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Medicina crítica (Colegio Mexicano de Medicina Crítica)
Print version ISSN 2448-8909
Abstract
CORONA MELENDEZ, Juan Carlos; ALFARO RIVERA, Christian Gerardo and PINA HERNANDEZ, Carlos Yehudi. Antimicrobial susceptibility and mortality of community and nosocomial acquired infections in the Intensive Care Unit at Hospital Ángeles del Carmen. Med. crít. (Col. Mex. Med. Crít.) [online]. 2022, vol.36, n.8, pp.514-520. Epub Aug 25, 2023. ISSN 2448-8909. https://doi.org/10.35366/109172.
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.
Keywords : antimicrobial sensitivity; mortality; intensive care unit.