• Sumit Ray, Dimple Anand, Sankalp Purwar, Arijit Samanta, Kaustubh V Upadhye, Prasoon Gupta, and Debashis Dhar.
• Department of Critical Care and Emergency Medicine, Sir Ganga Ram Hospital, New Delhi 110060, India; Department of Critical Care, City Hospital, New Delhi 110060, India. Electronic address: drsray2014@gmail.com.
• J Crit Care. 2018 Apr 1; 44: 255-260.

PurposeInfections due to multidrug resistant organisms have become a serious health concern worldwide. The present study was conducted to investigate the spectrum of microbial resistance pattern in the community and their effects on mortality.MethodsA retrospective review and analysis of prospectively collected data was done of all patients admitted with diagnosis of sepsis in two tertiary care ICU's for a period of two years. Demographics, culture positivity, microbial spectrum, resistance pattern and outcome data were collected.ResultsOut of 5309 patients enrolled; 3822 had suspected clinical infection on admission with 1452 patients growing positive microbial cultures. Among these, 201 bacterial strains were isolated from patients who had community acquired infections. 73% were Gram negative bacilli, commonest being E. coli (63%). 63.4% E. coli and 60.7% Klebsiella isolates were ESBL producers. The mortality in ESBL positive infections was significantly higher as compared to ESBL negative infections (Odds ratio 2.756). Moreover, ESBL positive patients empirically treated with Beta Lactams+Beta Lactamase inhibitors (BL+BLI) had significantly higher mortality as compared to patients treated with carbapenems. More data from multiple centres need to be gathered to formulate appropriate antibiotic policy for critically ill patients admitted from the community.Copyright © 2017 Elsevier Inc. All rights reserved.

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