Antimicrobial susceptibility at intensive care units in Sudan, antibiogram development

Abstract

Antibiograms are statistics on bacterial spectrum and resistance rates. It is of importance to regularly monitor the trends in antimicrobial resistance within the institution through the periodic cumulative resistance to provide the effective empiric antibiotic selection, enhanced infection control interventions, and containment strategies. Antimicrobial stewardship interventions improve quality and quantity of prescribing antimicrobial in ICUs without compromising any patient outcomes. The aim of this study was to develop a local unit-specific antibiogram for the Intensive Care Units based on the susceptibility rates of antimicrobials. Facility- based cross sectional study was done among ICU patients of a Tertiary hospital, Khartoum. Data were collected from the record of microbiology Laboratory from August-2021 to September-2022. Results were presented as tables and figures, Chi- square test was used to assess associations between variables, results were statistically significant when p < 0.05. Gram negative bacteria comprised 32% of the samples and only 4% of the samples had Gram positive bacteria, the remaining samples had no growth. Klebsiella spp. were the most prevalent 14.4% (44/306). The lowest susceptibility to antimicrobials were documented for Acinetobacter spp. and Klebsiella spp. Regarding Pseudomonas aeruginosa, it was susceptible to Meropenem but resistant to Pip/Tazo and Aminoglycosides. Gram positive bacteria, all were susceptible to Vancomycin and low Methicillin-resistant Staphylococcus aureus prevalence was observed. The antibiogram revealed high prevalence of Gram negative bacteria with low antimicrobials-susceptibility; especially Klebsiella spp. Low prevalence was recorded for MRSA and the most prevalent Gram positive bacteria were E. faecalis. This antibiogram of ICU can provide a reference for all future ICU antibiograms which will give a clear picture of the antimicrobial susceptibility pattern among ICU patients. Clinical trial number Not applicable.