gram-negative organisms, Intensive care units, Multidrug-resistant, Extensively drug-resistant, Pan-drug-resistantAbstract
Objectives: To determine the distribution and resistance profiles of Gram-negative bacteria (GNB) in intensive care units (ICUs) at Tertiary care centre Adesh Medical College and Hospital, Shahabad, Kurukshetra, Haryana.
Methods: A record-based retrospective study was conducted from January 2023 to December 2024. In total, 540 clinical specimens and isolates, 58 (9.7%) GPC and 302/540(55.9%) from the general intensive care unit (ICU), neonatal ICU (NICU), Respiratory ICU, Neurology ICU and coronary CU (CCU) were analysed for pathogens and their Antibiotic susceptibility patterns.
Results: Among GNB isolates, 302/540(55.9%) were isolated in the year 2023 and 238(44.1%) were isolated in the year 2024. Predominantly isolated from the Medicine ICU, with 109 isolates in 2023 and 87 in 2024, followed by the Neuro ICU. The predominant clinical sample from which GNB were isolated was a respiratory sample for both years, with 132/302 (43.7%) for 2023 and 131/238 (55%) for 2024. Klebsiella spp. were the most frequently isolated organism, accounting for 47.7% in 2023 and 36.6% in 2024, with 231 isolates (42.8%) across both years. Acinetobacter spp. showed a marked increase, rising from 13.9% in 2023 to 26.9% in 2024. Klebsiella displayed a high resistance pattern to cephalosporin and a high rising trend of carbapenems from 19.4% in 2023 to 71.2% in 2024, followed by Acinetobacter spp., E.coli and Pseudomonas spp. Multidrug-resistant (MDR) bacteria decreased sharply from 36.42% in 2023 to 11.76% in 2024, with concomitant increase of Extensively drug-resistant (XDR) bacteria from 16.89% in 2023 to 55.46% in 2024.
Conclusion: In this study, Gram-negative bacteria caused the majority of infections in patients admitted to the intensive care unit, with Klebsiella pneumoniae being the predominant pathogen. a shift of resistance amongst isolates from MDR to XDR, pointing toward more severe and difficult-to-treat infections in ICU settings
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