Abstract
A one year prospective, observational survey was performed to evaluate the abnormal carriage of multi-resistant Klebsiella pneumoniae and/ or Acinetobacter baumannii, to determine associated risk factors for carriage, and to correlate the abnormal carriage with infectious morbidity and mortality in the intensive care unit (ICU) of a University Hospital. Two hundred and ninety-eight patients who stayed in the ICU > 48h, and were not neutropenic, were studied. Salivary and rectal samples were obtained on admission and weekly until discharge. Out of 265 evaluable patients, 88 (33%) developed oropharyngeal and/or rectal carriage within a median of nine days. Three factors were significantly associated with abnormal carriage: higher 'severity of illness' score on admission, a threefold increase in ICU stay, and the need for mechanical ventilation. K. pneumoniae or A. baumannii accounted for 57/158 (36%) of all ICU-acquired infections (in 46 patients). They were considered as secondary endogenous infections (SEI) in 42 patients who were previously colonized with the same strains, and developed infection within a median of three days (range 0-68 days). Prolonged stay in ICU was the only factor associated with SEI in the carrier popula...Continue Reading
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