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2022, Number 8

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Med Crit 2022; 36 (8)

Antimicrobial susceptibility and mortality of community and nosocomial acquired infections in the Intensive Care Unit at Hospital Ángeles del Carmen

Corona MJC, Alfaro RCG, Piña HCY

Language: Spanish
References: 18
Page: 514-520
PDF size: 255.67 Kb.


ABSTRACT

Introduction: local identification of antimicrobial susceptibility and resistance patterns must be a priority in intensive care units. Material and methods: a cohort study was conducted in the intensive care unit from 2018 to 2020, identifying patients with an infectious diagnosis and a positive culture, with prospective clinical and laboratory follow-up. Antimicrobial resistance patterns were analyzed according to source, gram, type of infection, acute phase reactants and outcome, comparing means and proportions with χ2, Student t and ANOVA. OR were obtained to identify resolution-associated variables. A p < 0.05 value was considered as statistically significant. Results: 308 cultures were analyzed, obtained from 188 patients. Primary souces were respiratory, urinary and bloodstream (76.7%), 65.3% were from in-hospital infections, and 65% were caused by gram-negative multi-drug resistant bacteria. Community cultures were more associated with infection compares with in-hospital cultures (85 vs 61.7%, OR 3.5, 95% CI 1.93-6.45, p < 0.001). Gram-negative bacteria had a greater association with infection compared with gram-positive (71.8 vs 66%, OR 1.10, 95% CI 0.91-1.32, p = 0.297), but infections caused by gram-positive bacteria had a greater association with resolution (82.1 vs 68.8%, OR 2.07, 95% CI 1.16-3.70, p = 0.019), as well as community infections (82.2 vs 68.7%, OR 2.11, 95% CI 1.18-3.77, p = 0.016). Conclusion: multi-drug resistant gram-negative bacteria were the principal isolates found in respiratory, urine and bloodstream infections in our intensive care unit. Community infections and gram-positive isolates were associated with greater resolution rates.


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