Central line-associated bloodstream infection trend in Brazilian adult intensive care units: an ecological study

Silva, Alexsandra Gomes Resende de Souza da; Alves, Sandra; Guimarães, Elisângela Euripedes Resende; Braga, Jessyca Rodrigues; Neves, Heliny Carneiro Cunha; Santos, Silvana de Lima Vieira dos; Moreira, Maria Auxiliadora Carmo

doi:10.3855/jidc.14730

Cited by 4 publications

(4 citation statements)

References 16 publications

(24 reference statements)

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“…Policimbac® is one of the main manufactured polymyxin B plate used in Brazil and their inaccuracy represent a significant problem, as polymyxin B is still an important therapeutic choice for multidrug-resistant Gram-negative isolates, including K. pneumoniae . KPC-producing K. pneumoniae is the first Gram-negative pathogen associated to bloodstream infection in patients in intensive therapy units from Brazil ( Gomes et al., 2021 ). K. pneumoniae clinical isolates commonly do not present borderline MICs for polymyxins, in this way, a high categorical agreement and absence of very major errors was observed in our study.…”

Section: Discussionmentioning

confidence: 99%

Low performance of Policimbac® broth microdilution in determining polymyxin B MIC for Klebsiella pneumoniae

Rocha

Lopes²,

Russi

et al. 2023

Front. Cell. Infect. Microbiol.

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Klebsiella pneumoniae is a global threat to healthcare, and despite the availability of new drugs, polymyxins are still an important therapeutic option for this and other resistant gram-negative pathogens. Broth microdilution is the only method that is recommended for polymyxins. In this study, we evaluated the accuracy of a commercial Policimbac® plate in determining the polymyxin B MIC for K. pneumoniae clinical isolates. The results were compared with those of the broth microdilution method according to ISO 16782. The Policimbac® plate had an excellent 98.04% categorical agreement, but unacceptable 31.37% essential agreement rates. Almost 2% of major errors as observed. Additionally, 52.94% of the strains overestimated the MIC at 1 µg/mL. Three isolates were excluded from the analysis due to the drying of the Policimbac® plate. To avoid dryness, we included wet gauze for the test, obtaining a 100% of categorical agreement rate; however, a low essential agreement was maintained (25.49%). In conclusion, the Policimbac® plate was unable to correctly determine the polymyxin B MIC for K. pneumoniae isolates. This low performance may interfere with the clinical use of the drug and, thus, with the result of the patient’s treatment.

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Section: Discussionmentioning

confidence: 99%

Low performance of Policimbac® broth microdilution in determining polymyxin B MIC for Klebsiella pneumoniae

Rocha

Lopes²,

Russi

et al. 2023

Front. Cell. Infect. Microbiol.

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“…We identified 11 recent studies that provided insight into the occurrence, microbiology, and determinants of primary BSI in the critically ill [7 ▪▪ ,8 ▪ ,9–13,14 ▪ ,15,16] (Table 1).…”

Section: Epidemiologymentioning

confidence: 99%

“…Gomes Resende da Silva et al investigated CA-BSI incidence in 42 Brazilian ICUs and found a rate of 2.3 to 3.2 per 1000 catheter days with the most frequent organisms being coagulase-negative staphylococci, Klebsiella pneumoniae , Acinetobacter spp. and Pseudomonas aeruginosa [11]. Badia-Cebada et al reported on surveillance of hospital-acquired, CA-BSI in 55 hospitals in Catalonia, Spain during 2007–2019 [12].…”

Section: Epidemiologymentioning

confidence: 99%

Central line associated and primary bloodstream infections

Stewart,

Laupland,

Tabah

2023

Current Opinion in Critical Care

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Purpose of review Primary and intravascular catheter-associated bloodstream infections (CA-BSIs) represent an important clinical entity in the intensive care unit (ICU) being associated with significant morbidity and mortality. The purpose of this review was to examine the recently published data on epidemiology and management of CA-BSI and other primary BSIs specifically within the context of the ICU. Recent findings In critically ill patients, the pooled prevalence of primary and CA-BSI from contemporary studies was 19.7–40.7% and 26.4–37.3% of all BSIs, respectively. Failure to achieve source control (i.e., removal of catheter in CA-BSI) is associated with higher mortality. Higher severity scores and durations of ICU stay and catheter insertion are well established risk factors for CA-BSI. The use of prevention bundles when inserting a central venous line is able to reduce CA-BSI incidence from 4 to 1.6 episodes per 1000 central venous catheter days. Differential time-to-positivity of paired blood cultures may assist in the diagnosis of CA-BSI. Summary Primary BSI is frequently observed in ICU cohorts and has a poor effect on outcome. Surveillance for BSI among patients admitted to ICUs is fundamental to inform healthcare service delivery, design preventive approaches, to track resistance, and detect emerging pathogens.

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“…Para Silva et al (2021) a IPCS tende a se manter incidente dentro das UTI, Staphylococcus coagulase-negativo, K.…”

Section: Base Deunclassified

Medidas preventivas de infecção primária de corrente sanguínea associada ao cateter venoso central

Oliveira¹,

Cunha²

2023

RSD

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Objetivo: Identificar estudos científicos sobre a importância da conformidade das boas práticas de enfermagem na prevenção de infecção primária de corrente sanguínea relacionada ao manuseio do cateter venoso central. Metodologia: Trata-se de uma revisão integrativa de literatura, buscou-se pelas publicações nas bases de dados Medical Literature Analysis and Retrieva System On-line, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scientific Electronic Library Online e Bases de dados em Enfermagem. Resultado: Selecionaram-se 19 artigos que compuseram a amostra final desta revisão de literatura. Para uma melhor organização estrutural dos resultados extraídos, optou-se por abordar os estudos de acordo com eixos temáticos: segurança na inserção do cateter venoso central; conhecimento e aplicação de bundles; segurança na troca de linhas de infusão e desinfecção de conectores; segurança no preparo e administração de medicamentos; realização e troca de curativos; higienização das mãos. Conclusão: Detectam-se fragilidades na conformidade das ações de manuseio e manutenção do cateter venoso central, ambas as categorias apresentam déficit de conhecimento, embora o manuseio do dispositivo seja uma prática rotineira da enfermagem exige rigor no cuidado em sintonia com a política de segurança do paciente.

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Central line-associated bloodstream infection trend in Brazilian adult intensive care units: an ecological study

Cited by 4 publications

References 16 publications

Low performance of Policimbac® broth microdilution in determining polymyxin B MIC for Klebsiella pneumoniae

Low performance of Policimbac® broth microdilution in determining polymyxin B MIC for Klebsiella pneumoniae

Central line associated and primary bloodstream infections

Medidas preventivas de infecção primária de corrente sanguínea associada ao cateter venoso central

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