Profile of Infections in Intensive Care Unit (Icu) in a Central Nigeria Tertiary Hospital

Background: Intensive Care Units (ICUs) accommodate the most seriously ill patients in a relatively confined environment. Increased duration of stay, increased number of indwelling and invasive devices and prolonged or inappropriate use of antibiotics are common features of ICUs, with consequent or associated increase in selection of multi-resistant  pathogens, morbidity and mortality.Objectives: To determine the identity and antimicrobial resistance pattern of organisms commonly associated with infections in the ICU of the hospital.Method: A retrospective study of Intensive Care Units (ICU) infections in NHA over a three-year period January 1st, 2010 to December 31st, 2012 was conducted through review and analysis of laboratory data.Results: Data for 79specimens were fully analysed; 35(44%) from urine, 17 (22%) from blood, 6 (8%) from tracheal specimens and 8 (10%) from wound. Forty-one (52%)of the specimens yielded growth;16 (20%) from urine, 8 (10%) from wound, 6 (8%) from tracheal specimens,3(4%) from blood and others 8(10%). 14(34%) out of the 41 isolates were Escherichia coli, 8 (20%) Pseudomonas aeruginosa, 6 (15%) were Staphylococcus aureus and 6 (15%) Klebsiella pneumoniae. Three (4%) of the specimensyielded mixed growths while another 3 (4%) yielded Candida species. Sensitivity of E. coli to third generation cephalosporins ranged from 62-72%and 90% to imipenem. For Klebsiella pneumoniae it was 67-75% to third generation cephalosporins and 100% to imipenem. Pseudomonas aeruginosa was 71% and 83% sensitive to ceftazidime and imipenem respectively. Staphylococcus aureus was 67% and 83% sensitive to amoxicillin-clavulanate and imipenem respectively. Susceptibility of allthese isolates to fluoroquinolones and aminoglycosides remained poor.Conclusion: The isolates from the ICU were same as common in clinical specimens. There was wide variability in resistance with a tendency to increase over time. This trend needs to be monitored while antibiotic stewardship should be emphasised.Key words: Intensive care units (ICU), nosocomial Infections, antibiotic susceptibility

Neonatal infections caused by Escherichia coli at the National Hospital, Abuja: a three-year retrospective study

Background: Escherichia coli (E.coli) has been implicated as a common cause of both early and late onset neonatal infections. The emergence of different strains of E.coli that are multiply resistant to commonly used antibiotics has made continuous antibiotics surveillance relevant. Knowledge about common infections caused by E.coli as well as its antibiotics susceptibility pattern will guide paediatricians in choosing appropriate antibiotics for empirical treatment of neonatal infections.Methods: A retrospective study of E.coli neonatal infections in NHA was conduct for the period 1st January 2010 to 31st December 2012. The records of all specimens submitted to the Medical Microbiology laboratory within the neonatal period (first 28 days of life) were examined and data about E.coli isolates and their antibiotics susceptibility pattern were retrieved and evaluated.Results: 251(33.2%) bacteria were isolated out of a total of 757 specimen submitted for analysis within the period under review. 17(6.8%) were E.coli; 16 were from soft tissue specimen and one from blood. There was no isolate of E.coli from CSF. Most of the isolates were resistant to commonly used antibiotics for treatment of neonatal infections. Three isolates were resistance to amoxicillin-clavulanate and ceftriaxone. One isolate was resistance to amoxicillin-clavulanate, ceftriaxone and imipenem. 100% and 80% of the strains tested were susceptible to amikacin and imipenem respectively.Conclusion: E.coli is third among the gram negative bacteria isolated within the period under review. Most of them were resistant to commonly used antibiotics for treating neonatal infections but, susceptible to amikacin and imipenem. There is need for regular antibiotics resistance surveillance and stewardship.Keywords: Neonates, E.coli Infections, Antibiotics Resistance, Abuja