Evaluation of a rapid bacterial ATP assay for screening BAL samples from ICU patients submitted for quantitative bacterial cultures

Laupland, Kevin B.; Church, Deirdre L.; Gregson, Daniel B.

doi:10.1016/s0732-8893(03)00151-2

Cited by 7 publications

(4 citation statements)

References 35 publications

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“…1,26 S. aureus is clearly the most important pathogen in critically ill and trauma patients in the CHR. 13,27 This fact, as well as the relatively low rate of antimicrobial-resistant organisms, supports the previous assertion that empiric therapies do not necessarily require routine broad-spectrum antipseudomonal coverage in the CHR. 1,28 The identification of risk factors for the development of ICU-acquired BSI is important to guide means of devising and implementing preventive measures.…”

Section: Discussionsupporting

confidence: 74%

Intensive-care-unit-acquired bloodstream infections in a regional critically ill population

Laupland

Kirkpatrick

Church

et al. 2004

Journal of Hospital Infection

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Section: Discussionsupporting

confidence: 74%

Intensive-care-unit-acquired bloodstream infections in a regional critically ill population

Laupland

Kirkpatrick

Church

et al. 2004

Journal of Hospital Infection

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“…On the basis of the sensitivity of the assay of 86%, it is expected that a 10–15% reduction in the rate of culture positivity would occur with its implementation. However, a more important influence is that this assay does not detect yeast because it is based on the specific detection of bacterial ATP [16,19]. Candida species are among the most important causes of ICU-acquired UTI and a reduced rate of ICU-acquired UTI is expected if these organisms are not routinely cultured.…”

Section: Discussionmentioning

confidence: 99%

Untitled

et al. 2005

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Introduction Few studies have evaluated urinary tract infections (UTIs) specifically acquired within intensive care units (ICUs), and the effect of such infections on patient outcome is unclear. The objectives of this study were to describe the occurrence, microbiology, and risk factors for acquiring UTIs in the ICU and to determine whether these infections independently increase mortality. Methods A surveillance cohort study was conducted among all adults admitted to multi-system and cardiovascular surgery ICUs in the Calgary Health Region (CHR, population about 1 million) between 1 January 2000 and 31 December 2002. Results During the 3 years, 4465 patients were admitted 4915 times to a CHR ICU for 48 hours or more. A total of 356 ICU-acquired UTIs (defined as at least 10 5 colony-forming units/ml of one or two organisms 48 hours or more after ICU admission) occurred among 290 (6.5%) patients, yielding an overall incidence density of ICU-acquired UTIs of 9.6 per 1000 ICU days. Four bacteremic/fungemic ICU-acquired UTIs occurred (0.1 per 1000 ICU days). Development of an ICU-acquired UTI was more common in women (relative risk [RR] 1.58; 95% confidence interval [CI] 1.43-1.75; P < 0.0001) and in medical (9%) compared with non-cardiac surgical (6%), and cardiac surgical patients (2%). The most common organisms isolated were Escherichia coli (23%), Candida albicans (20%), and Enterococcus species (15%). Antibiotic-resistant organisms were identified among 14% isolates. Although development of an ICU-acquired UTI was associated with significantly higher crude inhospital mortality (86/290 [30%] vs. 862/4167 [21%]; RR = 1.43; 95% CI 1.19-1.73; P < 0.001); an ICU-acquired UTI was not an independent predictor for death. Conclusions Development of an ICU-acquired UTI is common in critically ill patients. Although a marker of increased morbidity associated with critical illness, it is not a significant attributable cause of mortality.

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“…In this work we have decided to re-examine the use of ATP-bioluminescence for performing a rapid AST because of its previous published applications in Clinical Microbiology, such as rapid AST in bacteria (including mycobacteria) and yeasts, 4,13-15 screening diagnostic in urinalysis and bacterial detection directly from urine samples 16 and bronchoalveolar lavage. 17 In order to set up the proposed AST based on ATPbiolumeniscence, the RLU obtained from ATCC collection strains incubated with antibiotic were compared to the RLU obtained from the same strains incubated without antibiotic after two hours of incubation. If intracellular ATP is measured, sensitive strains to the antibiotic tested should provide RLU values lower than the same strains incubated without antibiotic because ATP is associated with living cells.…”

Section: Discussionmentioning

confidence: 99%