Antimicrobial resistance in an intensive care unit and current trends: Critical Care Department, IntensiveCare Service of Guillermo Almenara-Irigoyen National Hospital, EsSalud, Lima. Peru, 2004-2006

Abstract

Introduction: This is a description and analysis of the behavior of most frequently isolated microorganisms in the Intensive Care Unit (ICU) of Gullermo Alemnara-Irigoyen Hospital in Lima. Antimicrobial susceptibility/resistance patterns were also analyzed.
Material and method: Microorganisms were isolated and their antimicrobial susceptibility patters were assessed using a Micro Scan Walk Away 96 automatic system and Combo NUC panels for determining minimal inhibitory concentrations (MIC) in patients hospitalized in the ICU during the period between 2004 and 2006.
Results: Acinetobacter spp. were increasingly isolated, and their resistance to carbapenem antimicrobials rose in a three-year period, from 0% in 2004 to nearly 40% in 2006. Most frequently isolated microorganisms in the respiratory tract were: S. aureus, P. aeruginosa, and Acinetobacter spp.; and S. aureus, Candida spp., and S. epidermidis were the most frequently isolated pathogens in blood cultures. Overall, S. aureus was the most commonly isolated microorganism in the ICU. Oxacillin-resistant S. aureus strains in the ICU had a 93% to 100% frequency in the last year of the study. P. aeruginosa and Acinetobacter spp. have increasing resistance to both traditional and modern antibiotics.
Conclusions: The pandemic of antibiotic resistant infections all over the world, and the decline in research and development of new antibacterial compounds may lead us to a somber future, particularly in cases of severe infections, especially in places most affected by antibiotic resistance, such as the ICUs. Since ICU patients have a high rate of infectious complications and considering they are exposed to wide-spectrum antibiotics, this emergence of antibiotic resistance stresses the urgent need for the appropriate use of antimicrobial agents.