scholarly journals Nosocomial sepsis and drug susceptibility pattern among patients admitted to adult intensive care unit of Ayder Comprehensive Specialized Hospital, Northern Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsega Cherkos Dawit ◽  
Reiye Esayas Mengesha ◽  
Mohamedawel Mohamedniguss Ebrahim ◽  
Mengistu Hagazi Tequare ◽  
Hiluf Ebuy Abraha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Statistical Significance ◽  
Drug Susceptibility ◽  
Northern Ethiopia ◽  
Susceptibility Pattern ◽  
Icu Patients ◽  
Nosocomial Sepsis ◽  
Specialized Hospital ◽  
Drug Susceptibility Pattern

Abstract Objective Developing nosocomial sepsis within intensive care unit (ICU) is associated with increased mortality, morbidity, and length of hospital stay. But information is scarce regarding nosocomial sepsis in intensive care units of Northern Ethiopia. Hence, this study aims to determine the incidence of nosocomial sepsis, associated factors, bacteriological profile, drug susceptibility pattern, and outcome among patients admitted to the adult ICU of Ayder Comprehensive Specialized Hospital (ACSH), which is the largest tertiary hospital in Northern Ethiopia. Method Facility-based longitudinal study was conducted by following 278 patients who were admitted for more than 48 h to adult ICU of ACSH, from October 2016 to October 2017. Data were collected from charts, electronic medical records, and microbiology registration book using a checklist. The collected data were subjected to descriptive statistics and multivariable logistic regression using SPSS version 25. Statistical significance was declared at p < 0.05. Result Of all the patients, 60 (21.6%) of them acquired nosocomial sepsis. The risk of mortality was about two times higher among adult ICU patients who acquired nosocomial sepsis (RR = 2.2; 95% CI of RR = 1.3–3.5; p = 0.003). The odds of acquiring nosocomial sepsis among those who were on a mechanical ventilator (MV) and stayed more than a week were 5.7 and 9.3 times higher, respectively, than their corresponding counterparts. Among 48 isolates, Klebsiella was the most common pathogen. The isolates had a broad antibiotic resistance pattern for cephalosporins, penicillins, and methicillin. Conclusion The incidence of nosocomial sepsis in the adult ICU patients of ACSH was higher when compared to the incidence reported from some African and Asian countries. Mortality was higher among patients who acquired nosocomial sepsis. Use of MV and longer length of ICU stay were the significant predictors of nosocomial sepsis. The isolates were resistant to several antibiotics. Therefore, strict application of infection prevention strategies and appropriate use of antibiotics is so crucial. As well, priority should be given to patients who develop nosocomial sepsis in ICU.

scholarly journals Nosocomial sepsis and drug susceptibility pattern among patients admitted to adult intensive care unit of Ayder Comprehensive Specialized Hospital, Northern Ethiopia

2021 ◽  
Author(s):  
Tsega Cherkos Dawit ◽  
Reiye Esayas Mengesha ◽  
Mohamedawel Mohamedniguss Ebrahim ◽  
Mengistu Hagazi Tequare ◽  
Hiluf Ebuy Abraha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Records ◽  
Drug Susceptibility ◽  
Northern Ethiopia ◽  
Susceptibility Pattern ◽  
Adult Intensive Care Unit ◽  
Nosocomial Sepsis ◽  
Specialized Hospital ◽  
Drug Susceptibility Pattern

Abstract Objective: Developing nosocomial sepsis within intensive care unit (ICU) is associated with increased mortality, morbidity, and length of hospital stay. But information is scarce regarding nosocomial sepsis in Northern Ethiopia. Hence, this study aims to determine the prevalence of nosocomial sepsis, associated factors, bacteriological profile, drug susceptibility pattern, and outcome among patients admitted to the adult intensive care unit of Ayder Comprehensive Specialized Hospital (ACSH).Method: Facility-based cross-sectional study was conducted by reviewing the medical records of 278 patients admitted for more than 48 hours to adult ICU of ACSH from October 2016 to October 2017. Data were collected from charts, electronic medical records, and microbiology laboratory data registration book using a checklist. The collected data were subjected to descriptive statistics and multivariable logistic regression using SPSS 25. Statistical significance was declared at p<0.05.Result: Of all the patients, 60(21.6%) of them acquired nosocomial sepsis. The risk of mortality was about two times higher among those who acquired nosocomial sepsis (RR=2.2; 95% CI of RR=1.3-3.5; p=0.003). The odds of acquiring nosocomial sepsis among those who were on a mechanical ventilator (MV) and stayed more than a week was 5.7 and 9.3 times higher respectively than their corresponding counterparts. Among 48 isolates, Klebsiella was the commonest. The isolated organisms had a broad antibiotic resistance pattern for cephalosporin, penicillin, and methicillin.Conclusion: Mortality due to nosocomial sepsis in adult ICU was higher. Use of MV and longer length of in-hospital stay were significant risk factors for nosocomial sepsis. The isolated organisms were resistant to several antibiotics. Therefore, strict application of infection prevention strategies and appropriate use of antibiotics is so crucial.

scholarly journals Bacterial Isolates and its Antibiotic Susceptibility Pattern in NICU

2014 ◽  
Vol 11 (1) ◽  
pp. 66-70 ◽  
Author(s):  
S Shrestha ◽  
NC Shrestha ◽  
S Dongol Singh ◽  
RPB Shrestha ◽  
S Kayestha ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Bacterial Isolates ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Antibiotic Susceptibility Pattern ◽  
Gram Negative ◽  
Nosocomial Sepsis

Background Neonatal sepsis is one of the major causes of morbidity and mortality among the newborns in the developing world. Objectives To determine the common bacterial isolates causing sepsis in neonatal intensive care unit and its antibiotic susceptibility pattern. Methods A one year discriptive prospective study was conducted in neonatal intensive care unit to analyse the results of blood culture and to look into the sensitivity of the commonly used antibiotics. Results The blood culture yield by conventional method was 44.13% with nosocomial sepsis accounting for 10.79%. 84.08% were culture proven early onset sepsis and 15.95% were late onset sepsis. Klebsiella infection was the commonest organism isolated in early, late and nosocomial sepsis but statistically not significant. Gram positive organisms were 39.36% in which Staphylococcus aureus was the leading microorganism followed by coagulase negative staphylococcus areus. Gram negative organisms were 60.64% amongst them Klebsiella was the most often encountered followed by Pseudomonas. The most common organism Klebsiella was 87.5% and 78.3% resistance to ampicillin and gentamycin respectively. Among gram negative isolates 87.5% and 77.2% were resistance to ampicillin and gentamycin respectively. Among gram positive isolates 58.5% and 31.5% resistance were noted to ampicillin and gentamycin respectively. Resistance to cefotaxim to gram negative and gram positive isolates were 87.34% and 59.35% respectively. Conclusion Klebsiella is most common organism which is almost resistance to first line antibiotics. Resistance to both gram negative and gram positive isolates among firstline antibiotics and even with cefotaxim is emerging and is a major concern in neonatal intensive care unit. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11030 Kathmandu University Medical Journal Vol.11(1) 2013: 66-70

scholarly journals Study of Fungal Contamination Intensive Care Units of Arak Educational Hospitals and Determining Drug Sensitivity Profiles of Isolated Species

2021 ◽  
Vol 24 (3) ◽  
pp. 348-359
Author(s):  
Erfan Rezaei ◽  
◽  
Mojtaba Didehdar ◽  
Seyed Hamed Mirhoseini ◽  
◽  
...  
Keyword(s):  
Intensive Care ◽  
Aspergillus Niger ◽  
Drug Sensitivity ◽  
Fungal Infections ◽  
Drug Susceptibility ◽  
Susceptibility Pattern ◽  
Medical Sciences ◽  
Fungal Contamination ◽  
Drug Susceptibility Pattern ◽  
Isolated Species

Background and Aim: Fungal infections are among the most critical and common issues for hospitalized patients, especially in intensive care units. This study aimed to determine the fungal contamination of indoor air and surfaces in sensitive wards of the Arak University of Medical Sciences educational hospitals and determine the drug susceptibility pattern of isolated species. Methods & Materials: In this descriptive cross-sectional study, 63 air samples were taken from sensitive hospital wards using the one-stage Anderson method, and 63 surfaces samples were taken using wet cotton swabs and cultured in saprodextrose agar medium containing chloramphenicol. Identification of the genus and, as far as possible, the species of fungi was performed using the culture method on the slide. Drug susceptibility testing was performed on isolated species by broth microdilution method (CLSI-M38A2 standard). Ethical Considerations: This study was approved by the Research Ethics Committee at Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.315). Results: From the total samples, 18 species of fungi were isolated. These included: Aspergillus niger (8), Aspergillus flavus (4), Aspergillus fumigatus (2), Rhizopus spp. (2), Mucor spp. (1) and Fusarium spp. (1). In the drug sensitivity assay, instances of resistance included: Partial sensitivity of Aspergillus fumigatus to Itraconazole (1), Partial sensitivity of Aspergillus niger to Ketoconazole (1), and Resistance of Aspergillus niger to Itraconazole (1). Conclusion: The pattern of nosocomial fungal infection with pathogenic fungi and the drug susceptibility pattern of these organisms in other regions of Iran and the world is relatively consistent with the present study results. And drugs listed in global guidelines for treating these infections, such as voriconazole and caspofungin in the treatment of invasive aspergillosis and amphotericin B in the treatment of invasive mucormycosis and Fusarium wilt, are now effective drugs. Keywords: Invasive fungal infections, Airborne fungi, Dru

scholarly journals Bacterial Isolates and Drug Susceptibility Pattern of Sterile Body Fluids from Tertiary Hospital, Northern Ethiopia: A Four-Year Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ephrem Tsegay ◽  
Aregawi Hailesilassie ◽  
Haftamu Hailekiros ◽  
Selam Niguse ◽  
Muthupandian Saravanan ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Drug Susceptibility ◽  
Body Fluids ◽  
Northern Ethiopia ◽  
Gram Negative Bacteria ◽  
Susceptibility Pattern ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Drug Susceptibility Pattern

This study was conducted in Ayder comprehensive specialized Hospital, Mekelle, Northern Ethiopia, to determine the bacterial profiles and drug susceptibility pattern from body fluids. A total of 218 patients were investigated, of which 146 (67%) were males. The age of the study subjects ranged from 2 days to 80 years with 96(44%) in the age group of 15 years and above. The overall bacterial infection was 44 (20.2 %) of which gram positive bacteria were prevalent, 23 (52.3%) than gram negative bacteria 21 (47.7%). The predominantly isolated bacteria wereS. pneumonia,followed byK.pneumoniae, S. aureus, andE coli.Multidrug resistance was observed in 12 (100%) of the isolated gram positive bacteria and in 6 (75%) of the isolated gram negative bacteria.

scholarly journals Microalbuminuria can predict the development of acute kidney injury in intensive care unit admission

2020 ◽  
Vol 7 (9) ◽  
pp. 1372
Author(s):  
Bharath G. ◽  
Prasanna Kumar ◽  
Mahendra S. V.
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Statistical Significance ◽  
Prognostic Significance ◽  
Kidney Injury ◽  
Common Finding ◽  
P Value ◽  
Icu Patients ◽  
Icu Stay

Background: Microalbuminuria, defined as 30–300 mg/day of albumin excretion in urine is a common finding in ICU patients and has shown not only as a predictor of organ failure but prolonged intensive care unit (ICU)  stay. Objective of the study was to determine the prediction of acute kidney injury using urine microalbuminuria and to determine the presence of urine microalbuminuria and relationship between ICU length of stay.Methods: The present study is conducted on patients admitted to Medical ICU in SDMCMSH, Dharwad from December 2016 to November 2017. 75 patients who met the inclusion and exclusion criteria were included in the study.Results: The present study included 75 patients, among which 50 were males and 25 were females. The mean age was 60.2years. AKI was developed more in non-diabetics than diabetics and non-hypertensives than hypertensives. The median urine microalbumin at admission in AKI was 80.9 and at 48 hr was130.1 predicted the AKI mean (1.79) in 59 patients with a p value of <0.001 using Mann Whitney test and P value statistically significant.Conclusions: Urine microalbuminuria at 48 hr has predicted AKI in 59 patients with median of 130.1 with statistical significance. Urine microalbuminuria of high value in AKI is directly proportional to prolonged ICU stay. At 48 hours of admission, increased levels of microalbuminuria compared at admission and 48 hour, indicates its prognostic significance among AKI and NON-AKI’s in ICU patients.

scholarly journals Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie-Susanne Stecher ◽  
Sofia Anton ◽  
Alessia Fraccaroli ◽  
Jeremias Götschke ◽  
Hans Joachim Stemmler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Clinical Course ◽  
Point Of Care ◽  
Clinical Deterioration ◽  
Normal Lung ◽  
Icu Patients ◽  
Standardized Protocol ◽  
Ultrasound Score

Abstract Background Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome. Methods We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group. Results The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559). Conclusions LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.

scholarly journals Should the CIWA-Ar be the standard monitoring strategy for alcohol withdrawal syndrome in the intensive care unit?

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tessa L. Steel ◽  
Shewit P. Giovanni ◽  
Sarah C. Katsandres ◽  
Shawn M. Cohen ◽  
Kevin B. Stephenson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Alcohol Withdrawal Syndrome ◽  
Patient Characteristics ◽  
Response To Treatment ◽  
Alternative Measure ◽  
Icu Patients ◽  
Verbal Responses

Abstract Background The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) is commonly used in hospitals to titrate medications for alcohol withdrawal syndrome (AWS), but may be difficult to apply to intensive care unit (ICU) patients who are too sick or otherwise unable to communicate. Objectives To evaluate the frequency of CIWA-Ar monitoring among ICU patients with AWS and variation in CIWA-Ar monitoring across patient demographic and clinical characteristics. Methods The study included all adults admitted to an ICU in 2017 after treatment for AWS in the Emergency Department of an academic hospital that standardly uses the CIWA-Ar to assess AWS severity and response to treatment. Demographic and clinical data, including Richmond Agitation-Sedation Scale (RASS) assessments (an alternative measure of agitation/sedation), were obtained via chart review. Associations between patient characteristics and CIWA-Ar monitoring were tested using logistic regression. Results After treatment for AWS, only 56% (n = 54/97) of ICU patients were evaluated using the CIWA-Ar; 94% of patients had a documented RASS assessment (n = 91/97). Patients were significantly less likely to receive CIWA-Ar monitoring if they were intubated or identified as Black. Conclusions CIWA-Ar monitoring was used inconsistently in ICU patients with AWS and completed less often in those who were intubated or identified as Black. These hypothesis-generating findings raise questions about the utility of the CIWA-Ar in ICU settings. Future studies should assess alternative measures for titrating AWS medications in the ICU that do not require verbal responses from patients and further explore the association of race with AWS monitoring.

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