Antibiotic resistance patterns in medical and surgical patients in a combined medical-surgical intensive care unit

• Published in: Journal of critical care 2013-08, Vol.28 (4), p.347-351
• Main Authors: Akulian, Jason A., MD, MPH, Metersky, Mark L., MD
• Format: Article
• Language: English
• Subjects: Aged; Antibiotic; Antibiotics; Antimicrobial agents; Bacteria; Bacterial infections; Bone surgery; Cardiovascular disease; Chronic obstructive pulmonary disease; Colleges & universities; Comorbidity; Critical Care; Drug resistance; Drug Resistance, Microbial; Female; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - drug therapy; Humans; Infection; Intensive care; Intensive Care Units - statistics & numerical data; Lactose; Male; Medical; Mortality; Patients; Retrospective Studies; Software; Surgery; Surgical; Teaching hospitals
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2012.02.006

Abstract Purpose Studies have found different rates of antimicrobial resistance among patients in medical and surgical intensive care units (ICUs). We studied whether these differences were a function of geography or differences in the patient populations, by comparing resistance rates among bacteria isolated from a combined medical/surgical ICU. Materials and Methods We retrospectively evaluated the results of bacterial cultures of each patient admitted to the ICU between February 2005 and September 2006. Data collection included patient demographics and culture and sensitivity results. Intensive care unit populations were compared using the Fisher exact test and the Student t test. Results One hundred seventy-one medical and 94 surgical patients with positive cultures were studied. Organisms were grouped into 4 classes: Staphylococcus aureus , nonlactose fermenting gram-negative bacilli, Enterococcus species, and gram-negative enteric bacteria. In the 4 classes, no significant difference in antibiotic resistance was found between medical and surgical patients. Conclusion Reported differences in resistance patterns among bacteria cultured from medical and surgical patients may be due to geographic separation of the ICUs as opposed to differences in the patient characteristics. This study suggests that ICU-specific antibiograms remain a useful tool to guide the choice of antimicrobial therapy, even in medical/surgical ICUs.