Rising Threat Of Multidrug-Resistant Pathogens In Icu Pus Specimens: Insights From A North Indian Tertiary Hospital

Abstract

Background: Infections acquired in intensive care units (ICUs) are often severe and caused by multidrug-resistant (MDR) organisms, making early identification and targeted therapy critical. This study aimed to analyze the bacteriological profile and antibiotic susceptibility patterns of clinical isolates from ICU patients at Sharda Hospital, Greater Noida.

Materials and Methods: A total of 2,125 clinical specimens including blood (46%), urine (30%), respiratory (20%), and pus (4%) were processed over the study period. Identification of pathogens and antimicrobial susceptibility testing were performed using standard microbiological techniques and CLSI guidelines.

Results: Out of 2,125 samples, 285 bacterial isolates were obtained. Respiratory specimens had the highest positivity (46%), followed by blood (23%), urine (20%), and pus (11%). The most frequently isolated organism was Escherichia coli (24%), followed by Acinetobacter spp. (23%), Klebsiella spp. (13%), Pseudomonas aeruginosa (10%), Staphylococcus aureus (10%), Enterococcus spp. (10%), Coagulase-negative Staphylococci (6%), Citrobacter spp. (3%), and Proteus spp. (1%). Among Gram-negative organisms, carbapenems and tigecycline showed moderate sensitivity, while resistance was high to cephalosporins and fluoroquinolones. For Acinetobacter spp., minocycline (68%) and tigecycline (45%) were the most effective. Pseudomonas isolates were mostly susceptible to amikacin, gentamicin, and carbapenems (75–79%). Among Gram-positive organisms, linezolid and vancomycin were highly effective against Staphylococcus aureus and Enterococcus spp. Alarmingly, resistance to commonly used antibiotics such as penicillin, fluoroquinolones, and erythromycin was widespread.

Conclusion: The study highlights the prevalence of multidrug-resistant organisms, especially Acinetobacter spp. and E. coli, in ICU settings. Regular surveillance and stringent antibiotic stewardship are vital for improving patient outcomes and combating antimicrobial resistance.