Multi-Drug Resistant Organisms in Medical Intensive Care Unit, Tripoli University Hospital

Abstract

Resistance of nosocomial and community acquired pathogens to antimicrobial agents is a serious problem with
significant clinical consequences. A study of multi-drug resistant microorganisms, in medical intensive care unit
(MICU) in Tripoli University Hospital, to identify the multidrug organisms in MICU among a period of time
and also to identify the effective antibiotics from those not effective. For epidemiologic purposes, MDROs are
defined as microorganisms, predominantly bacteria, that are resistant to one or more classes of antimicrobial agents.
Although the names of certain MDROs describe resistance to only one agent (e.g., MRSA, VRE), these pathogens
are frequently resistant to the most available antimicrobial agents. These highly resistant organisms deserve special
attention in healthcare facilities. In addition to MRSA and VRE, certain GNB, including those producing extended
spectrum beta-lactamases (ESBLs) and others, that are resistant to multiple classes of antimicrobial agents, are of
particular concern. Cross sectional study including all patients admitted in MICU, from the 1st of January 2014 to
the 31st of December 2014, a total of (797 cases), for about 501 samples, (277 blood and 224 sputum), the variability
was the gender, age from (20 to 90 years), use of broad spectrum antibiotic, admission and intubation for 2 weeks or
more, the samples were blood and sputum, cultured for a week in blood and chocolate agar in our microbiology lab.
In this study, a total 797 cases in 2014 were admitted in our medical ICU, 45 cases were isolated as a MDR cases
(5.64%) and the pathological organisms were 20 cases (2.5%) Acinetobacter baumanii, 19 cases (2.38%) Klebsiella
ESBL, 7 cases (0.8%) Pseudomonas aeruginosa a common risk factor between all the patients were previous use
of broad spectrum antibiotic and intubation for more than a week also from the MDR cases actually there were 8
cases from 20 of Acinenobacter resistant to all (EDR) even for Carbapenems and Amikacin and the mortality rate
reaches 90% for all the cases, and to minimize the development of resistance, antimicrobials must be administered
judiciously, and infection control practices must be instituted and followed