Journal of Clinical Care and Skills

Background: Rising antibiotic resistance among prevalent pathogens poses a critical challenge, especially in ICU patients. This study aimed to evaluate antibiotic susceptibility and resistance patterns in body fluid and urine samples from ICU patients at a tertiary care center in Tehran, Iran.

Methods: A cross-sectional study analyzed cultures from body fluids and urine samples collected from ICU patients at Imam Khomeini Hospital between 2019 and 2022. Cultures were processed per standard protocols and interpreted based on growth inhibition zones to classify bacterial isolates as sensitive, intermediate, or resistant. Data analysis was performed using STATA V.17.0.

Results: A total of 4232 body fluid and 4062 urine samples were examined; 2400 body fluid and 2824 urine cultures were negative. The most common bacteria in urine were Klebsiella pneumoniae (16.7%), Escherichia coli (15.43%), and Pseudomonas aeruginosa (6.08%), while body fluids predominantly grew Klebsiella pneumoniae (37.19%), Acinetobacter baumannii (25.52%), and Pseudomonas aeruginosa (8%). Klebsiella pneumoniae showed highest sensitivity to Gentamicin (12.37% in body fluids, 17.93% in urine) and Imipenem (9.72% in body fluids, 14.67% in urine). Resistance was notably high against Ampicillin-Sulbactam (over 90%), Ciprofloxacin (85-89%), and Cotrimoxazole or Nitrofurantoin (84-88%) depending on the sample type.

Conclusion: There is significant antimicrobial resistance in key ICU pathogens including Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. These findings underscore the necessity for hospital-based active surveillance and effective antibiotic stewardship programs in ICU settings to monitor and mitigate resistance patterns, aiding in optimized infection control and patient management.