Title : Blood stream Infections in Intensive Care Units. A Study from North India. Study Design: Prospective study. Place and Duration of Study: Sher-i-Kashmir Institute of Medical Sciences, Srinagar Kashmir. (July 2012 and Dec 2014). Methodology: A prospective analysis of blood specimens from various intensive care units (ICUs) was done over a period of four years. Antimicrobial susceptibility of culture positive isolates to various antibiotics was performed as per Clinical Laboratory Standards Institute (CLSI) guidelines.Gram-negative bacteria (GNB) were screened for extended spectrum -lactamase (ESBL) and metallo- -lactamase (MBL) production; whereas methicillin and vancomycin resistance was searched in staphylococci and nterococci isolates respectively. Results: The frequencies of Gram-positive and Gramnegative bacteria were 16.83% with yeast recovered in 5.78% of the specimens. Acinetobacter spp and K. pneumoniae were the most common Gram-negative bacteria and S. aureus the most common Gram-positive one. High level resistance to all the antimicrobials was seen; with Acinetobacter spp being the most multidrug resistant GNB isolated in the ICU setting. ESBL production was highest in K. pneumoniae isolates (77.1%). Also 49.6% of Acinetobacter isolates were found to be MBL producers. Methicillin resistance was seen in 95% of S. aureus and 91% of coagulase negative staphylococci (CoNS) isolates with vancomycin resistance seen in 46% of enterococcal isolates. Conclusion: An increasing trend over the years in the antibiotic resistance of blood stream pathogens in ICUs of this north Indian state was seen that calls for urgent measures to limit their continued rise.

Keywords: Gram-Negative Bacteria (GNB); Coagulase Negative Staphylococci (CoNS); Metallo-- actamase (MBL).