Nosocomial bacterial infections and their antimicrobial susceptibility patterns among patients in Ugandan intensive care units: A cross sectional study

被引：54
作者：
Agaba P. [1 ]
Tumukunde J. [1 ]
Tindimwebwa J.V.B. [1 ]
Kwizera A. [1 ]
机构：
[1] Department of Anaesthesia, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala
来源：
BMC Research Notes | / 10卷 / 1期
关键词：
Drug resistance; Intensive care unit; Mechanical ventilation; Nosocomial infections; Traumatic brain injury;
D O I：
10.1186/s13104-017-2695-5
中图分类号：
学科分类号：
摘要：
Background: The intensive care unit (ICU) admits critically ill patients requiring advanced airway, respiratory, cardiac and renal support. Despite the highly-specialized interventions, the mortality and morbidity is still high due to a number of reasons including nosocomial infections, which are the most likely complications in hospitalized patients with the rates being highest among ICU patients. Methods: In this cross-sectional study of 111 adult patients admitted to 2 of the ICUs in Uganda, we set out to describe the commonest bacterial infections, their antimicrobial susceptibility patterns and factors associated with development of a nosocomial infection. Results: Klebsiella pneumoniae (30%), Acinetobacter species (22%) and Staphylococcus aureus (14%) were the most frequently isolated bacteria. The prevalence of multidrug resistant bacterial species was 58%; 50% Escherichia coli and 33.3% Klebsiella pneumoniae were extended spectrum beta lactamase or AmpC beta lactamase producers and 9.1% Acinetobacter species were extensive drug resistant. Imipenem was the antibiotic with the highest susceptibility rates across most bacterial species. Institution of ventilator support (P 0.003) and severe traumatic brain injury (P 0.035) were highly associated with the development of nosocomial infections. Conclusion: Due to the high prevalence of multi drug resistant (MDR) and extensive drug resistant bacterial species, there is a need for development of strong policies on antibiotic stewardship, antimicrobial surveillance and infection control to help guide empirical antibiotic therapy and prevent the spread of MDR bacteria and antibiotic drug resistance. © 2017 The Author(s).
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  • [1] Vincent J., Nosocomial infections in adult intensive-care units, Lancet, 361, 9374, pp. 2068-2077, (2003)
  • [2] Erlandsson C.M., Hanberger H., Eliasson I., Hoffmann M., Isaksson B., Lindgren S., Et al., Surveillance of antibiotic resistance in ICUs in southeastern Sweden. ICU Study Group of the South East of Sweden, Acta Anaesthesiol Scand, 43, 8, pp. 815-820, (1999)
  • [3] Asensio A., Oliver A., Gonzalez-Diego P., Baquero F., Perez-Diaz J.C., Ros P., Et al., Outbreak of a multiresistant Klebsiella pneumoniae strain in an intensive care unit: Antibiotic use as risk factor for colonization and infection, Clin Infect Dis, 30, 1, pp. 55-60, (2000)
  • [4] Richards M.J., Edwards J.R., Culver D.H., Gaynes R.P., Nosocomial infections in combined medical-surgical intensive care units in the United States, Infect Control Hosp Epidemiol, 21, 8, pp. 510-515, (2000)
  • [5] Trilla A., Epidemiology of nosocomial infections in adult intensive care units, Intensive Care Med, 20, pp. S1-S4, (1994)
  • [6] Eggimann P., Pittet D., Infection control in the ICU, Chest, 120, 6, pp. 2059-2093, (2001)
  • [7] Brasme L., Nordmann P., Fidel F., Lartigue M.F., Bajolet O., Poirel L., Et al., Incidence of class A extended-spectrum beta-lactamases in Champagne-Ardenne (France): A 1 year prospective study, J Antimicrob Chemother, 60, 5, pp. 956-964, (2007)
  • [8] Chambers H.F., Community-associated MRSA-resistance and virulence converge, N Engl J Med, 352, 14, pp. 1485-1487, (2005)
  • [9] Weinstein R.A., Nosocomial infection update, Emerg Infect Dis, 4, 3, pp. 416-420, (1998)
  • [10] Jarvis W.R., Infection control and changing health-care delivery systems, Emerg Infect Dis, 7, 2, pp. 170-173, (2001)
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