Colonization pressure as a risk factor for colonization by multiresistant Acinetobacter spp and carbapenem-resistant Pseudomonas aeruginosa in an intensive care unit

DalBen, Mirian Freitas; Basso, Matteo; García, Camila; Costa, Sílvia Figueiredo; Toscano, Cristiana M.; Jarvis, William R.; Lobo, R.; Oliveira, Maura Salaroli de; Levin, Anna S.

doi:10.6061/clinics/2013(08)11

Cited by 26 publications

(25 citation statements)

References 19 publications

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“…En la presente investigación se logró determinar además que el estado portador en pacientes fue más frecuente en hombres con un 68,4%, observándose además que el 42,1% de ellos presentaron un rango de edad de 58-77 años, la frecuencia de mayor colonización en el género masculino también ha sido (29) reportada en otras investigaciones similares ; dejando abierto el debate del porque se suscita este evento.…”

Section: Resultsunclassified

Portadores de bacterias multirresistentes de importancia clínica en áreas críticas (UCI-UCIN) de un hospital al norte del Perú

et al. 2016

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Section: Resultsunclassified

Portadores de bacterias multirresistentes de importancia clínica en áreas críticas (UCI-UCIN) de un hospital al norte del Perú

et al. 2016

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“…The literature search identified a total of 165 citations; of which, 98 full-text articles were retrieved and assessed for eligibility. The systematic review included 19 articles (6 articles for AIAT versus IIAT [12][13][14][15][16][17]; 17 articles for acquisition of resistant or multidrug-resistant P. aeruginosa [12,[14][15][16][18][19][20][21][22][23][24][25][26][27][28][29][30] and 4 articles reported both outcomes [12,[14][15][16]) that met final eligibility criteria ( Fig. 1).…”

Section: Baseline Study and Population Characteristicsmentioning

confidence: 99%

“…Nineteen studies reported in 17 articles (two articles contributed to four studies) were included (Table 3) [12,[14][15][16][18][19][20][21][22][23][24][25][26][27][28][29][30]. A total of 3203 total subjects (1077 cases and 2126 controls) were examined for risk factors of acquisition of [29]).…”

Section: Risk Factors For Acquiring Resistant P Aeruginosamentioning

confidence: 99%

Pseudomonas infections among hospitalized adults in Latin America: a systematic review and meta-analysis

et al. 2020

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Background: Treatment of resistant Pseudomonas aeruginosa infection continues to be a challenge in Latin American countries (LATAM). We synthesize the literature on the use of appropriate initial antibiotic therapy (AIAT) and inappropriate initial antibiotic therapy (IIAT) in P. aeruginosa infections, and the literature on risk factors for acquisition of resistant P. aeruginosa among hospitalized adult patients in LATAM.Methods: MEDLINE, EMBASE, Cochrane, and LILAC were searched between 2000 and August 2019. Abstracts and full-text articles were screened in duplicate. Random effects meta-analysis was conducted when studies were sufficiently similar.Results: The screening of 165 citations identified through literature search yielded 98 full-text articles that were retrieved and assessed for eligibility, and 19 articles conducted in Brazil (14 articles), Colombia (4 articles), and Cuba (1 article) met the inclusion criteria. Of 19 eligible articles, six articles (840 subjects) examined AIAT compared to IIAT in P. aeruginosa infections; 17 articles (3203 total subjects) examined risk factors for acquisition of resistant P. aeruginosa; and four articles evaluated both. Four of 19 articles were rated low risk of bias and the remaining were deemed unclear or high risk of bias. In meta-analysis, AIAT was associated with lower mortality for P. aeruginosa infections (unadjusted summary OR 0.48, 95% CI 0.28-0.81; I 2 = 59%), compared to IIAT and the association with mortality persisted in subgroup meta-analysis by low risk of bias (3 articles; unadjusted summary OR 0.46, 95% CI 0.28-0.81; I 2 = 0%). No meta-analysis was performed for studies evaluating risk factors for acquisition of resistant P. aeruginosa as they were not sufficiently similar. Significant risk factors for acquisition of resistant P. aeruginosa included: prior use of antibiotics (11 articles), stay in the intensive care unit (ICU) (3 articles), and comorbidity score (3 articles). Outcomes were graded to be of low strength of evidence owing to unclear or high risk of bias and imprecise estimates. Conclusion:Our study highlights the association of AIAT with lower mortality and prior use of antibiotics significantly predicts acquiring resistant P. aeruginosa infections. This review reinforces the need for rigorous and structured antimicrobial stewardship programs in the LATAM region.

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“…As a result, colonization pressure increased due to the increase in patients already colonized upon admission. The authors concluded that when this pressure reaches critical levels, efforts aimed primarily at hand hygiene may not be sufficient to prevent transmission (27) .…”

Section: Introductionmentioning

confidence: 99%

Auditoria de práticas de precauções-padrão e contato em Unidade de Terapia Intensiva

Castro

Rodrigues

2019

Rev. esc. enferm. USP

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RESUMO Objetivo Avaliar a estrutura e a adesão às medidas de precauções-padrão e específicas dos profissionais de saúde em Unidade de Terapia Intensiva de hospital de ensino, no Distrito Federal. Método Estudo descritivo, transversal e prospectivo. Utilizou-se de questionário estruturado mediante observações que registraram as práticas dos profissionais com Equipamentos de Proteção Individual e indicações de precauções. Foi aplicado o teste Qui-quadrado, e calculado o p-valor . Resultados Participaram do estudo 52 profissionais, e foram observados 445 procedimentos assistenciais em 36 sessões de auditoria. A média da taxa de adesão ao uso de equipamentos foi de 72,72%, sendo 94,91% às luvas, 91,43% ao avental, 80% à máscara e 24,56% aos óculos de proteção. Quando não havia indicação e não foi utilizado o Equipamento de Proteção Individual, a média da taxa foi de 68,01%, sendo 30,77% em relação às luvas, 87,58% ao avental, 57,58% à máscara, e 96,13% aos óculos. As precauções de contato foram indicadas desnecessariamente em 35% dos pacientes. Conclusão Verificou-se boa adesão ao uso de luvas, avental e máscara, baixa adesão ao uso de óculos de proteção e uso desnecessário de máscaras e precauções de contato admissionais.

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Colonization pressure as a risk factor for colonization by multiresistant Acinetobacter spp and carbapenem-resistant Pseudomonas aeruginosa in an intensive care unit

Cited by 26 publications

References 19 publications

Portadores de bacterias multirresistentes de importancia clínica en áreas críticas (UCI-UCIN) de un hospital al norte del Perú

Portadores de bacterias multirresistentes de importancia clínica en áreas críticas (UCI-UCIN) de un hospital al norte del Perú

Pseudomonas infections among hospitalized adults in Latin America: a systematic review and meta-analysis

Auditoria de práticas de precauções-padrão e contato em Unidade de Terapia Intensiva

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