Noorzaitun, Ariffin
(2011)
A 5-years review of antibiotic resistance of
organism cultured from patients
in husm nicu compared to other ICUS.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
Most of the infections in intensive care settings need to be treated empirically before
the causative organism is known. The right choice of antibiotics is very important
and can make the difference between life and death of the infected patient. On the
other hand the overuse of broad spectrum antibiotics can lead to resistance. It is very
important to know the resistance pattern in particular wards in order to make rational
decisions for empirical therapy To determine and compare the bacterial demographics and antibiotic resistance
pattern of bacteria in the neonatal intensive care unit (NICU) and ICU/HD (intensive
care units /high dependency units) in HUSM (Hospital Universiti Sains Malaysia) This study is a retrospective descriptive study of organisms cultured from the NICU,
HUSM, and their antibiotic resistance pattern over the last 5 years (2005-2009)
compared to organisms (and their resistance pattern) grown from other intensive or
high dependency care units in the same hospital during the same period. The file
containing the positive cultures from each ward in HUSM was available in the archives of the Microbiology Laboratory of HUSM, Kubang Kerian. These data were
cleaned base on admission date and antibiotic resistance and they were subsequently
analyzed statistically using SPSS version 12.1. There were 6403 bacteria included in the study: 1320 from the NICU and 5083 from
ICU/HDU. In the NICU 25.8% were cultured from early specimens and 74.2% from
late specimens. In the ICU/HDU, 43.0% came from early and 57.0% from late
specimens. In the ICU/HDU Gram negative bacteria were significantly more
common than in the NICU. (60% vs. 49%, p < 0.001). The most common Gram
negative organism cultured from the ICU/HDU was Acinetobacter spp. The most
common one in the NICU was Klebsiella pneumoniae ss pneumonia. Among the
common Gram negative organisms there were significant differences between the
ICU/HDU and NICU. The most common Gram positive organism cultured from the
ICU/HDU was Staphylococcus aureus (40.0 vs. 18.7%; p<O.OOl) and from the NICU
was coagulase-negative staphylococci. (32.2 vs. 62.3%; p<O.OOI ).
Regarding antibiotic resistance, it was significantly lower in the NICU, compared to
other ICU/HDU. The most pronounced differences were found for Gram negative
organisms cultured but also for Gram positive organisms there was a less pronounced
lower resistance in the NICU.
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