To evaluate the incidence, microbiological pattern & clinical outcomes of blood stream infection among ICU patients.
A Retrospective study from a medical ICU (12 beds) in a tertiary care urban teaching hospital.Data was collected retrospectively for all patients admitted to medical ICU from 1st January to 31st December 2004. Number of blood cultures collected were noted isolated organisms were recorded.
A total of 3657 patients were admitted to MICU during the 12 month study period. 2091 blood cultures were sent during the period. There were a total of 370 episodes of bacteremia. Seven patients had more than two episodes of bacteremia.The organisms were as follows :-Klebseilla Pneumoniae = 10; Klebseilla species = 40; Klebseilla Ornitholytica=3; Pseudomonas aerogenosa =12; Pseudomonas species = 67; Staph.aureus = 72; Strep.Pneumoniae=21; E.coli=26; Candida albicans = 45; Citrobacter diversus=2; Citrobacter freundii=3; Enterobacter species=9; Acinetobacter species=3; Salmonella typhi = 3; Coagulase negative Staphylococcus=23; Streptococcus group ‘b’=2 & group ‘d’ = 5. The mortality in patients with bacteremia was 177/370 (47.8%) while it was 103/1721 (5.9%). The mortality in those patients with 2 or more episodes of bacterima was 4/7 (57.1%).
Bacteremia occurred in 10% of all ICU admissions. 1.9% had multiple episodes of bacteremia. Gram negative pathogens were the commonest organisms seen in our clinical practice. Pseudomonosa species were the commonest(n=79) followed by Staph.aureus (n=72) & Klebseilla(n=53). Candida species were grown on blood cultures in 12.1% of our ICU population.
Those with proven bacteremia had higher mortality than those without bacteremia.Hence it is prudent to recognize early these crtically ill patients with bacteremia and initiate prompt therapy to improve clinical outcomes.
Avanti Vigg, None.