Pattern Dynamics of Bacteriemia and Sepsis Pathogens in ICU Patients of Emergency Service
Abstract
The results of microbiological tests of 2382 blood specimens from 698 patients of three ICUs of the N. V. Sklifosovsky Research Institute of Emergency Service were analysed for a period of 2009 to 2012. No microbial growth was detected in 1160 specimens (48.7%). In the subsequent tests 816 isolates were used. The quota of grampositive isolates in the pathogen pattern decreased from 51.68 to 35.9% and that of gramnegative isolates increased from 38.26 to 48.1%. The number of the Candida isolates increased from 7.38 to 15.2%. The frequency of the S.aureus and Enterococcus spp. isolates lowered from 26.2 to 13.3% and from 15.4 to 11.5% respectively. The quota of K.pneumoniae isolates and Acinetobacter spp. increased from 8.1 to 18.9% and from 14.1 to 17.4% respectively. Most of the S.aureus isolates were methicillin resistant. All the staphylococcal isolates were susceptible to vancomycin and linezolid. All the strains of K.pneumoniae isolated in 2009-2012 produced extended spectrum beta-lactamases. In 2012 7.8% the K.pneumoniae isolates were resistant to carbapenems. In 2012 25.5% of the Acinetobacter spp. isolates were susceptible to carbapenems and 70.2% were susceptible to cefoperazon/sulbactam.
About the Authors
T. V. Chernenkaya
N.V. Sklifosovsky Research Institute of Emergency Service
Russian Federation
Russian Federation
L. A. Borisova
N.V. Sklifosovsky Research Institute of Emergency Service
Russian Federation
Russian Federation
I. V. Aleksandrova
N.V. Sklifosovsky Research Institute of Emergency Service
Russian Federation
Russian Federation
S. I. Rei
N.V. Sklifosovsky Research Institute of Emergency Service
Russian Federation
Russian Federation
O. V. Nikitina
N.V. Sklifosovsky Research Institute of Emergency Service
Russian Federation
Russian Federation
D. A. Kosolapov
N.V. Sklifosovsky Research Institute of Emergency Service
Russian Federation
Russian Federation
References
1. Hall M.J., Williams S.N., DeFrances C.J. et al. Inpatient саrе for septicemia or sepsis: a challenge for patients and hospitals [Электронный ресурс]. Режим доступа: www.cdc.gov/nchs/data/databriefs/db62.pdf
2. Angus D.C., Linde-Zwirble W.T., Lidicker J. et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001; 29: 7: 1303-1310.
3. Sogayar A.M., Machado F.R., Rea-Neto A. et al. A multicentre, prospective study to evaluate costs of septic patients in Brazilian Intensive Care Units. Pharmacoeconomics. 2008; 26: 5: 425-434.
4. National Committee for Clinical Laboratory Standards (NCCLS). Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard. - 8th ed. - Wayne, PA: NCCLS, 2003; M02-A8.
5. Tokars Ji. Predictive value of blood cultures positive for coagulase-negative staphylococci: implications for patient care and health care quality assurance. Clin Infect Dis 2004; 39: 3: 334-341.
6. Hashairi F., Hasan H., Azlan K. et al. An eight-year review of blood culture and susceptibility among sepsis cases in emergency department in North-Eastern Malaysia. Trop Biomed 2011; 28: 3: 599-605.
7. Orsini J., Mainardi C., Muzylo E. et al. Microbiological profile of organisms causing bloodstream infection in critically ill patients. J Clin Med Res 2012; 4: 6: 371-377.
8. Martin G.S. Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes. Expert Rev Anti Infect Ther 2012; 10: 6: 701-706.
9. Mitt P., Adamson V., Loivukene K. et al. Epidemiology of nosocomial bloodstream infections in Estonia. J Hosp Infect 2009; 71: 4: 365-370.
10. Chen Y.H., Hsueh P.R. Changing bacteriology of abdominal and surgical sepsis. Curr Opin Infect Dis 2012; 25: 5: 590-595.
11. Клясова Г.А., Сперанская Л.Л., Миронова A.B. и др. Возбудители сепсиса у иммунокомпрометированных больных: структура и проблемы антибиотикорезистентности (результаты многоцентрового исследования). Гематол. трансфузиол. 2007; 52: 1: 11-18.
12. Диагностика и лечение микозов в отделениях реанимации и интенсивной терапии. Российские национальные рекомендации. М.: 2010; 87.
13. Hajdu A., Kurcz A., Böröcz K. Hospital-acquired infections due to multidrug-resistant organisms in Hungary, 2005-2010 [Электронный ресурс]. - Режим доступа: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20352
14. Levy S.B. Antimicrobial resistance: bacteria on the defence. Resistance stems from misguided efforts to try to sterilise our environment. BMJ 1998; 317: 7159: 612-613.
15. Kallen A.J., Mu Y., Bulens S. et al. Health care-associated invasive MRSA infections, 2005-2008. JAMA 2010; 304: 6: 641-648.
16. Wareham D.W., Bean D.C., Khanna P. et al. Bloodstream infection due to Acinetobacter spp: epidemiology, risk factors and impact of multidrug resistance. Eur J Clin Microbiol Infect Dis 2008; 27: 7: 607-612.
17. Jung J.Y., Park M.S., Kim S.E. et al. Risk factors for multi-drug resistant Acinetobacter baumannii bacteremia in patients with colonization in the Intensive Care Unit. BMC Infect Dis 2010; 10: 228.
18. Grundmann H., Livermore D.M., Giske C.G. et al. Carbapenem-nonsusceptible Enterobacteriaceae in Europe: conclusions from a meeting of national experts [Электронный ресурс]. Режим доступа: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19711.
19. Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities [Электронный ресурс]. Режим доступа: http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5810a4.htm
Review
For citations:
Chernenkaya T.V., Borisova L.A., Aleksandrova I.V., Rei S.I., Nikitina O.V., Kosolapov D.A. Pattern Dynamics of Bacteriemia and Sepsis Pathogens in ICU Patients of Emergency Service. Antibiot Khimioter = Antibiotics and Chemotherapy. 2013;58(5-6):11-16. (In Russ.)
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