+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Resistance in gram-negative bacilli in a cardiac intensive care unit in India: risk factors and outcome



Resistance in gram-negative bacilli in a cardiac intensive care unit in India: risk factors and outcome



Annals of Cardiac Anaesthesia 11(1): 20-26



The objective of this study was to compare the risk factors and outcome of patients with preexisting resistant gram-negative bacilli (GNB) with those who develop sensitive GNB in the cardiac intensive care unit (ICU). Of the 3161 patients ( n=3,161) admitted to the ICU during the study period, 130 (4.11%) developed health care-associated infections (HAIs) with GNB and were included in the cohort study. Pseudomonas aeruginosa (37.8%) was the most common organism isolated followed by Klebsiella species (24.2%), E. coli (22.0%), Enterobacter species (6.1%), Stenotrophomonas maltophilia (5.7%), Acinetobacter species (1.3%), Serratia marcescens (0.8%), Weeksella virosa (0.4%) and Burkholderia cepacia (0.4%). Univariate analysis revealed that the following variables were significantly associated with the antibiotic-resistant GNB: females (P=0.018), re-exploration (P=0.004), valve surgery (P=0.003), duration of central venous catheter (P<0.001), duration of mechanical ventilation (P<0.001), duration of intra-aortic balloon counter-pulsation (P=0.018), duration of urinary catheter (P<0.001), total number of antibiotic exposures prior to the development of resistance (P=0.014), acute physiology and age chronic health evaluation score (APACHE II), receipt of anti-pseudomonal penicillins (piperacillin-tazobactam) (P=0.002) and carbapenems (P<0.001). On multivariate analysis, valve surgery (adjusted OR=2.033; 95% CI=1.052-3.928; P=0.035), duration of mechanical ventilation (adjusted OR=1.265; 95% CI=1.055-1.517; P=0.011) and total number of antibiotic exposure prior to the development of resistance (adjusted OR=1.381; 95% CI=1.030-1.853; P=0.031) were identified as independent risk factors for HAIs in resistant GNB. The mortality rate in patients with resistant GNB was significantly higher than those with sensitive GNB (13.9% vs. 1.8%; P=0.03). HAI with resistant GNB, in ICU following cardiac surgery, are independently associated with the following variables: valve surgeries, duration of mechanical ventilation and prior exposure to antibiotics. The mortality rate is significantly higher among patients with resistant GNB.

(PDF emailed within 1 workday: $29.90)

Accession: 055520836

Download citation: RISBibTeXText

PMID: 18182755


Related references

Antimicrobial use and resistance among Gram-negative bacilli in an Italian intensive care unit (ICU). Journal of ChemoTherapy 18(3): 261-267, 2006

Antimicrobial resistance of Gram-negative bacilli isolated from patients in intensive care unit. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue 17(7): 409-411, 2005

Molecular characterization and risk factors for carbapenem-resistant Gram-negative bacilli colonization in children: emergence of NDM-producing Acinetobacter baumannii in a newborn intensive care unit in Turkey. Journal of Hospital Infection 92(1): 67-72, 2016

Antimicrobial resistance of Gram-negative bacilli from an intensive care unit in Trinidad, West Indies. Saudi Medical Journal 25(9): 1305, 2004

Infections with gram-negative bacilli in a cardiac surgery intensive care unit: the relative role of enterobacter. Journal of Hospital Infection 11 Suppl A: 367-373, 1988

Trends in resistance among gram-negative bacilli from intensive care unit patients in Italy from 1999 to 2002. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 43: 148, 2003

Resistance patterns among selective Gram-negative bacilli from an intensive care unit in Trinidad, West Indies. Saudi Medical Journal 25(4): 478-483, 2004

Nosocomial prevalence and resistance surveillance of gram-negative Bacilli in an intensive care unit as a Malaysian teaching hospital. Journal of Hospital Infection 40(SUPPL A): P6314, Sept, 1998

Risk of acquiring multidrug-resistant Gram-negative bacilli from prior room occupants in the intensive care unit. Clinical Microbiology and Infection 17(8): 1201-1208, 2011

Antimicrobial resistance among Gram-negative bacilli causing infections in intensive care unit patients in the United States between 1993 and 2004. Journal of Clinical Microbiology 45(10): 3352-3359, 2007

Antibiotic resistance of Gram negative bacilli strains isolated from the Intensive Care Unit in Fundeni Clinical Institute, Bucharest, Romania. Roumanian Archives of Microbiology and Immunology 68(4): 228-234, 2010

Factors that predict preexisting colonization with antibiotic-resistant gram-negative bacilli in patients admitted to a pediatric intensive care unit. Pediatrics 103(4 Pt 1): 719-723, 1999

Antimicrobial resistance pattern among aerobic gram-negative bacilli of lower respiratory tract specimens of intensive care unit patients in a neurocentre. Indian Journal of Chest Diseases and Allied Sciences 49(1): 19-22, 2007

Analysis of antimicrobial resistance among gram-negative bacilli and antimicrobial use in intensive care unit patients for 5 years in a Veterans Affairs medical center. American Journal of Infection Control 30(7): 411-416, 2002

Prevalence and risk factors for colonisation with gram-negative bacteria in an intensive care unit. Acta Clinica Belgica 55(5): 249-256, 2000