Aim. The incidence of infections caused by multidrug resistant (MDR) bacteria is increasing worldwide. The intensive care unit (ICU) is often called the epicentre of infections, due to its extremely vulnerable population. The ICU population has one of the highest occurrence rates of (nosocomial) infections (20-30% of all ICU admissions), leading to an increased impact on morbidity, mortality and costs.

This study was undertaken to determine the prevalence of antimicrobial resistant of bacterial isolates from medical ICU. We analysed a 3-year period, from 2011 to 2014.
Methods. Multidrug-resistant isolates included in the analyses were methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), carbapenem-resistant Acinetobacter baumannii, Enterobactericeae (K.pneumoniae, E. coli) that produce extended-spectrum beta lactamases and/or carbapenemases (ESBLs and CREs, respectively), and carbapenem-resistant Pseudomonas aeruginosa.

Results. From the results it is evident that P. aeruginosa has the highest prevalence of the number of patient days in the ICU with carbapenem-resistance, which ranged from 46%-54%. It is followed by A. baumannii / sp. with carbapenem resistance of 81% in 2012 to 91% in 2011. The prevalence of MRSA increased slightly, and the MRSA resistance to ciprofloxacin (100%) in 2013. Enterobactericeae ESBL showed a slight decrease.
Vancomycin resistant enterococci are still sporadic; only three isolates were noted in 2013.

Conclusion. We conclude that the resistance of gram-negative pathogens is increasing. The first CREs in the ICU were extracted in 2013.
Preventive strategies to prevent the emergence and spread of multidrug-resistant bacteria in ICUs can be divided into two major categories: measures that attempt to improve the efficacy and utilization of antimicrobial therapy and infection control measures.

The table shows the analysis of the number of isolates of MDR bacteria per 1000 patient days

A.baumannii

A.spp.

MRSA

VRE

P.aeruginosa

K.pn.ESBL

E.coliESBL

2011

number

35

15

12

0

43

13

9

rate

11.04

4.73

3.78

0

13.56

4.10

2.84

2012

number

13

7

9

0

42

13

4

rate

4.47

2.41

3.09

0

14.43

4.47

1.37

2013

number

24

23

14

3

41

10

10

rate

8.64

8.61

5.04

1.08

14.75

3.60

1.8

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