scholarly journals Incidence of multidrug-resistant bacteria in tracheal secretions from critically ill patients in the intensive care unit

2020 ◽  
Vol 93 (2) ◽  
pp. 77-83
Author(s):  
Berki Ádám-József ◽  
Benkő Csongor ◽  
Székely Edit ◽  
Szász Izabella Éva ◽  
Vas Krisztina Eszter
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Bacterial Flora ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Multidrug Resistant Bacteria ◽  
Cell Counts

Abstract Ventilator-associated pneumonia is a severe nosocomial infection that affects the disease course of critically ill patients. Awareness of potential pathogens is essential for prevention, early detection, and proper treatment, as well. In this retrospective cross-sectional study, we investigated the tracheal secretions collected from critically ill patients with the aim to detect the occurrence of multidrug-resistant bacteria. We examined the bacteriological culture results of the tracheal secretions of the patients hospitalized at the Intensive Care Unit of Tîrgu Mureș Emergency Clinical County Hospital between 1st November 2017 and 31st January 2018. Admission diagnoses and comorbidities were recorded, and white blood cell counts were monitored. We determined the quality of the lower respiratory samples by microscopic examination and the results of the microbiological tests, taking into account the germ count of pathogens and the antibiotic-resistance pheno-type. During the three months, 194 samples were received from 107 patients for bacteriological examination. After the first sample collection 34 (31.77%) tracheal secretions were positive for pathogens, while in the remaining samples normal upper respiratory bacterial flora was found. From the 34 positive samples, 22 were colonizing pathogens and 30 were isolated in a clinically significant amount. Predominantly Staphylococcus aureus (n=14; 26.9%), Klebsiella pneumoniae (n=9; 17.3%), Escherichia coli (n=8.1%) and other Gram-negative bacteria (n=21; 40.4%) were identified. Among these strains 38 (73.07%) were not multidrug-resistant. The rate of positivity of individual sampling showed a positive correlation with the average duration of hospital stay (p=0.0016; r=0.8740). A total of 26 patients developed early-onset or late-onset ventilator-associated pneumonia. Potential risk factors for infection with multidrug-resistant bacteria were found. We can conclude that recently admitted patients in the intensive care unit are rarely carriers of multidrug-resistant bacteria, but become colonized or infected with multidrug-resistant strains during long-term intensive care.

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

scholarly journals Multidrug resistant bacteria in critically ill patients: a step further antibiotic therapy

2018 ◽  
Vol 2 ◽  
pp. 103-103 ◽  
Author(s):  
Martina Tosi ◽  
Erika Roat ◽  
Sara De Biasi ◽  
Elena Munari ◽  
Sophie Venturelli ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria

scholarly journals High dose tigecycline in critically ill patients with severe infections due to multidrug-resistant bacteria

Critical Care ◽  
2014 ◽  
Vol 18 (3) ◽  
pp. R90 ◽  
Author(s):  
Gennaro De Pascale ◽  
Luca Montini ◽  
Mariano Pennisi ◽  
Valentina Bernini ◽  
Riccardo Maviglia ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
High Dose ◽  
Multidrug Resistant Bacteria ◽  
Severe Infections

Oral Health and Care in the Intensive Care Unit: State of the Science

2004 ◽  
Vol 13 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Cindy L. Munro ◽  
Mary Jo Grap
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oral Health ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Dental Plaque ◽  
Oral Care ◽  
Microbial Flora ◽  
Tooth Surface ◽  
Ventilator Associated Pneumonia

Oral health is influenced by oral microbial flora, which are concentrated in dental plaque. Dental plaque provides a microhabitat for organisms and an opportunity for adherence of the organisms to either the tooth surface or other microorganisms. In critically ill patients, potential pathogens can be cultured from the oral cavity. These microorganisms in the mouth can translocate and colonize the lung, resulting in ventilator-associated pneumonia. The importance of oral care in the intensive care unit has been noted in the literature, but little research is available on mechanical or pharmacological approaches to reducing oral microbial flora via oral care in critically ill adults. Most research in oral care has been directed toward patients’ comfort; the microbiological and physiological effects of tooth brushing in the intensive care unit have not been reported. Although 2 studies indicated reductions in rates of ventilator-associated pneumonia in cardiac surgery patients who received chlorhexidine before intubation and postoperatively, the effects of chlorhexidine in reducing ventilator-associated pneumonia in other populations of critically ill patients or its effect when treatment with the agent initiated after intubation have not been reported. In addition, no evaluation of the effectiveness of pharmacological and mechanical interventions relative to each other or in combination has been published. Additional studies are needed to develop and test best practices for oral care in critically ill patients.

Procalcitonin-Guided Antibiotic Therapy Duration in Critically Ill Adults

2015 ◽  
Vol 26 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Caroline Walker
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antibiotic Therapy ◽  
Critically Ill ◽  
Bacterial Infections ◽  
Unit Length ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Control Group ◽  
Duration Of Treatment

Procalcitonin is a promising biomarker for antibiotic therapy because its levels rise and fall quickly with bacterial infections. A multi-database literature search was reviewed with 3 primary prospective randomized control trials used in further analysis. The results indicated that a procalcitonin-guided antibiotic protocol reduces the number of days a patient has to take antibiotics while having no effect on mortality when compared with control groups. Short-term studies did not show a difference in the intensive care unit length of stay, infection relapse rate, super-infection rate, or multidrug-resistant bacteria rate between the procalcitonin-protocol and control group. Because procalcitonin-guided antibiotic therapy has been shown to reduce the duration of treatment with antibiotics in critically ill patients without worsening the mortality rate or other outcomes, the implementation of a procalcitonin-guided antibiotic therapy should be considered for patients with proven or highly suspected bacterial infections in the intensive care unit.

scholarly journals Multidrug-resistant bacteria isolated from intensive-care-unit patient samples

2009 ◽  
Vol 13 (2) ◽  
Author(s):  
Aziz Japoni ◽  
Afsaneh Vazin ◽  
Mahdi Hamedi ◽  
Mohammad Ali Davarpanah ◽  
Abdolvahab Alborzi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Patient ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria
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