Burden of highly resistant microorganisms in a Dutch intensive care unit
| Autor: | H, Aardema, J P, Arends, A M G A, de Smet, J G, Zijlstra |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Methicillin-Resistant Staphylococcus aureus Adolescent Vancomycin-Resistant Enterococci Hospitals University Young Adult Enterobacteriaceae Klebsiella Pseudomonas Drug Resistance Bacterial Escherichia coli Humans Pseudomonas Infections Hospital Mortality Prospective Studies Child APACHE Aged Netherlands Aged 80 and over Enterobacteriaceae Infections Drug Resistance Microbial Length of Stay Middle Aged Staphylococcal Infections Intensive Care Units Female |
| Zdroj: | The Netherlands journal of medicine. 73(4) |
| ISSN: | 1872-9061 |
| Popis: | The occurrence of highly resistant microorganisms (HRMOs) is a major threat to critical care patients, leading to worse outcomes, need for isolation measures, and demand for second-line or rescue antibiotics. The aim of this study was to quantify the burden of HRMOs in an intensive care unit (ICU) for adult patients in a university hospital in the Netherlands. We evaluated local distribution of different HRMO categories and proportion of ICU-imported versus ICU- acquired HRMOs. Outcome of HRMO-positive patients versuscontrols was compared.In this prospective single-centre study, culture results of all ICU patients during a four-month period were recorded, as well as APACHE scores, ICU mortality and length of stay (LOS) in the ICU.58 of 962 (6.0%) patients were HRMO positive during ICU stay. The majority (60%) of those patients were HRMO positive on ICU admission. HRMO-positive patients had significantly higher APACHE scores, longer LOS and higher mortality compared with controls.Our study suggests that a large part of antibiotic resistance in the ICU is imported. This underscores the importance of a robust surveillance and infection control program throughout the hospital, and implies that better recognition of those at risk for HRMO carriage before ICU admission may be worthwhile. Only a small minority of patients with HRMO at admission did not have any known risk factors for HRMO. |
| Databáze: | OpenAIRE |
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