Impact of antibiotic-resistant pathogens colonizing the respiratory secretions of patients in an extended-care area of the emergency department

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Sônia R P E Dantas, M Luiza Moretti-Branchini

Abstract

To determine the incidence of acquired infection, and the incidence, risk factors, and molecular typing of multidrug-resistant bacterial organisms (MROs) colonizing respiratory secretions or the oropharynx of patients in an extended-care area of the emergency department (ED) in a tertiary-care university hospital. A case-control study was conducted regarding risk factors for colonization with MROs in ED patients from July 1996 to August 1998. The most prevalent MRO strains were determined using plasmid and genomic analysis with PFGE. MROs colonized 59 (25.4%) of 232 ED patients and 173 controls. The mean ED length of stay for the 59 cases was 13.9 days versus 9.8 days for the 173 controls. The mean length of stay prior to the first isolation of MROs was 9.9 days. MRO species included Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa. The rate of hospital-acquired infection was 32.7 per 1,000 ED patient-days. The case fatality rate was significantly higher for cases. Univariate analysis identified mechanical ventilation, nebulization, nasogastric intubation, urinary catheterization, antibiotic therapy, and number of antibiotics as risk factors for MRO colonization. Multivariate regression analysis found ...Continue Reading

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Citations

Jan 11, 2011·British Dental Journal·S J HooperD W Williams
Jan 22, 2011·Pediatric Emergency Care·Arpi BekmezianAdam L Hersh
Feb 22, 2012·Pediatric Emergency Care·Arpi Bekmezian, Paul J Chung
Dec 12, 2007·Antimicrobial Agents and Chemotherapy·Christian G GiskeUNKNOWN ReAct-Action on Antibiotic Resistance
Nov 16, 2010·BMC Infectious Diseases·Helena B SantosMário B Wagner
Apr 12, 2014·Annals of Emergency Medicine·Stephen Y LiangJonas Marschall
Aug 13, 2014·Australasian Emergency Nursing Journal : AENJ·Julia MorphetAllison Williams
Jun 23, 2015·Emergency Medicine Australasia : EMA·Julia MorphetAllison Williams
Jul 6, 2004·Arquivos de neuro-psiquiatria·Venâncio Pereira Dantas FilhoRenato G G Terzi

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