engleski

Evaluation of risk factors for colonisation with multidrug resistant microorganism in Medical Care Unit and Urological Intensive Care Unit, of University Hospital “Sveti Duh”

ICUs (Intensive Care Unit) are high risk areas for increasing occurrence of colonisation and infection caused by multidrug resistant pathogens (MDRO). Spreading of MDRO in ICU is result of overuse of antibiotics, suboptimal infection control and vulnerable population. Nasal and rectal colonisation often precede infection. From March until July 2016 we did a prospective study which included 142 patients, 77 males and 65 females aged 67.10±13.93 years. All patients admitted to the Medical and Urology ICU were screened upon admission and after discharge for nasal and rectal carriage. We evaluated risk factors for colonisation with MDRO. At admission, MDRO colonisation of NF was present in 8 cases (5.63%) and at discharge in 23 (16.2%). Rectal colonisation with MDRO at admission was present in 16 cases (11.27%) and at discharge in 60 cases (42.25 %). During the hospitalisation in ICU patients were prescribed with 1.7±1.3 antibiotics classes, treated with 3.71±1.66 invasive devices and on average spent 12.5 days in ICU (range 1-244 days). The differences in number of antibiotics, invasive devices and duration of hospitalisations between groups of patients that were colonised and those that were not, were statistically significant (Mann–Whitney U test all p’s<0.05) while groups did not significantly varied according to status of previous hospitalisation, dialysis or current immunosuppression (chi2 test all p’s>0.05). Multivariate logistic regression revealed that number of antibiotics (p=0.014) and duration of hospitalisation (p=0.018), but not number of invasive devices (p=0.620) nor the age (p=0.255) were significant predictors of colonisation. In conclusion, use of surveillance cultures is crucial for infection control purposes as limited spread of MDRO by early detection of carriers, as well as guide for empirical antimicrobial therapy.

Intensive Care Units; MDRO colonisation

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