Acquisition and Cross-Transmission of Staphylococcus aureus in European Intensive Care Units

2009 ◽  
Vol 30 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Alexander L. A. Bloemendaal ◽  
Ad C. Fluit ◽  
Wouter M. T. Jansen ◽  
Menno R. Vriens ◽  
Tristan Ferry ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Variable Number Tandem Repeat ◽  
Antibiotic Use ◽  
Multicenter Cohort Study ◽  
Colonization Pressure ◽  
Icu Admission ◽  
Icu Stay ◽  
Cross Transmission

Objective.To study the acquisition and cross-transmission of Staphylococcus aureus in different intensive care units (ICUs).Methods.We performed a multicenter cohort study. Six ICUs in 6 countries participated. During a 3-month period at each ICU, all patients had nasal and perineal swab specimens obtained at ICU admission and during their stay. All S. aureus isolates that were collected were genotyped by spa typing and multilocus variable-number tandem-repeat analysis typing for cross-transmission analysis. A total of 629 patients were admitted to ICUs, and 224 of these patients were found to be colonized with S. aureus at least once during ICU stay (22% were found to be colonized with methicillin-resistant S. aureus [MRSA]). A total of 316 patients who had test results negative for S. aureus at ICU admission and had at least 1 follow-up swab sample obtained for culture were eligible for acquisition analysis.Results.A total of 45 patients acquired S. aureus during ICU stay (31 acquired methicillin-susceptible S. aureus [MSSA], and 14 acquired MRSA). Several factors that were believed to affect the rate of acquisition of S. aureus were analyzed in univariate and multivariate analyses, including the amount of hand disinfectant used, colonization pressure, number of beds per nurse, antibiotic use, length of stay, and ICU setting (private room versus open ICU treatment). Greater colonization pressure and a greater number of beds per nurse correlated with a higher rate of acquisition for both MSSA and MRSA. The type of ICU setting was related to MRSA acquisition only, and the amount of hand disinfectant used was related to MSSA acquisition only. In 18 (40%) of the cases of S. aureus acquisition, cross-transmission from another patient was possible.Conclusions.Colonization pressure, the number of beds per nurse, and the treatment of all patients in private rooms correlated with the number of S. aureus acquisitions on an ICU. The amount of hand disinfectant used was correlated with the number of cases of MSSA acquisition but not with the number of cases of MRSA acquisition. The number of cases of patient-to-patient cross-transmission was comparable for MSSA and MRSA.

scholarly journals Methicillin-resistant Staphylococcus aureus nasal colonization and infection in an intensive care unit of a university hospital in China

2018 ◽  
Vol 46 (9) ◽  
pp. 3698-3708 ◽  
Author(s):  
Fu Qiao ◽  
Wenzhi Huang ◽  
Lin Cai ◽  
Zhiyong Zong ◽  
Weijia Yin
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Mainland China ◽  
Methicillin Resistant ◽  
Icu Admission ◽  
Icu Stay ◽  
Nasal Swabs ◽  
Mrsa Colonization

Objective This study was performed to determine the prevalence and risk factors associated with nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization upon intensive care unit (ICU) admission and during the ICU stay in mainland China. Methods A prospective observational study was performed in a 50-bed general ICU of a 4300-bed teaching hospital in China from 2011 to 2013. Nasal swabs for MRSA detection were obtained upon ICU admission and at discharge for patients having stayed in the ICU for longer than 3 days. Results In total, 115 patients (4.1%; 95% confidence interval [CI], 3.4–4.9) were already colonized with MRSA on ICU admission, and another 185 patients (10.7%; 95% CI, 9.3–12.2) acquired MRSA during their ICU stay. Development of an MRSA infection was significantly more likely in patients with than without MRSA colonization on ICU admission (odds ratio [OR], 2.8; 95% CI, 1.1–7.3). Patients who acquired MRSA had significantly prolonged lengths of stay in the ICU (23.3 days) and higher hospital bills (135,171 RMB; about 19,590 USD) than those who tested negative for MRSA. Conclusion The MRSA colonization rate among ICU patients in mainland China is high. Patients with MRSA-positive nasal swabs are more likely to develop MRSA infections.

Thrombocytopenia in Intensive care units

2019 ◽  
Author(s):  
Bahram Alamdary Badlou
Keyword(s):  
Intensive Care Unit ◽  
Emergency Medicine ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Organ Dysfunction ◽  
Illness Severity ◽  
Icu Admission ◽  
Icu Stay ◽  
High Illness Severity

Emergency Medicine Specialists (EMS) are supposed to helping/keeping certain patients alive. Although the Intensive Care Unit (ICU) personnel's priority is just saving life of ICU's patients but their approaches are not always in advantage of treated patients [1-5]. Prevalent thrombocytopenia (on ICU admission) occurred in 8.3% to 67.6% of patients; incident thrombocytopenia (developing during the course of the ICU stay) occurred in 13.0% to 44.1% of patients. High illness severity, sepsis, and organ dysfunction often correlated with thrombocytopenia.

Rapid Typing of Methicillin Resistant Staphylococcus aureus Isolated from Intensive Care Units in Babylon, Iraq

2019 ◽  
Vol 22 (10) ◽  
pp. 07-15
Author(s):  
Huda H. Al-Hasnawy ◽  
Inas Ahmed Saeed ◽  
Monqith A. Al-Janabi ◽  
Ali S. Baay ◽  
Zainab Hashim Nasser
Keyword(s):  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant

Variation in antibiotic use across intensive care units (ICU): A population-based cohort study in Ontario, Canada

2020 ◽  
Vol 41 (9) ◽  
pp. 1035-1041
Author(s):  
Erika Y. Lee ◽  
Michael E. Detsky ◽  
Jin Ma ◽  
Chaim M. Bell ◽  
Andrew M. Morris
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Ventilatory Support ◽  
Severity Of Illness ◽  
Antibiotic Use ◽  
Patient Factors ◽  
Days Of Therapy ◽  
Level 3 ◽  
Level 2

AbstractObjectives:Antibiotics are commonly used in intensive care units (ICUs), yet differences in antibiotic use across ICUs are unknown. Herein, we studied antibiotic use across ICUs and examined factors that contributed to variation.Methods:We conducted a retrospective cohort study using data from Ontario’s Critical Care Information System (CCIS), which included 201 adult ICUs and 2,013,397 patient days from January 2012 to June 2016. Antibiotic use was measured in days of therapy (DOT) per 1,000 patient days. ICU factors included ability to provide ventilator support (level 3) or not (level 2), ICU type (medical-surgical or other), and academic status. Patient factors included severity of illness using multiple-organ dysfunction score (MODS), ventilatory support, and central venous catheter (CVC) use. We analyzed the effect of these factors on variation in antibiotic use.Results:Overall, 269,351 patients (56%) received antibiotics during their ICU stay. The mean antibiotic use was 624 (range 3–1460) DOT per 1,000 patient days. Antibiotic use was significantly higher in medical-surgical ICUs compared to other ICUs (697 vs 410 DOT per 1,000 patient days; P < .0001) and in level 3 ICUs compared to level 2 ICUs (751 vs 513 DOT per 1,000 patient days; P < .0001). Higher antibiotic use was associated with higher severity of illness and intensity of treatment. ICU and patient factors explained 47% of the variation in antibiotic use across ICUs.Conclusions:Antibiotic use varies widely across ICUs, which is partially associated with ICUs and patient characteristics. These differences highlight the importance of antimicrobial stewardship to ensure appropriate use of antibiotics in ICU patients.

scholarly journals Early Prediction of Seven-Day Mortality in Intensive Care Unit Using a Machine Learning Model: Results from the SPIN-UTI Project

2021 ◽  
Vol 10 (5) ◽  
pp. 992
Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Giuliana Favara ◽  
Paolo Marco Riela ◽  
Giovanni Gallo ◽  
...  
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Learning Algorithm ◽  
Area Under The Curve ◽  
Support Vector ◽  
Icu Admission ◽  
Risk Of Death ◽  
Saps Ii ◽  
Svm Algorithm

Patients in intensive care units (ICUs) were at higher risk of worsen prognosis and mortality. Here, we aimed to evaluate the ability of the Simplified Acute Physiology Score (SAPS II) to predict the risk of 7-day mortality, and to test a machine learning algorithm which combines the SAPS II with additional patients’ characteristics at ICU admission. We used data from the “Italian Nosocomial Infections Surveillance in Intensive Care Units” network. Support Vector Machines (SVM) algorithm was used to classify 3782 patients according to sex, patient’s origin, type of ICU admission, non-surgical treatment for acute coronary disease, surgical intervention, SAPS II, presence of invasive devices, trauma, impaired immunity, antibiotic therapy and onset of HAI. The accuracy of SAPS II for predicting patients who died from those who did not was 69.3%, with an Area Under the Curve (AUC) of 0.678. Using the SVM algorithm, instead, we achieved an accuracy of 83.5% and AUC of 0.896. Notably, SAPS II was the variable that weighted more on the model and its removal resulted in an AUC of 0.653 and an accuracy of 68.4%. Overall, these findings suggest the present SVM model as a useful tool to early predict patients at higher risk of death at ICU admission.

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