Title: The Pattern of Antibiotics Resistance among Critically Ill Patients Admitted At a Tertiary Hospital in Chattogram

Authors: Dr Md. Mahade Hassan, Prof. Dr Alak Nandy, Prof. Dr Nahida Sultana, Dr Md. Saif Uddin Azad, Dr Tarequr Rahaman

DOI: https://dx.doi.org/10.18535/jmscr/v10i10.12

Abstract

Background: Antimicrobial resistance (AMR) has been a major concern to the successful treatment of an ever- increasing spectrum of illnesses that are caused by bacteria, parasites, viruses, and fungi for a number of decades now. This risk has become even more serious since the number of infections that need treatment has been steadily raising over the last several years. Because antibiotic resistance reduces the efficacy of drugs used to treat bacterial infections, it becomes more difficult, costly, and maybe even impossible to treat patients.

Objective: To assess the antibiotic resistance pattern of antibiotics resistance among critically ill patients admitted at a tertiary hospital in Chattogram.

Materials and Methods: This prospective observational research was undertaken from January to June 2022 at the Microbiology Lab of Chattagram Maa O Shishu Hospital Medical College. After receiving clearance from the CMC Ethical and Review Committee and authorization from the laboratory authorities, the research colleagues and research assistant gathered 79 data points from various labs in the form of MS-Excel files and entered them into a case record form.

Results: The Mean±SD age of the patients was 52.70±18.361 years. Among the patients 5.063% was adolescent, 51.9% was adult and 43.09% senior adult. Nearly, 64.6% of samples were collected from tracheal and 1.3% of samples were collected from pus culture. Furthermore, 55.7% Klebsiella, 16.5% Pseudomonas, 12.7% Acinetobacter, 7.6% Staph Aureus, 5.1% E. coli, and 2.5% Enterococcus bacteria were found in the patients. Microbe Klebsiella is highly resistant to most of the multidrug except Netilmicin and Mecillinum. Multidrug resistance such as Amikacin (p=0.006), Cefuroxime (p=0.041), Ampicillin (p=0.005), Vancomycin (p=0.000), Linezolid (p=0.000), Nitrofurantoin (p=0.000), Cloxacillin (p=0.005) and Mecillinum (p=0.02) were significantly associated with the micro-organisms. Prevalence of co-morbidities and antibiotic resistance among critically ill patient’s shows that most of antibiotics resistant with co morbidities which is higher than sensitivity and very few antibiotics are intermediate with co-morbidities.

Significant association observed between COTRIM vs COPD (p=0.007), CHLORAM vs HTN and IHD, CIPRO vs DM, AMOXICLAV vs IHD, CEFIXIME vs CVD, AMIKACIN vs CVD and PIPERCILLIN vs CVD. This study also identified that multidrug resistance has association with Specimen in some cases. Six antibiotics such as COTRIM, MECILLINUM, TETRACYCLINE, CEFOTAXIME, TIGECYCLINE and COLISTIN significantly associated with Specimen.

Conclusion: The primary scenario of rational anti-microbial medication for critically sick patients is presented in this research. There was a catastrophic scenario due to the gradual rise in the number of E. coli and Klebsiella organisms, as well as their resistance to popular antibiotics like Ampicillin, Ciprofloxacin, and Cefuroxime. This condition was worrying and severe.

Keywords: Antibiotics resistance, Critically Ill Patients, Bacterial infections, microbiotic infections, antiviral infections.

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Corresponding Author

Dr Md. Mahade Hassan

Assistant Professor, Department of ICU and Medicine, Chattagram Maa O Shishu Hospital Medical College