Duration of colonization with antimicrobial-resistant bacteria after ICU discharge

Autor: Haverkate, Manon R, Derde, Lennie P G, Brun-Buisson, Christian, Bonten, Marc J M, Bootsma, Martin C J, Sub Mathematical Modeling, Mathematical Modeling
Přispěvatelé: Sub Mathematical Modeling, Mathematical Modeling
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Male
Methicillin-Resistant Staphylococcus aureus
Colonization
Time Factors
Antimicrobial resistant bacteria
Drug resistance
medicine.disease_cause
Critical Care and Intensive Care Medicine
Survival function
Patient Readmission
Vancomycin-Resistant Enterococci
law.invention
Microbiology
03 medical and health sciences
0302 clinical medicine
Enterobacteriaceae
law
Drug Resistance
Bacterial
Humans
Medicine
030212 general & internal medicine
Likelihood Functions
0303 health sciences
biology
030306 microbiology
business.industry
Middle Aged
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
biology.organism_classification
Intensive care unit
Methicillin-resistant Staphylococcus aureus
Patient Discharge
3. Good health
Intensive Care Units
Staphylococcus aureus
ICU
Female
business
ntimicrobial-resistant bacteria
Interval censored data
Bacteria
Zdroj: Intensive Care Medicine; Vol 40
Intensive Care Medicine, 40(4), 564. Springer Verlag
ISSN: 1432-1238
0342-4642
DOI: 10.1007/s00134-014-3225-8
Popis: PURPOSE: Readmission of patients colonized with antimicrobial-resistant bacteria (AMRB) is important in the nosocomial dynamics of AMRB. We assessed the duration of colonization after discharge from the intensive care unit (ICU) with highly resistant Enterobacteriaceae (HRE), methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). METHODS: Data were obtained from a cluster-randomized trial in 13 ICUs in 8 European countries (MOSAR-ICU trial, 2008-2011). All patients were screened on admission and twice weekly for AMRB. All patients colonized with HRE, MRSA, or VRE and readmitted to the same ICU during the study period were included in the current analysis. Time between discharge and readmission was calculated, and the colonization status at readmission was assessed. Because of interval-censored data, a maximum likelihood analysis was used to calculate the survival function, taking censoring into account. A nonparametric two-sample test was used to test for differences in the survival curves. RESULTS: The MOSAR-ICU trial included 14,390 patients, and a total of 64,997 cultures were taken from 8,974 patients admitted for at least 3 days. One hundred twenty-five unique patients had 141 episodes with AMRB colonization and at least 1 readmission. Thirty-two patients were colonized with two or more AMRBs. Median times until clearance were 4.8 months for all AMRB together, 1.4 months for HRE
Databáze: OpenAIRE
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