Hospital-wide comparison of health care-associated infection among 8 intensive care units: A retrospective analysis for 2010-2015

Yue, DongMei; Song, Caiping; Zhang, Bo; Li, Yong; Chai, Jin; Luo, Yang; Wu, Hao

doi:10.1016/j.ajic.2016.10.011

Cited by 21 publications

(15 citation statements)

References 27 publications

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“…Ϫ ͩ K max,IPM ϫ C IPM C IPM ϩ ͑ OM_effect ϫ KC 50,SS,IPM͒ ϩ K max,SS,AGS ϫ C AGS C AGS ϩ KC 50,SS,AGS ͪ ϫ CFU SS1 (2) where C IPM is the imipenem concentration and C AGS the aminoglycoside (i.e., tobramycin, gentamicin, amikacin, or streptomycin) concentration in broth. The plateau factor (PLAT) is defined as 1 Ϫ [CFU all / (CFU all ϩ CFU max )], with CFU max being the maximum population size.…”

Section: Methodsmentioning

confidence: 99%

Aminoglycoside Concentrations Required for Synergy with Carbapenems against Pseudomonas aeruginosa Determined via Mechanistic Studies and Modeling

Yadav

Bulitta

Schneider‐Futschik

et al. 2017

Antimicrob Agents Chemother

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This study aimed to systematically identify the aminoglycoside concentrations required for synergy with a carbapenem and characterize the permeabilizing effect of aminoglycosides on the outer membrane of Monotherapies and combinations of four aminoglycosides and three carbapenems were studied for activity against strain AH298-GFP in 48-h static-concentration time-kill studies (SCTK) (inoculum: 10 CFU/ml). The outer membrane-permeabilizing effect of tobramycin alone and in combination with imipenem was characterized via electron microscopy, confocal imaging, and the nitrocefin assay. A mechanism-based model (MBM) was developed to simultaneously describe the time course of bacterial killing and prevention of regrowth by imipenem combined with each of the four aminoglycosides. Notably, 0.25 mg/liter of tobramycin, which was inactive in monotherapy, achieved synergy (i.e., ≥2-log more killing than the most active monotherapy at 24 h) combined with imipenem. Electron micrographs, confocal image analyses, and the nitrocefin uptake data showed distinct outer membrane damage by tobramycin, which was more extensive for the combination with imipenem. The MBM indicated that aminoglycosides enhanced the imipenem target site concentration up to 4.27-fold. Tobramycin was the most potent aminoglycoside to permeabilize the outer membrane; tobramycin (0.216 mg/liter), gentamicin (0.739 mg/liter), amikacin (1.70 mg/liter), or streptomycin (5.19 mg/liter) was required for half-maximal permeabilization. In summary, our SCTK, mechanistic studies and MBM indicated that tobramycin was highly synergistic and displayed the maximum outer membrane disruption potential among the tested aminoglycosides. These findings support the optimization of highly promising antibiotic combination dosage regimens for critically ill patients.

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Section: Methodsmentioning

confidence: 99%

Aminoglycoside Concentrations Required for Synergy with Carbapenems against Pseudomonas aeruginosa Determined via Mechanistic Studies and Modeling

Yadav

Bulitta

Schneider‐Futschik

et al. 2017

Antimicrob Agents Chemother

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“…Nesse contexto, uma evidência científica descreve que a cirurgia per se é um evento que contribui para a ocorrência de infecção relacionada à assistência à saúde, independente do tipo de unidade de terapia intensiva, seja ela cirúrgica ou clínica (28) .…”

Section: Idiscussãounclassified

Fatores De Risco Às Infecções Relacionadas À Assistência Em Unidades De Terapia Intensiva*

et al. 2018

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RESUMO: Objetivo: identificar os pacientes e os fatores de risco associados à ocorrência de infecções relacionadas à assistência à saúde em unidades de terapia intensiva. Método: estudo transversal realizado com 155 pacientes internados entre 2012 e 2014 em duas unidades de terapia intensiva de dois hospitais públicos do Distrito Federal. Os dados foram coletados em prontuário e registrados em planilha no programa Microsoft Excel®. Foram considerados significativos resultados com p-value<0,05. Resultados: do total de 155 pacientes, 55 (35,5%) pacientes foram acometidos por infecções relacionadas à assistência à saúde durante a internação na unidade de terapia intensiva. Tempo de internação (p=0,001), internação por causas clínicas (p=0,017), diabetes mellitus (p=0,002) e cirurgia eletiva (p=0,011), foram fatores de risco, independentes para essas infecções. Conclusão: as complicações infecciosas acometeram cerca de um terço dos pacientes no cenário de terapia intensiva. A vigilância dessas complicações pode orientar ações para melhoria da segurança do paciente crítico. DESCRITORES: Infecção hospitalar; Unidades de terapia intensiva; Fatores de risco; Hospitais públicos; Pacientes. RISK FACTORS FOR HEALTHCARE-ASSOCIATED INFECTIONS IN INTENSIVE CARE UNITSABSTRACT: Objective: to identify patients and risk factors related to the occurrence of healthcare-associated infections in intensive care units. Method: cross-sectional study with 155 hospitalized patients between 2012 and 2014 in two intensive care units of two public hospitals of the Federal District. Data were collected from the medical records and recorded in a spreadsheet using the Microsoft Excel® program. Results with p-value <0.05 were considered significant. Results: of the total of 155 patients, 55 (35.5%) patients were affected by healthcare-associated infections during hospitalization in the intensive care unit. Length of stay (p=0.001), hospitalization due to clinical causes (p=0.017), diabetes mellitus (p=0.002) and elective surgery (p=0.011) were independent risk factors for these infections. Conclusion: infectious complications affected approximately one third of the patients in the intensive care setting. Surveillance of these complications may guide actions to improve the safety of critical patients. KEYWORDS: Cross Infection; Intensive care units; Risk factors; Hospitals, public; Patients. FACTORES DE RIESGO A INFECCIONES ASOCIADAS A LA ASISTENCIA EN UNIDADES DE TERAPIA INTENSIVA*RESUMEN: Objetivo: identificar los pacientes y los factores de riesgo asociados a la ocurrencia de infecciones relacionadas a la asistencia a la salud en unidades de terapia intensiva. Método: estudio transversal realizado con 155 pacientes internados entre 2012 y 2014 en dos unidades de terapia intensiva de dos hospitales públicos de Distrito Federal. Se recogieron los datos por medio de prontuario y se los registraron en programa Microsoft Excel®. Se consideraron significativos resultados con p-value<0,05. Resultados: del total de 155 pacientes, 55 (35,5%) pacientes ...

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“…The resistance rates of P. aeruginosa to ciprofloxacin, imipenem, piperacillin tazobactam, cefoperazone sulbactam, amikacin, and polymyxin B were 18.9%, 30.7%, 16.7%, 17.1%, 6.2%, and 1.2%, respectively. A. baumannii, P. aeruginosa, and K. pneumoniae are three most common pathogens in the ICU and are multi-drug resistant in many cases (19,20). The above data indicate that when EM infections are combined with infections of other bacteria, although EM is sen- shows sensitivity only to tigecycline and polymyxin B.…”

Section: Discussionmentioning

confidence: 94%

Sepsis Caused by Elizabethkingia meningoseptica Successfully Treated by Polymyxin B: A Case Report

Zou

et al. 2020

Iran Red Crescent Med J

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Introduction: Elizabethkingia meningoseptica (EM) is a non-fermenting Gram-negative bacterium that is a conditional pathogen and easily causes infection in neonates and immunocompromised patients. The infection of the bacterium is prone to develop multi-drug resistance, difficult to treat, and associated with a high mortality rate. Case Presentation: A 28-year-old female was admitted to the intensive care unit (ICU) of our hospital due to fulminant myocarditis, cardiogenic shock, acute heart failure, and multiple organ dysfunction syndrome (MODS) on 24 April 2019. The patient developed a lung infection and sepsis after admission. Two sputum culture tests on 27 April and 4 May showed infection with Pseudomonas aeruginosa and multi-drug resistance. The minimum inhibitory concentration (MIC) for imipenem was 4 mg/L and 8 mg/L, respectively. Four blood cultures on 9 May suggested an EM infection and multi-drug resistance, the MIC for imipenem was ≥ 16 mg/L. Due to the serious condition of the patient, imipenem-resistant lung infection, and typical sepsis manifestations, we initiated a regimen of polymyxin B combined with meropenem between 3 and 12 May. The infection was well-controlled and the patient was discharged on 14 May. Conclusions: A polymyxin B-based combinational regimen is effective in the treatment of sepsis due to EM and play an important role in controlling EM-associated mixed infections.

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Hospital-wide comparison of health care-associated infection among 8 intensive care units: A retrospective analysis for 2010-2015

Cited by 21 publications

References 27 publications

Aminoglycoside Concentrations Required for Synergy with Carbapenems against Pseudomonas aeruginosa Determined via Mechanistic Studies and Modeling

Aminoglycoside Concentrations Required for Synergy with Carbapenems against Pseudomonas aeruginosa Determined via Mechanistic Studies and Modeling

Fatores De Risco Às Infecções Relacionadas À Assistência Em Unidades De Terapia Intensiva*

Sepsis Caused by Elizabethkingia meningoseptica Successfully Treated by Polymyxin B: A Case Report

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