Rates Of Multidrug-resistant Organisms Research Articles

Source, pattern and antibiotic resistance of blood stream infections in hematopoietic stem cell transplant recipients

Mucositis developing as a result of myelo-ablative high dose therapy administered prior to hematopoietic stem cell transplantation (HSCT) is associated with the risk of bacteremia. The aim of the present study was to detect the pattern of bacteremia coinciding with the present practice of HSCT, to study the contribution of health-care associated infection (HAI) to the pattern of infection, in the context of the problem of antibiotic resistance in HSCT recipients. Patients and methodsThis is a retrospective, single center study including patients who developed febrile neutropenia (FN) among HSCT recipients in one year duration. ResultsNinety FN episodes were recorded in 50 patients. Out of 39 positive blood cultures, Gram negative rods (GNR) were the predominant pathogens, constituting 67% (n=26) of isolated organisms, while 33% of infections were caused by gram positive cocci (GPC) (n=13). Bacteremia was significantly associated with central venous line (CVL) infections and gastroenteritis (diarrhea and vomiting) with a p-value 0.024, 0.20 and 0.0001, respectively. Multi-drug resistant organisms (MDROs) were identified in 27 (69%) of the 39 positive blood cultures. ConclusionIn one year duration, gram negative pathogens were the predominant causes of infection in HSCT recipients with high rates of MDROs in our institution. Gastroenteritis and central venous line infections are the main sources of bacteremia.

Antibiogram of Urinary Isolates

Long term care facilities (LTCFs), especially those with high levels of acuity, often breed high levels of multidrug-resistant organisms (MDROs). 1 Prabaker K. Lin M.Y. McNally M. Transfer from high-acuity long-term care facilities is associated with carriage of Klebsiella pneumoniae carbapenemase–producing Enterobacteriaceae: A multihospital study. Infect Control Hosp Epidemiol. 2012; 33: 1193-1199 Crossref PubMed Scopus (82) Google Scholar Facilities should not assume that published rates of MDROs reflect the level of MDROs in their facility. Considerable variation between LTCFs exists. 2 Crnich C.J. Duster M. Hess T. et al. Antibiotic resistance in non-major metropolitan skilled nursing facilites: Prevalence and inter-facility variation. Infect Control Hosp Epidemiol. 2012; 33: 1172-1174 Crossref PubMed Scopus (16) Google Scholar Unfortunately, it is our impression that many LTCFs are not tracking or aware of their burden of MDROs. Perhaps a good starting point and potential motivator for antibiotic stewardship is the construction of a facility-specific antibiogram.

A study on bacterial profile of burn wound infections

Aim: This study was conducted to find out the bacterial aetiological agents of burn wound infections with antimicrobial testing of the bacterial isolates. Materials and Methods: This is a descriptive study of 203 patients with burn wound infections at Government Medical College, Thiruvananthapuram during the period January 2010 to April 2011. The specimens were cultured using aerobic microbiological techniques. Antimicrobial susceptibility testing to different agents was carried out using the disc diffusion method. Results: Cultures from burn wound revealed Pseudomonas aeruginosa as the most common organism followed by Staphylococcus aureus, Escherichia coli, Acinetobacter baumannii and Klebsiella pneumoniae. There was a high rate of multidrug-resistant organisms. However, all the staphylococci were susceptible to Vancomycin and the gram negatives were susceptible to Carbapenems. Conclusion: Collection of appropriate specimens for culture before starting of antibiotics helps in better management, along with isolation precautions. However close follow-up and repeat specimens are necessary for appropriate change in antibiotics. For empiric treatment Vancomycin and Imipenem appear to be a good combination in this hospital.

Certification in infection control matters: Impact of infection control department characteristics and policies on rates of multidrug-resistant infections

The study objective is to describe infection control policies aimed at multidrug-resistant organisms (MDRO) in California hospitals and assess the relationship among these policies, structural characteristics, and rates of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) bloodstream infections and Clostridium difficile infections. Data on infection control policies, structural characteristics, and MDRO rates were collected through a 2010 survey of California infection control departments. Bivariate and multivariable Poisson and negative binomial regressions were conducted. One hundred eighty hospitals provided data (response rate, 54%). Targeted MRSA screening upon admission was reported by the majority of hospitals (87%). The majority of hospitals implemented contact precautions for confirmed MDRO and C difficile patients; presumptive isolation/contact precautions for patients with pending screens were less frequently implemented. Few infection control policies were associated with lower MDRO rates. Hospitals with a certified infection control director had significantly lower rates of MRSA bloodstream infections (P < .05). Although most California hospitals are involved in activities to decrease MDRO, there is variation in specific activities utilized with the most focus placed on MRSA. This study highlights the importance of certification and its significant impact on infection rates. Additional research is needed to confirm these findings.