Prevalence of multidrug drug resistant organisms and hand hygiene compliance in surgical NICU in Cairo University Specialized Pediatric Hospital

Halim, Mona M A; Eyada, Iman; Tongun, Rose Micheal

doi:10.1016/j.epag.2018.09.003

Cited by 10 publications

(14 citation statements)

References 26 publications

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“…On the other hand, CONS (12.5%) was the most common gram-positive pathogen. These results were similar to the results reported by other researchers studying bacterial strains in Egypt [15,17] as well as from countries other than Egypt. Osifo, and Aghahowa from Nigeria reported that E. coli and Klebsiella pneumoniae were the most frequently isolated pathogens [18].…”

Section: Discussionsupporting

confidence: 92%

“…In this study, gram-negative isolates (57.5%, n = 736) were more prevalent compared to gram-positive ones (31.1%, n = 399). Comparable results were found by Halim et al [ 15 ] where gram-negative bacteria took the upper hand among all nosocomial pathogens (53%) while gram-positive organisms represented 37.9%. Similarly, gram-negative organisms constituted 65.7% of cases in a study conducted by Sawhney and colleagues [ 16 ].…”

Section: Discussionsupporting

confidence: 60%

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Prevalence and antimicrobial susceptibility profile of multidrug-resistant bacteria among intensive care units patients at Ain Shams University Hospitals in Egypt—a retrospective study

Fahim

2021

J. Egypt. Public. Health. Assoc.

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Background The nightmare of the rising numbers of multidrug-resistant organisms (MDROs) requires the implementation of effective stewardship programs. However, this should be preceeded by making available evidence-based knowledge regarding the local antimicrobial resistance pattern, which is fundamental. The aim of the current study is to determine the prevalence of MDRO among different Ain Shams University Hospitals (ASUHs) intensive care units (ICUs) and detect the resistance profile of the common pathogens. Results The 1-year records of a total of 1280 pathogens were studied. The highest number of pathogens were isolated from blood cultures (44.84%), followed by urine (41.41%) then wound swabs (13.75%). Gram-negative isolates (57.5%) were more prevalent than gram-positive ones (31.1%). The most frequently isolated pathogens were Klebsiella spp. (22.5%), Escherichia coli (13.4%), and Coagulase-negative Staphylococci (12.5%). The highest percentage of resistance among gram-positive organisms was exhibited by penicillin (89.5%) followed by erythromycin (83.98%) and then cefoxitin (76.52%). None of the isolates showed resistance to linezolid and resistance to vancomycin was minimal (2.62%). Gram-negative isolates exhibited high overall resistance to all used antibiotic classes. The least frequency of resistance was recorded against nitrofurantoin (52.5%), amikacin (58.01%), followed by imipenem (59.78%) and meropenem (61.82%). All isolates of Pseudomonas and Acinetobacter showed 100% susceptibility to colistin. Conclusions The prevalence of antibiotic resistance in Ain Shams University Hospitals (ASUHs) was high among both gram-negative and gram-positive organisms. This high resistance pattern foreshadows an inevitable catastrophe that requires continuous monitoring and implementation of effective antibiotic stewardship.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 60%

Prevalence and antimicrobial susceptibility profile of multidrug-resistant bacteria among intensive care units patients at Ain Shams University Hospitals in Egypt—a retrospective study

Fahim

2021

J. Egypt. Public. Health. Assoc.

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“…Conversely, Wang et al showed that out of the 79 cases of MDRIs, 43 (54.4%) cases were detected in the whole blood, 23 (29.1%) cases in sputum [ 11 ], matching several previous studies which detected most of MDR isolates at blood cultures (69.7%) [ 2 ]. Similar findings were obtained in other studies in Egypt [ 29 – 31 ] and other different countries (including China, Mexico, South Africa, and Kenya) [ 32 – 34 ].…”

Section: Discussionsupporting

confidence: 91%

“…Healthcare-associated infections (HCAI) are a global major threat in intensive care units. Infections affecting patients in Pediatric and Neonatal intensive care units (PICU and NICU) range from 6 to 12% and 10 to 25% respectively [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care

Rezk

Bawady

Abdelghaffar

2021

Egypt Pediatric Association Gaz

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Background Healthcare-associated infections (HCAI) are a worldwide threat in intensive care units particularly in the pediatric intensive care units with a major cause of morbidity and mortality among this age group. The aim of the study is to determine the prevalence and risk factors predisposing to multidrug-resistant organisms (MDROs) infections among pediatric intensive care unit (PICU) patients at Ain Shams Pediatric University Hospitals as well as determining mortality and morbidity rates along with the length of stay at PICU. Results Culture results revealed that of the 282 patients evaluated, only 26 (9.2%) were MDROs (half of the affected patients had Acinetobacter species (50%) and the rest of them were free, 256 (90.8%). Our study revealed that the majority of MDROs were isolated from sputum in more than half of the patients 19/32 (59.3%) followed by whole blood in 10/32 (31.2%) and urine in 3/32 (9.4%). Pulmonary system was the most common affected site and was mainly colonized by MDR Acinetobacter (71.4%) followed by MDR Klebsiella (41.6%). Regarding MDR risk factors in our PICU, multivariate logistic regression analyses showed significant relationship between MDROs and age under 1 year (odds ratio [OR] 2.4554; 95% confidence interval [95% CI] (1.072–5.625); p = 0.043) and underlying pulmonary disease (OR 2.417; 95% CI (1.014–5.761); p = 0.592). A statistically significant higher mortality was detected in patients colonized with MDROs 9/26 (34.6%) versus MDROs non-colonized patients 32/256 (12.5%) [P=0.002]. Moreover, MDROs infection has negative significant risk with discharged patients ([OR] 0.269; [95% CI] (0.111–0.656); p = 0.002). Additionally, patients infected with MDROs did have significantly greater PICU stay than those non-infected [median (IQR), 16.5 (10.7–22), 5 (4–8), P=0.00] and have longer ventilation [median (IQR), 15.5 (10–18), 3 (2–10), P=0.00]. Conclusion Prevalence of MDROs (9.2%) was low among PICU cases at Ain Shams University Hospitals. Most common MDROs were Acinetobacter and Klebsiella followed by pseudomonas species. The frequency of gram-negative organisms is much more common than gram-positive organisms. An increasing rate of antimicrobial resistance with increasing mortality and morbidity among PICU patients is observed worldwide; even for new categories, so, strict infection control programs should be implemented.

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“…Interestingly, the introduction of ABHR in clinical environments is also associated with a reduction in nosocomial transmission of multidrug resistant bacteria such as MRSA and VRE (21) and extended-spectrum β-lactamase producing bacteria (22). This latter finding is particularly significant, given the increasing prevalence of multidrug resistant organisms in both acute (23) and chronic (24) healthcare settings globally.…”

Section: Benefits Of Abhrmentioning

confidence: 99%

A review of the science and clinical use of alcohol-based hand rubs

Law

Tan

et al. 2022

IJIC

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Alcohol has a longstanding history as an antiseptic, and the coronavirus disease 2019 (COVID-19) pandemic has sparked a renewed interest in its use as a hand sanitizer. Alcohol works by denaturing protein and rendering cell membranes permeable. It offers excellent germicidal effects against Gram-positive and Gram-negative bacteria, Mycobacterium tuberculosis, fungi, and lipid-containing viruses. However, it is less reliable against non-lipid containing viruses and is ineffective against bacterial and fungal spores. Alcohol-based hand rub (ABHR) usually contains 60–90% isopropanol or ethanol. Additives such as chlorhexidine to complement the action of alcohol and emollients to ameliorate the drying effect of alcohol are often included to improve the formulation of ABHR. In the clinical setting, ABHR provides biocidal activity against multidrug resistant bacteria such as methicillin-resistant Staphylococcus aureus as well as viruses like human coronavirus, severe acute respiratory syndrome coronavirus, and Middle East respiratory syndrome. Moreover, its use is associated with an improved compliance with hand hygiene, which has been shown to translate into better patient outcomes. However, there are cases of intoxications secondary to ingestion of ABHR or adulterated alcohol when resources are diverted away from the normal beverage production to meet the increased need for hand sanitizer during the COVID-19 pandemic. The risk of unintentional topical absorption and fire hazard among healthcare workers is low but should not be ignored. We proposed recommendations to mitigate the risk of ABHR ingestion and poisoning as well as that of fire hazard.

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Prevalence of multidrug drug resistant organisms and hand hygiene compliance in surgical NICU in Cairo University Specialized Pediatric Hospital

Cited by 10 publications

References 26 publications

Prevalence and antimicrobial susceptibility profile of multidrug-resistant bacteria among intensive care units patients at Ain Shams University Hospitals in Egypt—a retrospective study

Prevalence and antimicrobial susceptibility profile of multidrug-resistant bacteria among intensive care units patients at Ain Shams University Hospitals in Egypt—a retrospective study

Incidence of emerging multidrug-resistant organisms and its impact on the outcome in the pediatric intensive care

A review of the science and clinical use of alcohol-based hand rubs

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