Incidence of ventilator-associated pneumonia: Egyptian study

Elkolaly, Reham M.; Bahr, Hoda M.; El-Shafey, Basem I.; Basuoni, Ahmed S.; Elber, Eman H.

doi:10.4103/ejb.ejb_43_18

Cited by 10 publications

(10 citation statements)

References 20 publications

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“…In our Pulmonary ICU, the most common organism was K. pneumoniae . This finding is not in agreement with reports from the USA which suggest that P. aeruginosa is the most frequent bacterium isolated from the respiratory tract (31.6%) [ 31 ], and also, the Egyptian study by Elkolaly et al in their results found that the isolated organisms were Pseudomonas (37.5%), Klebsiella (25%), Staphylococcus (20.8%), and methicillin-resistant Staphylococcus aureus (4.2%) [ 32 ].…”

Section: Discussioncontrasting

confidence: 58%

Antibiograms of intensive care units at an Egyptian tertiary care hospital

et al. 2021

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Background Intensive care unit (ICU) infection management is a growing challenge, and physicians should have regularly updated antibiograms. The aim of this study was to find out the prevalence of pathogens and to determine their antibiotic susceptibility in different ICUs of an Egyptian tertiary care hospital. This retrospective record-based cross-sectional study was conducted from the first of January to the last of December 2019 with a total of 45,221 diagnostic first-isolate culture/patient obtained from different ICUs in Zagazig University Hospitals. The antibiogram construction was done according to Clinical and Laboratory Standards Institute instructions and a Web-based antibiogram at Stanford University. Results The positive blood isolate was the most prevalent infection site (32.37%) followed by sputum and urine isolates. Gram-negative microorganisms (74.41%) were the most common pathogens, with Klebsiella pneumoniae as the most frequently identified one with an incidence of 33.51% followed by Escherichia coli with 19.3% incidence. Antibiotic sensitivity showed that colistin is the most effective antibiotic with 96.2%, 94.7%, and 89.9% sensitivity for Klebsiella, E. coli, and Acinetobacter, respectively, while carbepenems sensitivity was extremely low, showing 19.5% and 19% imipenem and meropenem sensitivity for Klebsiella, 48% imipenem and 52.7% meropenem sensitivity for E. coli, 20.1% imipenem and 20.3% meropenem sensitivity for Acinetobacter, and 17.3% imipenem and 15.2% meropenem sensitivity for Pseudomonas aeruginosa. Fungal infection in our results represented less than 1%. Conclusion Our study provides a local baseline epidemiological data which describes the extent of the ICU infections problem in this tertiary care hospital. Trial registration ClinicalTrials.gov (NCT04318613)

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Section: Discussioncontrasting

confidence: 58%

Antibiograms of intensive care units at an Egyptian tertiary care hospital

et al. 2021

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“…That agrees with our study results where 35% of patients developed VAP in the follow-up period during their stay in the ICU. Also, it was documented in an Egyptian study done by Elkolaly et al [ 29 ], the incidence of VAP was 38.4% in all patients admitted to ICU which is very close to our study results.…”

Section: Discussionsupporting

confidence: 92%

Study of the gut microbiome as a novel target for prevention of hospital-associated infections in intensive care unit patients

Elfiky

Ahmed

Elmenshawy

et al. 2023

ACC

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Background: Hospital-acquired infections (HAIs) are increasing due to the spread of multi-drug-resistant organisms. Gut dysbiosis in intensive care unit (ICU) patients at admission showed an altered abundance of some bacterial genera associated with the occurrence of HAIs and mortality. In the present study, we investigated the pattern of the gut microbiome in ICU patients at admission to correlate it with the development of HAIs during ICU stay. Methods: Twenty patients admitted to the ICU were included in and a cross-matching control group of 30 healthy subjects of similar age and sex. Stool specimens were collected. Quantitative SYBR green real-time polymerase chain reaction was done for the identification and quantitation of selected bacteria.Results: Out of those twenty patients, 35% developed ventilator associated pneumonia during their ICU stay. Gut microbiome analysis showed a significant decrease in Firmicutes and Firmicutes to Bacteroidetes ratio in ICU patients in comparison to the control and in patients who developed HAIs in comparison to the control group and patients who did not develop HAIs. There was a statistically significant increase in Bacteroides in comparison to the control group. There was a statistically significant decrease in Bifidobacterium and Faecalibacterium prausnitzii and an increase in Lactobacilli in comparison to the control group with a negative correlation between Acute Physiology and Chronic Health Evaluation (APACHE) score and Firmicutes to Bacteroidetes and Prevotella to Bacteroides ratios.Conclusions: Gut dysbiosis of patients at the time of admission highlights the importance of identification of the microbiome of patients admitted at the ICU as a target for preventing of HAIs.

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“…In a recent study at Tanta University Hospitals, the incidence of VAP in all ICU patients studied was 38.4%. 13 The sample size (n) was determined using the formula: n ¼ Z 2 P 1 À P ð Þ=d 214 , where n = sample size = Z value is 1.96, for a confidence level (α) of 95%, P = expected proportion (in proportion of one. If VAP infection was 38.4%, according to a previously published study, 13 so P = 0.38.4, and d = precision = 0.06.…”

Section: Sample Sizementioning

confidence: 99%

“…13 The sample size (n) was determined using the formula: n ¼ Z 2 P 1 À P ð Þ=d 214 , where n = sample size = Z value is 1.96, for a confidence level (α) of 95%, P = expected proportion (in proportion of one. If VAP infection was 38.4%, according to a previously published study, 13 so P = 0.38.4, and d = precision = 0.06. So, the calculated minimal sample size will be "357".…”

Section: Sample Sizementioning

confidence: 99%

Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales

Hegazy¹,

Bahey²,

Hagar³

et al. 2022

IDR

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Background: Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant gram-negative bacteria has been proven to be an escalating public health challenge in Egypt owing to its high mortality rate and raised health care costs. Purpose: Detection of carbapenem-resistant gram-negative bacilli among VAP patients, genotypic identification of carbapenemase genes in the isolated strains with evaluation of their impact on patient outcome and detection of carbapenemase-producing enterobacterales by MASTDISCS combi Carba plus disc system. Methods: Broncho-alveolar lavage fluid (BALF) and endotracheal aspirate were collected aseptically from clinically suspected VAP patients. Pathogen identification and antibiotic sensitivity testing were done. Carbapenemase-encoding genes (bla KPC , bla NDM , and bla OXA-48 ) were tested by PCR in all carbapenem-resistant gram-negative isolates. Performance of MASTDISCS combi Carba plus in isolated Enterobacterales was assessed in relation to the PCR results. Results: Eighty-three carbapenem-resistant gram-negative isolates were detected. The most frequent pathogens were Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa representing 34.9%, 20.5% and 18.1%, respectively. bla KPC was the predominant gene. Patients with persistent mechanical ventilation less than 15 days and Pseudomonas aeruginosa infection were significantly associated with a higher death rate. MAST-Carba plus had the highest sensitivity, specificity, positive and negative predictive values for detecting OXA-48 carbapenemases representing 81.8%, 92.5%, 75% and 94.9%, respectively. Conclusion: Worse outcome in VAP patients was associated with carbapenem-resistant gram-negative bacilli. MASTDISCS combi Carba plus is an efficient simple method for identification of different carbapenemases among enterobacterales.

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Incidence of ventilator-associated pneumonia: Egyptian study

Cited by 10 publications

References 20 publications

Antibiograms of intensive care units at an Egyptian tertiary care hospital

Antibiograms of intensive care units at an Egyptian tertiary care hospital

Study of the gut microbiome as a novel target for prevention of hospital-associated infections in intensive care unit patients

Carbapenem-Resistant Gram-Negative Bacilli Causing Ventilator Associated Pneumonia: Study of MASTDISCS Combi Carba Plus for Detection of Carbapenemase Producing Enterobacterales

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