spite of controlling many risk factors, there are higher risk for infections in
ICUs compared with regular wards. In comparison to pneumonia and wound
infections, BSI and UTI have a higher incidence in ICUs compared with other wards.
Patients should be managed in ICUs for an optimal period necessary for their
care 1. BSIs being leading cause of morbidity and mortality represent a
common complication among critically ill patients. The effective and prompt
antibiotic therapy is necessary in order to improve clinical outcomes and
reduce mortality. Nevertheless, due to worldwide spread of multi-drug resistant
(MDR) organisms the choice of the empiric antibiotic regimen is often
challenging. We need to have new therapeutic challenges to minimize the risk of
resistance selection in turn improve the effectiveness of antibiotic treatment
2. BSIs form leading infections among critically ill patients. The
case-fatality rate related to BSIs in patients admitted to ICUs is very high
(35–50%). The development and dissemination of antibiotic resistant bacteria is
a global health problem 3. Along with management of severe sepsis and septic
shock which may ultimately develop, antimicrobial therapy is the main support
of treatment of BSIs, During the last decade, clinicians have observed a rising
occurrence of BSIs by bacteria resistant to commonly used antimicrobials 4. A
MDR microorganism is resistant to at least one agent in three or more
antimicrobial classes. Extensive drug-resistant (XDR) microorganisms is
susceptible to only one or two antimicrobial classes, while pan-DR (PDR)
isolates are resistant to all agents from all antimicrobial classes 5.
Emergence of antibiotic resistance is a global public health problem 6,7.
Likewise, catheter-associated UTI is a main cause of morbidity and mortality
affecting all age groups 8. Bacteriuria or candiduria is nearly unavoidable
in half of the patients on indwelling urinary catheter for more than five days.
Patients with asymptomatic bacteriuria harbor major pool of antibiotic resistant
pathogens in hospitals 9. With this background in mind, we designed this
study with the following aim and objectives.
Aim: To study the prevalence of blood Stream Infection
(BSI) and Urinary Tract Infection (UTI) causing antibiotic resistant bacterial
pathogens isolated from Intensive Care Unit (ICU) Patients
analyze the types of bacteria isolates cultured in blood and urine samples from
Intensive Care Unit (ICU) patients prior to and after the surgery performed.
determine the bacterial drug resistance profile & phenotypic detection of
detect antibiotic resistance coding genes in representative isolates.
assess biofilm forming potential of selected dominant isolates
study will be carried out after obtaining the ethical clearance for
Institutional ethical clearance committee. The results obtained will help us to
assess the prevalence of nosocomial drug resistant bacterial pathogens among
the ICU patients. Further, the data obtained will help advising the concerned
officials on matters related to the proper use of antibiotics, develop
antibiotic policies and recommend remedial measures (antimicrobial stewardship
and antibiotic cycling) when antibiotic resistant strains are detected in ICUs.