Introduction: Inspite of controlling many risk factors, there are higher risk for infections inICUs compared with regular wards. In comparison to pneumonia and woundinfections, BSI and UTI have a higher incidence in ICUs compared with other wards.Patients should be managed in ICUs for an optimal period necessary for theircare 1. BSIs being leading cause of morbidity and mortality represent acommon complication among critically ill patients. The effective and promptantibiotic therapy is necessary in order to improve clinical outcomes andreduce mortality.
Nevertheless, due to worldwide spread of multi-drug resistant(MDR) organisms the choice of the empiric antibiotic regimen is oftenchallenging. We need to have new therapeutic challenges to minimize the risk ofresistance selection in turn improve the effectiveness of antibiotic treatment2. BSIs form leading infections among critically ill patients. Thecase-fatality rate related to BSIs in patients admitted to ICUs is very high(35–50%). The development and dissemination of antibiotic resistant bacteria isa global health problem 3. Along with management of severe sepsis and septicshock which may ultimately develop, antimicrobial therapy is the main supportof treatment of BSIs, During the last decade, clinicians have observed a risingoccurrence of BSIs by bacteria resistant to commonly used antimicrobials 4. AMDR microorganism is resistant to at least one agent in three or moreantimicrobial classes.
Extensive drug-resistant (XDR) microorganisms issusceptible to only one or two antimicrobial classes, while pan-DR (PDR)isolates are resistant to all agents from all antimicrobial classes 5.Emergence of antibiotic resistance is a global public health problem 6,7.Likewise, catheter-associated UTI is a main cause of morbidity and mortalityaffecting all age groups 8.
Bacteriuria or candiduria is nearly unavoidablein half of the patients on indwelling urinary catheter for more than five days.Patients with asymptomatic bacteriuria harbor major pool of antibiotic resistantpathogens in hospitals 9. With this background in mind, we designed thisstudy with the following aim and objectives.Aim: To study the prevalence of blood Stream Infection(BSI) and Urinary Tract Infection (UTI) causing antibiotic resistant bacterialpathogens isolated from Intensive Care Unit (ICU) Patients Objectives: 1. Toanalyze the types of bacteria isolates cultured in blood and urine samples fromIntensive Care Unit (ICU) patients prior to and after the surgery performed. 2. Todetermine the bacterial drug resistance profile & phenotypic detection ofantibiotic resistance. 3.
Todetect antibiotic resistance coding genes in representative isolates. 4. Toassess biofilm forming potential of selected dominant isolates Expectedoutcome: Thestudy will be carried out after obtaining the ethical clearance forInstitutional ethical clearance committee.
The results obtained will help us toassess the prevalence of nosocomial drug resistant bacterial pathogens amongthe ICU patients. Further, the data obtained will help advising the concernedofficials on matters related to the proper use of antibiotics, developantibiotic policies and recommend remedial measures (antimicrobial stewardshipand antibiotic cycling) when antibiotic resistant strains are detected in ICUs.