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BACKGROUND: India has ratified with the United Nations Convention on the Rights of Persons with Disabilities and has passed the Rights of People with Disabilities Act in 2016. There is need for training healthcare professionals in disability competencies as people with disabilities are many and marginalized. Disability competencies were introduced in the foundation course of revised competency based medical curriculum for Indian medical graduates by the Medical Council of India (MCI) just prior to the rollout of the programme. We intend describing our center's experience in implementing the same. METHODS: FC 4.5.1 TO 4.5.8 of MCI foundation course guidelines were resource material. Eight faculty members participated. Setting was the lecture theatre. The suggested and actual teaching learning methods are compared for each competency. Notes made from delivering disability competencies, photographs, videos and reflections from students were source of data. RESULTS: We used sensitizing lectures of 15 min each for FC 4.5.1, 4.5.2 and 4.5.4 [cognitive] with interesting set induction, student narratives of family members with disability, buzz groups for interaction and self-directed learning activity using mobile phones. We facilitated FC 4.5.3 and 4.5.5 [skill/affective domain] demonstrating unacceptable and acceptable disability etiquettes using standardized patients and role play. We conducted a forum theatre of the oppressed for FC 4.5.6. We introduced our learners to universal design in our campus for teaching 4.5.7. As a part of the principle of inclusivity we involved two staff members with motor disabilities for delivering FC 4.5.8 in an interview. We assessed the learners using written reflections and obtained feedback on a rating scale.
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OBJECTIVE: To evaluate the antibiotic sensitivity and resistance pattern in an intensive care unit (ICU) setting of a tertiary care hospital. MATERIALS AND METHODS: A cross-sectional, retrospective study was conducted for a period of 1 month in October 2017 on a total of 195 patients who were admitted to ICU of tertiary care hospital. The culture and sensitivity pattern of clinical isolates from blood, urine, sputum, endotracheal tube (ET) aspirate, catheter sites, and wound swabs were analyzed. Positive cultures were segregated and their antibiotic sensitivity testing was performed under the guidelines of clinical and laboratory standard institute (CLSI). RESULTS: Of the total 195 ICU admissions, cultures were sent for 167 cases. Of which 127 patients were culture positive and 40 cases were culture negative. Isolated bacteria were mostly gram-negative bacilli, of which Escherichia coli was (18.6%), Acinetobacter (14.5%), Klebsiella (11.6%), Pseudomonas (9.8%), and Proteus (1.74%). Among the gram-positive organisms, coagulase negative staphylococcus (CoNS) (15.6%) was most commonly isolated followed by Streptococcus (2.32%). Fungal growth was also seen in 26 (15.11%) samples. Samples that grew organisms were blood (n = 48), sputum (n = 17), urine (n = 39), ET aspirate (n = 40), pus (n = 11), catheter (n = 4), ear swab (n = 2), and stool (n = 1). CONCLUSION: Gram-negative bacterial infections are increasing in ICUs, leading to inappropriate selection of antibiotics. Hence, antibiotic sensitivity and resistance pattern in a hospital setup has to be studied so as to guide the treating consultant to initiate empirical antibiotics in critical cases. HOW TO CITE THIS ARTICLE: Savanur SS, Gururaj H. Study of Antibiotic Sensitivity and Resistance Pattern of Bacterial Isolates in Intensive Care Unit Setup of a Tertiary Care Hospital. Indian J Crit Care Med 2019;23(12):547-555.
