Bacterial etiology, antimicrobial susceptibility patterns and the prevalence of nosocomial infection in different clinical sample from patients attending intensive care unit in Tikur Anbessa Hospital,Addis Ababa,Ethiopia
Creators: name: Mohammed, Jemal
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2019

description: Background: Nosocomial infections are widespread health problems in the world including in developed and developing countries which are the most important aggravating agents of mortality, morbidity, length of hospital stay and cost in the world. Nosocomial infections are becoming difficult to treat due to the increasing trend of antibiotics resistance, especially the critically ill patients in the intensive care unit (ICU). Relatively, few data are available from Ethiopia to indicate present health care associated infections (HAIs) status of situation. Objective: To determine bacterial etiology, antimicrobial susceptibility patterns and the prevalence of nosocomial infection in different clinical sample from intensive care unit patients in Tikur anbessa hospital Methods: A cross-sectional study was conducted from January to December 2018 in intensive care unit of Tikur Anbessa Specialized Hospital. Among 612 patients admitted to intensive care unit, 192 study participants (patients) who were suspected of bacterial nosocomial infections were included based on WHO guidelines for nosocomial infections using convenient sampling technique. Bacteria were isolated using culture and biochemical tests. Antimicrobial susceptibility testing was performed using Kirby-Bauer disc diffusion method as per CLSI. ESBLs confirmation was done by double disk synergy diffusion method. Data was analyzed with SPSS version 23.0. Results: During a 12 months period from January to December 2018, 612 patients admitted to intensive care unit to Tikur Anbessa Hospital were studied for prevalence of nosocomial infection. A total of 192 patients were selected based on their clinical ground as per WHO 2002 guidelines. Total 14 % (87/612) patients were confirmed by culture to have nosocomial infection. Of the 77 patients were 70.1 %( 61) male and 29.9% (26) females. The distribution of nosocomial infection among positive cases was blood stream infection (38.5%). Respiratory tract infection(20.2%),urinary tract infection(17.4%) and surgical site infection(11.0%).A total of 109 bacterial strains were isolated ,K.pneumoniae accounted for (26.6%) of total isolates, followed by Acinitobacter spps (17.4%), E.coli (16.5%) and CoNS (9.2%). A large majority of bacteria isolates (82.6%) were gram negative. High multi drug resistances (MDRs) bacteria were observed in ICU and Overall, multi drug resistance was observed in 71.6 %( 78/109) of isolates. Gram positive and Gram negative isolates showed 52.6% and 75.6% MDR respectively. Both Gram-positive and-negative isolates expressed resistance to most of the penicillin and cephalosporins tested. Amikacin and Meropenem were the most effective antibiotics against gram negative bacteria isolates (except Acinitobacter spps). Acinitobacter Spps showed highly resistance for most drugs including amikacin and meropenem.High rates of the extended spectrum beta lactamases (ESBLs) of K. pneumonia and E. coli were observed (31.9% and 21.3% respectively). Low rates (1.8%) of methicillin resistant staphyloccus aures (MRSA) was observed, whereas no vancomycin resistance Enterococcus spps were detected.