Antibiotic Resistance Pattern and Stewardship Program in Critical Care Settings.

To study the sensitivity pattern of isolate from patients specimens associated with infection as admitted to the critical care centers with empiric or prophylactic antibiotic use, till identification of the organism and resultant sensitivity awaited; compared with sensitive antibiotic to the isolate which could be used for management. The study was an analytical cross sectional one carried out during the period April 2016-July 2016 in the critical care center of CMH Dhaka Cantonment. Patient’s urine, and other specimens that included wound swab, pus, sputum, tracheal aspirate, catheter tip, nasal swab, high vaginal swab, broncheoloalveolar lavage, blood, urethral discharge ;samples collected from the patients in critical care settings at CMH Dhaka observing aseptic conditions and subjected to test at Armed Forces Institute of Pathology (AFIP); and isolate identification was done using standard procedure and sensitivity testing was performed using antibiotic disc diffusion technique. A total of One thousand six hundred and seventy (1670) patients were dealt with in the study and positive yield obtained in 190 (11.38%) cases. One hundred and sixteen ( 116) urine specimens which constituted 69 (57.76%) female and 47(42.24%) male patients. A total of one thousand and eighty eight (1088) discs of antibiotics were used on average nine (9) discs per isolate. Six hundred and forty nine (649/ 59.65%) showed resistance to the antibiotic used against them while four hundred and thirty nine (439/40.35%) showed sensitive response. Age range in both types of specimens combined included patients from 2-80 years. Other specimens include 74 isolates. Fifty (50/67.57%) were male and twenty four (24/32.43%) were females patients. A total of eight hundred and twenty seven (827/11.18 disc per isolate) antibiotic doses were used 479 (479/57.92%) showed resistant and 348 (348/42.08%) sensitive result, Enteric gram negative bacilli (GNB) were the majority of isolates in both types of specimens.The study indicates that, newer antimicrobials have a substantial impact in decreasing human morbidity and mortality rates.


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