An Outbreak of Multidrug-ResistantPseudomonas AeruginosaAssociated with Increased Risk of Patient Death in an Intensive Care Unit

2002 ◽  
Vol 23 (8) ◽  
pp. 441-446 ◽  
Author(s):  
Geir Bukholm ◽  
Tone Tannæs ◽  
Anne Britt Bye Kjelsberg ◽  
Nils Smith-Erichsen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Bacterial Isolates ◽  
Patient Death ◽  
Antibiotic Policy ◽  
Outbreak Period ◽  
Increased Risk ◽  
Gastric Tubes

Objective:To investigate an outbreak of multidrug-resistantPseudomonas aeruginosain an intensive care unit (ICU).Design:Epidemiologic investigation, environmental assessment, and ambidirectional cohort study.Setting:A secondary-care university hospital with a 10-bed ICU.Patients:All patients admitted to the ICU receiving ventilator treatment from December 1,1999, to September 1, 2000.Results:An outbreak in an ICU with multidrug-resistant isolates ofP. aeruginosabelonging to one amplified fragment-length polymorphism (AFLP)–defined genetic cluster was identified, characterized, and cleared. Molecular typing of bacterial isolates with AFLP made it possible to identify the outbreak and make rational decisions during the outbreak period. The outbreak included 19 patients during the study period. Infection with bacterial isolates belonging to the AFLP cluster was associated with reduced survival (odds ratio, 5.26; 95% confidence interval, 1.14 to 24.26). Enhanced barrier and hygiene precautions, cohorting of patients, and altered antibiotic policy were not sufficient to eliminate the outbreak. At the end of the study period (in July), there was a change in the outbreak pattern from long (December to June) to short Quly) incubation times before colonization and from primarily tracheal colonization (December to June) to primarily gastric or enteral Quly) colonization. In this period, the bacterium was also isolated from water taps.Conclusion:Complete elimination of the outbreak was achieved after weekly pasteurization of the water taps of the ICU and use of sterile water as a solvent in the gastric tubes.

scholarly journals Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience

2021 ◽  
Vol 9 ◽  
pp. 205031212110011
Author(s):  
Thabit Alotaibi ◽  
Abdulrhman Abuhaimed ◽  
Mohammed Alshahrani ◽  
Ahmed Albdelhady ◽  
Yousef Almubarak ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Acinetobacter Baumannii ◽  
Care Setting ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Published Data ◽  
Tertiary Teaching ◽  
The Mean

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.

scholarly journals Multidrug-resistant bacteria isolated from patients hospitalized in Intensive Care Unit in University Hospital of Constantine, Algeria (2011 - 2015)

2016 ◽  
Vol 10 (33) ◽  
pp. 1328-1336 ◽  
Author(s):  
Hecini-Hannachi Abla ◽  
Bentchouala Chafia ◽  
Lezzar Abdesselam ◽  
Laouar Houcine ◽  
Benlabed Kaddour ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria

Surveillance of Antimicrobial Susceptibility among Bacterial Isolates from Intensive Care Unit Patients of a Tertiary-Care University Hospital in Iran: 2006–2009

Chemotherapy ◽  
2010 ◽  
Vol 56 (6) ◽  
pp. 478-484 ◽  
Author(s):  
Zohreh Mohammadtaheri ◽  
Maryam Pourpaki ◽  
Forouzan Mohammadi ◽  
Rocsanna Namdar ◽  
Mohammad-Reza Masjedi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
University Hospital ◽  
Bacterial Isolates

scholarly journals What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Vincenzo Russotto ◽  
Andrea Cortegiani ◽  
Teresa Fasciana ◽  
Pasquale Iozzo ◽  
Santi Maurizio Raineri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Healthcare Workers ◽  
Uv Light ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Major Health Problem ◽  
Resistant Species ◽  
Increased Risk

Intensive care unit- (ICU-) acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2.13, 95% confidence intervals 1.62–2.81) of being colonized and potentially infected by the same bacterial species of the previous patient. Biofilm formation, even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. No-touch methods (e.g., UV-light, hydrogen peroxide vapour) are under investigation and further studies with patient-centred outcomes are needed, before considering them the standard of terminal cleaning in ICUs. Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.

Epidemiology of Methicillin-SusceptibleStaphylococcus Aureusin the Neonatal Intensive Care Unit

2002 ◽  
Vol 23 (11) ◽  
pp. 677-682 ◽  
Author(s):  
Philip L. Graham ◽  
Anne-Sophie Morel ◽  
Juyan Zhou ◽  
Fann Wu ◽  
Phyllis Della-Latta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Strategies ◽  
Cost Effective ◽  
Multidrug Resistant ◽  
Increased Risk ◽  
Endemic Infections

Objective:When the incidence of methicillin-susceptibleStaphylococcus aureus(MSSA) infection or colonization increased in our neonatal intensive care unit (NICU), we sought to further our understanding of the relationship among colonization with MSSA, endemic infection, and clonal spread.Design:A retrospective cohort study was used to determine risk factors for acquisition of a predominant clone of MSSA (clone “B”).Setting:A 45-bed, university-affiliated, level III-IV NICU.Patients:Infants hospitalized in the NICU from October 1999 to September 2000.Interventions:Infection control strategies included surveillance cultures of infants, cohorting infected or colonized infants, contact precautions, universal glove use, mupirocin treatment of the anterior nares of all infants in the NICU, and a hexachlorophene bath for infants weighing 1,500 g or more.Results:During the 1-year study period, three periods of increased incidence of MSSA colonization or infection, ranging from 6.4 to 13.5 cases per 1,000 patient-days per month, were observed. Molecular typing using pulsed-field gel electrophoresis demonstrated two predominant clones, clone “B” and clone “G,” corresponding to two periods of increased incidence. Multivariate analysis demonstrated that length of stay (OR, 1.035; 95% confidence interval [CI95], 1.008 to 1.062;P= .010) (increased risk per day) and the use of H2-blockers (OR, 20.44; CI95, 2.48 to 168.26;P= .005) were risk factors for either colonization or infection with clone “B,” and that the use of peripheral catheters was protective (OR, 0.06; CI95, 0.01 to 0.43;P= .005).Conclusions:Control of MSSA represents unique challenges as colonization is expected, endemic infections are tolerated, and surveillance efforts generally focus on multidrug-resistant pathogens. Future studies should address cost-effective surveillance strategies for endemic infections.

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