Bacterial Multidrug Resistant Patterns Associated with Intensive Care Unit Infections in Akum, Cameroon

Abstract

Background: Patients admitted into the intensive care unit (ICU) usually have impaired immunity and are therefore at high risk of acquiring hospital associated infections. Infections caused by multidrug resistant bacteria now constitute a major problem, limiting the choice of antimicrobial therapy. Objectives: This study was aimed at determining the antimicrobial resistance pattern of pathogens causing ICU infections at the Catholic Holy Family Hospital Akum-Bamenda. The etiological agents, prevalence and types ICU infections were also determined. Methods: Thirteen months hospital associated infections surveillance was conducted in the hospital for patients admitted into ICU. Blood, urine, tracheal aspirate and wound biopsies specimens were collected under strict asepsis and sent to the Medical Microbiology laboratory of the same institution for immediate processing. All pathogens were isolated and identified by standard microbiological methods. Disk diffusion antibiotic susceptibility testing was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The overall prevalence of ICU infections was 30.9% out of which 12.9% were bloodstream infections, 31.5% urinary tract infections, 38.9% pneumonia, and 16.7% skin and soft tissue infections. Klebsiella species and Escherichia coli were the predominant pathogens. Multidrug resistant organisms constituted 59.3% of the pathogens, MDR Klebsiella spp and MDR E. coli were 70.8% and 71.4% respectively. Resistance to Cefuroxime was the highest (92.9%) while Meropenem had the least resistance (21.4%). Conclusion: There is a high prevalence of multidrug resistant bacteria causing ICU infections.  With the advent of covid-19, infection control procedures and institution of functional antimicrobial stewardship are needed to be put in place in order to cover come this herculean task.