scholarly journals Incidence of intravenous colistin nephrotoxicity in hospitalized patients

2020 ◽  
Author(s):  
Cristian Rosas Espinoza ◽  
◽  
José Manuel Caro Teller ◽  
Guillermo Maestro de la Calle ◽  
María Arrieta Loitegui ◽  
...  
Keyword(s):  
Cumulative Dose ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Severe Illness ◽  
Resistant Bacteria ◽  
Duration Of Treatment ◽  
Intravenous Contrast ◽  
Treatment Prevalence ◽  
End Of Treatment ◽  
Nephrotoxic Drugs

Objectives. The increase in infections with multidrug resistant bacteria has forced to return to the use of colistin, antibiotic with known nephrotoxicity. The aim of the study is to determine the incidence of colistin nephrotoxicity nowadays. Material and methods. Retrospective-observational-unicentric study was collected hospitalized patients in intravenous colistin treatment during the years 2018-2019. Nephrotoxicity was defined according to the RIFLE scale. The variables to determine it were serum creatinine (sCr) and glomerular filtration (GF). The variables analyzed were age, sex, treatment duration, loading and cumulative dose, empirical/targeted treatment, chronic kidney disease, concomitant use of intravenous contrast and nephrotoxic drugs. Results. A total of 90 patients (60% men) were included, with an average age of 58.2±18.1 years. The mean duration of treatment was 9±8.3 days, with an average cumulative dose of 69.8±71MU. There were no differences between sCr and GF at the beginning and end of treatment. The incidence of nephrotoxicity was 1.73 cases/100 days of treatment (prevalence of 15.56%). Conclusions. Colistin nephrotoxicity has an important incidence, without developing severe illness.

Procalcitonin-Guided Antibiotic Therapy Duration in Critically Ill Adults

2015 ◽  
Vol 26 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Caroline Walker
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antibiotic Therapy ◽  
Critically Ill ◽  
Bacterial Infections ◽  
Unit Length ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Control Group ◽  
Duration Of Treatment

Procalcitonin is a promising biomarker for antibiotic therapy because its levels rise and fall quickly with bacterial infections. A multi-database literature search was reviewed with 3 primary prospective randomized control trials used in further analysis. The results indicated that a procalcitonin-guided antibiotic protocol reduces the number of days a patient has to take antibiotics while having no effect on mortality when compared with control groups. Short-term studies did not show a difference in the intensive care unit length of stay, infection relapse rate, super-infection rate, or multidrug-resistant bacteria rate between the procalcitonin-protocol and control group. Because procalcitonin-guided antibiotic therapy has been shown to reduce the duration of treatment with antibiotics in critically ill patients without worsening the mortality rate or other outcomes, the implementation of a procalcitonin-guided antibiotic therapy should be considered for patients with proven or highly suspected bacterial infections in the intensive care unit.

scholarly journals Epidemiology of Multidrug-resistant Bacteria Isolated from Hospitalized Patients in a Regional Central Hospital in China

2020 ◽  
Author(s):  
Jixun Zhang ◽  
Rui Li ◽  
Zhenzhong Liu ◽  
Chao Wang
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Acinetobacter Baumannii ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Resistant Bacteria ◽  
Central Hospital ◽  
Gram Negative ◽  
E Coli ◽  
Significant Difference ◽  
The Impact

Abstract Objectives: Considering the dynamic changes of MDR, we did an up-to-date study and analyzed the impact of MDR on the outcome of patients. Design: Collected MDR isolated from hospitalized patients between June 2018 and May 2020 and performed retrospective analysis. Setting: This study was conducted in a public regional central hospital in China.Patients: 1156 patients with MDR infections.Results: Total 1291 MDRS were isolated, intensive care unit (ICU) accounted for 32.3% as the most. The main samples were sputum (75.1%) and 89.6% MDR were Gram-negative. The most common MDR were Acinetobacter baumannii, carbapenemase-producing K. pneumoniae, Pseudomonas aeruginosa, ESBL-producing E. coli. Methicillin-resistant Staphylococcus aureus (MRSA) and ESBL-producing K.pneumoniae. 35.6% were nosocomial infections and 64.4% were community-acquired infections. There was a statistically significant difference in mortality between patients infected with MDR and those with non-MDR (7.4% [32/432] vs 2.6% [17/655]; P = 0.001). The Acinetobacter baumannii and Klebsiella pneumoniae were mainly sensitive to tigecycline. The Pseudomonas aeruginosa was mainly sensitive to amikacin and levofloxacin. More than 80% of the Escherichia coli were sensitive to tigecycline and carbapenems. More than 90% of MRSA were sensitive to vancomycin, linezolid, and quinoprptin / daptoptin.Conclusions: The MDRS are mainly gram-negative bacteria. ICU contributes most MDR and pulmonary infection is the main origin of MDR. MDR infection is an independent risk factor for death. ESBL-producing Enterobacteriaceae, especially carbapenemase producing Enterobacteriaceae, should be paid more attention. This study is helpful to understand the distribution of MDR in hospital and the extent of antibiotic resistance.

scholarly journals Urinary tract infections by multidrug resistant Acinetobacter species- A Retrospective Analysis

2018 ◽  
Vol 08 (03) ◽  
pp. 017-024
Author(s):  
Prashant Mule ◽  
Niranjan Patil ◽  
Seema Gaikwad
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Resistant Bacteria ◽  
Routine Practice ◽  
Polymorphonuclear Leucocytes ◽  
Acinetobacter Species ◽  
Therapeutic Decisions ◽  
Tract Infections

Abstract Background: Acinetobacter species have emerged as important cause of nosocomial infections like pneumonia and urinary tract infections. Acinetobacter species are known to be highly resistant to commonly used antimicrobial agents. SinceAcinetobacter species are ubiquitous and have tremendous colonizing capacity, it is difficult to explain the role of Acinetobacter acquisition in the ICU and medical wards. The objective of this study was to determine the frequency of urinary tract infection (UTI) caused by different Acinetobacter species in hospitalized patients and in the community and to analyze their antimicrobial susceptibility pattern. Materials and Methods: This is a retrospective analysisfrom January 2016 to December 2017. Urine samples collected in appropriate sterile manner were screened for polymorphonuclear leucocytes and bacteria by routine microscopic examination. This was followed by plating on MacConkey's agar and Blood agar. Isolated Acinetobacter strains which are oxidase negative and non-lactose fermenters from MacConkey's agar were identified with Matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) to confirm the TM identification. Antibiotic susceptibility was performed by VitekCompact™ 2 (Biomeuriux, France) as per CLSI standards establishing MIC (Minimum Inhibitory Concentration). Results: Of the 429 isolates of Acinetobacterspecies from urinary tract, Acinetobacterbaumannii complex (78%) found to be the most common species followed by Acinetobacterjunii(10%) and Acinetobacterbaumannii(8%). Of the 334 (78%) isolates of Acinetobacterbaumannii complex from urinary tract, 73 (21.85%) isolates were resistant with doripenem, 62 (18.56%) with imipenem and 59 (17.66%) were resistant with meropenem with MIC values >=8 μg/ml. The rest of the isolates like Acinetobacterjunii, Acinetobacterjohnsonii, andAcinetobacterlwoffiiare found to be more sensitive with carbapenems with lower MIC values. Discussion: The treatment of multidrug-resistant bacteria in hospitalized patients continues to be a challenge for the clinician's in routine practice. Acinetobacter baumannii complex has proven to be an important pathogen in health care associated infections with significant mortality and morbidity. The drug resistant nature of the pathogen and its unpredictable susceptibility patterns make empirical and therapeutic decisions even more difficult. Conclusion: A. baumanniiis an important opportunistic agent of nosocomial UTI, especially in patients with longer hospitalization, antibiotic exposure, urinary catheterization and decreased immunity. High antimicrobial resistance and patient co-morbidities limit therapeutic choices. Hence, alternative therapeutic options are urgently needed to treat a patient with A. baumanniiinfection.

scholarly journals Mortality, Length of Stay, and Healthcare Costs Associated With Multidrug-Resistant Bacterial Infections Among Elderly Hospitalized Patients in the United States

2021 ◽  
Author(s):  
Richard E Nelson ◽  
David Hyun ◽  
Amanda Jezek ◽  
Matthew H Samore
Keyword(s):  
United States ◽  
Length Of Stay ◽  
Healthcare Costs ◽  
The United States ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Invasive Infections ◽  
Mortality Estimates

Abstract Background This study reports estimates of the healthcare costs, length of stay, and mortality associated with infections due to multidrug-resistant bacteria among elderly individuals in the United States. Methods We conducted a retrospective cohort analysis of patients aged ≥65 admitted for inpatient stays in the Department of Veterans Affairs healthcare system between 1/2007–12/2018. We identified those with positive cultures for multidrug-resistant bacteria and matched each infected patient to ≤10 control patients. We then performed multivariable regression models to estimate the attributable cost and mortality due to the infection. We also constructed multistate models to estimate the attributable length of stay due to the infection. Finally, we multiplied these pathogen-specific attributable cost, length of stay, and mortality estimates by national case counts from hospitalized patients in 2017. Results Our cohort consisted of 87 509 patients with infections and 835 048 matched controls. Costs were higher for hospital-onset invasive infections, with attributable costs ranging from $22 293 (95% confidence interval: $19 101–$24 485) for methicillin-resistant Staphylococcus aureus (MRSA) to $57 390 ($34 070–$80 710) for carbapenem-resistant (CR) Acinetobacter. Similarly, for hospital-onset invasive infections, attributable mortality estimates ranged from 14.2% (12.2–16.2%) for MRSA to 24.1% (12.1–36.0%) for CR Acinetobacter. The aggregate cost of these infections was an estimated $1.9 billion ($1.3 billion–$2.5 billion) with 11 852 (8719–14 985) deaths and 448 224 (354 513–541 934) inpatient days in 2017. Conclusions Efforts to prevent these infections due to multidrug-resistant bacteria could save a significant number of lives and healthcare resources.

scholarly journals Effectiveness of essential oil from the Artemisia herba-alba aerial parts against multidrug-resistant bacteria isolated from food and hospitalized patients

2021 ◽  
Vol 22 (7) ◽  
Author(s):  
Abdelaziz Ed-Dra ◽  
Fouzia Rhazi Filali ◽  
Vittorio Lo Presti ◽  
Badr Zekkori ◽  
Luca Nalbone ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Gas Chromatography ◽  
Antioxidant Activity ◽  
Essential Oil ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
World Health ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Aerial Parts

Abstract. Ed-Dra A, Filali FR, Presti VL, Zekkori B, Nalbone L, Elsharkawy ER, Bentayeb A, Giarrtana F. 2021. Effectiveness of essential oil from the Artemisia herba-alba aerial parts against multidrug-resistant bacteria isolated from food and hospitalized patients. Biodiversitas 22: 2995-3005. The World Health Organization has sounded the warning on the diffusion of multidrug resistance (MDR) bacteria, requiring solutions and alternatives to solve the therapeutic failure that may occur. This study aims to evaluate the antioxidant activity and bactericidal effectiveness against MDR bacteria of Artemisia herba-alba essential oil (A-EO) collected from semi-arid region of Morocco. Chemical composition of the A-EO was determined by Gas Chromatography-Flame Ionisation Detector and Gas Chromatography-Mass Spectrometry, while the antioxidant activity was performed by DPPH scavenging activity and ?-carotene bleaching assay. Antibacterial activity of A-EO, performed by disc diffusion assay and broth dilution method, was tested against: four MDR strains (Escherichia coli, Staphylococcus aureus, Salmonella Typhimurium and Enterococcus faecalis) isolated from food matrices, two (Klebsiella pneumonia and Pseudomonas aeruginosa) from hospitalized patients, and Escherichia coli ATCC 25922 as reference strain. Davanone was the main compound among the 17 identified. An antioxidant activity with IC50 of 1.13±0.02 mg/mL, EC50 of 2.12±0.05 mg/mL and RC50 of 0.87±0.02 mg/mL was observed. A weak activity against P. aeruginosa was observed, while it was intermediate or high against the other bacteria. This study confirms that A-EO could be a suitable alternative to antibiotics in the infection treatment related to MDR bacteria.

Sign in / Sign up

Export Citation Format

Share Document