Application of control measures for infections caused by multi-resistant gram-negative bacteria in intensive care unit patients

Abstract

Multi-resistant gram-negative rods are important pathogens in intensive care units (ICU), cause high rates of mortality, and need infection control measures to avoid spread to another patients. This study was undertaken prospectively with all of the patients hospitalized at ICU, Anesthesiology of the Hospital São Paulo, using the ICU component of the National Nosocomial Infection Surveillance System (NNIS) methodology, between March 1, 1997 and June 30, 1998. Hospital infections occurring during the first three months after the establishment of prevention and control measures (3/1/97 to 5/31/97) were compared to those of the last three months (3/1/98 to 5/31/98). In this period, 933 NNIS patients were studied, with 139 during the first period and 211 in the second period. The overall rates of infection by multi-resistant microorganisms in the first and second periods were, respectively, urinary tract infection: 3.28/1000 patients/day; 2.5/1000 patients/day; pneumonia: 2.10/1000 patients/day; 5.0/1000 patients/day; bloodstream infection: 1.09/1000 patients/day; 2.5/1000 patients/day. A comparison between overall infection rates of both periods (Wilcoxon test) showed no statistical significance (p = 0.067). The use of intervention measures effectively decreased the hospital bloodstream infection rate (p < 0.001), which shows that control measures in ICU can contribute to preventing hospital infections

Susceptibility of clinical isolates of multiresistant Pseudomonas aeruginosa to a hospital disinfectant and molecular typing

“…The intrinsic susceptibility is limited to only a few antimicrobial agents and the emergence of resistance during therapy occurs with a relatively high frequency (Bert & Lambert-Zechovsky 1999). In the Global SENTRY Antimicrobial Surveillance Program, 1997-1999 the occurrence rates of multi-drug resistant P. aeruginosa raged from 8.2% (Latin America) to 0.9% (Canada) (Gales Martins et al (2004) P. aeruginosa and Acinetobacter baumannii are the most resistant bacteria in Intensive Care Unit at Hospital São Paulo, in Brazil. Thus, we decided to study resistant isolates since they are the major problem in clinical settings.…”

Silver nanoparticles as active ingredient used for alcohol-free mouthwash

“…Hence, it’s important to avoid the use of alcoholic mouthwash. Gram-negative bacteria, such as Klebsiella pneumoniae and Pseudomonas aeruginosa , and Gram-positive bacteria, such as Methicillin-resistant Staphylococcus aureus that frequently colonize the oral cavity of hospitalized patients [25], have emerged as causes of nosocomial pneumonia. This has stimulated the search for preventive and therapeutic measures to minimize oral and respiratory colonization by the simple use of a broad-spectrum antiseptic mouthwash pre-operatively or pre-intubation [2].…”

Diretrizes brasileiras para tratamento das pneumonias adquiridas no hospital e das associadas à ventilação mecânica - 2007

“…Este estudo estima acréscimo de 13,3 dias de internação na unidade de terapia intensiva, em razão da aquisição da PAVM. (7) Outro estudo nacional, que avaliou a mortalidade em PAVM, atribui a esta condição aumento de 25% da letalidade (8) Alguns autores (9) encontraram taxa de 13,1/1000 pacientes/dia. A PAH foi a segunda infecção mais comum e 63,7% estavam associadas à VM.…”