PREVALENCE AND CHARACTERISTICS OF MULTI-DRUG RESISTANT BACTERIA AND ANTIMICROBIAL SUSCEPTIBILITY PROFILE AMONG INTENSIVE CARE UNITS PATIENTS: AN EXPERIENCE STUDY FROM A DEVELOPING COUNTRY

Abu Arar, Yasmine

PREVALENCE AND CHARACTERISTICS OF MULTI-DRUG RESISTANT BACTERIA AND ANTIMICROBIAL SUSCEPTIBILITY PROFILE AMONG INTENSIVE CARE UNITS PATIENTS: AN EXPERIENCE STUDY FROM A DEVELOPING COUNTRY

Date

2025-08-20

Authors

Abu Arar, Yasmine

Publisher

An-Najah National University

Abstract

Background Multidrug-resistant (MDR) organisms pose a major threat to critically ill patients, particularly those in intensive care units (ICUs), where invasive procedures and extensive antibiotic exposure are common. This study aimed to assess the prevalence, resistance patterns, and clinical outcomes of MDR bacterial infections among ICU patients in a tertiary care hospital in Palestine. Methods A retrospective analysis was conducted on 129 ICU patients who developed infections caused by MDR organisms. Data on patient demographics, comorbidities, device use, antibiotic exposure, organism types, sample sources, antimicrobial susceptibility, and outcomes were collected. Descriptive statistics and mortality comparisons were performed. Results The cohort had a mean age of 53 ± 17 years and was predominantly female (64.4%). Comorbid conditions, including hypertension (41%), diabetes (34%), and malignancies (35%), were common. Most patients had prior antibiotic exposure (43%), recent hospitalizations (58%), and invasive devices such as central lines (92%), Foley catheters (93%), and endotracheal tubes (73%). The most prevalent MDR organisms were Acinetobacter baumannii (24%), vancomycin- resistant enterococci (VREs) (25%), and carbapenem-resistant Enterobacteriaceae (CREs) (23%). Additional pathogens included Pseudomonas aeruginosa (12%), MRSA (10%), and ESBL-producing organisms (6%). The overall mortality rate was 59%, which was highest for MRSA infections (70%). Antibiotic resistance is widespread, particularly to ceftazidime, 11 carbapenems, fluoroquinolones, and vancomycin. Colistin, glycylcycline, and amikacin retained partial activity against several pathogens. Conclusion MDR infections in the ICU are associated with high mortality rates and resistance to most conventional antibiotics. The predominance of highly resistant organisms such as A. baumannii, CRE, and VRE, alongside extensive device use and comorbidities, stresses the critical importance of meticulous infection control, regular screening, and the responsible use of antibiotics. Tailored empirical therapy on the basis of local resistance patterns is critical for improving patient outcomes.