Screening for Multidrug-Resistant Bacteria as a Predictive Test for Subsequent Onset of Nosocomial Infection

Galoisy-Guibal, L; Soubirou, J L; Desjeux, G.; Dusseau, J.-Y.; Eve, Olivier; Escarment, J.; Écochard, René

doi:10.1086/507277

Cited by 10 publications

(7 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In France, isolation of resistant bacteria ranges from 30% to 40%, reaching a percentage of up to 78% of the units. (14) According to SENTRY (the Program of Antimicrobial Surveillance) results from Latin America and Brazil, the non-fermenting Gram negative rods (Acinetobacter spp. and Pseudomonas aeruginosa) multidrug-resistance, and the Enterobacteriaceae (Escherichia coli, Salmonella spp, Shigella spp and Proteus mirabilis), producers of the extended spectrum beta-lactamase (ESBL) constitute the main problem in pharmaceutical resistence in these countries.…”

Section: Resultsmentioning

confidence: 99%

“…We observed high rates of resistant isolates, except the polymyxins, since the program's inception, in 1997. (14) Of the Gram-positive cocci, oxycillin resistance among staphylococci represents an important problem in Latin America and the United States. However, rates vary significantly between hospitals and countries, although the percentage of isolates of Staphylococcus aureus sensitive to oxacillin originatimg from cases of bacteremia in Brazil, in comparison to Latin America, has been approached: 68.2% and 68.5%, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…However, rates vary significantly between hospitals and countries, although the percentage of isolates of Staphylococcus aureus sensitive to oxacillin originatimg from cases of bacteremia in Brazil, in comparison to Latin America, has been approached: 68.2% and 68.5%, respectively. (14) The prevalence of MRSA increased dramatically, becoming responsible for more than half of the staphylococcal infections in various healthcare services worldwide. At the end of the 1980s, clinically significant resistance to vancomycin became identified among enterococci (VRE).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Microrganismos isolados de pacientes em hemodiálise por cateter venoso central e evolução clínica relacionada

et al. 2013

View full text Add to dashboard Cite

Objective: To identify the microorganisms isolated on the pericatheter skin, catheter tip and blood stream of patients on hemodialysis by central venous catheter, to verify the profile of sensitivity of these microorganisms to antimicrobials and to assess the clinical evolution and mortality related to these microorganisms. Methods: A cross sectional study. The strains were isolated from the patients on hemodialysis by central venous catheter that, in a previous study, presented pericatheter skin, catheter tip and blood stream infection and were analyzed for microbiological profile and lethality related. Results: 128 microorganisms were isolated in the bloodstream in the 94 patients studied. There were 35 cases of septicemia and 27 of endocarditis. The mortality in cases of endocarditis due to methicillin-resistant Staphylococcus aureus was 100%. Conclusion: Infection in the bloodstream and endocarditis caused by methicillin-resistant Staphylococcus aureus was predictive of mortality and lethality. ResumoObjetivo: Identificar os microrganismos isolados da pele pericateter, ponta do cateter e corrente sanguínea de pacientes em hemodiálise por cateter venoso central, verificar o perfil de sensibilidade destes microrganismos aos antimicrobianos e avaliar a evolução clínica e a mortalidade relacionada a estes microrganismos. Métodos: Estudo transversal. As cepas isoladas de pacientes em hemodiálise por cateter venoso central que em estudo prévio apresentaram infecção na pele pericateter, ponta do cateter e corrente sanguínea foram analisadas quanto ao perfil microbiológico e letalidade relacionada. Resultados: Foram isolados 128 microrganismos em corrente sanguínea nos 94 pacientes estudados. Ocorreram 35 casos de septicemia e 27 de endocardite. A letalidade nos casos de endocardite por Staphylococcus aureus resistente à meticilina foi 100%. Conclusão: Infecção em corrente sanguínea e endocardite por Staphylococcus aureus resistente à meticilina são preditivas de alta mortalidade e letalidade.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Microrganismos isolados de pacientes em hemodiálise por cateter venoso central e evolução clínica relacionada

et al. 2013

View full text Add to dashboard Cite

show abstract

“…aureus infections [ 6 , 7 ]. Similarly, rectal carriage of multidrug-resistant Enterobacteriaceae on ICU admission has been identified as a key factor for subsequent bloodstream, lung, urinary tract, and central venous catheter infection [ 8 , 9 ]. Whilst the majority of these studies only assessed colonization and infection with the same bacterial species according to their antimicrobial susceptibility profile, a study conducted in a Spanish ICU found that among 77 patients who developed Pseudomonas aeruginosa ( P .…”

Section: Introductionmentioning

confidence: 99%

Hospital-acquired colonization and infections in a Vietnamese intensive care unit

et al. 2018

View full text Add to dashboard Cite

Data concerning intensive care unit (ICU)-acquired bacterial colonization and infections are scarce from low and middle-income countries (LMICs). ICU patients in these settings are at high risk of becoming colonized and infected with antimicrobial-resistant organisms (AROs). We conducted a prospective observational study at the Ho Chi Minh City Hospital for Tropical Diseases, Vietnam from November 2014 to January 2016 to assess the ICU-acquired colonization and infections, focusing on the five major pathogens in our setting: Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Klebsiella spp., Pseudomonas spp. and Acinetobacter spp., among adult patients with more than 48 hours of ICU stay. We found that 61.3% (223/364) of ICU patients became colonized with AROs: 44.2% (161/364) with rectal ESBL-producing E. coli and Klebsiella spp.; 30.8% (40/130) with endotracheal carbapenemase-producing Acinetobacter spp.; and 14.3% (52/364) with nasal methicillin-resistant S. aureus. The incidence rate of ICU patients becoming colonized with AROs was 9.8 (223/2,276) per 100 patient days. Significant risk factor for AROs colonization was the Charlson Comorbidity Index score. The proportion of ICU patients with HAIs was 23.4% (85/364), and the incidence rate of ICU patients contracting HAIs was 2.3 (85/3,701) per 100 patient days. The vascular catheterization (central venous, arterial and hemofiltration catheter) was significantly associated with hospital-acquired bloodstream infection. Of the 77 patients who developed ICU-acquired infections with one of the five specified bacteria, 44 (57.1%) had prior colonization with the same organism. Vietnamese ICU patients have a high colonization rate with AROs and a high risk of subsequent infections. Future research should focus on monitoring colonization and the development of preventive measures that may halt spread of AROs in ICU settings.

show abstract

“…Prior studies have demonstrated that for MDROs, colonization precedes infection, and antimicrobial use is higher among patients colonized with MDROs. 24,25 Importantly, our stratified analyses demonstrated consistent relationships between exposures and risk of antimicrobial receipt, including in the presumptively lower-risk strata: in the stratum of patients who were MDRO negative at baseline, tunneled catheter for CHD access still conferred a higher odds of antimicrobial receipt than arteriovenous access; and in the stratum of patients with arteriovenous access at baseline, MDRO positivity at baseline was associated with a higher odds of antimicrobial receipt. One likely interpretation of this finding is that the increased risk of antimicrobial receipt may be independent of MDRO status in patients with a tunneled catheter because of the significantly higher risk of infection with any pathogen among patients with tunneled catheter.…”

Section: Discussionmentioning

confidence: 52%

Factors associated with the receipt of antimicrobials among chronic hemodialysis patients

Patel

Kallen

Strom

et al. 2016

American Journal of Infection Control

View full text Add to dashboard Cite

Background Antimicrobial use is common among patients receiving chronic hemodialysis (CHD) and may represent an important antimicrobial stewardship opportunity. The objective of this study is to characterize CHD patients at increased risk of receiving antimicrobials, including not indicated antimicrobials. Methods We conducted a prospective cohort study over a 12-month period among patients receiving CHD in 2 outpatient dialysis units. Each parenteral antimicrobial dose administered was characterized as indicated or not indicated based on national guidelines. Patient factors associated with receipt of antimicrobials and receipt of ≥1 inappropriate antimicrobial dose were analyzed. Results A total of 89 of 278 CHD patients (32%) received ≥1 antimicrobial doses and 52 (58%) received ≥1 inappropriately indicated dose. Patients with tunneled catheter access, a history of colonization or infection with a multidrug-resistant organism, and receiving CHD sessions during daytime shifts were more likely to receive antimicrobials (odds ratio [OR], 5.16; 95% confidence interval [CI], 2.72–9.80; OR, 5.43; 95% CI, 1.84–16.06; OR, 4.59; 95% CI, 1.20–17.52, respectively). Patients with tunneled catheter access, receiving CHD at dialysis unit B, and with a longer duration of CHD prior to enrollment were at higher risk of receiving an inappropriately indicated antimicrobial dose (incidence rate ratio, 2.23; 95% CI, 1.16–4.29; incidence rate ratio, 2.67; 95% CI, 1.34–5.35; incidence rate ratio, 1.11; 95% CI, 1.01–1.23, respectively). Conclusions This study of all types of antimicrobials administered in 2 outpatient dialysis units identified several important factors to consider when developing antimicrobial stewardship programs in this health care setting.

show abstract

Screening for Multidrug-Resistant Bacteria as a Predictive Test for Subsequent Onset of Nosocomial Infection

Abstract: Carriage proved to be a risk factor for subsequent nosocomial infection. However, the carriage test was useful as a predictive tool only for patients with a positive test result.

Cited by 10 publications

References 40 publications

Microrganismos isolados de pacientes em hemodiálise por cateter venoso central e evolução clínica relacionada

Microrganismos isolados de pacientes em hemodiálise por cateter venoso central e evolução clínica relacionada

Hospital-acquired colonization and infections in a Vietnamese intensive care unit

Factors associated with the receipt of antimicrobials among chronic hemodialysis patients

Contact Info

Product

Resources

About