Identifying Risk Factors for Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit

Sultan, Amira M.; Seliem, Wael

doi:10.18295/squmj.2018.18.01.012

Cited by 32 publications

(42 citation statements)

References 22 publications

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“…Ayrıca invaziv girişimlerin sık uygulanmasıda sağlık bakım ilişkili enfeksiyon (SBİE)'ların sıklığını yükseltir (3,4). SBİE'ler bu bebekler için önemli bir morbidite ve mortalite nedeni olup hastanede kalış süresini ve maliyetleri arttırır (3,5,6).…”

Section: Introductionunclassified

Yenidoğan Yoğun Bakım Ünitesinde Gelişen Sağlık Bakım İlişkili Enfeksiyonlar: Son 6 Yılın Değerlendirilmesi

Karabay¹,

Kaya²,

Güçlü³

et al. 2020

Turkish Journal of Pediatric Disease

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Sağlık bakım ilişkili enfeksiyon (SBİE)'ların yenidoğan yoğun bakım ünite (YYBÜ)'lerinde önemli morbidite ve mortalite nedenidir. Bu çalışmada altı yıllık zaman diliminde YYBÜ'deki SBİE'ler ve ilişkili faktörlerin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Çalışma YYBÜ'de 1 Ocak 2013-31 Aralık 2018 tarihleri arasında yapıldı. YYBÜ'de gelişen SBİE'ler retrospektif olarak değerlendirildi. YYBÜ günlük aktif sürveyansla takip edildi. SBİE tanısı Center for Disease Control and Prevention (CDC) kriterlerine göre konuldu. YYBÜ'de yatan hasta sayısı, hasta günü, tespit edilen SBİE, invaziv araç kullanım oranı ve tespit edilen patojenler değerlendirildi. Bulgular: Bu araştırmada 2196 hasta, 33652 hasta günü, 4157 ventilatör günü, 3343 umbilikal kateter günü, 5210 santral venöz kateter günü ve 92 üriner kateter günü değerlendirildi. SBİE hızı %4.78 (105/2196) ve insidans dansitesi ‰3.12 (105/33652)'di. SBİE dağılımları değerlendirildiğinde; SBİE'nin 101 (%96.1)'i kan dolaşımı enfeksiyonu (KDE), ikisi (%1.90) pnömoni, biri (%0.95) merkezi sinir sistemi enfeksiyonu ve biri (%0.95) yumuşak doku enfeksiyonuydu. SBİE sıklığı 2500 gr dan büyük bebeklerde daha az (%1.02) iken, 751-1000 gr arası bebeklerde daha fazla (%23.95)'di (p<0.001). Etken dağılımına göre; %59.0 (62/105)'u gram negatif bakteri (GNB), %41.0 (43/105)'i gram pozitif bakteri (GPB) kaynaklıydı. En sık izole edilen GNB'ler; Klebsiella spp. (%34.2), Enterobacter spp. (%12.3) ve en sık izole edilen GPB'ler; Stafilokoklardı (%37.0). İnvaziv araç ilişkili enfeksiyon hızları değerlendirildiğinde; santral venöz kateter ilişkili KDE hızı ‰ 0.95, umbilikal kateter ilişkili KDE hızı ‰2.09'du. Sonuç: SBİE'ler içinde en sık görüleni KDE'di. İnvaziv girişimler ve düşük doğum ağırlığı enfeksiyon riskini artıran faktörler olarak saptandı. SBİE gelişme sıklığı bebek doğum ağırlığı ile ters orantılıydı. Düşük doğum ağırlıklı bebeklerde daha hassas enfeksiyon kontrol önlemlerinin gerektiği düşünüldü.

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Section: Introductionunclassified

Yenidoğan Yoğun Bakım Ünitesinde Gelişen Sağlık Bakım İlişkili Enfeksiyonlar: Son 6 Yılın Değerlendirilmesi

Karabay¹,

Kaya²,

Güçlü³

et al. 2020

Turkish Journal of Pediatric Disease

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“…26 The outcomes in patients with Acinetobacter infections appeared poorer if caused by isolates with resistance to multidrug antimicrobial trait. 27 Surgery, catheterization, mechanical ventilation and antibiotic therapy for aged patients and respiratory distress syndrome, mechanical ventilation and prematurity for pediatric patients were the main factors for Acinetobacter infection in one study. 28 We found fever with shock and septicemia as main medical causes, trauma and organectomy as main surgical event, while indwelling catheter and patients of coma in ventilator eventually lead to drug resistant nosocomial…”

Section: Discussionmentioning

confidence: 93%

Health Care Associated Multidrug Resistant Acinetobacter Infections in a Tertiary Critical Care Center of Dhaka, Bangladesh

Mia

Khan

Chakraborty

2020

J. Bangladesh Coll. Phys.

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Introduction: Acinetobacter spp, emerged as important pathogen exhibiting increasing antimicrobial resistance. Worldwide, multi-drug resistant Acinetobacter is being established as a significant cause of health-care-associated infections along with their resistant trait. Methods:This retrospective, cross-sectional study was done in critical care centers (CCC) of Combined Military Hospital (CMH) from May to September 2016. Total 69 patients with infection by Acinetobacter were included in this study. Center for Disease Control (CDC) criteria for selection of nosocomial infection were used. Specimen were inoculated in blood and MacConkey agar, incubated 24 hours at 37°C in aerobic condition and yield in plates were examined. Antibiotic resistance of isolated organisms were observed in Mueller Hinton agar sensitivity media by using Kirby Bauer disc diffusion method. Results:Among the total 69 (males 27, females 42,) and age range 2-75 years, Acinetobacter infected patients, 31 were from medical, 23 from surgical and 15 were from high dependency unit (HDU). Specimens were tracheal aspirate (24, 34.80%), urine (18, 26.90%), wound swab (12, 17.40%), pus (6, 8.70%), high vaginal swab (6, 8.70%) and bronchoalveolar lavage (3, 4.35%). Empiric antibiotics were given in all, one course of antibiotic was used in one, in others two or more courses were given. In the study, total 17 antibiotics were used for identifying resistance pattern of Acinetobacter isolates. Ceftazidime (91.30%), ceftriaxone (91.30%), amikacin(52.20%), gentamicin (33.33%), cotrimoxazole (50%) and ciprofloxacin (65.22%) were mostly resistant. Colistin appeared as most effective antibiotic with only 7.70% resistance rate. Conclusion: Acinetobacter, isolated in this study were resistant to most antibiotics. Colistin was the most sensitive one. Multi drug resistance (DR), extended DR and pan DR Acinetobacter organisms are reported worldwide, work on clinical presentation, trends of drug use in particular set up is important to combat the situation of ‘Going out of drug state’. J Bangladesh Coll Phys Surg 2020; 38(2): 59-63

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“…Potential confounders were selected based on previous literature [20][21][22], and included age, gender, principal diagnosis, tumor, liver failure, kidney failure, heart failure, respiratory failure, diabetes, hypertension, chronic obstructive pulmonary disease, hemodialysis, venous catheterization, mechanical ventilation, urinary catheterization, tracheotomy, surgery, ICU admission now or in the past and community infections.…”

Section: Confounding Factorsmentioning

confidence: 99%

Previous use of quinolones was not significantly correlated with antibiotic-induced carbapenem-resistant Gram-negative bacilli in China: a retrospective cohort study

Chen

Xiang

et al. 2020

Preprint

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Background: Increasing resistance to carbapenem, particularly common in Gram-negative bacilli (GNB), has become a growing public health concern around the world. The objective of this study was to investigate risk factors associated with antibiotic-induced carbapenem-resistant Gram-negative bacilli (CR-GNB) among inpatients.Methods: A retrospective cohort study was conducted in one of the largest tertiary A-level hospitals including patients with GNB cultured from any of the clinical specimens who had been admitted for more than 2 calendar days from January 2017 to June 2019. Kaplan-Meier analysis and Cox proportional hazard model were used to estimate the hazard of CR-GNB induction by antibiotics.Results: 2490 patients including 7 cohorts were included. After cox proportional risk model analysis, carbapenem, β-lactamase inhibitor, and cephalosporin had significantly higher hazards than other types of antimicrobial (P<0.001). But even without using any antimicrobials, the hazard would increase with the length of hospital stay. On multivariate analysis, carbapenem was the most principal hazard factor for antibiotic-induced CR-GNB (hazard ratio [HR], 2.968; 95% confidence interval [CI], 1.706 5.162), followed by ICU admission (HR, 1.815; 95% CI, 1.507 2.186), cephalosporin (HR, 1.605; 95% CI, 1.288 1.999), tracheotomy (HR, 1.563; 95% CI, 1.251 1.952) and β-lactamase inhibitor (HR, 1.542; 95% CI, 1.237 1.921). However, quinolone effects on antibioticinduced CR-GNB were not statistically significant.Conclusions: Prior carbapenem was a strongly risk factor for antibiotic-induced CR-GNB, but quinolone was not associated with that. Rational use of carbapenems should be implemented and antimicrobial stewardship policies should be adjusted according to the characteristics of each hospital.

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Identifying Risk Factors for Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit

Abstract: Various risk factors were significantly associated with CRAB-caused HAIs among the studied NICU patients.

Cited by 32 publications

References 22 publications

Yenidoğan Yoğun Bakım Ünitesinde Gelişen Sağlık Bakım İlişkili Enfeksiyonlar: Son 6 Yılın Değerlendirilmesi

Yenidoğan Yoğun Bakım Ünitesinde Gelişen Sağlık Bakım İlişkili Enfeksiyonlar: Son 6 Yılın Değerlendirilmesi

Health Care Associated Multidrug Resistant Acinetobacter Infections in a Tertiary Critical Care Center of Dhaka, Bangladesh

Previous use of quinolones was not significantly correlated with antibiotic-induced carbapenem-resistant Gram-negative bacilli in China: a retrospective cohort study

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