Clinical Profile of Patients with Infection in Intensive Care Units in a Tertiary Care Hospital

BACKGROUND All around the world, it is seen that patients in the intensive care units (ICU) experience a rise of antibiotic resistant pathogens. In the previous 20 years, ICUs have become progressively significant areas where numerous infections happen. ICU beds account for a significant number of hospital beds. ICU-acquired infection rates are five or more times higher than emergency clinic procured infections. ICUs are areas where inadequate anti-microbial use happens, and where anti-microbial safety profile for patients are being seen commonly.1-4 METHODS The examination included 200 cases admitted in intensive care unit of K.S. Hegde Medical Academy, Deralakatte, Karnataka, India. This cross sectional study was done from November 2010 to May 2012. All adult patients > 18 years in the ICU suspected to have been infected based on systemic inflammatory response syndrome (SIRS +) with one of the following criteria were included in the study. a) Positive laboratory cultures i.e., sputum or tracheal aspirate or urine or blood or, catheter tip or, b) Progression of chest x-ray infiltrates, urine routine showing pus cells or bacteria or increase in productive sputum. RESULTS A total of 200 cases were selected for the study who met the inclusion criteria. 25 cases belonged to the age group of > 75 years and 70 cases belonged to the age group of 45 to 59 years, 141 cases were males and 59 cases were females. Among 200 cases with SIRS+ infection as evidenced by investigations; 104 cases were culture positive. 57 cases survived and 47 cases expired. Klebsiella was the commonest organism isolated (30 cases, 28.85 %), followed by acinetobacter (25 cases, 24.04 %). 21 cases had infection by Staphylococcus aureus (20.19 %) and another 12 cases had Escherichia coli (11.54 %) infection. Polymicrobial infection was seen in 22 cases. 58 out of 200 cases had diabetes mellitus, 47 cases had systemic hypertension, 17 cases had chronic liver disease, 32 cases had chronic obstructive pulmonary disease, 21 cases had cerebrovascular accidents and 19 cases had chronic kidney disease, and 17 cases had ischemic heart disease. CONCLUSIONS In this study, acinetobacter species was found in large numbers from lab tests in ICU infections; furthermore, multidrug resistance in acinetobacter was more commonly seen as compared with other organisms, which is of concern. Overall, 48.08 % of cases expired in this study and majority of them had infection due to acinetobacter species or Staphylococcus aureus.