Multiresistance of GNB causing BSI was associated with higher mortality rates and longer LOS in ICU. The initial antibiotic therapy was significantly more often inadequate and might have had an impact on overall mortality. Thus, an effective strategy to administer an appropriate initial empirical antibiotic therapy, especially in patients with risk factors, must be sought. Moreover, the overall usage of antimicrobials must be limited and infection control guidelines should be followed to reduce the emergence and transmission of multiresistant GNB.
Neurologic intensive care patients have relatively high rates of device-associated nosocomial pneumonia and UTI. For a valid comparison of surveillance data and implementation of targeted prevention strategies, we would strongly recommend provision of national benchmarks for the neurologic ICU setting.
In addition to MIC and MBC tests in this study the serum bactericidal activity of 3.1 µg/ml of moxifloxacin or 5.2 µg/ml of levofloxacin was determined against ten susceptible strains of S. aureus, S. epidermidis, E. coli and K. pneumoniae. Moxifloxacin achieved markedly better activity against S. aureus and S. epidermidis as compared to levofloxacin. Activity of moxifloxacin against E. coli and K. pneumoniae was excellent but not superior to levofloxacin. In conclusion both fluorquinolones are highly effective against E. coli and K. pneumoniae, moxifloxacin being superior with respect to gram-positives like S. aureus and S. epidermidis.
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