Trends in prevalence of multidrug-resistant bacteria in patients undergoing intensive therapy
Abstract number: 1134_04_196
Wroblewska M., Rudnicka J., Marchel H., Luczak M.
The analysis of change in prevalence and resistance to antibiotics of bacteria isolated from patients hospitalized in two intensive care units (ICU) of a tertiary care hospital.
The clinical specimens comprised blood, pus, sputum, bronchial aspirates, wound swabs and peritoneal swabs taken intraoperatively. An analysis comprised 1673 bacterial strains isolated over a period of two years: 861 (51.5%) strains from ICU-A and 812 (48.5%) strains from ICU-B of a university-affiliated hospital (1200 beds). Identification of the isolates were done with API and VITEK automated tests (BioMerieux), while susceptibility testing by a disk-diffusion method according to the NCCLS recommendations.
Prevalence of Gram-positive cocci in ICU-A decreased from 35.3% in 2002 to 19.1% in 2003, while in ICU-B from 27.7% to 16.4%, respectively. There was an increase in the frequency of isolation of non-fermenting Gram-negative rods (ICU-A: from 32.9% to 49.3% and in ICU-B from 41.2% to 48.8%) in the analysed period. Prevalence of Gram-negative rods of the Enterobacteriaceae family and enterococci remained stable in both ICUs. Overall a higher percentage of multi-drug resistant strains was isolated from ICU-A patients in comparison to ICU-B. An emergence of Acinetobacter spp. strains resistant to imipenem was recorded in ICU-A (from 3.6% in 2002 to 12.1% in 2003) and ICU-B (from 2.9% to 6.7%, respectively). There was a marked increase in HLAR strain isolation in ICU-A (from 22.7% in 2002 to 86.4% in 2003) and ICU-B (from 29.4% to 90.0%, respectively). However, frequency of methicillin-resistant S. aureus declined in ICU-A from 69.6% to 44.1%, while in ICU-B from 70.0% to 64.1%.
(1) A rise in prevalence of Gram-negative rods was observed, particularly of the non-fermenters group. (2) Overall a higher percentage of multi-drug resistant strains was isolated from ICU-A, corresponding to longer patients mean stay in comparison to ICU-B. (3) Imipenem-resistant strains of Acinetobacter spp. have emerged in both ICUs. (4) Monitoring of bacterial prevalence and susceptibility patterns helps in determining optimal empiric therapy of infections in critically ill patients.
|Session name:||XXIst ISTH Congress|
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