scholarly journals A Fatal Bloodstream Infection byStaphylococcus pettenkoferiin an Intensive Care Unit Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Caterina Mammina ◽  
Celestino Bonura ◽  
Maria Stella Verde ◽  
Teresa Fasciana ◽  
Daniela Maria Palma
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Patient ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Fatal Case ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococci

Coagulase negative staphylococci are increasingly recognized as leading pathogens in bacteremia, with incidence peaking in intensive care units. Interpretation of blood cultures that are positive for CoNS is often doubtful. We describe a fatal case of bacteremia by a newly recognized species of CoNS,Staphylococcus pettenkoferi, in an ICU patient.

scholarly journals 265. Blood culture results pre- and post- antimicrobial administration in the Medicine Intensive Care Unit: a retrospective study in South Bronx

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S131-S132
Author(s):  
Chia-Yu Chiu ◽  
Amara Sarwal ◽  
Addi Feinstein
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Culture ◽  
Blood Cultures ◽  
Antibiotic Administration ◽  
Culture Result ◽  
Blood Culture Result ◽  
South Bronx ◽  
Coagulase Negative Staphylococci ◽  
Before And After

Abstract Background It is intuitive that obtaining blood cultures prior to administering antibiotics can increase the likelihood of a positive blood culture result. Surviving Sepsis Campaign Hour-1 bundle stipulates that obtaining a blood culture and administering antibiotics within 1 hour is a critical determinant of survival. However, the diagnostic sensitivity shortly after antibiotic administration remains unknown. In clinical practice, some health care providers delay antibiotic administration in order to first obtain a blood culture. Methods Adult patients (> 18 years of age) admitted to the Medicine Intensive Care Unit in Lincoln Medical Center, located in South Bronx, New York City, from 09/2019 to 12/2019. Patients needed to have at least one blood culture obtained within 12 hours of admission and have received intravenous antibiotics during the admission to the Medicine Intensive Care Unit. Results Of 327 patients screened, 196 met enrolment criteria and 253 sets of blood cultures underwent analysis. Blood cultures grew bacteria in 21.8% of pre-antimicrobial group whereas 26.9% in post-antimicrobial group (p=0.37). 25.9% of patients received antibiotics within 1 hour before blood culture sampling, while 34.0% of patients received antibiotics >1 hour prior to obtaining blood culture. Blood culture results positive for coagulase-negative staphylococci were more prevalent in the pre-antimicrobial group. Table 1. Patient Characteristics Table 2. Number of blood cultures obtained and blood culture result Table 3. Initial antimicrobial agent and 30-day mortality Conclusion In the sequence of blood culture and antibiotic administration, there is no 30-day survival difference in pre-antimicrobial group and post-antimicrobial group (p=0.15), as long as both received antibiotics within 12 hours of coming to the hospital. Coagulase-negative staphylococci were higher in the pre-antimicrobial group which may indicate that the health care provider hastily obtained the blood culture in a non-sterile manner. Antibiotic administration should not be delayed because of pending blood culture collection. In addition, given that more than 70% of patients were ultimately found to have negative blood cultures, it would be useful to develop practical tools to identify low-risk patients that can be treated without obtaining blood culture, as the blood culture would not be likely to provide diagnostic information. Figure 1: Hours Before and After IV Antibiotic Started Figure 2: Distribution of Blood Culture Before and After IV Antibiotics Disclosures All Authors: No reported disclosures

scholarly journals Persistence of Clones of Coagulase-Negative Staphylococci among Premature Neonates in Neonatal Intensive Care Units: Two-Center Study of Bacterial Genotyping and Patient Risk Factors

1998 ◽  
Vol 36 (9) ◽  
pp. 2485-2490 ◽  
Author(s):  
Clementien L. Vermont ◽  
Nico G. Hartwig ◽  
André Fleer ◽  
Peter de Man ◽  
Henri Verbrugh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
The Netherlands ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Blood Cultures ◽  
Neonatal Intensive Care Units ◽  
Bacterial Isolates ◽  
Coagulase Negative Staphylococci ◽  
Children's Hospital

From 1 January 1995 until 1 January 1996, we studied the molecular epidemiology of blood isolates of coagulase-negative staphylococci (CoNS) in the Neonatal Intensive Care Units (NICUs) of the Sophia Children’s Hospital (SCH; Rotterdam, The Netherlands) and the Wilhelmina Children’s Hospital (WCH; Utrecht, The Netherlands). The main goal of the present study was to detect putatively endemic clones of CoNS persisting in these NICUs. Pulsed-field gel electrophoresis was used to detect the possible presence of endemic clones of clinical significance. In addition, clinical data of patients in the SCH were analyzed retrospectively to identify risk factors for the acquisition of positive blood cultures. In both centers, endemic CoNS clones were persistently present. Thirty-three percent of the bacterial isolates derived from blood cultures in the SCH belonged to a single genotype. In the WCH, 45% of all bacterial strains belonged to a single clone. These clones were clearly different from each other, which implies that site specificity is involved. Interestingly, we observe that the clonal type in the SCH differed significantly from the incidentally occurring strains with respect to both the average pH and partial CO2 pressure of the patient’s blood at the time of bacterial culture. We found that the use of intravascular catheters, low gestational age, and a long hospital stay were important risk factors for the development of a putative CoNS infection. When the antibiotic susceptibility of the bacterial isolates was assessed, a clear correlation between the nature of the antibiotics most frequently used as a first line of defense versus the resistance profile was observed. We conclude that the intensive use of antibiotics in an NICU setting with highly susceptible patients causes selection of multiresistant clones of CoNS which subsequently become endemic.

scholarly journals Health vigilance concerning bacteremia in neonatology - neonatal intensive care unit at the Mohammed VI University Hospital of Oujda (Morocco): epidemiological profile and antibiotic resistance

2021 ◽  
Vol 319 ◽  
pp. 01011
Author(s):  
Loubna Yacoubi ◽  
Soumia Farih ◽  
Abderazzak Seddari ◽  
Noussaiba Benhamza ◽  
Adnane Aarab ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Blood Cultures ◽  
University Hospital ◽  
Coagulase Negative Staphylococci ◽  
Hygiene Measures ◽  
Epidemiological Profile

The objective of our study was to describe the epidemiological profile of blood culture isolates in the neonatology - neonatal intensive care unit of the Mohammed VI University Hospital of Oujda (Morocco) and to specify the resistance profile of the main germs isolated to antibiotics .This is a retrospective and descriptive study of 21 months from December 14, 2016 to September 14, 2018 and covering all positive blood cultures processed in the microbiology laboratory in accordance with REMIC (reference in medical microbiology) and EUCAST (European Committee on Antimicrobial Susceptibility Testing).contaminated blood cultures were excluded. As results, we collected 275 positive blood cultures. They occurred in the context of intravascular device (IVD) use in 59% (n=162) of cases. The most isolated bacterial groups were coagulase-negative staphylococci (CNS) 41.45 %( n=114), followed by Enterobacteriaceae 32.36 %( n=89).CNS were resistant to all beta-lactams in 57.89 %( n=66), and to glycopeptides in 5.26 %( n=6). Enterobacteriaceae were producers of extended-spectrum betalactamases in 79.77% (n=71) and producers of carbapenemases in 13.48% (n=12) of cases. The alarming increase of enterobacteriaceae isolates and their antibiotic resistance rates should encourage the reinforcement of hygiene measures in our University Hospital.

scholarly journals Mining of a Clinical Database: The Interpretation of Intense Serial Procalcitonin in the Prediction for Bloodstream Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhiyi Jiang ◽  
Ning Liu ◽  
Luhao Wang ◽  
Jianfeng Wu ◽  
Xiangdong Guan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Bloodstream Infection ◽  
Critically Ill Patients ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Blood Cultures ◽  
Clinical Database ◽  
Positive Groups

Background: Procalcitonin (PCT) is a promising biomarker for predicting infection. Bloodstream infection (BSI) is usually a deteriorating stage of sepsis. The purpose of this study was to explore the predictive value of intense serial PCT assays for BSI in the intensive care unit (ICU).Methods: This study was a retrospective study based on a clinical database. We analyzed the data of critically ill patients from February 2016 to May 2020. The patients who received PCT assays and blood cultures (BCs) were classified into four groups according to the BCs: (i) BC negative, (ii) bacteria positive, (iii) fungi-positive, and (iv) combined-positive, and the patients with bacteremia were further subdivided into Gram+ and Gram– bacteremia.Results: The database included 11,219 patients. There were 3,593 patients who met the criteria for the analysis. The PCT concentration differed significantly across BC groups (p < 0.0001). The fluctuation of PCT significantly increased in the BC positive groups (p < 0.0001). According to the receiver operating characteristic (ROC), the optimum cutoff of the fluctuation of PCT was around 8 ng/ml for predicting BSI.Conclusion: Our study indicated that the fluctuation of PCT could be an indicator for screening BSI, but less accurate for Gram-positive infections. With a fluctuation of PCT less than 8 ng/ml, BSI should not be a rational cause for sepsis exacerbating.

scholarly journals Infecções da corrente sanguínea em unidade de terapia intensiva: estudo retrospectivo em um hospital de ensino

2019 ◽  
Vol 87 (25) ◽  
Author(s):  
Betina Brixner ◽  
Nayanna Dias Bierhals ◽  
Caio Fernando de Oliveira ◽  
Jane Dagmar Pollo Renner
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Heart Diseases ◽  
Blood Cultures ◽  
Coagulase Negative Staphylococcus ◽  
Resistance Profile ◽  
History Of ◽  
Terapia Intensiva

O objetivo deste estudo foi verificar os fatores de risco e perfil epidemiológico dos pacientes diagnosticados com infecçãode corrente sanguínea, bem como os microrganismos responsáveis pela infecção. Estudo transversal, em que foi realizadoum levantamento das hemoculturas e dados dos pacientes internados em unidade de terapia intensiva adulto com diagnóstico de infecção de corrente sanguínea, durante o ano de 2016. Foram coletadas informações referente ao paciente esua internação, bem como ao agente responsável pela infecção e seu perfil de resistência. Foram incluídas 24 hemoculturaspositivas para crescimento bacteriano. A média de idade dos pacientes foi de 53,9±21,1 anos e 54,5% dos pacientes acometidos pela infecção eram homens. Dos pacientes, 59,1% apresentavam histórico de doença cardíaca, sendo que destes,63,6% foram a óbito. As bactérias Gram positivas foram mais relacionadas com a infecção, em que 54,2% eram Staphylococcus coagulase negativa e destes, 76,9% foram resistentes meticilina. Identificou-se que o sexo masculino, indivíduos idosos e com histórico de alguma comorbidades prévia, com destaque para as doenças cardíacas, foram os mais acometidoscom bacteremia. Quanto ao agente bacteriano responsável pela infecção, o Staphylococcus coagulase negativa foi o maisrelacionado aos casos diagnosticados, bem como o seu alto perfil de resistência deste microrganismo frente a meticilina.Palavras-chave: Bacteremia; Fatores de Risco; Diagnóstico; Unidade de Terapia Intensiva. ABSTRACTThe objective of this study was to verify the risk factors and epidemiological profile of the patients diagnosed with bloodstream infection, as well as the microorganisms responsible for the infection. A cross-sectional study was carried out inwhich blood cultures were collected and data were collected from patients admitted to an adult intensive care unit with adiagnosis of bloodstream infection during the year 2016. Information about the patient and hospitalization was collected,as well as the agent responsible for the infection ‘and its resistance profile. 24 blood cultures positive for bacterial growthwere included. The mean age of the patients was 53.9±21.1 years and 54.5% of the patients affected by the infection weremen. Of the patients, 59.1% had a history of heart disease, of which 63.6% died. Gram positive bacteria were more relatedto infection, in which 54.2% were coagulase negative Staphylococcus and of these, 76.9% were resistant to methicillin. Itwas identified that the male sex, elderly individuals and with history of some previous comorbidities, especially heart diseases, were the most affected with bacteremia. As for the bacterial agent responsible for the infection, Coagulase negativeStaphylococcus was the most related to the diagnosed cases, as well as its high resistance profile of this microorganismagainst methicillin.Keywords: Bacteremia; Risk factors; Diagnosis; Intensive Care Unit.

Parameters of bed occupancy of intensive care units in Hungary

2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Insurance ◽  
Intensive Care Units ◽  
Emergency Care ◽  
Present Author ◽  
Bed Occupancy ◽  
National Network ◽  
Bed Capacity

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.

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