Analysis of antimicrobial resistance among gram-negative bacilli and antimicrobial use in intensive care unit patients for 5 years in a veterans affairs medical center

2002 ◽  
Vol 30 (7) ◽  
pp. 411-416 ◽  
Author(s):  
Chris Gentry ◽  
Dayl J. Flournoy ◽  
Richard Reinert
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Medical Center ◽  
Veterans Affairs ◽  
Antimicrobial Use ◽  
Gram Negative

Antimicrobial Use and Resistance Among Gram-negative Bacilli in an Italian Intensive Care Unit (ICU)

2006 ◽  
Vol 18 (3) ◽  
pp. 261-267 ◽  
Author(s):  
M. Bassetti ◽  
M. Cruciani ◽  
E. Righi ◽  
B. Rebesco ◽  
R. Fasce ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antimicrobial Use ◽  
Gram Negative

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 Risk of Acquiring Extended-Spectrumβ-Lactamase–ProducingKlebsiellaSpecies andEscherichia colifrom Prior Room Occupants in the Intensive Care Unit

2013 ◽  
Vol 34 (5) ◽  
pp. 453-458 ◽  
Author(s):  
Adebola O. Ajao ◽  
J. Kristie Johnson ◽  
Anthony D. Harris ◽  
Min Zhan ◽  
Jessina C. McGregor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Center ◽  
Bacterial Species ◽  
Academic Medical Center ◽  
Gram Negative Bacteria ◽  
Icu Patients ◽  
Gram Negative ◽  
Colonization Pressure ◽  
Icu Length Of Stay

Objective.To quantify the association between admission to an intensive care unit (ICU) room most recently occupied by a patient positive for extended-spectrumβ-lactamase (EBSL)-producing gram-negative bacteria and acquisition of infection or colonization with that pathogen.Design.Retrospective cohort study.Setting and Patients.The study included patients admitted to medical and surgical ICUs of an academic medical center between September 1, 2001, and June 30, 2009.Methods.Perianal surveillance cultures were obtained at admission to the ICU, weekly, and at discharge from the ICU. Patients were included if they had culture results that were negative for ESBL-producing gram-negative bacteria at ICU admission and had an ICU length of stay longer than 48 hours. Pulsed-field gel electrophoresis (PFGE) was performed on ESBL-positive isolates from patients who acquired the same bacterial species (eg,Klebsiellaspecies orEscherichia coli) as the previous room occupant.Results.Among 9, 371 eligible admissions (7, 651 unique patients), 267 (3%) involved patients who acquired an ESBL-producing pathogen in the ICU; of these patients, 32 (12%) were hospitalized in a room in which the prior occupant had been positive for ESBL. Logistic regression results suggested that the prior occupant's ESBL status was not significantly associated with acquisition of an ESBL-producing pathogen (adjusted odds ratio, 1.39 [95% confidence interval, 0.94-2.08]) after adjusting for colonization pressure and antibiotic exposure in the ICU. PFGE results suggested that 6 (18%) of 32 patients acquired a bacterial strain that was the same as or closely related to the strain obtained from the prior occupant.Conclusions.These data suggest that environmental contamination may not play a substantial role in the transmission of ESBL-producing pathogens among ICU patients. Intensifying environmental decontamination may be less effective than other interventions in preventing transmission of ESBL-producing pathogens.

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.

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