Microbial isolates from patients in an intensive care unit, and associated risk factors

Tennant, I; Harding, H. E.; Ali, Nelson, Mojaverian,; Roye-Green, Karen

doi:10.1590/s0043-31442005000400003

Cited by 13 publications

(21 citation statements)

References 16 publications

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“…Each invasive procedure performed poses a risk of infection. There was a direct correlation between central venous catheterization, tracheostomy, mechanical ventilation and the risk of infection in our study, in agreement with the results of other studies [7,11,14,18]. …”

Section: Discussionsupporting

confidence: 93%

Nosocomial infections and risk factors in the intensive care unit of a teaching and research hospital: A prospecive cohort study

Batırel

Özer

et al. 2011

Med Sci Monit

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SummaryBackgroundTo evaluate the incidence, risk factors and etiology of nosocomial infections (NIs) in the intensive care unit (ICU) of our hospital in order to improve our infection control policies.Material/MethodsA 1-year prospective cohort study of nosocomial infection (NI) surveillance was conducted in our ICU in 2008.ResultsOut of 1134 patients hospitalized in the ICU for a period of 6257 days, 115 patients acquired a total of 135 NIs distributed as follows: 36.3% bacteremia, 30.4% ventilator-associated pneumonia (VAP), 18.5% catheter-associated urinary tract infection, 7.4% central-line infection, 5.9% cutaneous infection, and 1.3% meningitis. The incidence rate of NI was 21.6 in 1000 patient-days, and the rate of NI was 25.6%. Length of ICU stay, central venous catheterisation, mechanical ventilation and tracheostomy were statistically significant risk factors for NI. Of all NI, 112 (83%) were microbiologically-confirmed and 68.8% of the isolates were Gram-negative, 27.6% were Gram-positive, and 3.6% were fungi. 23 (17%) were clinically-defined infections. The most frequently isolated organism was P. aeruginosa (25%), followed by S. aureus (21.4%), E. coli (18.7%) and A. baumannii (16.9%).ConclusionsThe bloodstream was the most common site and Gram-negatives were the most commonly reported causes of ICU infections.

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Section: Discussionsupporting

confidence: 93%

Nosocomial infections and risk factors in the intensive care unit of a teaching and research hospital: A prospecive cohort study

Batırel

Özer

et al. 2011

Med Sci Monit

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“…Multivariate analysis showed a 3.57 times higher risk of infection in newborns previously exposed to antimicrobial agents. Similar results have been reported by other investigators 2,32. Lopes et al33 found an association between previous antibiotic treatment and a higher mortality rate in premature low-weight newborns.…”

Section: Discussionsupporting

confidence: 90%

Risk Factors for Infection with Coagulase-Negative Staphylococci in Newborns from the Neonatal Unit of a Brazilian University Hospital

Oliveira

Sanches

Lyra

et al. 2011

Clin Med Insights Pediatr

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Background:Coagulase-negative staphylococci (CoNS) are one of the most frequent causative agents of neonatal nosocomial infections, especially in premature and low-weight newborns. Risk factors for infection include extracellular polysaccharide production and consequent biofilm formation that permit adhesion to the smooth surface of catheters and other medical devices. The objective of this study was to identify CoNS strains isolated from 105 newborns admitted to the Neonatal Unit of our hospital, and to evaluate the association of biofilm production and host risk factors with the occurrence of infection.Methods:CoNS isolates were identified and classified as significant or contaminant based on clinical and laboratory data of the newborn medical records. Perinatal risk factors for infection, neonatal clinical evolution, and antibiotic treatment were analysed. In addition, the presence of genes (icaA, icaC and icaD) responsible for biofilm production in CoNS was investigated.Results:Among the 130 CoNS strains studied, 66 (50.8%) were classified as clinically significant and 64 (49.2%) as contaminant. There was no difference in the detection of biofilm-specific genes between CoNS strains isolated from newborns with (81.8%) and without infection (84.3%), although 11 (91.7%) of the 12 children whose death was related to CoNS were infected with strains that were positive for these genes. Forty-five (83.3%) of the 54 newborns infected with CoNS were premature and 33 (61.1%) had a birth weight ≤ 1,500 g. Most newborns infected with CoNS had been submitted to invasive procedures, including catheter use (85.2%), parenteral nutrition (61.1%), and mechanical ventilation (57.4%). S. epidermidis was the most frequently isolated species (81.5%) and was more related to infection (86.3%) than to contamination (76.5%).Conclusion:Most newborns infected with CoNS presented factors that contributed to the colonization and development of infection with these microorganisms, including a birth weight ≤ 1,500 g, catheter complications, use of a drain, and previous antibiotic treatment. The fact that most children who died of CoNS-related infection carried strains positive for biofilm-specific genes indicates the importance of this virulence factor for the outcome of staphylococcal infections.

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“…13 Earlier similar findings have been reported. 14 , 15 However, unlike the present study, it has shown that the independent risk factors for late versus early VAP acquired in ICU was advanced age. 16 …”

Section: Discussioncontrasting

confidence: 88%

Risk factors for acquisition of ventilator-associated pneumonia in adult intensive care units

2013

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Objective: Ventilator Associated Pneumonia (VAP) has an imperative place amongst nosocomial infections leading to increase morbidity and mortality rates. The present study aimed to determine risk factors for acquisition of ventilator- associated pneumonia in an intensive care unit (ICU). Methods: A nested case-control study was carried out from September 2007 to June 2008. All 183 patients hospitalized at the adult ICU ward in Be’sat Hospital, Sanandaj city western Iran over a 48 hour period were included. Bacteriologic diagnosis and antibiotic susceptibility patterns were performed based on Edward & Ewing’s methods and CLSI system guidelines. Results : Of the 149 samples which were taken from endotracheal tubes of 183 patients, 48 cases were diagnosed for VAP with an incidence rate of 26.2%. Mean duration of hospitalization was 23.4±10.2 days. The maximum and minimum antibiotic resistance for the gram negative bacteria was 93.3% for Cefalotin and 50% for Amikacin. The main risk factors for acquisition of ventilator- associated pneumonia were mechanical ventilation (Adjusted OR: 1.55, 95% CI: 1.37-1.74), history of antibiotic consumption (AOR: 8.92, CI: 1.16- 66.66) and fever (AOR: 3.11, CI: 1.22- 7.93). Conclusions: VAP is significantly related to ICU hospitalization, mechanical ventilation and history of antibiotics consumption. Cefalotin and Amikacin showed the highest and lowest antibiotic resistance against gram negative bacteria respectively.

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Microbial isolates from patients in an intensive care unit, and associated risk factors

Cited by 13 publications

References 16 publications

Nosocomial infections and risk factors in the intensive care unit of a teaching and research hospital: A prospecive cohort study

Nosocomial infections and risk factors in the intensive care unit of a teaching and research hospital: A prospecive cohort study

Risk Factors for Infection with Coagulase-Negative Staphylococci in Newborns from the Neonatal Unit of a Brazilian University Hospital

Risk factors for acquisition of ventilator-associated pneumonia in adult intensive care units

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