Spectrum of microbes and antimicrobial resistance in a surgical intensive care unit, Barbados.
BACKGROUND
To survey the epidemiologic findings of infections and antibiotic resistance patterns in the surgical intensive care unit (ICU) of a tertiary care university teaching hospital.


METHODS
The microbiologic culture-sensitivity reports of patients admitted to a surgical ICU were prospectively studied for 6 months each of 3 consecutive years. The antibiotic usage for these patients also was studied concurrently. Reports from general surgical wards for 6 months of 1 year also were analyzed for comparison. The common specimens assayed microbiologically were tracheal aspirate, urine, blood, wound swabs, invasive catheter tips, and screening swabs for methicillin-resistant Staphylococcus aureus.


RESULTS
The organisms reported were Enterobacteriaceae, Pseudomonas species, S aureus, and enterococci. Organisms were highly resistant to amoxicillin and first-generation cephalosporins because of the wide use of these drugs in the hospital. Pseudomonas species showed a 25% increase in resistance to piperacillin-tazobactam and an 18% increase to ciprofloxacin, which was correlated with the increased use of these antimicrobial agents (82% and 200% increases, respectively) in the unit during the 3 years. There was no increase in the resistance to ceftazidime because it is used less often. The resistance to ciprofloxacin, piperacillin-tazobactam, and ceftazidime was significantly greater in the ICU than in the general surgical wards in the same study period.


CONCLUSIONS
The study provided data of antimicrobial resistance in a developing country with tourism as the main industry for epidemiologic comparison with other countries.
Hariharan
Seetharaman
S
Department of Anaesthesia, Queen Elizabeth Hospital.
Nanduri
Srikrishna B
SB
Moseley
Harley S L
HS
Areti
Kumar Y
KY
Jonnalagadda
Ramesh
R
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000145:classification / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D001460:Barbados / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D004352:Drug Resistance, Microbial; D005260:Female; D006302:Health Services Research; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged