Risk factors for nosocomial bacteraemia in intensive care units vary depending on causative agents: results of a prospective surveillance study from 2003 to 2006

2011 ◽  
Vol 79 (2) ◽  
pp. 184-185
Author(s):  
N. Khanafer ◽  
B. Allaouchiche ◽  
L. Argaud ◽  
A. Lepape ◽  
C. Guerin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Surveillance Study ◽  
Prospective Surveillance ◽  
Causative Agents

scholarly journals Risk factors for the development of hospital infections in the intensive care units

2005 ◽  
Vol 62 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Biljana Mijovic ◽  
Slavenka Jankovic ◽  
Natasa Maksimovic ◽  
Jelena Marinkovic
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Surveillance Study ◽  
Prospective Surveillance ◽  
Surgical Interventions ◽  
Endotracheal Tubes ◽  
Icu Discharge ◽  
Independent Risk Factors ◽  
Tract Infections

Background. Patients admitted to intensive-care units (ICU) are at a high risk of nosocomial infections (NI) due to susceptibility associated with severity of their condition, but also the invasive medical procedures they undergo. Aim. To determine the frequency of NI at the ICU of the General Hospital Uzice, and to identify the risk factors for their development. Methods. A prospective surveillance study of NI, conducted between June 27 and December 31 2001, included 914 patients who spent at least 24 hours in the ICU (total of 2 615 days). The surveillance of NI in the ICU was carried out daily. Follow-up period covered the time from the ICU admission to 48 hours after the ICU discharge. To assess risk factors for NI, we performed a case-control study. The variables measuring of extrinsic and intrinsic risk factors for NI were collected. Results. In a six-month prospective surveillance study, the incidence of NI was 16.7% or 58.5 per 1,000 patient-day, respectively. The most frequent were the infections of the surgery wounds (32.6%), urinary tract infections (23.5%), and infections of the blood (7.1%). The identified independent risk factors for NI were: surgical intervention (OR = 5.74; CI = 2.01-16.41), endotracheal tubes (OR = 3.40; CI = 1.07-10.89), cystoscopy (OR = 2.35; CI = 1.38- 4.02), obesity (OR = 1.98; CI = 1.27-3.11), and the duration of the infusion (OR = 1.34; CI = 1.23-1.46). Conclusions. The most important risk factors for NI at ICU were surgical interventions and endotracheal tubes.

scholarly journals A genomic epidemiology study of multidrug-resistant Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii in two intensive care units in Hanoi, Vietnam

2020 ◽  
Author(s):  
Leah W. Roberts ◽  
Le Thi Hoi ◽  
Fahad A. Khokhar ◽  
Nguyen Thi Hoa ◽  
Tran Van Giang ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
United Kingdom ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Intensive Care Units ◽  
Surveillance Study ◽  
Community Settings ◽  
Prospective Surveillance ◽  
E Coli

AbstractBackgroundVietnam has high rates of antimicrobial resistance (AMR) but limited genomic surveillance, impeding our ability to assess transmission dynamics. This study aimed to use whole genome ssequencing (WGS) to examine the transmission of key AMR pathogens in two intensive care units in Hanoi, Vietnam.MethodsA prospective surveillance study of all adults admitted to two intensive care units (ICUs) at the National Hospital for Tropical Diseases (NHTD) and Bach Mai Hospital (BMH) was conducted between June 2017 and January 2018. Clinical and environmental samples were cultured on selective media, characterised using MALDI TOF MS, and Illumina sequenced. Phylogenies based on the de novo assemblies (SPAdes) were constructed using Mafft (PARsnp), Gubbins and RAxML. Resistance genes were detected using Abricate against the NCBI database.Findings3,153 Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii isolates from 369 patients were analysed. Phylogenetic analysis revealed predominant lineages within A. baumannii (global clone [GC]2, sequence types [ST]2, ST571) and K. pneumoniae (ST15, ST16, ST656, ST11, ST147) isolates. Colonisation was most common with E. coli (88.9%) followed by K. pneumoniae (62.4%). 91% of E. coli carried a blaCTX-M variant, while 81% of K. pneumoniae isolates carried blaNDM (54%) and/or blaKPC (45%). Transmission analysis using single nucleotide polymorphisms (SNPs) identified 167 clusters involving 251 (68%) patients, in some cases involving patients from both ICUs. There were no significant differences between the lineages or AMR genes recovered between the two ICUs.InterpretationThis study represents the largest prospective surveillance study of key AMR pathogens in Vietnamese ICUs. Clusters of closely related isolates in patients across both ICUs suggests recent transmission prior to ICU admission in other healthcare settings or in the community.FundingThis work was funded by the Medical Research Council Newton Fund, United Kingdom; the Ministry of Science and Technology, Vietnam (HNQT/SPÐP/04.16) and the Wellcome Trust, United Kingdom.Research in contextEvidence before this studyGlobally, antimicrobial resistance (AMR) is projected to cause 10 million deaths annually by 2050. While 90% of these deaths are expected to occur in African and Asian low- and middle-income countries (LMIC), attributing morbidity and mortality is difficult without the availability of comprehensive AMR data in these settings. Whilst efforts have been made to improve AMR surveillance in these settings, this is often hampered by limited infrastructure, training and financial resources.Added value of this studyThis is the largest prospective surveillance study of three key AMR pathogens (E. coli, K. pneumoniae and A. baumannii) conducted in critical care settings in Vietnam. All patients were colonised or infected with one or more extended spectrum beta-lactamase (ESBL) producing and/or carbapenem-resistant organism. Colonisation with more than one organism was very common, with resistant E. coli predominantly isolated from stool. A small number of predominant lineages were identified for K. pneumoniae and A. baumannii, while the E. coli isolates were highly genetically diverse. A large number of genomic clusters were identified within the two ICUs, some of which spanned both ICUs. There were no significant differences between lineages or AMR genes between the two ICUs.Implications of all the available evidenceThis study found high rates of colonisation and infection with three key AMR pathogens in adults admitted to two Vietnamese ICUs. Whilst transmission was common within ICUs the finding of similar lineages and AMR genes in both ICUs suggests that dissemination of AMR occurs prior to ICU admission, from either referral sites or in community settings prior to hospital admission. Strategies to tackle AMR in Vietnam will need to account for this by extending surveillance beyond ICU to hospital and community settings.

Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study

2018 ◽  
Vol 57 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ferhat Arslan ◽  
Hulya Caskurlu ◽  
Sema Sarı ◽  
Hayriye Cankar Dal ◽  
Sema Turan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Absolute Risk ◽  
Subsequent Development ◽  
Bloodstream Infections ◽  
Case Control ◽  
Prior Exposure ◽  
Control Study

Abstract Candida bloodstream infections are associated with high mortality among critically ill patients in intensive care units (ICUs). Studies that explore the risk factors for candidemia may support better patient care in intensive care units. We conducted a retrospective, multicenter case-control study to investigate the risk factors for noncatheter-related Candida bloodstream infections (CBSI) in adult ICUs. Participants selected controls randomly on a 1:1 basis among all noncase patients stayed during the same period in ICUs. Data on 139 cases and 140 controls were deemed eligible. Among the controls, 69 patients died. The stratified Fine-Gray model was used to estimate the subdistribution Hazard ratios. The subdistribution hazards and 95% confidence intervals for final covariates were as follows: prior exposure to antimycotic agents, 2.21 (1.56–3.14); prior exposure to N-acetylcysteine, 0.11 (0.03–0.34) and prior surgical intervention, 1.26 (0.76–2.11). Of the patients, those exposed to antimycotic drugs, 87.1% (54/62) had breakthrough candidemia. Serious renal, hepatic, or hematologic side effects were comparable between patients those exposed and not-exposed to systemic antimycotic drugs. Untargeted administration of antimycotic drugs did not improve survival among candidemic patients (not-exposed, 63.6% [49/77]; exposed % 66.1 [41/62]; P = .899). This study documented that exposure to an antifungal agent is associated with increased the risk of subsequent development of CBSIs among nonneutropenic adult patients admitted to the ICU. Only two centers regularly prescribed N-acetylcysteine. Due to the limited number of subjects, we interpreted the positive effect of N-acetylcysteine on the absolute risk of CBSIs with caution.

scholarly journals The treatment and risk factors of retinopathy of prematurity in neonatal intensive care units

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Yunxia Leng ◽  
Wenzhi Huang ◽  
Guoliang Ren ◽  
Cheng Cai ◽  
Qingbiao Tan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Retinopathy Of Prematurity ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units
Sign in / Sign up

Export Citation Format

Share Document