The Effect of Infection Agents Obtained From Intensive Care Patients on the Resistance Pattern and Patient Outcomes

Abstract

Objective: Infection is a significant problem associated with increased morbidity and mortality in intensive care units (ICU). This study aimed to examine the effect of infectious agents obtained from Medical ICU on the resistance pattern and the patient outcomes in a 3 year period retrospectively. Material and Method: The patients with positive culture results while hospitalized in a tertiary level medical ICU between January 2016 and April 2019 were included in the study. The patients were grouped as survivors and non-survivors. These groups were compared for infection foci, infectious agents, mortality, and the sensitivity of the infectious pathogens to the antibiotics. Results: From a total of 426 patients admitted to ICU with the diagnosis of infection, culture positivity was determined in 212 samples. The highest rates of positivity were determined from the urinary tract specimens (n:90, 42.4%), followed by bloodstream specimens (n:62, 29.2%) and then lower respiratory tract specimens (n:47, 22.1%). The most frequently isolated micro-organisms were gram-negative bacteria (n.152, 70.6%) and within these, the most common micro-organism was Escherichia coli (n:59, 27.8%). When the microorganisms evaluated according their antibiotic susceptibility it was found that, A. baumanii strains were sensitive to colistin, and K. pneumonia, E.coli, and Pseudomonas aeruginosa (P. aeruginosa) strains were sensitive to aminoglycosides and colistin. The mortality rate of the hospitalized patients because of infection was found to be 51.8% (n:112). Conclusion: When selecting empirical antibiotics in the treatment of infection in critically ill patients, the intensive care unit flora and the antibiotic resistance patterns must be known. Therefore, it is important to periodically determine the infectious agents and antibiotic sensitivity.