ANTIMICROBIAL RESISTANCE OF PATHOGENS OF HEALTHCARE-ASSOCIATED INFECTIONS IN SURGERY AND INTENSIVE CARE UNITS

2018 ◽  
Vol 2 (2-3) ◽  
pp. 41-49
Author(s):  
A.G. Salmanov ◽  
L.F. Slepova ◽  
O.M. Verner ◽  
T.P. Yarema ◽  
P.V. Riabokon
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Intensive Care Units ◽  
Antimicrobial Susceptibility ◽  
Bacterial Resistance ◽  
Clinical Symptoms ◽  
Healthcare Associated Infections ◽  
Infection Treatment ◽  
Acinetobacter Spp ◽  
Healthcare Associated

OBJECTIVE. To determine resistance to antibiotics of the pathogens of healthcare-associated infections (HAIs) in surgery and intensive care units in Kyiv hospitals. MATERIALS AND METHODS. The investigation included the analysis of 6159 strains from patients with clinical symptoms HAIs. The identification and antimicrobial susceptibility of cultures were determined, using automated microbiology analyzer Vitek 2 Compact (BioMerieux, France). Susceptibility to antibiotics was determined using AST cards (BioMerieux, France). Some antimicrobial susceptibility test used Kirby – Bauer antibiotic testing. Interpretative criteria were those suggested by the CLSI (USA). RESULTS. The leading agents are E.coli, S.aureus, S.epidermidis, P.aeruginosa, Enterobacter in surgical departments, and Klebsiella, Acinetobacter spp., P.aeruginosa and Enterobacter in departments of intensive care. Multiple resistant hospital cultures are shared in surgical as well as in the departments of intensive care. Its susceptibility to antibiotics was given. CONCLUSIONS. HAIs remain an important cause of morbidity in surgery and intensive care units. Antimicrobial resistance among these and other clinically important pathogens is an increasing problem. The clinical should choose antimicrobial drug in accordance with the local bacterial resistance characteristics for reduce the production of drug resistance and improve the effect of anti-infection treatment possibly.

scholarly journals Pathogen Distribution and Antimicrobial Resistance Among Pediatric Healthcare-Associated Infections Reported to the National Healthcare Safety Network, 2011–2014

2017 ◽  
Vol 39 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Jason G. Lake ◽  
Lindsey M. Weiner ◽  
Aaron M. Milstone ◽  
Lisa Saiman ◽  
Shelley S. Magill ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Intensive Care Units ◽  
Healthcare Associated Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Resistance Data

OBJECTIVETo describe pathogen distribution and antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) from pediatric locations during 2011–2014.METHODSDevice-associated infection data were analyzed for central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI). Pooled mean percentage resistance was calculated for a variety of pathogen-antimicrobial resistance pattern combinations and was stratified by location for device-associated infections (neonatal intensive care units [NICUs], pediatric intensive care units [PICUs], pediatric oncology and pediatric wards) and by surgery type for SSIs.RESULTSFrom 2011 to 2014, 1,003 hospitals reported 20,390 pediatric HAIs and 22,323 associated pathogens to the NHSN. Among all HAIs, the following pathogens accounted for more than 60% of those reported: Staphylococcus aureus (17%), coagulase-negative staphylococci (17%), Escherichia coli (11%), Klebsiella pneumoniae and/or oxytoca (9%), and Enterococcus faecalis (8%). Among device-associated infections, resistance was generally lower in NICUs than in other locations. For several pathogens, resistance was greater in pediatric wards than in PICUs. The proportion of organisms resistant to carbapenems was low overall but reached approximately 20% for Pseudomonas aeruginosa from CLABSIs and CAUTIs in some locations. Among SSIs, antimicrobial resistance patterns were similar across surgical procedure types for most pathogens.CONCLUSIONThis report is the first pediatric-specific description of antimicrobial resistance data reported to the NHSN. Reporting of pediatric-specific HAIs and antimicrobial resistance data will help identify priority targets for infection control and antimicrobial stewardship activities in facilities that provide care for children.Infect Control Hosp Epidemiol 2018;39:1–11

HEALTHCARE-ASSOCIATED INFECTIONS IN INTENSIVE CARE UNITS

2019 ◽  
Vol 72 (5) ◽  
pp. 963-969
Author(s):  
Aidyn Salmanov ◽  
Viktor Litus ◽  
Sergiy Vdovychenko ◽  
Oleksandr Litus ◽  
Lena Davtian ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Antimicrobial Susceptibility ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

Introduction: Healthcare-associated infections (HAIs) remain a major public health problem and patient safety threat worldwide. Scant information is available on the occurrence HAI and antimicrobial susceptibility of responsible pathogens in Ukrainian intencive care units (ICUs). The aim: To evaluate the prevalence of HAIs and antimicrobial resistance of the responsible pathogens. Materials and methods: The study included 642 patients and 262 samples isolated from patients with microbiologically proven HAI. The identification and antimicrobial susceptibility of the cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby — Bauer antibiotic testing. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute. Results: Among 642 patients, 148 HAIs were observed (23.1%). Death during hospitalization was reported in 20.1% HAI cases. Pneumonia (47.3%), blood stream infection (21.6%), and urinary tract infection (14.9) together accounted for 83.8% of all HAIs reported. Most cases of these infections were device-associated. Considering all HAI types together, Klebsiella pneumoniae were most commonly reported, accounting for 21.8% of all organisms, followed by Acinetobacter baumanni (14.3%), Pseudomonas aeruginosa (12.4%) and Escherichia coli (9.4%). 59.8% and 6.6% of Staphylococcus aureus were oxacillin and teicoplanin resistant, respectively. Third-generation cephalosporins resistancewas found in 53.8% of K.pneumoniae and 32.1% of E.coli isolates; and carbapenem resistance in 78.6% of A. baumanni and 29.3% of K. pneumoniae isolates. Conclusions: Infection control priorities in intensive care units should include preventing nosocomial pneumonia, blood stream infection, urinary tract infection and of deviceassociated infections.

Antibiotic Molecules Involved in Increasing Microbial Resistance

2019 ◽  
Vol 70 (7) ◽  
pp. 2622-2626 ◽  
Author(s):  
Letitia Doina Duceac ◽  
Constantin Marcu ◽  
Daniela Luminita Ichim ◽  
Irina Mihaela Ciomaga ◽  
Elena Tarca ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Enterobacter Aerogenes ◽  
Healthcare Associated Infections ◽  
Medical Department ◽  
Microbial Resistance ◽  
Antimicrobial Sensitivity ◽  
Interpretation Criteria ◽  
Tract Infections ◽  
Healthcare Associated

Over the past two decades, the resistance to antibiotics, especially for Gram-negative bacteria, has increased at an alarming rate, requiring constant concern for resolving and controlling this extremely important therapeutic aspect in any medical department but in particular, in Anaesthesia and Intensive Care Units, in units of neonatology, paediatrics, neurosurgery, burned patients and immunosuppressed. Specialists note a particular concern for the resistance of Enterobacteriaceae to third-generation cephalosporins and aztreonam, with a resistance profile frequently associated with the expression of extended-spectrum �-lactamases (ESBL). The Enterobacter genus comprises 14 species, but two are of medical interest, Enterobacter aerogenes and E. cloacae, which are involved in inducing healthcare-associated infections such as urinary tract infections, pneumonia associated with mechanical ventilation, bacteremia, septicemia, etc. The purpose of the study was to highlight the antibiotic molecules in which microbial resistance of some circulating strains of enterobacteria was detected. A descriptive and retrospective study was conducted between 2012-2017, on a batch of 35 patients, admitted to the Sf. Maria Emergency Clinical Hospital for Children of Iasi, from whom various pathological products were collected to highlight the Enterobacter sp strains involved in the production of infections associated with the inpatient medical care. The antimicrobial sensitivity of each strain was determined by diffusimetric method, while the interpretation criteria were considered to be those of the laboratory standards. Most cases were reported in 2017 (31.42%). The majority were registered in new-borns (42.85%) and infants (25.71%). The Anaesthesia and Intensive Care Units and Neonatology Anaesthesia and Intensive Care Units departments were the most involved. Microbial antibacterial resistance of Enterobacter sp isolates showed that all manifested resistance to ampicillin, amoxicillin and clavulanic acid, 48.57% were resistant to Cefuroxime, 42.85% resistant to Ceftazidime and Ceftriaxone, 14.28% to ciprofloxacin, 11.42% to ertapenem, 5.71% to Meronem. Although it showed relatively few cases with infections associated with healthcare in which strains of Enterobacter sp. were isolated our study, which was carried out over a period of 5 years, provides useful indications regarding the prevalence of healthcare associated infections with Enterobacter sp in paediatric patients and guidelines for antibiotic therapy.

scholarly journals Longitudinal Trends in All Healthcare-Associated Infections through Comprehensive Hospital-wide Surveillance and Infection Control Measures over the Past 12 Years: Substantial Burden of Healthcare-Associated Infections Outside of Intensive Care Units and “Other” Types of Infection

2015 ◽  
Vol 36 (10) ◽  
pp. 1139-1147 ◽  
Author(s):  
Hajime Kanamori ◽  
David J. Weber ◽  
Lauren M. DiBiase ◽  
Emily E. Sickbert-Bennett ◽  
Rebecca Brooks ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Linear Models ◽  
Infection Type ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Control Measures ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

OBJECTIVETargeted surveillance has focused on device-associated infections and surgical site infections (SSIs) and is often limited to healthcare-associated infections (HAIs) in high-risk areas. Longitudinal trends in all HAIs, including other types of HAIs, and HAIs outside of intensive care units (ICUs) remain unclear. We examined the incidences of all HAIs using comprehensive hospital-wide surveillance over a 12-year period (2001–2012).METHODSThis retrospective observational study was conducted at the University of North Carolina (UNC) Hospitals, a tertiary care academic facility. All HAIs, including 5 major infections with 14 specific infection sites as defined using CDC criteria, were ascertained through comprehensive hospital-wide surveillance. Generalized linear models were used to examine the incidence rate difference by infection type over time.RESULTSA total of 16,579 HAIs included 6,397 cases in ICUs and 10,182 cases outside ICUs. The incidence of overall HAIs decreased significantly hospital-wide (−3.4 infections per 1,000 patient days), in ICUs (−8.4 infections per 1,000 patient days), and in non-ICU settings (−1.9 infections per 1,000 patient days). The incidences of bloodstream infection, urinary tract infection, and pneumonia in hospital-wide settings decreased significantly, but the incidences of SSI and lower respiratory tract infection remained unchanged. The incidence of Clostridium difficile infection (CDI) increased remarkably. The outcomes were estimated to include 700 overall HAIs prevented, 40 lives saved, and cost savings in excess of $10 million.CONCLUSIONSWe demonstrated success in reducing overall HAIs over a 12-year period. Our data underscore the necessity for surveillance and infection prevention interventions outside of the ICUs, for non–device-associated HAIs, and for CDI.Infect Control Hosp Epidemiol 2015;36(10):1139–1147

scholarly journals Increased Involvement of Klebsiellapneumoniae and Enterococcusfaecium in Healthcare-Associated Infections of Intensive Care Units in Taiwan

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1349
Author(s):  
Yu-Ren Lin ◽  
Yen-Yue Lin ◽  
Chia-Peng Yu ◽  
Ya-Sung Yang ◽  
Chun-Gu Cheng ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Intensive Care Units ◽  
Enterococcus Faecium ◽  
Healthcare Providers ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Chi Square ◽  
Control Protocols ◽  
Healthcare Associated

Background: Healthcare-associated infections (HAIs) cause increases in length of stay, mortality, and healthcare costs. A previous study conducted in Taiwan obtained similar results to those reported in Korea and Japan in 2015. Changes in microorganisms have been noted in recent years. Understanding the recent condition of HAIs in intensive care units (ICUs) can enable healthcare providers to develop effective infection control protocols to reduce HAIs. Methods: We used the Taiwan Nosocomial Infection Surveillance System to evaluate the incidence densities of HAIs, the proportions of causative pathogens, and the proportions of antimicrobial resistance (AMR). The Poisson regression model was constructed to incidence density, and the chi-square test was used to assess proportion. Results: The incidence density of HAIs decreased 5.7 to 5.4 per 1000 person-days. However, the proportions of Klebsiella pneumoniae and Enterococcus faecium significantly increased. In addition, the proportions of carbapenem-resistant K. pneumoniae and vancomycin-resistant Enterococcus faecium significantly increased over time. Conclusion: Analysis of the microorganisms involved in HAIs in ICUs showed elevated proportions of K. pneumoniae and E. faecium with AMR. Infection control protocols have been implemented for several years and require improvements regarding environmental cleanliness and medical staff prevention.

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