Prevalence and Pattern of Infection in Intensive Care Unit of a Tertiary Care Hospital in Bangladesh

Background:

Intensive Care Units (ICUs) accommodate the critically ill patients in a relatively confined environment. Infection is a major cause of morbidity and mortality in ICUs worldwide. However, relatively little information is available about the epidemiology of such infection.

Aim of the study is to identify organisms commonly associated with infections in the ICU and provide an up-to-date picture of the extent and patterns.

Materials and Methods:

This was a single center, retrospective study of all patients admitted to ICU between January’2024 and December’2024 at Ahsania Mission Cancer and General Hospital, Dhaka, Bangladesh. The study was conducted through review and analysis of data. The data collected from each patient beginning with admission and extending until discharge from the ICU, included age, gender, duration of ICU stay, microbiological cultures and mortality.

Results:

Data for 988 specimens were analyzed; 448 (45.34%) from blood, 381(38.56%) from urine, 130 (13.16%) from sputum, 16 (1.62%) from tracheal specimens and 11 (1.11%) from wound. 512 (51.82%) of the specimens yielded growth; 220 (42.96%) from blood, 158 (30.86%) from urine, 116 (22.66%) from sputum, 08 (1.56%) from tracheal specimens and 09 (1.76%) from wound. The most prevalent organisms isolated from specimens were Klebsiella species 127 (24.19%), Staphylococcus aureus 82 (15.62%) Candida species 81 (15.43%), Pseudomonas species 73 (13.9%) and Escherichia coli 70 (16.4%). 13 (1.54%) of the specimens yielded mixed growth. 59.62% of the positive isolates were gram-negative organisms, 24.95% were gram-positive, and 15.43% were fungi. The ICU mortality rate of culture positive patients was more than that of culture negative patients (52.87% [184/ 348] vs 38.46% [35/91], respectively). The main nosocomial pathogens in the ICU were Klebsiella (31.88%), followed by Candida (21.74%), Acinetpbacter (14.49%), Staphylococcus aureus (13.04%) and Pseudomonas species (11.59%).

Conclusion:

Critically ill patients are at particularly high risk for Gram-negative sepsis. Among which prevalence of Klebsiella isolate is highest in number and also the cause of hospital acquired infections. Mortality is highest in blood culture positive of Escherichia coli. The association between infection and mortality mandates a reappraisal of infection control policy.