scholarly journals Local microbiological monitoring as a basis for determining etiological significance of conditional pathogens: data from a burn intensive care unit

2021 ◽  
Vol 23 (1) ◽  
pp. 100-112
Author(s):  
Yuliya I. Yarets ◽  
N.I. Shevchenko ◽  
V.F. Eremin ◽  
V.O. Kovalev
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Gram Negative Bacteria ◽  
Jaccard Coefficient ◽  
Microbiological Monitoring ◽  
Microbial Associations ◽  
Resistant Strains ◽  
Resistance Rates ◽  
Extensive Burns

Objective. To assess the etiology of infections, microbial associations and antimicrobial resistance in a burn intensive care unit. Materials and Methods. A microbiological study of 1322 biological samples from 195 patients with extensive burns included 479 blood samples, 82 respiratory samples, 326 urine samples, and 435 wound samples. Antimicrobial susceptibility testing was performed, and coefficients of constancy and associativity (CA), as well as the Jaccard coefficient were calculated. Results. The etiology of infections was represented by: Pseudomonas aeruginosa – 23%, Acinetobacter baumannii – 19.1%, Enterococcus faecalis – 18.6%, Klebsiella pneumoniae – 8.2%, CoNS (coagulasenegative staphylococci) – 8.2%, Staphylococcus aureus – 7.1%, Candida albicans – 7.1%, Candida non-albicans – 3%, other species were isolated with a frequency of less than 2%. Majority of the above mentioned pathogens showed high associativity: non-fermenting rods (NFR), S. aureus, Enterobacterales, E. faecalis, Candida non-albicans formed associations in 60.0%, 88.8%, 83.0%, 83.3% and 65% of cases, respectively. The prevalence of methicillin-resistant strains of S. aureus and CoNS was 71% and 81%, respectively. CoNS showed higher resistance to fluoroquinolones and gentamicin compare to S. aureus: 42% vs 23%, 46% vs 29%, respectively (χ2 = 6.91; p = 0.086; χ2 = 6.58; p = 0.013). E. faecalis showed high resistance rates to aminoglycosides and fluoroquinolones (> 60%). All Gram-positive isolates were completely susceptible to vancomycin, linezolid, tigecycline, and teicoplanin. Resistance rates of Gram-negative bacteria (NFR, K. pneumoniae) to penicillins, cephalosporins, carbapenems (for NFR), and aminoglycosides were high (from 60% to 100%). The most active antimicrobial against NFR was colistin. Resistance of K. pneumoniae isolates to carbapenems was 23%, while other enterobacteria were highly susceptible to carbapenems. Conclusions. The implementation of the local microbiological monitoring made it possible to characterize the qualitative pathogen structure and antimicrobial resistance in our burns intensive care unit. This data will serve as the basis for improving of the infection control and antimicrobial stewardship.

scholarly journals Incidence of Hospital-Acquired Bacterial Pneumonia and Its Resistance Profiles in Patients Admitted to Intensive Care Unit

2016 ◽  
Vol 9 (3) ◽  
pp. 73 ◽  
Author(s):  
Vahid Boostani ◽  
Farzaneh Dehghan ◽  
Afsaneh Karmostaji ◽  
Nader Zolghadri ◽  
Afsaneh Shafii
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Bacterial Pneumonia ◽  
Clinical Signs ◽  
Resistance Rate ◽  
Gram Negative Bacteria ◽  
Cross Sectional ◽  
Gram Negative ◽  
Hospital Acquired

<p>Hospital-acquired bacterial pneumonia (HABP) is one of the most important causes of morbidity, mortality and economic problems especially for patients admitted in the intensive care unit (ICU) ward. The aim of this study was to determine the incidence of nosocomial pneumonia in ICU, identify the causative bacteria and their resistance profiles. This cross sectional study was performed on 214 patients who were admitted in the ICU ward of a general hospital requiring mechanical ventilation for at least 48 h. Identification of HABP was based on the clinical signs manifested 48 h or more after admission, new chest X-ray infiltrates and microbiologic examination of endo tracheal secretion. Data were analyzed using SPSS 21 to perform the descriptive statistics. The isolated gram negative bacteria were <em>Klebsiella pneumoniae</em> (50%), <em>Staphylococcus aureus</em> (18.7%), <em>Acinetobacter baumannii</em> (12.5%), <em>Escherichia coli</em> (12.5%) and <em>Pseudomonas aeroginosa</em> (6.3%). The maximum antimicrobial resistance of gram negative bacteria was to Cefazolin (100%) and Ampicillin (84.6%), while antimicrobial resistance to Clindamycin, Azithromycin, Amoxycillin+clavulanate, Trimethoprim+sulfamethoxazole and Ciprofloxacin was 33.3%. No resistance was seen towards carbapenems.The most frequent gram negative isolated bacterium was <em>K. pneumoniae, </em>and maximum antimicrobial resistance rate was observed for Cefazolin and Ampicillin, which is due to betalactamase production.</p>

scholarly journals Increased colistin resistance of Acinetobacter species in intensive care unit-acquired infections in a tertiary care hospital

10.3823/815 ◽  
2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Sanem Karadag Gecgel ◽  
Canan Demir
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Acinetobacter Baumannii ◽  
Tertiary Care ◽  
Care Hospital ◽  
Colistin Resistance ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Resistance Rates

Background: The aim of our study was to evaluate the antimicrobial resistance rates among pathogen microorganisms especially colistin resistant rates of Acinetobacter baumannii in intensive care unit (ICU)-acquired infections and to determine infection-specific correct treatment strategies. Methods: The data of adult and newborn infant patients diagnosed with ICU-acquired infection in a tertiary education and research hospital in Bursa in 2014 and 2016 were analyzed, retrospectively. Results: Acinetobacter baumannii was the most frequent pathogen of ICU-acquired infections in 2014 and 2016. There was a significant increase in colistin (CO) resistance rates in A. baumanii (0.0%-6.8%). A significant increase in CO, cefepime (FEP), ciprofloxacin (CIP) resistance rates was established in all gram negative bacteria (0.0%-7.9%, 50.0%-91.9%, 54.7%-74.6%), respectively. A significant increase in the rate of detection of A. baumanii as the pathogen microorganism in respiratory tract infection (RTI) was established (53.9% -79.5%). In addition, the average ventilator-associated pneumonia (VIP) infection rate also increased in 2016 compared to 2014 (VIP rate 2014: 7.12, 2016: 7.45, per 1000 ventilator days). A significant decrease in the rate of detection of all gram negative microorganisms in the surgical site infection (SSI), and a significant increase in the rate of detection of all gram positive microorganisms in the SSI was determined. Conclusion: Increased antimicrobial resistance, especially increased colistin resistance rates in ICU-acquired infections, necessitates the creation of new strategies in empirical therapy. Detection of antimicrobial resistance profiles of local and infectious pathogen microorganisms in ICUs is a good guide for correct antimicrobial management.

scholarly journals National Surveillance of Antimicrobial Resistance in Pseudomonas aeruginosa Isolates Obtained from Intensive Care Unit Patients from 1993 to 2002

2004 ◽  
Vol 48 (12) ◽  
pp. 4606-4610 ◽  
Author(s):  
Marilee D. Obritsch ◽  
Douglas N. Fish ◽  
Robert MacLaren ◽  
Rose Jung
Keyword(s):  
Intensive Care Unit ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
The United States ◽  
Treatment Regimens ◽  
Ongoing Surveillance ◽  
Resistance Rates ◽  
Susceptibility Patterns ◽  
Study Database

ABSTRACT Nosocomial infections caused by Pseudomonas aeruginosa in critically ill patients are often difficult to treat due to resistance to multiple antimicrobials. The purpose of this study was to evaluate antimicrobial resistance among P. aeruginosa isolates from intensive care unit patients in the United States from 1993 to 2002 by using the Intensive Care Unit Surveillance Study database. Over the 10-year period, susceptibility of 13,999 nonduplicate isolates of P. aeruginosa was analyzed. From 1993 to 2002, nationwide increases in antimicrobial resistance were greatest for ciprofloxacin, imipenem, tobramycin, and aztreonam. Rates of multidrug resistance (resistance to ≥3 of the following drugs: ceftazidime, ciprofloxacin, tobramycin, and imipenem) increased from 4% in 1993 to 14% in 2002. The lowest dual resistance rates were observed between aminoglycosides or fluoroquinolones with piperacillin-tazobactam while the highest were for those that included β-lactams and ciprofloxacin. Ongoing surveillance studies are crucial in monitoring antimicrobial susceptibility patterns and selecting empirical treatment regimens.

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