What antibiotics for what pathogens? The sensitivity spectrum of isolated strains in an intensive care unit

Sci Total Environ. 2019 Oct 15:687:118-127. doi: 10.1016/j.scitotenv.2019.06.076. Epub 2019 Jun 7.

Abstract

Antibiotic sensitivity spectrum of isolated strains differs according to hospital departments, the hospitals themselves, and countries. Discrepancies also exist in terms of antibiotic use and dosage. The aim of the present study is to compare the antibacterial agents, the types of infections, the number and type of pathogens, and the sensitivity to antibiotics used in the Intensive Care Unit (ICU) of the Emergency Clinical County Hospital of Oradea, Romania. Over a one-year period, data were gathered from the pharmacy computer system and medical records of inpatients. WHO Anatomical Therapeutic Chemical (ATC)/defined daily doses (DDD) methodology was used to assess drug administration data, and antibiotic use was expressed as DDD/1000 PD (patient days). The antibiotic susceptibility of isolated strains was expressed through the cumulative antibiogram. The overall consumption of antimicrobial agents was 1247.47 DDD/1000 PD. The most common drugs used were cephalosporins and fluoroquinolones (52.97% of the total). Ceftriaxone was the most commonly used, followed by levofloxacin. Infections of the respiratory and urinary tract were the most frequently diagnosed infections. The most commonly isolated bacteria type was Acinetobacter baumannii (22.12% overall), isolated especially from the respiratory tract and resistant to all the β-lactam antibiotics including carbapenems. Antimicrobials intake at the ICU is much higher compared to medical and surgical wards. After we tested the existence of a possible connection between antibiotic consumption and antibiotic resistance of bacteria, it was revealed that on our sample exists a poor positive association.

Keywords: Antibiotic; Bacteria; Defined daily dose; Infection; Intensive care unit; Susceptibility.

MeSH terms

  • Acinetobacter baumannii / isolation & purification
  • Anti-Bacterial Agents*
  • Drug Resistance, Multiple, Bacterial
  • Drug Utilization
  • Intensive Care Units*
  • Microbial Sensitivity Tests
  • Romania

Substances

  • Anti-Bacterial Agents