Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levelsReport as inadecuate




Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels - Download this document for free, or read online. Document in PDF available to download.

BMC Infectious Diseases

, 14:513

Bacterial and fungal diseases

Abstract

BackgroundAntimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant ABR strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit ICU with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.

MethodsData from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey and countries with MRSA rates of < 5% lowABR: Denmark, Finland, Netherlands, Norway, and Sweden.

ResultsOn the study day, 1187-2204 53.9% patients in the HighABR ICUs were infected and 255-558 45.7% in the LowABR ICUs P < 0.01. Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score 35.6 vs 32.7, P < 0.05 and had longer median ICU 12 days vs 5 days and hospital 24 days vs 16 days lengths of stay. They also had higher crude ICU 20.0% vs 15.4% and hospital 27.0% vs 21.5% mortality rates both P < 0.05. However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.

ConclusionsBeing hospitalized in an ICU in a region with high levels of antimicrobial resistance is not associated per se with a worse outcome.

KeywordsInfection Critically ill Antibiotic Resistance Electronic supplementary materialThe online version of this article doi:10.1186-1471-2334-14-513 contains supplementary material, which is available to authorized users.

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Author: Håkan Hanberger - Massimo Antonelli - Martin Holmbom - Jeffrey Lipman - Peter Pickkers - Marc Leone - Jordi Rello - Yasser

Source: https://link.springer.com/







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