scholarly journals Frequency and characteristics of multi-resistant bacteria in the intensive care unit

2021 ◽  
Vol 5 (8) ◽  
pp. 13-18
Author(s):  
Darija Knežević ◽  
Silvana Trifunović ◽  
Duška Jović ◽  
Jadranka Stanisavić-Šimić
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Multidrug Resistant ◽  
Incidence Density ◽  
Resistant Bacteria ◽  
Microbiological Methods ◽  
Surgical Icus ◽  
One Year ◽  
Tract Infections

Introduction: Patients in intensive care units (ICUs) are at higher risk of infections due to invasive procedures and antibiotic therapy. Infections caused by multidrug-resistant (MDR) bacteria represent a global problem, limiting the choice of antimicrobial therapy. Objective: To determine the rate of infections in ICUs, as well as the type of MDR bacteria associated with such infections. Material and methods: The study included strains of MDR bacteria isolated from laboratory samples of hospitalized patients in surgical ICUs in a one-year period. All strains of MDR bacteria were isolated and identified by standard microbiological methods for aerobic bacteria according to the recommendations and guidelines are given by the Clinical and Laboratory Standards Institute (CLSI). Results: Infections caused by MDR bacterial isolates were confirmed in 199 (19.17%) patients in ICUs. The frequency of Gram-negative isolates was significantly higher than Gram-positive (88.35% and 11.65%, p <0.001). The most common infections in ICUs caused by MDR bacteria were respiratory tract infections (49%), followed by soft tissue and skin infections. The CDI incidence density 1.13 cases/10,000 patient-days. Conclusion: A high frequency of infections caused by MDR bacteria was found with patients in ICUs, and respiratory tract infections dominated. Information on the types of infections and pathogens can help develop policies for prevention, diagnosis, treatment, and resource allocation.

scholarly journals Burden of multidrug resistant respiratory pathogens in intensive care units of tertiary care hospital

2019 ◽  
Vol 10 (2) ◽  
pp. 14-19 ◽  
Author(s):  
Dharm Raj Bhatta ◽  
Deependra Hamal ◽  
Rajani Shrestha ◽  
Supram HS ◽  
Pushpanjali Joshi ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Intensive Care Units ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Bacterial Pathogens ◽  
Multidrug Resistant ◽  
Lower Respiratory Tract Infections ◽  
Acinetobacter Species ◽  
Tract Infections

Background: Lower respiratory tract infections are one of the most common infections among the patients in Intensive Care Units (ICUs). Admission in ICUs and use of life supporting devices increase the risk of infection with multidrug resistant pathogens. Aims and Objectives: This study was aimed to determine the prevalence and antibiograms ofthe bacterial pathogens causing lower respiratory tract infectionsamong patients of ICUs. Materials and Methods: A total of 184 specimens from patients admitted in ICUswith lower respiratory tract infections were included in this study. Isolation, identification and antibiotic susceptibility testing of the isolates was performed by standard microbiological techniques. Carbapenamase detection was performed by modified Hodge test method.Detection of metallo beta lactamase (MBL) was tested by imipenem and imipenem/EDTA disc. Detection of Klebsiellapneumoniaecarbapenamase (KPC) was performed by imipenem and imipenem/phenyl boronic acid. Results: Out of 184 samples, 131 showed significant growth of bacterial pathogens. Acinetobacter species (42.6%), Staphylococcus aureus (16.9%) and Pseudomonasaeruginosa(13.9%)were the three most common isolates. Out of 22 imipenem resistant isolates of Acientobacter species, 9 were KPC producer, 4 were MBL producers and 3 isolates were positive for MBL and KPC both. Among the Acinetobacter species, 5.1% isolates were resistant to tigecycline and colistin. One isolate of Pseudomonas aeruginosa was positive for MBL. Conclusions:High prevalence of multidrug resistant bacteria in ICUs was recorded. Gram negative bacilli were predominantly associated with LRTI among ICU patients;Acinetobacterspecies being most common isolate. Detection of carbapenamase among the Acinetobacterand emergence of tigecycline resistancelimits the therapeutic options.Regular monitoring of such resistant isolates would be important for managing infection control in critical units.

scholarly journals Impact of immunosuppression on incidence, aetiology and outcome of ventilator-associated lower respiratory tract infections

2018 ◽  
Vol 51 (3) ◽  
pp. 1701656 ◽  
Author(s):  
Anne-Sophie Moreau ◽  
Ignacio Martin-Loeches ◽  
Pedro Povoa ◽  
Jorge Salluh ◽  
Alejandro Rodriguez ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Multidrug Resistant ◽  
Hazard Ratio ◽  
Resistant Bacteria ◽  
Ventilator Associated Pneumonia ◽  
Immunocompromised Patients ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

The aim of this planned analysis of the prospective multinational TAVeM database was to determine the incidence, aetiology and impact on outcome of ventilator-associated lower respiratory tract infections (VA-LRTI) in immunocompromised patients.All patients receiving mechanical ventilation for >48 h were included. Immunocompromised patients (n=663) were compared with non-immunocompromised patients (n=2297).The incidence of VA-LRTI was significantly lower among immunocompromised than among non-immunocompromised patients (16.6% versus 24.2%; sub-hazard ratio 0.65, 95% CI 0.53–0.80; p<0.0001). Similar results were found regarding ventilator-associated tracheobronchitis (7.3% versus 11.6%; sub-hazard ratio 0.61, 95% CI 0.45–0.84; p=0.002) and ventilator-associated pneumonia (9.3% versus 12.7%; sub-hazard ratio 0.72, 95% CI 0.54–0.95; p=0.019). Among patients with VA-LRTI, the rates of multidrug-resistant bacteria (72% versus 59%; p=0.011) and intensive care unit mortality were significantly higher among immunocompromised than among non-immunocompromised patients (54% versus 30%; OR 2.68, 95% CI 1.78–4.02; p<0.0001). In patients with ventilator-associated pneumonia, mortality rates were higher among immunocompromised than among non-immunocompromised patients (64% versus 34%; p<0.001).Incidence of VA-LRTI was significantly lower among immunocompromised patients, but it was associated with a significantly higher mortality rate. Multidrug-resistant pathogens were more frequently found in immunocompromised patients with VA-LRTI.

scholarly journals Bacterial Multidrug Resistant Patterns Associated with Intensive Care Unit Infections in Akum, Cameroon

2020 ◽  
pp. 13-21
Author(s):  
Asakizi Augustine Nji ◽  
Forcham Emmanuel Duna
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Klebsiella Species ◽  
Microbiological Methods ◽  
Tract Infections ◽  
Hospital Associated Infections

Background: Patients admitted into the intensive care unit (ICU) usually have impaired immunity and are therefore at high risk of acquiring hospital associated infections. Infections caused by multidrug resistant bacteria now constitute a major problem, limiting the choice of antimicrobial therapy. Objectives: This study was aimed at determining the antimicrobial resistance pattern of pathogens causing ICU infections at the Catholic Holy Family Hospital Akum-Bamenda. The etiological agents, prevalence and types ICU infections were also determined. Methods: Thirteen months hospital associated infections surveillance was conducted in the hospital for patients admitted into ICU. Blood, urine, tracheal aspirate and wound biopsies specimens were collected under strict asepsis and sent to the Medical Microbiology laboratory of the same institution for immediate processing. All pathogens were isolated and identified by standard microbiological methods. Disk diffusion antibiotic susceptibility testing was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: The overall prevalence of ICU infections was 30.9% out of which 12.9% were bloodstream infections, 31.5% urinary tract infections, 38.9% pneumonia, and 16.7% skin and soft tissue infections. Klebsiella species and Escherichia coli were the predominant pathogens. Multidrug resistant organisms constituted 59.3% of the pathogens, MDR Klebsiella spp and MDR E. coli were 70.8% and 71.4% respectively. Resistance to Cefuroxime was the highest (92.9%) while Meropenem had the least resistance (21.4%). Conclusion: There is a high prevalence of multidrug resistant bacteria causing ICU infections.  With the advent of covid-19, infection control procedures and institution of functional antimicrobial stewardship are needed to be put in place in order to cover come this herculean task.

scholarly journals The Acquisition of Multidrug-Resistant Bacteria in Patients Admitted to COVID-19 Intensive Care Units: A Monocentric Retrospective Case Control Study

2020 ◽  
Vol 8 (11) ◽  
pp. 1821
Author(s):  
Elisa G. Bogossian ◽  
Fabio S. Taccone ◽  
Antonio Izzi ◽  
Nicolas Yin ◽  
Alessandra Garufi ◽  
...  
Keyword(s):  
Intensive Care ◽  
Risk Analysis ◽  
Case Control Study ◽  
Multidrug Resistant ◽  
Case Control ◽  
Incidence Density ◽  
Resistant Bacteria ◽  
Competing Risk Analysis ◽  
Multidrug Resistant Bacteria ◽  
Control Study

Whether the risk of multidrug-resistant bacteria (MDRB) acquisition in the intensive care unit (ICU) is modified by the COVID-19 crisis is unknown. In this single center case control study, we measured the rate of MDRB acquisition in patients admitted in COVID-19 ICU and compared it with patients admitted in the same ICU for subarachnoid hemorrhage (controls) matched 1:1 on length of ICU stay and mechanical ventilation. All patients were systematically and repeatedly screened for MDRB carriage. We compared the rate of MDRB acquisition in COVID-19 patients and in control using a competing risk analysis. Of note, although we tried to match COVID-19 patients with septic shock patients, we were unable due to the longer stay of COVID-19 patients. Among 72 patients admitted to the COVID-19 ICUs, 33% acquired 31 MDRB during ICU stay. The incidence density of MDRB acquisition was 30/1000 patient days. Antimicrobial therapy and exposure time were associated with higher rate of MDRB acquisition. Among the 72 SAH patients, 21% acquired MDRB, with an incidence density was 18/1000 patient days. The septic patients had more comorbidities and a greater number of previous hospitalizations than the COVID-19 patients. The incidence density of MDRB acquisition was 30/1000 patient days. The association between COVID-19 and MDRB acquisition (compared to control) risk did not reach statistical significance in the multivariable competing risk analysis (sHR 1.71 (CI 95% 0.93–3.21)). Thus, we conclude that, despite strong physical isolation, acquisition rate of MDRB in ICU patients was at least similar during the COVID-19 first wave compared to previous period.

Effectiveness of Oral Rinse with Chlorhexidine in Preventing Nosocomial Respiratory Tract Infections among Intensive Care Unit Patients

2009 ◽  
Vol 30 (10) ◽  
pp. 952-958 ◽  
Author(s):  
Fernando Bellissimo-Rodrigues ◽  
Wanessa Teixeira Bellissimo-Rodrigues ◽  
Jaciara Machado Viana ◽  
Gil Cezar Alkmim Teixeira ◽  
Edson Nicolini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Respiratory Tract Infections ◽  
Icu Patients ◽  
Oral Application ◽  
Tract Infections

Objective.To evaluate the effectiveness of the oral application of a 0.12% solution of Chlorhexidine for prevention of respiratory tract infections among intensive care unit (ICU) patients.Design.The study design was a double-blind, randomized, placebo-controlled trial.Setting.The study was performed in an ICU in a tertiary care hospital at a public university.Patients.Study participants comprised 194 patients admitted to the ICU with a prospective length of stay greater than 48 hours, randomized into 2 groups: those who received Chlorhexidine (n = 98) and those who received a placebo (n = 96).Intervention.Oral rinses with Chlorhexidine or a placebo were performed 3 times a day throughout the duration of the patient's stay in the ICU. Clinical data were collected prospectively.Results.Both groups displayed similar baseline clinical features. The overall incidence of respiratory tract infections (RR, 1.0 [95% confidence interval [CI], 0.63-1.60]) and the rates of ventilator-associated pneumonia per 1,000 ventilator-days were similar in both experimental and control groups (22.6 vs 22.3; P = .95). Respiratory tract infection-free survival time (7.8 vs 6.9 days; P = .61), duration of mechanical ventilation (11.1 vs 11.0 days; P = .61), and length of stay (9.7 vs 10.4 days; P = .67) did not differ between the Chlorhexidine and placebo groups. However, patients in the Chlorhexidine group exhibited a larger interval between ICU admission and onset of the first respiratory tract infection (11.3 vs 7.6 days; P = .05). The chances of surviving the ICU stay were similar (RR, 1.08 [95% CI, 0.72-1.63]).Conclusion.Oral application of a 0.12% solution of Chlorhexidine does not prevent respiratory tract infections among ICU patients, although it may retard their onset.

A Potential Infection Hazard Associated with the Use of Disposable Saline Vials

1984 ◽  
Vol 5 (4) ◽  
pp. 170-172 ◽  
Author(s):  
William A. Rutala ◽  
Marsha M. Stiegel ◽  
Felix A. Sarubbi
Keyword(s):  
Intensive Care ◽  
Respiratory Tract ◽  
Intensive Care Units ◽  
Respiratory Tract Infections ◽  
Respiratory Therapy ◽  
Streptococcus Viridans ◽  
The Past ◽  
Skin Contact ◽  
Tract Infections

AbstractNosocomial respiratory tract infections have occasionally been associated with contaminated respiratory therapy devices and techniques. In the past two years, our hospital purchased disposable saline squeeze vials for use during suctioning of intubated patients. These vials have a cap which must be flipped or twisted-off by the user before the contents can be instilled into the patient's respiratory tract. We observed use of this item in our intensive care units (ICU) and studied the potential for contamination. ICU nurses use ungloved hand(s) to flip or twist-off squeeze vial cups resulting in skin contact with the vial opening. Cultures of nurses' hands and squeeze vial contents were obtained in the ICU where 24 nurses opened 92 vials in the manner previously described. Twenty-three percent of vial contents were contaminated and cultures revealed S. epidermidis, S. aureus, Streptococcus viridans and enterococcus. On six occasions, organisms recovered from vial contents were believed to be identical to organisms isolated from the hands of the nurse who opened the vial. When nurses used care in removing the saline vial cap, cultures of vial contents were sterile.

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