scholarly journals 388. Epidemiologic and Microbiologic Characteristics of Hospital-acquired Infections in Patients with COVID-19 at Intensive Care Unit, Mexico City

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S296-S296
Author(s):  
Paulo Castañeda-Méndez ◽  
Maria Lorena Cabrera-Ruiz ◽  
Armando Barragán-Reyes ◽  
Esperanza Aleman Aguilar ◽  
Brenda Aceves Sanchez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mexico City ◽  
Antimicrobial Susceptibility ◽  
Severe Pneumonia ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
Stay Hospital

Abstract Background Patients with severe SARS-CoV-2 infection are at high risk of complications due to the intensive care unit stay. Hospital-acquired infections (HAI) are one of the most common complication and cause of death in this group of patients, it is important to know the epidemiology and microbiology of this hospital-acquired infections in order to begin to the patients a proper empirical treatment. We describe the epidemiologic and microbiologic characteristics of HAI in patients with COVID-19 hospitalized at intensive care unit (ICU) in a tertiary level private hospital in Mexico City. Methods From April to December 2020, data from all HAIs in patients with severe pneumonia due to SARS-CoV-2 infection with mechanical ventilation at ICU were obtained. The type of infection, microorganisms and antimicrobial susceptibility patterns were determined. Results A total of 61 episodes of HAIs were obtained, the most common was ventilator associated pneumonia (VAP) in 52.4% (n=32) followed by urinary tract infection (UTI) 34.4%(n=21) and bloodstream infection (BSI) 9.84% (n=6). Only two episodes corresponded to C. difficile associated diarrhea. We identified 82 different microorganisms, the most frequent cause of VAP was P. aeruginosa 22% (10/45) followed by K. pneumoniae 20% (9/45); for UTI, E. coli 28.5% (6/21), and S. marcescens 19% (4/21); for BSI the most frequent microorganism was S. aureus 28.5 (2/7). Regarding the antimicrobial susceptibility patters the most common were Extended Spectrum Beta-Lactamase (ESBL) Gram-negative rods followed by Methicillin-resistant Staphylococcus aureus. Conclusion In patients with severe COVID-19 hospitalized in the ICU the most frequent HAIs were VAP and UTI caused by P. aeruginosa and E. coli respectively. ESBL enterobacteriaceae was the most common resistant pattern identifed in the bacterial isolations in our series. Disclosures All Authors: No reported disclosures

scholarly journals COVID-19 in-hospital mortality of a secondary care center of Mexico City in a marginated area during the first months of the Mexican epidemic

2021 ◽  
Author(s):  
José Martín Alanís-Naranjo ◽  
Víctor Manuel Anguiano-Álvarez ◽  
Eduardo Federico Hammeken-Larrondo
Keyword(s):  
Intensive Care ◽  
Hospital Mortality ◽  
Mexico City ◽  
Secondary Care ◽  
Care Center ◽  
Severe Pneumonia ◽  
P Value ◽  
Intravenous Antibiotics ◽  
Tertiary Hospitals ◽  
Hospital Acquired

Abstract Introduction: Low socioeconomic conditions and hospital saturation have been associated with higher mortality rates in hospitalized patients with COVID-19. Mexico City has become the country’s highest death toll. Iztapalapa is the district with the highest population density and marginalization in Mexico City. Most of the information on COVID-19 in-hospital mortality in Mexico comes from intensive care units or tertiary hospitals without considering the level of income. Data regarding hospital mortality in care centers with low availability of intensive care beds has not been explored.Material and methods: A retrospective cohort study in consecutive patients with COVID-19 hospitalized managed outside the intensive care unit in a secondary care center in Mexico City from April 1st, 2020, to May 31st, 2020. Analysis was performed between subgroups with a p-value <0.05 considered statistically significant.Results: A total of 164 patients were recruited; the median age was 52.5 years (IQR 44 - 64.5), 68% were males, 48.7% were obese, and 59.7% had comorbidities. Among those patients, 67% required mechanical ventilation and 32.3% vasopressor support. In this population, 52 recovered (31.7%) and 112 died (68.3%). The main risk factors associated with death were male sex, age > 50 years, diabetes, severe pneumonia on admission, PORT / PSI > 91, SMART-COP > 5, SCAP score > 10, dyspnea on admission, fever during hospitalization [p <0.05] and the administration of intravenous antibiotics [RR 3.45, 95% CI 1.69-7.06, p <0.001].Conclusion: In this study, we found higher in-hospital mortality compared to previous reports. We suggest that the administration of intravenous antibiotics could impact patient survival for the risk of developing hospital-acquired infections.

DOES CHLORHEXIDINE WIPE HELP IN REDUCING HOSPITAL ACQUIRED INFECTIONS (HAIS) AMONG CRITICALLY ILL CHILDREN ADMITTED TO A PAEDIATRIC INTENSIVE CARE UNIT?

2021 ◽  
pp. 35-37
Author(s):  
Madhan Kumar ◽  
Jolly Chandran ◽  
Pragathesh Pragathesh ◽  
Ebor Jacob Gnananayagam ◽  
Hema Paul ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Critically Ill Children ◽  
Intervention Period ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
Historical Controls

OBJECTIVE: To determine the effect of chlorhexidine wipes in reducing the incidence of hospital acquired infections (HAIs) among critically ill children admitted in Paediatric Intensive Care Unit (PICU). METHODS: An interventional study, wherein enrolled children were wiped with chlorhexidine after routine bath. The incidence of HAIs were noted and compared with data from historical controls of previous year during the same period (pre-intervention). RESULTS: One hundred and ninety nine children in the intervention period were compared with 271 children from pre-intervention period. The numbers of ventilator-days were 777 and 696 respectively for the intervention period and pre-intervention periods. Incidence of ventilator associated pneumonia (VAP) reduced from 12.9/1000 ventilator-days in the pre-intervention period to 6.4/1000 ventilator-days in the intervention period (p=0.1). VAP prevalence was 3.3% in the pre-intervention period as compared to 2.5% in the intervention period (p=0.6). The incidence of CLABSI was 3.6/1000 catheter-days (catheter days: 1377) with prevalence of 2.5% in the intervention period, whereas among the historic controls of the previous year it was 4.2/1000 days (catheter days 1432) with a prevalence of 2.2% (p= 0.8). No untoward effect was reported. CONCLUSION: The use of chlorhexidine wipes in ICU was feasible but did not signicantly decrease HAIs.

scholarly journals Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ifeyinwa N. Nwafia ◽  
Martin E. Ohanu ◽  
Samuel O. Ebede ◽  
Uchenna C. Ozumba
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Associated Risk Factors

Abstract Background The use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital. Results Out of the 200 E. coli isolates, 70 (35.00%) were confirmed positive for extended-spectrum beta-lactamase production. Fifty-three (75.7%) were from hospital acquired infections. All the isolates were resistant to ampicillin, tetracycline and chloramphenicol while 68 (97.14%) of the 70 isolates were susceptible to imipenem. BlaTEM, blaSHV and blaTEM were detected in 66 (94%) of the 70 isolates. The ESBL bla genes detected were blaCTX-M (n = 26; 37.14%), blaTEM (n = 7; 10.00%), blaSHV (n = 2; 2.86%), blaCTX-M/TEM (n = 7; 10.0%), blaCTX-M/SHV (n = 14; 20.0%) and blaCTX-M/TEM/SHV (n = 10; 14.29%). The three bla genes were not detected in 4 (5.71%) of the isolates. Recent surgery, previous antibiotic and intensive care unit admission were the associated risk factors to infections caused by extended-spectrum beta-lactamase producing E. coli. Conclusion There is a high rate of infections caused by extended-spectrum beta-lactamase producing E. coli. Recent surgery, previous antibiotic and intensive care unit admission were associated risk factors.

Nosocomial Infections in a New Medical Center, Turkey

2000 ◽  
Vol 21 (8) ◽  
pp. 534-536 ◽  
Author(s):  
Bengül Durmaz ◽  
Riza Durmaz ◽  
Bariş Otlu ◽  
Emine Sönmez
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
General Surgery ◽  
Nosocomial Infections ◽  
Medical Center ◽  
The Other ◽  
Hospital Acquired Infections ◽  
Bed Capacity ◽  
Hospital Acquired

Nosocomial infection was found in 255 (2.5%) of 10,164 inpatients in a new medical center with a 310-bed capacity. The infection rate was 12.5% in the intensive care unit, 9.5% in neurology, 5.5% in general surgery, and 4.0% in orthopedics. Rates in the other services were lower. Hospital-acquired infections in our medical center frequently involved multiply resistant Enterobacteriaceae and staphylococci.

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