title: Profile of micro-organisms in intensive care unit of a level-1 trauma centre: A retrospective study.
abstract: BACKGROUND
  Patients with trauma usually require highly specialized care in ICU and many times their recovery is complicated by infections. Aim of this study was to determine the profile of pathogens and their impact on outcome among these patients.
  
  
  METHODS
  The clinical records of 101 consecutive patients who were admitted for more than 48-hrs in ICU during Jun-Dec 2007 were analyzed.
  
  
  RESULTS
  Total of 953 samples from blood, urine, BAL or pus/collection were subjected to cultures. From 276 samples, 299 organisms were isolated. Among pathogens Candida Spp. [89 (29%)] were the most common, followed by Acinetobacter Spp. [69 (23%)], Pseudomonas Spp. [63 (21%)], Klebsiella Spp. [31 (10%)], coagulase negative Staphylococcus aureus [16 (5%)], E coli [12 (4%)], Enterobacter Spp. [7 (2%)], S aureus [6 (2%)], Enterococcus Spp. [5 (2%)], Citrobacter Spp. [2 (0.6%)], S maltophila [1 (0.3%)] and Providentia Spp. [1 (0.3%)]. For gram negative pathogens drug-resistance rates were as follows: Fluoroquinolones, 76%; 3(rd) generation cephalosporins, 74%; aminoglycosides, 66%; β-lactams/β-lactamase inhibitors combinations, 64%; and carbapenems, 50%. Among these 27% of pathogens were resistant to all 5 classes of drugs. 58% of Staphylococcus aureus were methicillin-resistant whereas 85% of coagulase negative Staphylococcus were methicillin resistant. The mortality was higher among patients in whom pathogens were isolated [Odd's Ratio (OR) 0.185; 95% confidence interval (CI) 0.049-0.640; P = 0.002].
  
  
  CONCLUSIONS
  Isolation of multi-drug resistant pathogens is common among trauma patients admitted in ICU and is associated with increased mortality and could impact on the consumption of hospital resources. The importance of high rate of fungal isolation needs to be studied among these patients.
authors: Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Shefali K
authors: SK
authors: Sharma
authors: Vijay
authors: V
authors: Hadda
authors: Purvi
authors: P
authors: Mathur
authors: Vinay
authors: V
authors: Gulati
authors: Chhavi
authors: C
authors: Sahney
keywords: Drug resistance; Intensive Care Unit; micro-organisms; mortality; nosocomial infection; trauma
references: J Pediatr Surg. 2000 Aug;35(8):1174-8
references: 10945689
references: Rev Clin Esp. 1998 May;198(5):284-8
references: 9658909
references: J Infect. 2006 Aug;53(2):98-105
references: 16343637
references: J Trauma. 2001 Apr;50(4):612-7; discussion 617-9
references: 11303154
references: Antimicrob Agents Chemother. 2010 Nov;54(11):4684-93
references: 20805395
references: Semin Respir Crit Care Med. 2010 Feb;31(1):79-86
references: 20101550
references: Antimicrob Agents Chemother. 2008 Apr;52(4):1430-7
references: 18285482
references: Am J Med. 1985 Jul 15;79(1A):68-76
references: 4025370
references: Surg Clin North Am. 1980 Feb;60(1):133-44
references: 7361216
references: J Infect. 2010 Sep;61(3):259-65
references: 20624423
references: J Trauma. 1999 Nov;47(5):923-7
references: 10568723
references: BMC Pediatr. 2010 Sep 10;10:66
references: 20831797
references: Am J Med. 1981 Mar;70(3):638-40
references: 7211896
references: Crit Care. 2011;15(6):R287
references: 22126425
references: JAMA. 1995 Sep 27;274(12):968-74
references: 7674528
references: Surg Today. 2010 Sep;40(9):793-808
references: 20740341
references: J Trauma. 1980 Sep;20(9):760-6
references: 7411664
references: Clin Infect Dis. 2007 Jan 15;44(2):159-77
references: 17173212
references: Colorectal Dis. 2012 Jan;14(1):e16-22
references: 21831191
references: Clin Epidemiol. 2011;3:175-91
references: 21750627
references: Cytometry B Clin Cytom. 2003 May;53(1):48-53
references: 12717691
references: Crit Care. 2008;12(1):R5
references: 18199317
references: Trop Doct. 2008 Oct;38(4):233-5
references: 18820195
references: Arch Surg. 1991 Jan;126(1):97-9
references: 1985639
references: Crit Care Med. 1999 May;27(5):887-92
references: 10362409
references: J Trauma. 1982 Feb;22(2):141-6
references: 7062358
references: Injury. 2003 Sep;34(9):686-92
references: 12951294
references: Injury. 2003 Jan;34(1):41-6
references: 12531376
references: Am J Infect Control. 2010 Mar;38(2):95-104.e2
references: 20176284
references: Clin Infect Dis. 2008 Jan 15;46(2):155-64
references: 18171244
references: Intensive Care Med. 2010 Jun;36(6):963-70
references: 20229040
references: J Assoc Physicians India. 2010 Dec;58 Suppl:32-6
references: 21563611
references: World J Surg. 2008 Aug;32(8):1613-7
references: 18553048