scholarly journals Dynamics of the microbiological scope and antibiotic susceptibility in intensive care unit patients

2020 ◽  
Vol 7 (7) ◽  
pp. 3860-3864
Author(s):  
Kostiv Olga ◽  
Yakymchuk Elena ◽  
Kostiv Sviatoslav ◽  
Dmytriiev Dmytro ◽  
Dmytriiev Kostiantyn
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Antibiotic Use ◽  
Infectious Complications ◽  
University Hospital ◽  
Antibacterial Drugs ◽  
And Control ◽  
Rational Antibiotic Use ◽  
Prevention Plan

Introduction: This study addresses and evaluates the decrease of antibiotic resistance after introduction of a proposed prevention plan and control complex in the intensive care unit (ICU). Methods: Data from 1,111 bacteriological analyses, taken from patients who received treatment in the ICU of Ternopil University Hospital from January to August 2015 (group 1) and the same period of 2018 (group II), were included in the study. The complex included measures for the prevention of antibiotic resistance spread and for rational antibiotic use. Results: We found that resistance to imipenem changed more than other antibacterial drugs, increased by 60% (р ≤ 0.05), which was conditioned predominantly by Pseudomonas aeruginosa isolates for 100%. A decrease in 39% of polyresistant clinical isolates of Klebsiella pneumoniae in patients of groups I and II showed important prognostic value. Conclusion: A complex of the proposed measures included the division of patients in blocks according to the risk of infectious complications, control of antibiotics administration, adherence to sanitary norms by ICU staff, use of sodium hypochlorite resulting in decrease of pathogenic isolates, and level of antibiotic resistance to specific groups of antibacterial drugs.

scholarly journals Health vigilance concerning bacteremia in neonatology - neonatal intensive care unit at the Mohammed VI University Hospital of Oujda (Morocco): epidemiological profile and antibiotic resistance

2021 ◽  
Vol 319 ◽  
pp. 01011
Author(s):  
Loubna Yacoubi ◽  
Soumia Farih ◽  
Abderazzak Seddari ◽  
Noussaiba Benhamza ◽  
Adnane Aarab ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Blood Cultures ◽  
University Hospital ◽  
Coagulase Negative Staphylococci ◽  
Hygiene Measures ◽  
Epidemiological Profile

The objective of our study was to describe the epidemiological profile of blood culture isolates in the neonatology - neonatal intensive care unit of the Mohammed VI University Hospital of Oujda (Morocco) and to specify the resistance profile of the main germs isolated to antibiotics .This is a retrospective and descriptive study of 21 months from December 14, 2016 to September 14, 2018 and covering all positive blood cultures processed in the microbiology laboratory in accordance with REMIC (reference in medical microbiology) and EUCAST (European Committee on Antimicrobial Susceptibility Testing).contaminated blood cultures were excluded. As results, we collected 275 positive blood cultures. They occurred in the context of intravascular device (IVD) use in 59% (n=162) of cases. The most isolated bacterial groups were coagulase-negative staphylococci (CNS) 41.45 %( n=114), followed by Enterobacteriaceae 32.36 %( n=89).CNS were resistant to all beta-lactams in 57.89 %( n=66), and to glycopeptides in 5.26 %( n=6). Enterobacteriaceae were producers of extended-spectrum betalactamases in 79.77% (n=71) and producers of carbapenemases in 13.48% (n=12) of cases. The alarming increase of enterobacteriaceae isolates and their antibiotic resistance rates should encourage the reinforcement of hygiene measures in our University Hospital.

scholarly journals Prescription pattern analysis of antibiotic use in a paediatric intensive care unit of a tertiary care teaching hospital in South India

2018 ◽  
Vol 7 (6) ◽  
pp. 1094
Author(s):  
Sindhu S. ◽  
Syed Mohsin Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Paediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Paediatric Intensive Care ◽  
Tertiary Care Teaching Hospital ◽  
Rational Use Of Antibiotics

Background: Antibiotic resistance is rising to alarming levels that necessitates the evaluation of prescription patterns for the rational use of antibiotics. Hence this study was conducted to evaluate antibiotic use in a government run general hospital.Methods: A prospective observational study was conducted to evaluate the rationality of antimicrobial prescription in a paediatric intensive care unit (PICU) of a government run tertiary care teaching hospital using the USAID indicators for rational use of antibiotics. Case records of 104 patients were documented and analysed.Results: The most common antimicrobials prescribed were 3rd generation Cephalosporins namely Ceftriaxone, followed by Aminoglycosides (Amikacin), Imipenams (Meropenam), Anti-Influenza Antiviral (Oseltamivir) and Oxazolidinones (Linezolid). A common trend of antibiotic overuse emerged due to paucity of resources to support decision making and choice of antibiotic. This led to patients being exposed to a high number of antibiotics with an associated increase in morbidity.Conclusions: Antibiotic resistance would remain a challenge until systems for rapid, precise and low cost detection of the causative micro-organisms and antibiotic sensitivity are developed, surveillance systems are increased and antibiotic stewardship programs are enforced.

scholarly journals Determinants and Magnitude of Neonatal Sepsis at Hiwot Fana Comprehensive Specialized University Hospital, Harar, Ethiopia: A Cross-Sectional Study

2021 ◽  
Author(s):  
Astawus Alemayehu Feleke ◽  
Mohammed Yusuf Abdella ◽  
Abebaw Demissie W/mariam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Sepsis ◽  
Birth Asphyxia ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Urban Residence ◽  
Cross Sectional

Introduction: Neonatal sepsis is a serious blood bacterial infection in neonates at the age of equal to or less than 28 days of life, and it's still the major significant cause of death and long-term morbidity in developing countries. Therefore, this study has assessed the prevalence and related factors with neonatal sepsis among new born admitted to the neonatal intensive care unit at Hiwot Fana Comprehensive Specialized University Hospital, Harar, Ethiopia. Methods: An institutional based retrospective cross-sectional study design was conducted among 386 neonates admitted to NICU from September 2017 to August 2019 G.C. A systematic random sampling method was used. Data was analyzed using SPSS V.26. Descriptive summary statistics was done. Bivariate analysis was computed to identify association between dependent and independent variables. Multivariate analysis was used to control possible confounder variables and variables with p-value <0.05 were declared as having statistically significant association. Result: The prevalence of neonatal sepsis was 53.1% and 59.5% were males. Among the total neonates who had sepsis, 67.8% had early neonatal sepsis. Among neonatal factors, preterm neonates (AOR: 8.1, 95%CI: 2.1, 31.2), birth asphyxia (AOR: 4.7, 95%CI: 1.6, 13.6); and among maternal factors, urban residence (AOR: 0.26, 95%CI: 0.1, 0.5), ANC attendance (AOR: 0.32, 95%CI: 0.2, 0.6), SVD (AOR: 0.047, 95%CI: 0.01, 0.2), Maternal antibiotic use (AOR: 0.39; 95%CI: 0.2, 0.8), duration of rupture of membrane < 12 hours (AOR: 0.11; 95%CI: 0.05, 0.2) were found to have significant association with neonatal sepsis. Conclusion: Overall, the magnitude of neonatal sepsis was high. Being preterm, low birth weight and having birth asphyxia were found to significantly increase the odds of neonatal sepsis. Urban residence, having ANC follow up, giving birth by SVD and CS, history of antibiotic use and having rupture of membrane < 18 hours were found to significantly decrease the odds of neonatal sepsis. Key words: Neonatal Sepsis, Intensive Care Unit, Harar

scholarly journals Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil

2011 ◽  
Vol 44 (6) ◽  
pp. 731-734 ◽  
Author(s):  
Daiane Silva Resende ◽  
Jacqueline Moreira do Ó ◽  
Denise von Dolinger de Brito ◽  
Vânia Olivetti Steffen Abdallah ◽  
Paulo Pinto Gontijo Filho
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Multiple Logistic Regression Analysis ◽  
Bloodstream Infections ◽  
University Hospital ◽  
Neonatal Intensive Care Units ◽  
Care Bundle ◽  
Evidence Based ◽  
And Control

INTRODUCTION: Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. METHODS: An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. RESULTS: A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. CONCLUSIONS: A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

scholarly journals 1210. Investigating a Staphylococcus aureus Outbreak in a Clinical Intensive Care Unit: What Is the Role of the Mobile Phones?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S435-S435
Author(s):  
Evelyn Patricia Sanchez Espinoza ◽  
Lauro Viera Perdigão Neto ◽  
Sania Alves dos Santos ◽  
Camila Risek ◽  
Maria Renata Gomes Franco ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Hand Hygiene ◽  
University Hospital ◽  
Whole Genome Sequence ◽  
Two Samples ◽  
Mrsa Infection ◽  
Access Resistance ◽  
And Control

Abstract Background Staphylococcus aureus (Sa) outbreaks are serious infections that if not controlled in time can be life-threating. The aim of this study was to describe the investigation and control of a Sa outbreak in an intensive care unit including analysis of MP. Methods During a microbiological research of MP conducted in December 2018 in a clinical intensive care unit (ICU) of a tertiary university hospital two patients had an MRSA infection. Since this unit had not reported MRSA infections during the last year it was recognized as an outbreak. The CDC criteria was applied to define MRSA colonization and infection. Hand hygiene (HH) adhesion in this unit was 47%,it has 9 beds and 30 Healthcare professionals (HP). Nasal Swab (NS) of all the HPs and of the patients in the same unit as well. HP’s MP were also analyzed. The samples were subjected to MALDI-TOF (Biomerieux), phenotypical tests, PCR for detection of gene coA and mecA, pulsed-field gel electrophoresis (PFGE), and whole-genome sequence to access resistance, virulence profile and sequence type. Feedback of microbiology results, reinforcement of hand hygiene and MP cleaning was discussed with the unit staff. Results A total of 34 samples were collected, 25 were Sa, 13 NS of all HPs and patients, 7 from the MPs and 3 from HPs hands. During the time of the outbreak 5 patients were in the unit. Patients with infection by MRSA (n = 2), had Methicillin-susceptible Sa in their NSs. Another patient that from the same unit had a MRSA in the NS that when submitted to PFGE was seen to be closely related with the MRSA that originated the outbreak. The patients isolates were assigned to different STs and they had more virulent and resistance genes in comparison with two samples of MPs. The Sa recovered from the MPs belonged to the same ST, same resistance gene and same virulent genes. Figure 1, Table1. Since the feedback to the unit no cases of MRSA have been reported in the last 4 months. Conclusion The outbreak was controlled using simply measures (feedback, reinforcement of HH and MP cleaning). The ST398 from the MP has already been described in outbreaks in literature. It seems that MP can be a reservoir for Sa There was more than one Sa lineage in the ICU. Our findings highlighted the need of rethinking the MP cleaning policy in our hospital. Disclosures All authors: No reported disclosures.

scholarly journals Monitoring the antibiotic resistance in the intensive care unit of a multidisciplinary hospital

2018 ◽  
Vol 10 (4) ◽  
pp. 284-297
Author(s):  
V. Yu. Zemko ◽  
V. K. Okulich ◽  
A. M. Dzyadz’ko
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Organ Transplantation ◽  
Antibacterial Therapy ◽  
Infectious Complications ◽  
Clinical Hospital ◽  
Therapy Initiation ◽  
Study Results ◽  
Acinetobacter Spp

Background. Infectious complications remain a serious post-transplant problem and make a major cause of poor outcome. Given the active development of transplant services at a regional level, the problem of infectious complications becomes increasingly important and requires monitoring of the etiological structure and level of antibiotic resistance in each hospital dealing with this problem.The purpose was to analyze the changes over time in the structure and antimicrobial resistance of the most common pathogens in various nosology, including in patients after organ transplantation, regardless gender and age.Material and methods. The study included 37,103 patients, of whom 8,091 (21.8%) were treated in the Intensive Care Unit (ICU) of the Vitebsk Regional Clinical Hospital (VRCH) for the period from 2015 to 2017; infectious complications after organ transplantation made 3%. The clinical samples were studied for bacteriology in the Republican Scientific and Practical Center "Infection in Surgery"; 20,280 clinical isolates were investigated.Results. Staphylococcus aureus (20.96%) dominated in the general structure of microorganisms cultured mainly from the wound surface in thermal burns; meanwhile, in the ICU, gram-negative microflora dominated and was presented with Acinetobacter spp. (22.75%) and Pseudomonas aeruginosa (22.74%) in the majority of cases. By 2017, there had been an increase in resistant isolates of Klebsiella spp. (22.87%) and Acinetobacter spp. (23.09%) and a reduction of P. aeruginosa (13.31%) and S. aureus (18.88%) seeding. The protocol of the antibacterial therapy initiation was set up in the ICU of Vitebsk Regional Clinical Hospital, based on the obtained results demonstrating that all S. aureus isolates were sensitive to linezolid, vancomycin and teicoplanin, while P. aeruginosa was sensitive to colistin. All isolated Acinetobacter spp. were sensitive to colistin and 80% of the isolates were sensitive to sulbactam. More than 95% of K. pneumonia isolates were sensitive to colistin and tigecycline.Conclusion. The current epidemiology is characterized by the prevalence of S. aureus (20.96%) in the overall structure of microorganisms, while Acinetobacter spp. (22.25%) and P. aeruginosa (22.74%) dominate in the ICU. Based on the microbiology study results, the protocol of antibacterial therapy initiation was established in the ICU of Vitebsk Regional Clinical Hospital. It is necessary to monitor the resistance of common microorganisms to certain antibiotics in order to develop algorithms for rational antibacterial treatment in each hospital.

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