Nosocomial sepsis and drug susceptibility pattern among patients admitted to adult intensive care unit of Ayder Comprehensive Specialized Hospital, Northern Ethiopia

Objective: Developing nosocomial sepsis within intensive care unit (ICU) is associated with increased mortality, morbidity, and length of hospital stay. But information is scarce regarding nosocomial sepsis in Northern Ethiopia. Hence, this study aims to determine the prevalence of nosocomial sepsis, associated factors, bacteriological profile, drug susceptibility pattern, and outcome among patients admitted to the adult intensive care unit of Ayder Comprehensive Specialized Hospital (ACSH). Method: Facility-based cross-sectional study was conducted by reviewing the medical records of 278 patients admitted for more than 48 hours to adult ICU of ACSH from October 2016 to October 2017. Data were collected from charts, electronic medical records, and microbiology laboratory data registration book using a checklist. The collected data were subjected to descriptive statistics and multivariable logistic regression using SPSS 25. Statistical significance was declared at p<0.05. Result: Of all the patients, 60(21.6%) of them acquired nosocomial sepsis. The risk of mortality was about two times higher among those who acquired nosocomial sepsis (RR=2.2; 95% CI of RR=1.3-3.5; p=0.003). The odds of acquiring nosocomial sepsis among those who were on a mechanical ventilator (MV) and stayed more than a week was 5.7 and 9.3 times higher respectively than their corresponding counterparts. Among 48 isolates, Klebsiella was the commonest. The isolated organisms had a broad antibiotic resistance pattern for cephalosporin, penicillin, and methicillin. Conclusion: Mortality due to nosocomial sepsis in adult ICU was higher. Use of MV and longer length of in-hospital stay were significant risk factors for nosocomial sepsis. The isolated organisms were resistant to several antibiotics. Therefore, strict application of infection prevention strategies and appropriate use of antibiotics is so crucial.