Abstract:
OBJECTIVE:To measure patients' risk for acquiring antibiotic-resistant microorganisms associated with intensive care unit admission. DESIGN:Prospective, observational study. SETTING:Ten public hospitals including one university medical center. PATIENTS:Consecutive patients admitted to ten intensive care units. INTERVENTIONS:Serial patient surveillance cultures were screened for vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus (MRSA), ceftazidime-resistant Gram-negative bacilli (CR-GNB), Acute Physiology and Chronic Health Evaluation II score, and antibiotic and medical device exposures. MEASUREMENTS AND MAIN RESULTS:A total of 1,697 patient admissions in ten intensive care units were enrolled. The overall carriage rate of antibiotic-resistant bacteria at intensive care unit entry was 12.1% for MRSA, 14% for CR-GNB and 4.7% for both. At discharge from the intensive care unit, new carriage of MRSA, CR-GNB, and both was found in 11.1%, 14.2%, and 2.4% of the patients, respectively. The acquisition rates in the individual units correlated highly and positively with proportion of patients with carriage at intensive care unit entry for both MRSA (n = 10, Pearson's r =.89, p < 0.001) and CR-GNB (n = 10, Pearson's r =.92, p < 0.001). By logistic regression, severity of illness (odds ratio, 1.4), length of stay (odds ratio, 1.7), use of penicillins (odds ratio, 1.9), and number of antibiotics (odds ratio, 1.2) and medical devices (odds ratio, 1.2) were independently associated with intensive care unit acquisition of MRSA. In comparison, variables independently associated with intensive care unit acquisition of CR-GNB were Acute Physiology and Chronic Health Evaluation II score (odds ratio, 1.5), number of antibiotics (odds ratio, 1.1), and artificial airway (odds ratio, 1.5). CONCLUSIONS:These data suggest that hospitalization in the intensive care unit introduces significant risk to patients in terms of transmission of MRSA and/or CR-GNB. This risk seems to be influenced strongly by the proportion of patients with colonization at intensive care unit admission and is associated with severity of illness, length of stay, and exposures to antibiotics and medical devices.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Ho PL,Hong Kong intensive care unit antimicrobial resistance study (HK-ICARE) Group.doi
10.1097/01.CCM.0000059437.01924.97subject
Has Abstractpub_date
2003-04-01 00:00:00pages
1175-82issue
4eissn
0090-3493issn
1530-0293journal_volume
31pub_type
杂志文章,多中心研究abstract:OBJECTIVES:To investigate the frequency, types, and implications of complications during intensive care in patients after status epilepticus has been successfully terminated. DESIGN:Retrospective study. SETTING:ICUs at a Swiss tertiary academic medical care center. PATIENTS:Data were collected from the digital patie...
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journal_title:Critical care medicine
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更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Atrial fibrillation is frequently seen in sepsis-related hospitalizations. However, large-scale contemporary data from the United States comparing outcomes among sepsis-related hospitalizations with versus without atrial fibrillation are limited. The aim of our study was to assess the frequency of atrial fib...
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更新日期:2019-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-199802000-00033
更新日期:1998-02-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-01-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199502000-00023
更新日期:1995-02-01 00:00:00
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更新日期:2006-03-01 00:00:00
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更新日期:1984-08-01 00:00:00
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更新日期:2015-11-01 00:00:00
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doi:10.1097/CCM.0000000000004667
更新日期:2020-12-01 00:00:00
abstract::In order to determine and analyze the complication rate of the insertion and maintenance of the balloon-tipped, flow-directed pulmonary artery catheter (PAC), the authors prospectively studied the use of 320 catheters in 219 critically ill patients. Mean patient age was 53 +/- 1 years, and 36% had a history of cardiov...
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doi:10.1097/00003246-198104000-00006
更新日期:1981-04-01 00:00:00
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更新日期:2013-05-01 00:00:00
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更新日期:2005-07-01 00:00:00
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pub_type: 临床试验,杂志文章
doi:10.1097/01.CCM.0000059725.60509.A0
更新日期:2003-05-01 00:00:00
abstract::Cardiac arrest has a poor prognosis, regardless of age group. Children who fail to respond to two standard doses of epinephrine (0.01 mg/kg) rarely survive to hospital discharge, and most die without the return of spontaneous circulation (ROSC). We treated seven consecutive children in cardiac arrest with high dose ep...
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doi:10.1097/00003246-198912000-00004
更新日期:1989-12-01 00:00:00
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更新日期:2000-04-01 00:00:00
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更新日期:2002-08-01 00:00:00
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更新日期:1995-02-01 00:00:00
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更新日期:2000-09-01 00:00:00
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pub_type: 评论,杂志文章
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更新日期:2006-09-01 00:00:00
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更新日期:2015-01-01 00:00:00
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更新日期:1999-09-01 00:00:00
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更新日期:2016-09-01 00:00:00
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更新日期:2002-10-01 00:00:00
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更新日期:1991-09-01 00:00:00