Incidence, prevalence and control of multidrug resistant (MDR) carbapenemase producing Acinetobacter baumanii in Indian intensive care units

Introduction: Intensive unit microflora mainly consists of organism capable of surviving in moist media, such as gram-negative bacteria, skin-colonizing microorganisms, those with the ability to adhere to medical devices, and microorganisms resistant to conventional antibiotics. Therefore, cleansing and disinfection of intensive care units is of great importance in the prevention and control of hospital infections.Material and Methods: The use of the device was demonstrated in the isolation room of the intensive care unit after a patient colonized with hospital bacterial strains was discharged. The first sampling was carried out immediately after the patient was discharged, the second after the standard medical cleansing of the equipment and space, and the third after the disinfection with the “SterisafePro”. The analysis of the smears was performed at the OU Clinical Microbiology. Quantitative method analyses was performed according to standard operative procedure (SOP). The results of the analysis are calculated according to the formula and expressed in the values of CFU / cm2.Results: After the patient was discharged and the area cleaned mechanically, the Acinetobacter baumanii was isolated in three samples, coagulase negative staphylococci in one, while two smears remained sterile. Acinetobacter baumanii and coagulase negative staphylococci were isolated in three samples. After using the disinfecting device, all swabs were sterile.Conclusion: Disinfection of the hospital with the “Sterisafe”Pro” device has proved to be very successful. The advantages of using the “Sterisafe”Pro” device are that is uses no chemicals, has a low labor and usage costs, is harmless to the patients and staff, and is very easy to use.

Download Full-text

Prevention and Control of Multidrug-Resistant Gram-Negative Bacteria in Adult Intensive Care Units: A Systematic Review and Network Meta-analysis

Clinical Infectious Diseases ◽

10.1093/cid/cix112 ◽

2017 ◽

Vol 64 (suppl_2) ◽

pp. S51-S60 ◽

Cited By ~ 35

Author(s):

Nattawat Teerawattanapong ◽

Kirati Kengkla ◽

Piyameth Dilokthornsakul ◽

Surasak Saokaew ◽

Anucha Apisarnthanarak ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Intensive Care Units ◽

Prevention And Control ◽

Meta Analysis ◽

Multidrug Resistant ◽

Gram Negative Bacteria ◽

Gram Negative ◽

And Control

Download Full-text

Evaluation and Control of Professional Risks in Intensive Care Units

Occupational and Environmental Safety and Health II - Studies in Systems, Decision and Control ◽

10.1007/978-3-030-41486-3_3 ◽

2020 ◽

pp. 21-29

Author(s):

Ana Ferreira ◽

João Paulo Figueiredo ◽

Mariana Girão ◽

Ana Lança

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

And Control

Download Full-text

Effectiveness of application of a manual for improvement of alarms management by nurses in Intensive Care Units

Investigación y Educación en Enfermería ◽

10.17533/udea.iee.v39n2e11 ◽

2021 ◽

Vol 39 (2) ◽

Author(s):

Amirhossein Yousefinya ◽

Camellia Torabizadeh ◽

Farid Zand ◽

Mahnaz Rakhshan ◽

Mohammad Fararooei

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Blood Pressure Monitoring ◽

Post Intervention ◽

Alarm Management ◽

Effective Interventions ◽

Significant Difference ◽

Quasi Experimental ◽

And Control ◽

Time Type

Objective. To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU). Methods. This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour workshop was on topics related to the adverse effects of alarms, standardization of ECG, oxygen saturation and blood pressure monitoring systems, and the use of ventilators and infusion pumps. Data were collected thorough 200 hours of observation of 60 ICU nurses (100 hours’ pre-intervention and 100 hours’ post-intervention). Response time, type of response, customization of alarm settings for each patient, the person responding to an alarm, and the cause of the alarm were analyzed. Alarms were classified into three types: false, true and technical. Results. The results showed a statistically significant difference between the pre- and post-intervention frequency of alarm types, frequency of monitoring parameters, customized monitoring settings for patients, and individuals who responded to alarms. The percentage of effective interventions was significantly higher for all parameters after the intervention (46.9%) than before the intervention (38.9%). Conclusion. The employment of a manual for management of alarms from electronic equipment in ICUs can increase the frequency of appropriate responses to alarms in these units.

Download Full-text

528. Longitudinal Evaluation of Chlorhexidine Resistance Among Multidrug-Resistant Organisms in Relation to Intervention of Daily Chlorhexidine Bathing in Adult Intensive Care Units

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.597 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S254-S254

Author(s):

Min Ja Kim ◽

You Seung Chung ◽

Hojin Lee ◽

Jin Woong Suh ◽

Yoojung Cheong ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Clinical Laboratory ◽

Multidrug Resistant ◽

University Hospital ◽

Microdilution Method ◽

Broth Microdilution Method ◽

Multidrug Resistant Organisms ◽

Before And After ◽

The Republic

Abstract Background Chlorhexidine digluconate (CHG), the most widely used antiseptic, has recently been applied to patient washing to decolonize the multidrug-resistant organisms (MDROs), but there are little data on susceptibilities of MDROs to CHG. The purpose of this study was to evaluate CHG resistance among MDROs before and after the intervention of daily CHG bathing in adult intensive care units (ICUs). Methods The intervention of daily body washing with 2% CHG cloths were taken in adult patients the medical or surgical ICU of 23-bed by a crossover manner for 6 months (MICU, July to December 2017; SICU, January to June 2018) in a 1,050-bed, university hospital in the Republic of Korea. Available MDRO isolates were randomly selected from clinical cultures of ICU patients within 6 months before, during and after the intervention, including MRSA, MR-CoNS, VRE, Carbapenem-resistant Pseudomonas aeruginosa (CR-PA), CR-Acinetobacter baumannii (CR-AB). Minimum inhibitory concentrations (MICs) were determined using the broth microdilution method set by the Clinical Laboratory Standards Institute. Determination of the minimum bactericidal concentrations (MBCs) was performed by subculturing 10 µL from each well without visible microbial growth. Cumulative amounts of CHG used in both ICUs was estimated across the study period from January 2008 to June 2018. Results The cumulative CHG consumption from both ICUs increased sharply from 27,503 g to 29,556 g after one-year intervention. The ranges of MICs and MBCs of CHG among MDRO clinical isolates selected by a 6-month phase are summarized in Table 1. Particularly, CR-PA and CR-AB isolates revealed four to eight times higher MICs and MBCs compared with the majority of Gram-positives excepting some VRE isolates. On the other hand, neither MICs and MBCs ranges of CHG from the MDRO isolates nor the monthly incidence of the MDROs from both ICUs were significantly increased before and after the intervention of daily CHG bathing. Conclusion This study indicates that some Gram-negative MDRO isolates with higher MICs and MBCs of CHG might be from longstanding exposure to CHG or efflux pumps. Although 2% daily CHG bathing uses over 1,000 times higher concentrations than the lethal concentration, it might be needed to monitor CHG resistance among MDROs. Disclosures All authors: No reported disclosures.

Download Full-text

Variability of cutaneous and nasal population levels between patients colonized and infected by multidrug-resistant bacteria in two Brazilian intensive care units

SAGE Open Medicine ◽

10.1177/2050312114566668 ◽

2015 ◽

Vol 3 ◽

pp. 205031211456666 ◽

Cited By ~ 1

Author(s):

Quésia Damaceno ◽

Jacques R Nicoli ◽

Adriana Oliveira

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Multidrug Resistant Bacteria

Download Full-text

Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i2.21098 ◽

2019 ◽

Vol 10 (2) ◽

pp. 14-19 ◽

Cited By ~ 1

Author(s):

Dharm Raj Bhatta ◽

Deependra Hamal ◽

Rajani Shrestha ◽

Supram HS ◽

Pushpanjali Joshi ◽

...

Keyword(s):

Intensive Care ◽

Respiratory Tract ◽

Intensive Care Units ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Bacterial Pathogens ◽

Multidrug Resistant ◽

Lower Respiratory Tract Infections ◽

Acinetobacter Species ◽

Tract Infections

Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.

Download Full-text

Emerging Chryseobacterium indologenes Infection in Indian Neonatal Intensive Care Units: A Case Report

Antibiotics ◽

10.3390/antibiotics7040109 ◽

2018 ◽

Vol 7 (4) ◽

pp. 109 ◽

Cited By ~ 4

Author(s):

Rishika Mehta ◽

Ashish Pathak

Keyword(s):

Health Care ◽

Intensive Care ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Multidrug Resistant ◽

Neonatal Intensive Care Units ◽

Indwelling Catheters ◽

Chryseobacterium Indologenes ◽

Life Threatening ◽

Health Care Associated Infections

Antibiotic-resistant pathogens and nosocomial infections constitute common and serious problems for neonates admitted to neonatal intensive care units worldwide. Chryseobacterium indologenes is a non-lactose-fermenting, gram-negative, health care-associated pathogen (HCAP). It is ubiquitous and intrinsically resistant to several antibiotics. Despite its low virulence, C. indologenes has been widely reported to cause life-threatening infections. Patients on chronic immunosuppressant drugs, harboring invasive devices and indwelling catheters become the nidus for C. indologenes. Typically, C. indologenes causes major health care-associated infections such as pneumonia, empyema, pyelonephritis, cystitis, peritonitis, meningitis, and bacteremia in patients harboring central venous catheters. Management of C. indologenes infection in neonates is not adequately documented owing to underreporting, particularly in India. Because of its multidrug resistance and the scant availability of data from the literature, the effective empirical treatment of C. indologenes is challenging. We present an uncommon case of bacteremia caused by C. indologenes in a preterm newborn baby with moderate respiratory distress syndrome who was successfully treated. We also provide a review of infections in the neonatal age group. Henceforth, in neonates receiving treatments involving invasive equipment use and long-term antibiotic therapy, multidrug resistant C. indologenes should be considered an HCAP.

Download Full-text