Magnitude and Prevention of Nosocomial Infections in the Intensive Care Unit

Fridkin, Scott K.; Welbel, Sharon F.; Weinstein, Robert A.

doi:10.1016/s0891-5520(05)70366-4

Cited by 175 publications

(96 citation statements)

References 53 publications

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“…Escherichia coli, one of the most common pathogens in community-acquired and nosocomial infections (5,15), is usually susceptible to amoxicillin-clavulanate; with increasing use of this antimicrobial agent, however, resistance has begun to emerge (8,12,17,29,30). Resistance is most often conferred by plasmid-encoded TEM-type ␤-lactamase production (23,28).…”

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Variety of β-Lactamases Produced by Amoxicillin-Clavulanate-Resistant Escherichia coli Isolated in the Northeastern United States

Kaye

Gold

Schwaber

et al. 2004

Antimicrob Agents Chemother

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This study analyzed the enzymatic basis and molecular epidemiology of amoxicillin-clavulanate-resistant Escherichia coli isolated by the microbiology laboratory of a United States tertiary care hospital. From October 1998 to December 1999, all E. coli isolates were screened for ampicillin-sulbactam resistance. Of 283 isolates that tested resistant to ampicillin-sulbactam, 69 unique patient isolates were also resistant to amoxicillinclavulanate by disk diffusion testing (zone diameter < 13 mm). These amoxicillin-clavulanate-resistant E. coli isolates underwent agar dilution testing, pulsed-field gel electrophoresis, PCR analysis, and isoelectric focusing. The mean age of study patients was 52 years; 78% were female. Among the isolates, 12 were nosocomial (rate of amoxicillin-clavulanate resistance ‫؍‬ 4.7%) and 57 were community acquired (rate of amoxicillinclavulanate resistance ‫؍‬ 2.8%). No predominant strain was identified. By agar dilution testing, 67 isolates were nonsusceptible (39 resistant and 28 intermediate) to amoxicillin-clavulanate and 37 were piperacillin-tazobactam resistant but only 8 were ceftazidime resistant (ceftazidime MIC > 32 g/ml). Two isolates were susceptible to amoxicillin-clavulanic acid by agar dilution, although they were resistant by disk diffusion testing. The distribution of ␤-lactamases was as follows: the TEM type alone was found in 52 isolates, the AmpC type was found in 4 isolates (2 identified as containing CMY-2), the TEM type and CMY-2 were found in 2 isolates, and the OXA type was found in 1 isolate. Also, there was one isolate with the TEM type and the SHV type and one with the TEM type and a second, unidentified enzyme. Among the isolates with TEM-type enzymes, two extended-spectrum ␤-lactamase-producing isolates were identified but two isolates with inhibitor-resistant TEM (IRT) enzymes (one with TEM-34 [IRT-6] and the other with a novel enzyme [tentatively assigned the designation TEM-122]) were more interesting.

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confidence: 99%

Variety of β-Lactamases Produced by Amoxicillin-Clavulanate-Resistant Escherichia coli Isolated in the Northeastern United States

Kaye

Gold

Schwaber

et al. 2004

Antimicrob Agents Chemother

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“…For example, both of these purified plasma proteins enhanced the binding of Staphylococcus aureus to surfaces while inhibiting the binding of Staphylococcus epidermidis (9,12) and gram-negative bacteria (1,13,(19)(20)(21). Gram-negative bacteria, however, do colonize CVCs and other vascular access devices exposed to human blood components, resulting in bloodstream infections (23.2% of the central line-associated infections in intensive care units for 1986 to 1989 and 19.5% for 1990 to 1995) (10). This finding suggests that these organisms must not be completely inhibited by surfaces conditioned with whole blood.…”

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Biofilm Formation by Gram-Negative Bacteria on Central Venous Catheter Connectors: Effect of Conditioning Films in a Laboratory Model

2001

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Human blood components have been shown to enhance biofilm formation by gram-positive bacteria. We investigated the effect of human blood on biofilm formation on the inner lumen of needleless central venous catheter connectors by several gram-negative bacteria, specifically Enterobacter cloacae, Pseudomonas aeruginosa, and Pantoea agglomerans. Results suggest that a conditioning film of blood components promotes biofilm formation by these organisms in an in vitro system.

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“…Çeşitli çalışmalarda yoğun bakım ünitele-rinde (YBÜ) yatan hastalarda, nozokomiyal infeksiyon riskinin arttığı ve nozokomiyal infeksiyonların daha fazla görüldüğü belirtilmektedir (15,34) . YBÜ'de infeksiyon oranının yüksek bulunmasının başlıca nedenleri arasında; hastaların altta yatan hastalıklarına bağlı olarak uzun süreli yoğun bakımda kalmaları, tanı ve tedavi amacıyla invazif girişimlerin sık uygulanıyor olması, hasta başına düşen personel yetersizliği nedeniyle infeksiyon kontrol önlemlerinin yeterince uygulanamaması ve yoğun bakım ünitesi-nin fiziki koşullarından kaynaklanan yetersizlikler sayılabilmektedir (28) .…”

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Nosocomial Infections, Causative Microorganisms and Antibiotic Resistance in Batman State Regional Hospital

Dagi¹,

Mert²

2012

ANKEM Derg

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ÖZET SUMMARY Nosocomial Infections, Causative Microorganisms and Antibiotic Resistance in Batman State Regional Hospital The ratio of nosocomial infections in Batman State Regional Hospital and antibiotic resistance rates of bacteria most frequently isolated from these infections were investigated. Various samples sent from patients observed with prospective and active surveillance methods in 2009-10 and diagnosed with nosocomial infections according to the criteria of Centers for Disease Control and Prevention (CDC) were inoculated in blood agar and EMB agar and incubated for 18 to 24 hours at 37°C. The identification of species was carried out with conventional methods. Antibiotic susceptibility tests were performed with the Kirby-Bauer disk-diffusion method according to the criteria of the Clinical Laboratory Standards Institute (CLSI).In the year 2009, 3910 patients were admitted to our hospital and 36 infection attacks were detected. The rate of nosocomial infections was 0.9 %. The rate of hospital infections according to departments was 44.4 % in the urology clinic, 16.7 % in the orthopedics clinic an 16.7 % in internal medicine clinic. The most common types of hospital infections were surgical site infections (80.5 %), bloodstream infections (11.1 %) and urinary tract infections (8.3 %) respectively. The isolated microorganisms were, in order of frequency, Pseudomonas spp. (55.3 %), Escherichia coli (18.4 %) and Enterobacter spp. (7.9 %).In

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Magnitude and Prevention of Nosocomial Infections in the Intensive Care Unit

Cited by 175 publications

References 53 publications

Variety of β-Lactamases Produced by Amoxicillin-Clavulanate-Resistant Escherichia coli Isolated in the Northeastern United States

Variety of β-Lactamases Produced by Amoxicillin-Clavulanate-Resistant Escherichia coli Isolated in the Northeastern United States

Biofilm Formation by Gram-Negative Bacteria on Central Venous Catheter Connectors: Effect of Conditioning Films in a Laboratory Model

Nosocomial Infections, Causative Microorganisms and Antibiotic Resistance in Batman State Regional Hospital

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