Bacteraemia in Intensive Care Unit: Clinical, Bacteriological, and Prognostic Prospective Study (original) (raw)
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Research Article Bacteraemia in Intensive Care Unit: Clinical, Bacteriological
2020
Objectives. We conducted a one-year observational study from December 2012 to November 2013 to describe the epidemiology of bacteraemia in intensive care units (ICU) of Mohammed V Military Teaching Hospital of Rabat (Morocco). Methods. The study consisted of monitoring all blood cultures coming from intensive care units and studying the bacteriological profile of positive blood cultures as well as their clinical significance. Results. During this period, a total of 46 episodes of bacteraemia occurred, which corresponds to a rate of 15,4/1000 patients. The rate of nosocomial infections was 97% versus 3% for community infections. The most common source of bacteraemia was the lungs in 33%, but no source was identified in 52% of the episodes. Gram negative organisms were isolated in 83,6% of the cases with Acinetobacter baumannii being the most frequent. Antibiotic resistance was very high with 42,5% of extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and 100% of carbapen...
European Journal of Microbiology and Immunology
Introduction Bacteremia is responsible for high rates of morbidity and mortality. The increasing prevalence of multidrug-resistant (MDR) bacteria in intensive care units (ICU) is a growing concern. Hence, prior knowledge of bacterial epidemiology and resistance phenotypes is required to optimize these infections' management. The objective of this study was to determine the epidemiological profile of bacteremia in ICU settings, as well as the place occupied by MDR bacteria in these infections. Methods It is a prospective study carried out over 10 months on episodes of bacteremia in the ICU of Mohammed V Military Teaching Hospital (Rabat, Morocco). Microorganism growth was detected using fluorescent technology, species identification was based on morphological and biochemical characteristics. Antimicrobial susceptibility testing was performed following the recommendations of the Antibiogram Committee of the French Society of Microbiology (CA-SFM) and the European Committee on Anti...
Aim: Blood stream infections are common in critically sick patients and the clinicians have to use antibiotics to manage. The susceptibility of the microorganisms varies widely from institution to institution, and from country to country. This study was carried out to document the distribution and antimicrobial susceptibility patterns of bloodstream bacterial infections over a six-month period in the medical and surgical intensive care units (ICUs) at NRI Academy of Medical Sciences, in the Southern Region of India. Methodology: This was a retrospective study conducted from June 2020 to December 2020. The study included all patients of either gender, aged above 18 years, admitted in the medical and surgical ICUs for whom blood specimens for culture were positive for BSI. The data for each of the ICUs was compared separately for the type and the number of isolates. The antibiotic susceptibility was assessed for both the ICUs together. The data was analysed using the Medcalc® software. Results: Medical and surgical intensive care units had 103 and 30 culture positive cases respectively. Among the culture positive cases, fermentive and non-fermentive gram-negative were equally isolated at 51 (38.3%) samples each and 31(23.3%) were gram-positive organisms. Altogether, Acinetobacter (20.3%) was the major isolate followed by E. coli (14.2%) and Klebsiella (13.5%). Acinetobacter was most sensitive to colistin (70.4%) followed by levofloxacin (63.0%) and tigecycline (55.6%). E. coli were sensitive to colistin and tigecycline, (100%), followed by amikacin (78.9%), meropenem (68.4%), gentamicin (63.2%). Similar sensitivity was observed for Klebsiella. Conclusion: This study highlights the predominance of gram-negative bacteria in the ICUs and the emergence of multidrug resistant organisms and higher rate of antimicrobial resistance among gram-negative and gram-positive organisms which is an alarming issue. The knowledge of the pathogens causing BSIs in the ICUs and their antibiotic sensitivity patterns can be of help to the clinicians in choosing appropriate empiric antimicrobial therapy. Appropriate empiric therapy is key for decreasing the length of hospital stay and mortality associated with severe sepsis and septic shock associated with blood stream infection in the ICUs.
BioSight
Aim: To determine the prevalence and antibiotic susceptibility pattern of microorganisms in the ICU patients of a tertiary care facility in Karachi, Pakistan. Method: A retrospective study was conducted on the laboratory records of 50 patients with positive culture admitted to a tertiary care facility. A structured questionnaire was used to obtain patients’ records comprising of their name, sex, age, diagnosis, sample source, isolated pathogen culture results and antibiotic susceptibility patterns. Blood, tracheal fluid, urine, sputum, pus, peritoneal fluid and catheter tips were included as specimen sources. Total 94% patients selected had clinically suspected nosocomial infections. Results: Overall, 45% of them had traumatic brain or spinal injury followed by 35% of post-operative cases, 10% respiratory disease related patients, 6% cardiac patients, 2% renal failure and 2% with miscellaneous infections. Majority of the patients admitted to the ICU were in the age range 51- 65 year...
Five-Years Bacteremia Surveillance in the Intensive Care Unit
Kocaeli Medical Journal
Objective: Intensive care units are the areas where nosocomial infections and bacteremia are most common. With the surveillance study, it is aimed to determine the agents, to know their characteristics, to create the resistance profile, to prevent cross-infection and contamination, and to reduce the rates of nosocomial infections. In this study, it was aimed to examine the distributions and susceptibility rates of the agents in nosocomial bacteremia in patients followed up in the
Journal of Infection and Public Health, 2019
Background: Intensive care units (ICUs) are considered epicenters of antibiotic resistance. The aim of this study is to determine clinical risk factors, epidemiology and the causative agents of multi-drug resistant bacteria in the ICU of the University Hospital in Marrakesh-Morocco. Methods: A one year case control study was carried out in our 10-bed clinical and surgical ICU from March 2015 to March 2016. The epidemiological surveillance was done by collecting data in the medical records with the help of a questionnaire. The antibiotic susceptibility testing was used following the recommendations of the Antibiogram Committee of the French Society of Microbiology and the European Committee for Antimicrobial Susceptibility Testing, 2015. Results: Among the 479 admitted patients, 305 bacteria were isolated and identified as Acinetobacter baumannii (31%), Enterobactereacae species (30%), and Staphylococcus (24%), P. aeruginosa (10%) and other bacterial strains (5%). The rate of MDR bacteria acquisition was 41% (124/305) with domination of A. baumannii resistant to imipenem (70%) and followed by Extended Spectrum -lactamases producing Enterobacteriaceae, P. aeruginosa resistant to Ceftazidime, and Methicillin-resistant S. aureus (18%, 7%, and 5% respectively). The distribution of the common nosocomial infections were dominated by pneumonia, bacteremia, and catheter-related blood stream infections (39%, 29%, and 17%) respectively. Multivariate analysis identified lack of patient isolation precautions (OR: 7.500), use of quadri or triple therapy (OR: 5.596; OR: 5.175), and mechanical ventilation (OR: 4.926), as the most significant clinical and epidemiological factors associated with acquisition of MDR bacteria. The attributable mortality, in this ICU, of patients with MDR bacteria, is about 12%. Conclusions: The incidence of MDR was higher compared with that of developed countries. The implementation of standard infection control protocols, active surveillance of MDR and generation of data on etiological agents and their antimicrobial susceptibility patterns are urgently needed in our hospital.
Epidemiology and Prognosis of Intensive Care Unit–Acquired Bloodstream Infection
The American Journal of Tropical Medicine and Hygiene, 2020
Intensive care unit-acquired bloodstream infections (ICU-BSI) are frequent and are associated with high morbidity and mortality rates. We conducted this study to describe the epidemiology and the prognosis of ICU-BSI in our ICU and to search for factors associated with mortality at 28 days. For this, we retrospectively studied ICU-BSI in the ICU of the Cayenne General Hospital, from January 2013 to June 2019. Intensive care unit-acquired bloodstream infections were diagnosed in 9.5% of admissions (10.3 ICU-BSI/1,000 days). The median delay to the first ICU-BSI was 9 days. The ICU-BSI was primitive in 44% of cases and secondary to ventilator-acquired pneumonia in 25% of cases. The main isolated microorganisms were Enterobacteriaceae in 67.7% of patients. They were extended-spectrum beta-lactamase (ESBL) producers in 27.6% of cases. Initial antibiotic therapy was appropriate in 65.1% of cases. Factors independently associated with ESBL-producing Enterobacteriaceae (ESBL-PE) as the causative microorganism of ICU-BSI were ESBL-PE carriage before ICU-BSI (odds ratio [OR]: 7.273; 95% CI: 2.876-18.392; P < 0.000) and prior exposure to fluoroquinolones (OR: 4.327; 95% CI: 1.120-16.728; P = 0.034). The sensitivity of ESBL-PE carriage to predict ESBL-PE as the causative microorganism of ICU-BSI was 64.9% and specificity was 81.2%. Mortality at 28 days was 20.6% in the general population. Factors independently associated with mortality at day 28 from the occurrence of ICU-BSI were traumatic category of admission (OR: 0.346; 95% CI: 0.134-0.894; P = 0.028) and septic shock on the day of ICU-BSI (OR: 3.317; 95% CI: 1.561-7.050; P = 0.002). Mortality rate was independent of the causative organism.
Japanese journal of infectious diseases, 2009
Intensive care unit (ICU)-acquired infections can bring some degree of morbidity and mortality to patients staying in the ICU. In this study, over a 6-month period, the prevalence of infections and mortality rates among ICU patients, the predominant organisms and their resistance patterns were determined in a cross-sectional study. Samples of all the patients hospitalized longer than 48 h in two Shiraz university teaching hospitals in Shiraz, Iran, were microbiologically cultured, and antimicrobial susceptibility was determined using the disk diffusion method. We studied 123 specimens from 89 patients aged 1 month to 80 years (38.3-/+13.4), and among them 46 patients (51.7%; 95% CI, 41.3-62.1%) showed infection based on culture and clinical findings. Of these, 37 patients (41.6%) had more than one ICU-related nosocomial infection and 9 patients (10.1%) had only one ICU-related nosocomial infection. The overall mortality rate for ICU-acquired infections was 10.9% (5 patients). Gram-n...
Common infections acquired in intensive care: Microbiological aspects and risk factors
Periodicum Biologorum
Nosocomial infections are a serious health problem resulting in an enormous burden of morbidity and mortality rates, and high health care costs. The various microorganisms implicated in nosocomial infections were not known for causing recalcitrant nosocomial infections, they are opportunistic pathogens and hence pose a challenge to patients especially those with immunocompromised conditions. Patients at the intensive care unit are the most at risk of these hospital-acquired infections The infections usually encountered in intensive care unit (ICU) include urinary tract infection, pneumonia, tuberculosis, gastroenteritis. The main risk factors for these infections can be divided into three key groups: those related to patient characteristics and underlying diseases, those related to the acute disease process, and those related to the use of invasive diagnostic or therapeutic procedures. Incidence of ICU-acquired infections vary between hospitals and according to the type of populatio...
Background: Intensive care unit infections are health care problems affecting millions globally each year. Intensive care unit mortality of infectious patients is increasing and as high as 14.31% to 45.4%. This study aimed to determine the microbiological culture profile and antimicrobial susceptibility pattern of patients admitted to two intensive care units in Addis Ababa. Methods and materials: An institutional-based retrospective observational study was carried out on all patients with microbiological culture and susceptibility results after admission to the adult intensive care unit at two Addis Ababa hospitals from January 2019 to December 2019. Data were collected by trained data collectors using a standard and pretested questionnaire. Collected data were coded, entered into Epi-Info, and analyzed using SPSS version 25. Correlation and regression analysis was used for assessing associations. A p-value of less than 0.05 was taken as significant. Results: A total of 106 patients with 173 culture results were analyzed. The majority, 68(64.2%), were males. The mean age of the patients was 35.08±1.6 years. The most common documented source of infection was the pulmonary system 84(54.5%), followed by urinary tract infection 26(16.9%). Forty-four (25.43%) of cultures had growth. Gram-negative was identified in 35(68.63%) isolates. Acinetobacter species account for 10(28.57%), followed by Klebsiella pneumoniae and E. coli 7(13.725%) respectively. Higher antimicrobial resistance was shown to cephalosporin and penicillin. The mortality rate among subjects was 32.1%. Conclusion and Recommendations: Pulmonary source being the common infection site, resistant gram negatives were the predominant microorganisms identified. Designs of future multicenter and prospectively designed studies are crucial to improve the outcome of critically ill patients.