title: Antibiotic resistance patterns in medical and surgical patients in a combined medical-surgical intensive care unit.
abstract: OBJECTIVE
  Studies have found different rates of antimicrobial resistance among patients in medical and surgical intensive care units (ICUs). We studied whether these differences were a function of geography or differences in the patient populations, by comparing resistance rates among bacteria isolated from a combined medical/surgical ICU.
  
  
  METHODS
  We retrospectively evaluated the results of bacterial cultures of each patient admitted to the ICU between February 2005 and September 2006. Data collection included patient demographics and culture and sensitivity results. Intensive care unit populations were compared using the Fisher exact test and the Student t test.
  
  
  RESULTS
  One hundred seventy-one medical and 94 surgical patients with positive cultures were studied. Organisms were grouped into 4 classes: Staphylococcus aureus, nonlactose fermenting gram-negative bacilli, Enterococcus species, and gram-negative enteric bacteria. In the 4 classes, no significant difference in antibiotic resistance was found between medical and surgical patients.
  
  
  CONCLUSIONS
  Reported differences in resistance patterns among bacteria cultured from medical and surgical patients may be due to geographic separation of the ICUs as opposed to differences in the patient characteristics. This study suggests that ICU-specific antibiograms remain a useful tool to guide the choice of antimicrobial therapy, even in medical/surgical ICUs.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD 21224-6801, USA. jakulia1@jhmi.edu
authors.forename: Jason A
authors.initials: JA
authors.lastname: Akulian
authors.forename: Mark L
authors.initials: ML
authors.lastname: Metersky
mesh_terms: D000368:Aged; D015897:Comorbidity; D004352:Drug Resistance, Microbial; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D012189:Retrospective Studies