Device Associated Infections in Intensive Care Units in a Tertiary Care Hospital

Objective: To isolate the bacteria in Device associated infections (DAI) and assess their sensitivity patterns in Intensive Care Units of Services Hospital, Lahore from January to December 2010. Materials & methods: This cross-sectional study was carried out on bacterial isolates from samples of devices from various Intensive Care Units of Services Hospital Lahore in the Microbiology section, Department of Pathology, Services Institute of Medical Sciences Lahore. All samples isolates were tested for anti-biotic sensitivity pattern. Results: In 2010, eight hundred and eighty-six samples were submitted to Microbiology Section for culture from different ICUs. Three hundred and fifty samples (39.5%) were devices or samples from devices. Trachea derived samples were 212(60.6%), Central Venous tips(CV tips) 96(27.4%) and Folley's catheter 43(12.28%). Maximum positive cultures were obtained from tracheal samples (50.7%) followed by CV tips (14%) and least from Folley's catheter (6.7%). Thirty-two CV tips (10%) 32(9%) trachea derived samples and 13(3.7%) did not yield any growth on culture. Bacterial yield was obtained from 67.7% device associated samples and fungal from 8.6% samples. Gram negative isolates comprised 216 (91%) of the total 237 isolates and Gram positive 21(8.8%) of which maximum number again were of tracheal origin followed by CV tips. Almost one fourth (24.4%) Acenatobacters exhibited resistance to all drugs used with (52.3%) sensitive to one drug only, mainly Imepenem (26.7%). Two drug sensitivity was exhibited by (21%) whereas sensitivity to three or more drugs was exhibited only in 3 cases. The converse was true for the rest of 130(60%) Gram' negative isolates as Pseudomonas and Enterobacteriaceae. Resistance to all the drugs tested was exhibited by 30(13.9%) Gram's negative isolates. Grams positive isolates as ORSA, OSSA and coagulase negative staphylococci comprised 21 bacteria. ORSA were sensitive to Vancomycin, Fucidic acid and Linezolid but OSSA and coagulase negative staphylococcal were sensitive to one drug. Conclusion: Use of devices and device associated infections are on the rise and so are the samples sent for culture especially from Intensive Care Units. Inappropriate use of antibiotics leads to multiresistant and pan-resistant strains. This alarming increase of drug resistant infections in ICUs has been presented in this study. Bacterial and fungal cultures should be requested with their drug sensitivity patterns.