Burden of Infections Caused by Multidrug Resistant Organisms and Antibiotics Stewardship Program in Poor Country

Abstract

Objective: To assess the burden of resistant infections and need for Antibiotic Stewardship Program at hospital of resource limited country.

Study Design: Prospective cross-sectional study

Place and Duration of Study: This study was conducted at the Department of Pulmonology, Fatima Jinnah Chest Institute affiliated with Bolan Medical College Quetta from January 2017 to December 2019.

Materials and Methods: Two hundred and two patients aged 14 years and above with pneumonia or sepsis, admitted to intensive care unit, high dependency unit and ward were enrolled. Demographics, physical examination findings, duration of illness and use of antimicrobials (along with group) during last three months were documented. Blood, respiratory secretions, pleural fluid/pus, and urine samples are sent for microbiological studies at time of admission.

Results: One hundred and sixty (79.2%) showed positive bacterial growth while 42 (20.8%) exhibited no growth. Out of 160 positive samples, 66 (41.2%) grew multi-drug resistant Pseudomonas 28 (17.5%) samples grew extended spectrum beta lactamases producing Gram negatives and 17 (10.7%) showed growth of Methicillin resistant Staphylococcus aureus. One hundred and thirteen (70.6%) of patients were required care in critical areas like intensive care unit and high dependency unit.

Conclusion: Infections caused by multi-drug resistant organisms are very high in our country. Patients infected with resistant organisms generally require admission to critical care areas that might have significant financial implications on patients and hospital budgets.