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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antibiotic Resistance Patterns and Hospital-acquired Infection among COVID-19 Patients Attending Intensive Care Unit:
Muhammad Gulzada1, Rukhsana Yasmeen1, Komal Jamil2
1Pakistan Navy Nursing College, Bahria University Health Sciences Campus, Karachi, Pakistan.
Introduction:
The emergence of COVID-19 and the resulting disease necessitated significant changes to the healthcare system. The effect of hospital-acquired infection on the healthcare system and patients is significant and continues to grow. Antimicrobial resistance is particularly concerning in intensive care units (ICUs), where options for empiric therapy are limited. The misuse of antibiotics and reduced surveillance for antibioticresistant species may contribute to resistance. This study was designed to assess antibiotic resistance patterns and hospital-acquired infections among COVID-19 patients.
Methods:
A total of 31 culture and sensitivity reports from COVID-19-positive patients who were admitted to the hospital were obtained.
Results:
The Burkholderia cepacia was the most frequently detected pathogen in blood samples, followed by Acinetobacter baumannii and Klebsiella pneumoniae. Others included Pseudomonas species and Escherichia coli in urine and ascitic fluid. Antibiotic sensitivity patterns indicated that Polymyxin B is effective against multiple organisms, while B. cepacia responds to Levofloxacin, Chloramphenicol, Cotrimoxazole, Meropenem, Minocycline, and Ceftazidime. E. coli in urine samples is sensitive to Fosfomycin, Amikacin, and Nitrofurantoin. An A. baumannii strain in blood is resistant to all tested antibiotics, indicating multidrug-resistance. K. pneumoniae demonstrated limited susceptibility, primarily to Polymyxin B and fourth-generation Cefepime.
Discussion:
The frequent isolation of B. cepacia in blood suggests further investigation. The reliance on Polymyxin B in multiple cases indicates extensive drug-resistant infections, emphasizing the need for robust antibiotic stewardship.
Conclusion:
This study identifies B. cepacia, A. baumannii, and K. pneumoniae as the top three organisms in culture, while the most effective antibiotics against multidrug-resistant organisms are Polymyxin B, Levofloxacin, and Ceftazidime.
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