Details

Autor(en) / Beteiligte

• Masse, J.
• Elkalioubie, A.
• Blazejewski, C.
• Ledoux, G.
• Wallet, F.
• Poissy, J.
• Preau, S.
• Nseir, S.

Titel

Colonization pressure as a risk factor of ICU-acquired multidrug resistant bacteria: a prospective observational study

Ist Teil von

• European journal of clinical microbiology & infectious diseases, 2017-05, Vol.36 (5), p.797-805

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2017

Quelle

Springer LINK 全文期刊数据库

Beschreibungen/Notizen

• The primary objective of this study was to evaluate the impact of colonization pressure on intensive care unit (ICU)-acquired multidrug resistant bacteria (MDRB). All patients hospitalized for more than 48 h in the ICU were included in this prospective observational study. MDRB were defined as methicillin resistant Staphylococcus aureus , Pseudomonas aeruginosa resistant to ceftazidime or imipenem, Gram-negative bacilli producing extended-spectrum beta-lactamases (ESBL), and all strains of Acinetobacter baumannii and Stenotrophomonas maltophilia . Colonization pressure was daily calculated in the three participating ICUs. Univariate and multivariate analyses were used to determine risk factors for ICU-acquired MDRB. Two hundreds and four (34%) of the 593 included patients acquired an MDRB during their ICU stay. Multivariate analysis identified colonization pressure as an independent risk factor for ICU-acquired MDRB (OR (95% CI) 4.18 (1.03–17.01), p = 0.046). Other independent risk factors for ICU-acquired MDRB were mechanical ventilation (3.08 (1.28–7.38), p = 0.012), and arterial catheter use (OR, 3.04 (1.38–6.68), p = 0.006). ICU-acquired MDRB were associated with increased mortality, duration of mechanical ventilation, and ICU stay. However, ICU-acquired MDRB was not independently associated with ICU-mortality. Colonization pressure is an independent risk factor for acquiring MDRB in the ICU.