Patterns of antimicrobial consumption and bacterial resistance in intensive care units: a pilot study from Palestine

Background: Antimicrobial resistance has become a worldwide issue as the number of multidrug-resistant (MDR) bacteria has risen considerably. The irrational use of antibiotics contributes significantly to this issue. Methods: A prospective study was conducted over three months at a teaching hospital in surgical and medical intensive care units (SICU, MICU) in Palestine. Antimicrobial consumption data were recorded and analyzed using the antimi-crobial consumption tool. Microorganisms and their resistance patterns were obtained from the microbiology laboratory. Results: One hundred patients with a median age of 50 years were included in this study (65% males). More than half of the patients were admitted to the MICU (55 patients). Vancomycin, piperacillin-tazobactam, and fluconazole were the most highly consumed antimicrobials, in terms of defined daily dose(DDD)/100-bed day, in the SICU (37, 31, and 27, respectively). On the other hand, meropenem, vancomycin, and levofloxacin were the most commonly consumed antimicrobials in the MICU (49, 35, and 26, respectively). The most frequent organisms were Coagulase-negative Staphylococci spe-cies, Escherichia coli, and Enterococcus faecalis (15%, 12%, and 9%, respectively). There were two Vancomycin-resistant Enterococcus faecium (VRE) cases in each ICU. Methicillin-resistant Staphylococcus aureus (MRSA) was common in the MICUs (five isolates). In both ICUs, A. baumannii, Escherichia coli, P. aeruginosa, and Klebsiella pneumonia showed ex-tensive resistance to the tested antibiotics. The isolated Enterococcus faecium from both ICUs were highly resistant to the commonly used antibiotics. Conclusion: This study revealed high consumption of the most potent antibiotics and the prevalence of multidrug-resistant or-ganisms (MDRO) in the tested ICUs. This highlights the need to adhere to the antibiotic stew-ardship policy to use antibiotics appropriately and reduce the presence of these MDROs.