Mateen Izhar, S Khan, A Naqvi.
Anti-Microbial Resistance among Gram-Negative Bacteria Prevalent in Intensive Care Units.
Pak J Surg Jan ;17(3):23-6.

The objective of this study was to establish the prevalence of antimicrobial resistance among the different types of gram-negative bacteria colonising or infecting the patients in the intensive care units (ICU). 900 consecutive gramnegative bacteria isolated over a period of 6 months (approx.) in 9996-1997 were analysed. The organisms were identified by biochemical methods (API system, Biomeriux, France.) and the minimum inhibitory concentrations (MIC) of 12 different antimicrobial were established for each of these isolates using the E-test system (AB Biodisk, Sweden). The results show that Pseudomonas spp., Enterobacter spp. and Klebsiella spp. were the commonest groups of organisms isolated. Antimicrobial susceptibility testing (MTC) results showed highest susceptibility to Tmipenem (95%) followed by Amikacin (87%) and Ciprofloxacin (81 %). Overall susceptibility to second and third generation cephalosporins was poor. The results confirm the over all trend of acquisition of antimicrobial resistance by the nosocomial bacteria and indicate that imipenem alone or amikacin in combination with one broad spectrum beta lactum drug should be used as initial therapy in any severe nosocomial infection. The results also highlight the need and urgency for effective infection control measures.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com