Risk factors for acquiring multi-drug resistant organisms in the intensive care unit: a single-centre study in Mauritius

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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Ischaemic-reperfusion injury and different risk factors for acute kidney injury in donation after circulatory death liver transplantation. UK single centre study

Journal of Hepatology ◽

10.1016/s0168-8278(17)30654-2 ◽

2017 ◽

Vol 66 (1) ◽

pp. S183

Author(s):

I. Umbro ◽

F. Tinti ◽

F. Evison ◽

M. Kalisvaart ◽

A. Sharif ◽

...

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Acute Kidney Injury ◽

Reperfusion Injury ◽

Kidney Injury ◽

Donation After Circulatory Death ◽

Single Centre ◽

Centre Study ◽

Single Centre Study ◽

Circulatory Death

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Clonal spread and patient risk factors for acquisition of extensively drug-resistant Acinetobacter baumannii in a neonatal intensive care unit in Italy

Journal of Hospital Infection ◽

10.1016/j.jhin.2012.08.018 ◽

2012 ◽

Vol 82 (4) ◽

pp. 260-265 ◽

Cited By ~ 24

Author(s):

R. Zarrilli ◽

A. Di Popolo ◽

M. Bagattini ◽

M. Giannouli ◽

D. Martino ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Acinetobacter Baumannii ◽

Neonatal Intensive Care ◽

Drug Resistant ◽

Patient Risk ◽

Extensively Drug Resistant ◽

Clonal Spread

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G10 An investigation of risk factors for acute and late toxicities in children undergoing treatment for acute lymphoblastic leukaemia, a single-centre study

Archives of Disease in Childhood ◽

10.1136/archdischild-2016-310863.10 ◽

2016 ◽

Vol 101 (Suppl 1) ◽

pp. A7.1-A7

Author(s):

R Dhandayuthapani ◽

A Macdonald ◽

J Hamilton ◽

A Latif ◽

F Patrick ◽

...

Keyword(s):

Risk Factors ◽

Acute Lymphoblastic Leukaemia ◽

Lymphoblastic Leukaemia ◽

Single Centre ◽

Centre Study ◽

Single Centre Study

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Revisiting cytomegalovirus serostatus and replication as risk factors for inferior long-term outcomes in the current era of renal transplantation

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz268 ◽

2020 ◽

Vol 35 (2) ◽

pp. 346-356

Author(s):

Nicole Bischof ◽

Caroline Wehmeier ◽

Michael Dickenmann ◽

Patricia Hirt-Minkowski ◽

Patrizia Amico ◽

...

Keyword(s):

Risk Factors ◽

Renal Transplantation ◽

Patient Survival ◽

Long Term Outcomes ◽

Single Centre ◽

Centre Study ◽

Single Centre Study ◽

Cmv Disease ◽

The Impact

Abstract Background Cytomegalovirus (CMV) serostatus and CMV replication are considered as risk factors for inferior graft and patient survival after renal transplantation, but long-term outcome data are limited. The aim of this retrospective single-centre study was to investigate the impact of CMV serostatus and CMV replication/disease on long-term outcomes in a well-defined cohort managed by a standardized CMV prevention/treatment protocol. Methods We investigated 599 consecutive kidney transplantations having a CMV prevention protocol consisting of either prophylaxis (D+/R− and R+ with ATG induction) or screening/deferred therapy (R+ without ATG induction). Patients were grouped according to CMV serostatus [high risk (D+/R−): n = 122; intermediate risk (R+): n = 306; low risk (D−/R−): n = 171] and occurrence of CMV replication/disease (no CMV replication: n = 419; asymptomatic CMV replication: n = 110; CMV syndrome: n = 39; tissue-invasive CMV disease: n = 31). The median follow-up time was 6.5 years. Results Graft and patient survival were not different among the three CMV serostatus groups as well as the four CMV replication/disease groups (P ≥ 0.44). Eighty-seven patients died, 17 due to infections (21%), but none was attributable to CMV. The overall hospitalization incidence for CMV-related infection was 3% (17/599 patients). The incidence of clinical and (sub)clinical rejection was similar among the groups (P ≥ 0.17). In a multivariate Cox proportional hazard model, neither CMV serostatus, nor CMV replication, nor CMV disease were independent predictors for patient death or graft failure, respectively. Conclusions This retrospective single-centre study suggests that the negative impact of CMV infection on long-term patient and allograft survival as well as on allograft rejection can be largely eliminated with current diagnostic/therapeutic management.

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