title: ICU Pathogens: A Continuous Challenge.
abstract: OBJECTIVE
  To determine the frequency and antibiogram of pathogens in an intensive care unit (ICU).
  
  
  METHODS
  Cross-sectional, observational study.
  
  
  METHODS
  Department of Microbiology, Army Medical College, National University of Science and Technology, Islamabad, from January 2013 to January 2014.
  
  
  METHODS
  Clinical samples, received from patients admitted in ICU, were inoculated on various medias like blood agar, chocolate agar, MacConkey agar and urine samples on CLED. These were then incubated at 37°C for 24 hours. Isolates were identified by colony morphology, Gram reaction, catalase test, oxidase test. Species identification in case of Gram Negative Rods was done by using API 20E (BioMérieux). Antibiotic susceptibility was done by using modified KirbyBauer disc diffusion technique. Bacterial isolates were prepared and inoculated on Mueller-Hinton agar plates followed by application of various antibiotic disc (Oxoid, UK) as per manufacturer's instructions. The plates were then incubated at 37°C aerobically for 18 - 24 hours. Zone diameters were measured and interpreted as sensitive and resistant, according to Clinical and Laboratory Standards Institute (CLSI) guidelines.
  
  
  RESULTS
  Out of the 367 positive cultures, 116 (31.08%) were Acinetobacter baumanniisusceptible to minocycline and tigecycline followed by Klebsiella pneumoniae (n=71, 16%) susceptible to tigecycline and meropenem. Others were Pseudomonas aeruginosa, Escherichia coli,Coagulase Negative Staphylococcus, Staphylococcus aureus, Enterococcus spp., Streptococcus spp., Klebsiella oxytoca, Stenotrophomonas maltophilia,and Candida spp.
  
  
  CONCLUSIONS
  Acinetobacter baumanniiwas the most frequently isolated pathogen. Most of the cultures yielding pathogens were from respiratory tract samples. Gram negative isolates were multidrug resistant but most were tigecycline and susceptible to meropenem.
authors: Department of Microbiology, Army Medical College, Rawalpindi.
authors: Amira
authors: A
authors: Hafeez
authors: Department of Microbiology, Army Medical College, Rawalpindi.
authors: Tehmina
authors: T
authors: Munir
authors: Department of Microbiology, Army Medical College, Rawalpindi.
authors: Sara
authors: S
authors: Najeeb
authors: Department of Microbiology, Army Medical College, Rawalpindi.
authors: Sabahat
authors: S
authors: Rehman
authors: Department of Microbiology, Army Medical College, Rawalpindi.
authors: Mehreen
authors: M
authors: Gilani
authors: Department of Microbiology, Army Medical College, Rawalpindi.
authors: Maliha
authors: M
authors: Ansari
authors: Department of Microbiology, Army Medical College, Rawalpindi.
authors: Nadia
authors: N
authors: Saad
mesh_terms: D040981:Acinetobacter baumannii; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D024881:Drug Resistance, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006094:Gram-Positive Bacteria / Q000187:drug effects* / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D007711:Klebsiella pneumoniae; D008297:Male; D008826:Microbial Sensitivity Tests; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents