Incidence of Multidrug Resistant Organisms and Adequacy of Empiric Antibiotic Treatment in Hospitalized Patients with Sepsis at Ain Shams University Hospital

Abstract

Abstract Background Bloodstream infections (BSIs) are the most severe infections that cause the highest mortality rate, especially in patients admitted to the intensive care unit (ICU). The nightmare of the rising numbers of multidrug-resistant organisms (MDROs) requires the implementation of effective Antibiotic stewardship programs (ASPs). However, this should be preceded by making available evidence-based knowledge regarding the local antimicrobial resistance pattern, which is fundamental. Objective Is to determine the prevalence of MDROs and to measure the adequacy of the empirical Anti-Microbial Therapy (EAMT) in adult patients with sepsis hospitalized at Ain Shams University Hospitals (ASUHs) ICUs. Patients & Methods This was a prospective cohort study carried out on hospitalized adult patients with evidence of BSI admitted at ICUs of ASUH by +ve blood culture and sensitivity results. 276 patients were included in the study during the period from December 1st 2022 till may 30th 2023. Results In 276 patients, our study showed male to female ratio 1:1.1, Community acquired infections account for 34.8%, while healthcare associated infections account for 65.2% of total cases. The primary source of BSI was identified in only 62% of cases; the most prevalent cause was UTI in 29.1%, and pneumonia in 16.6% of total cases with identified source. Prevalence of MDROs was 88.8% among all the studied patients, Klebsiella spp. was the most prevalent among isolated organisms in 30.8% of total cases, and adequacy of EAMT was achieved in only 40.9% of total cases. Mortality rate within 2 weeks was 23.2%, and long hospital stay > 2weeks noticed in 54.3% of the studied patients and only 22.5% of patients improved and discharged from ICU. Conclusion MDROs are a public health threat and their prevalence is rising over the past few years, effective ASPs are mandatory to combat that threat and improve the adequacy of EAMT.