Risk factors of multidrug-resistant, extensively drug-resistant and pandrug-resistant Acinetobacter baumannii ventilator-associated pneumonia in a Medical Intensive Care Unit of University Hospital in Thailand

2015 ◽  
Vol 21 (8) ◽  
pp. 570-574 ◽  
Author(s):  
Juthamas Inchai ◽  
Chalerm Liwsrisakun ◽  
Theerakorn Theerakittikul ◽  
Romanee Chaiwarith ◽  
Weerayut Khositsakulchai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Ventilator Associated Pneumonia ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Medical Intensive Care

scholarly journals Incidence, determinants and outcomes of ventilator associated pneumonia in medical intensive care unit: a prospective cohort study from South Western India

2021 ◽  
Vol 9 (5) ◽  
pp. 1306
Author(s):  
Shivaram Rao ◽  
Nitin Bhat ◽  
Adarsha Gopadi Krishna Bhat ◽  
H. Manjunatha Hande
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Developing Countries ◽  
Intensive Care ◽  
Organ Failure ◽  
Medical Intensive Care Unit ◽  
Ventilator Associated Pneumonia ◽  
Emergency Intubation ◽  
Medical Intensive Care

Background: Ventilators are being increasingly used in developing countries as a result of which complications like ventilator associated pneumonia is also increasing. Present study is being undertaken to evaluate the impact of risk factors and their changing trends for Ventilator associated pneumonia.Methods: A prospective observational study was conducted in mechanically ventilated patients of medical intensive care unit from October 2013 to April 2015.Results: In present study 166 patients receiving mechanical ventilation in a medical ICU were observed. Incidence of VAP in present study is 43.5 for 1000 days of mechanical ventilation. The risk factors that were significant in the study are organ failure (p=0.001), emergency intubation (p=0.001), reintubation (p=0.023) and COPD (p=0.026). The common organisms responsible for VAP were Acinetobacter (30%), Klebsiella pneumoniae (27.1%) and Pseudomonas aeruginosa (20%). The mortality was higher in VAP group (31.3%) compared to the non VAP group (15.7%).Conclusions: There is high incidence of VAP in the developing countries. The risk factors that were found to be associated with VAP in the present study were the presence of COPD, reintubation, organ failure and emergency intubation. VAP is associated with significantly increased duration of hospital stay, morbidity and mortality.

Risk of Clostridium difficile-Associated Disease Among Patients Receiving Proton-Pump Inhibitors in a Quebec Medical Intensive Care Unit

2007 ◽  
Vol 28 (11) ◽  
pp. 1305-1307 ◽  
Author(s):  
Mathieu Beaulieu ◽  
David Williamson ◽  
Gilbert Pichette ◽  
Jean Lachaine
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clostridium Difficile ◽  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Medical Intensive Care Unit ◽  
Antibiotic Use ◽  
Medical Intensive Care

Our study was conducted to determine whether use of gastric acid-suppressive agents increased the risk of Clostridium difficile-associated disease (CDAD) in a medical intensive care unit of one of the first hospitals to be threatened by the current CDAD epidemic in Quebec, Canada. Our findings suggest that efforts to determine risk factors for CDAD should focus on other areas, such as older age and antibiotic use.

scholarly journals Impacts of Multidrug-Resistant Pathogens and Inappropriate Initial Antibiotic Therapy on the Outcomes of Neonates with Ventilator-Associated Pneumonia

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 760
Author(s):  
Hsiao-Chin Wang ◽  
Chen-Chu Liao ◽  
Shih-Ming Chu ◽  
Mei-Yin Lai ◽  
Hsuan-Rong Huang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Treatment Failure ◽  
Neonatal Intensive Care ◽  
Multidrug Resistant ◽  
Ventilator Associated Pneumonia ◽  
Neurological Sequelae ◽  
Independent Risk Factors

It is unknown whether neonatal ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) pathogens and inappropriate initial antibiotic treatment is associated with poor outcomes after adjusting for confounders. Methods: We prospectively observed all neonates with a definite diagnosis of VAP from a tertiary level neonatal intensive care unit (NICU) in Taiwan between October 2017 and March 2020. All clinical features, therapeutic interventions, and outcomes were compared between the MDR–VAP and non-MDR–VAP groups. Multivariate regression analyses were used to investigate independent risk factors for treatment failure. Results: Of 720 neonates who were intubated for more than 2 days, 184 had a total of 245 VAP episodes. The incidence rate of neonatal VAP was 10.1 episodes/per 1000 ventilator days. Ninety-six cases (39.2%) were caused by MDR pathogens. Neonates with MDR–VAP were more likely to receive inadequate initial antibiotic therapy (51.0% versus 4.7%; p < 0.001) and had delayed resolution of clinical symptoms (38.5% versus 25.5%; p = 0.034), although final treatment outcomes were comparable with the non-MDR–VAP group. Inappropriate initial antibiotic treatment was not significantly associated with worse outcomes. The VAP-attributable mortality rate and overall mortality rate of this cohort were 3.7% and 12.0%, respectively. Independent risk factors for treatment failure included presence of concurrent bacteremia (OR 4.83; 95% CI 2.03–11.51; p < 0.001), septic shock (OR 3.06; 95% CI 1.07–8.72; p = 0.037), neonates on high-frequency oscillatory ventilator (OR 4.10; 95% CI 1.70–9.88; p = 0.002), and underlying neurological sequelae (OR 3.35; 95% CI 1.47–7.67; p = 0.004). Conclusions: MDR–VAP accounted for 39.2% of all neonatal VAP in the neonatal intensive care unit (NICU), but neither inappropriate initial antibiotics nor MDR pathogens were associated with treatment failure. Neonatal VAP with concurrent bacteremia, septic shock, and underlying neurological sequelae were independently associated with final worse outcomes.

scholarly journals Surveillance of healthcare-associated infections in a Tunisian university hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Hannachi ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
S Khefacha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
University Hospital ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Healthcare Associated Infection ◽  
Carbapenem Resistant ◽  
Independent Risk Factors ◽  
Healthcare Associated

Abstract Introduction Healthcare -associated infections has become a worldwide public health problem. The aim of this study was to estimate the incidence of healthcare- associated infections in a university hospital of Tunisia. Methods This was a cohort study conducted in six intensive care units in a university hospital of Tunisia during three months (from august to October 2018). Data was provided from patients’ files. Data entry and analysis was done using SPSS version 22. Multivariate analysis was used in order to identify independent risk factors for healthcare associated infection. Results A total of 202 patients were enrolled in this study. The incidence rate of healthcare-associated infections was 53,96%(109/202). The ratio infection/infected was estimated to 1.65(109/66). The incidence of multi-drug resistant pathogens was 21,28% (43/202). The most common resistant pathogens included pseudomonas aeruginosa resistant to cefdazidime in 13,76%(15/109) followed by those resistant to extended spectrum cephalosporin 11.92% (13/109), followed by carbapenem-resistant acinetobcater baumanii 6,42%(7/109) then by carbapenem resistant pathogens and enterococcus resistant to vancomycin 2.75%(3/109) and finally staphylococcus aureus resistant to methicillin 2.1%(2/1.83). The multivariate analysis showed that long duration of central line catheterisation (RR = 7.44; 95%CI[2.79-19.82]), tracheotomy(RR = 8.61;95%CI[2.09-35,39]) and length of stay (RR = 1.08; 95%CI[1.04-1.13]) were found as independent risk factors for healthcare -associated infection. Conclusions The emergence of mutli-drug resistant pathogens needs to be deeply studied and effective measures have to be taken in order to detect and prevent transmission of resistant strains and/or their resistance determinants, especially those with phenotypes having the fewest viable treatment options. Key messages The incidence of healthcare associated infection in the intensive care unit was high. Effective measures have to be taken in the intensive care unit to detect and prevent transmission of resistant pathogens.

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