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Objective: We aimed to describe the pattern of nosocomial infections in an adult medical-surgical intensive care unit (ICU). Subjects and Methods: A 2-year prospective cohort study of nosocomial infection surveillance in a 15-bed adult combined medical and surgical ICU of Farwaniya Hospital, Kuwait, was carried out. Data were collected between January 2004 and December 2005 using the standard surveillance protocols and nosocomial infection site definitions of the National Nosocomial Infections Surveillance System’s ICU surveillance component. Results: Of 1,173 patients hospitalized in the ICU for an aggregate duration of 6,855 days, 89 patients acquired a total of 140 nosocomial infections; 46 (33%) ventilator-associated pneumonia (VAP), 33 (24%) central-line-associated bloodstream infection and 15 (11%) catheter-associated urinary tract infection, 22 (16%) cutaneous infection and 24 (17%) other infections. The overall patient day rate was 20.6/1,000 patient days. The patient infection rate was 10.6/100 patients at risk. The mean VAP rate was 9.1/1,000 ventilator days (95% CI, 5–13.2), the central-line-associated bloodstream infection rate 5.5/1,000 central line days (95% CI, 3.2–7.8) and the catheter-associated urinary tract infection rate 2.3/1,000 catheter days (95% CI, 1.2–3.4). Of all nosocomial infections, 119 (85%) were culture-confirmed and 21 (15%) were clinically defined culture-negative infections. Of the culture-confirmed nosocomial infections, 81 (68%) were Gram-negative, 32 (27%) Gram-positive and 6 (5%) fungal. The most frequent organism was Pseudomonas aeruginosa (20, 17%), followed by Acinetobacter baumannii (15, 13%), Klebsiella spp. (13, 11%) and Escherichia coli (10, 8%). The crude mortality was 27% among ICU-infected patients. Conclusion: VAP was the most common nosocomial infection in our ICU. Gram-negative organisms were more commonly reported as etiologic agents of ICU infections.

This is a retrospective single-center study of 417 consecutive patients with coronavirus disease 2019 (COVID-19) admitted to Jaber Al-Ahmad Hospital in Kuwait between February 24, 2020 and May 24, 2020. In total, 39.3% of patients were asymptomatic, 41% were symptomatic with mild/moderate symptoms, 19.7% were admitted to the intensive care unit (ICU). Most common symptoms in cohort patients were fever (34.3%) and dry cough (32.6%) while shortness in breath was reported in (75.6%) of ICU admissions. Reported complications requiring ICU admission included Sepsis (68.3%), acute respiratory distress syndrome (95.1%) and heart failure (63.4%). ICU patients were more likely to have comorbidities, in comparison to non-ICU patients, including diabetes (35.4% vs 20.3%) and hypertension (40.2% vs 26.9%). Mortality rate of cohort was 14.4% and mean age of death was 54.20 years (± 11.09) and 90% of death cases were males. Chest high-resolution computed tomography for ICU cases reveled multifocal large patchy areas of ground glass opacification mixed with dense consolidation. Cases admitted to ICU showed abnormal levels of markers associated with infection, inflammation, abnormal blood clotting, heart problems and kidney problems. Mean hospital stay for asymptomatic cases was 20.69 days ±8.57 and for mild/moderate cases was 21.4 days ±8.28. Mean stay in ICU to outcome for survivors was 11.95 days ±8.96 and for death cases 13.15 days ±10.02. In this single-center case series of 417 hospitalized COVID-19 patients in Kuwait 39.3% were asymptomatic cases, 41% showed mild/moderate symptoms and 18.7% were admitted to ICU with a mortality rate of 14.4%.

Objective: To report an uncommon incidence of sporadic bloodstream infection (BSI) caused by Pantoea agglomerans in preterm neonates. Case Presentation and Intervention: Fives cases of nosocomial BSI with P. agglomerans in preterm neonates (weight ≤1,500 g; age 8–17 days; gestational age 26–30 weeks) are presented. All cases were late onset neonatal sepsis (>7 days of age). Lethargy, skin mottling and bradycardia were often present. Although there was no evidence of pneumonia, desaturation was a common feature. Thrombocytopenia developed in 4 patients, metabolic acidosis in 2 and jaundice in 2. No bleeding tendency or disseminating intravascular coagulation was recorded. Organisms cultured from blood were identified by the Vitek-2 system (bioMérieux, France) and the findings confirmed by testing the isolate on the API 20E system. All isolates shared in vitro susceptibility to gentamicin, amikacin, ciprofloxacin, piperacillin/tazobactam and meropenem. One patient was treated with a cefotaxime/amikacin combination, 2 with meropenem and the remaining 2 with tazocin. All patients responded well to antibiotic treatment and survived. Conclusion:P. agglomerans is an unusual pathogen in the etiology of neonatal sepsis. Despite significant clinical deterioration, early detection and proper antibiotic therapy carry a favorable outcome.