Comparative Analysis of Antimicrobial Resistance Patterns in ICU and Non-ICU Isolates from a Gujarat Surveillance Network, India: A Semi-annual Antibiogram Study
Panchal Y. S. *
Department of Animal Genetics and Breeding, College of Veterinary Science and Animal Husbandry, Kamdhenu University, Anand, Gujarat, India.
Patel A. S.
Department of Animal Genetics and Breeding, College of Veterinary Science and Animal Husbandry, Kamdhenu University, Anand, Gujarat, India.
Joshi B. A.
Department of Veterinary Biotechnology, College of Veterinary Science and Animal Husbandry, Kamdhenu University, Anand, Gujarat, India.
Parmar G. S.
Department of Animal Genetics and Breeding, College of Veterinary Science and Animal Husbandry, Kamdhenu University, Anand, Gujarat, India.
Ramani U. V.
Department of Veterinary Biotechnology, College of Veterinary Science and Animal Husbandry, Kamdhenu University, Anand, Gujarat, India.
Jakhesara S. J.
Department of Veterinary Biotechnology, College of Veterinary Science and Animal Husbandry, Kamdhenu University, Anand, Gujarat, India.
Koringa P. G.
Department of Veterinary Biotechnology, College of Veterinary Science and Animal Husbandry, Kamdhenu University, Anand, Gujarat, India.
*Author to whom correspondence should be addressed.
Abstract
Aims: To compare antimicrobial resistance patterns between intensive care unit (ICU) and non-intensive care unit (non-ICU) isolates in hospitals participating in the Gujarat State surveillance network.
Study Design: Retrospective analytical surveillance study.
Place and Duration of Study: Hospitals enrolled in the Gujarat State Antimicrobial Resistance Surveillance Network, India, using semi-annual antibiogram data from July to December 2024.
Methodology: Aggregate antibiogram data were obtained from the Gujarat State Antimicrobial Resistance Surveillance Network. Three bacterial pathogens- Escherichia coli, Klebsiella pneumoniae and Staphylococcus aureus were included. Resistance proportions for clinically relevant antibiotics were compared between intensive care unit and non-intensive care unit inpatient isolates. Statistical analysis was performed using chi-square test. Odds ratios (OR) with 95% confidence intervals were calculated to assess the association between intensive care unit admission and antimicrobial resistance. Interpretation of findings is limited by the use of aggregated surveillance data without patient-level variables, isolate de-duplication or inter-hospital standardization adjustment.
Results: A total of 837 isolates were analyzed, including 300 intensive care unit and 537 non-intensive care unit isolates. Escherichia coli from intensive care units showed higher carbapenem resistance (41.0% vs 27.9%; OR = 1.79; P = 0.026). Klebsiella pneumoniae exhibited significantly greater resistance in ICU to piperacillin-tazobactam (69.0% vs 52.0%; OR = 2.06; P = 0.006) and carbapenems (imipenem: 48.0% vs 23.5%, OR = 3.01; P < 0.001). Methicillin resistance in Staphylococcus aureus was higher in ICU isolates (48.0% vs 34.6%; OR = 1.74; P = 0.029).
Conclusion: ICU isolates demonstrated significantly higher resistance to key antibiotics compared with non-ICU isolates, highlighting intensive care units as focal points for antimicrobial resistance and priority targets for stewardship and infection control interventions.
Keywords: Antimicrobial resistance, intensive care units, hospital surveillance, antibiogram, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus