Assessment of the pathogen microorganisms and resistance patterns in patient with device-associated infections in the ICU

Introduction

Although several precautions are taken or studies using national guidelines are conducted for preventing device-associated infections (DAI), it is still a big problem with high morbidity and mortality rates, related to frequent and long-term usage of invasive devices [1]. The aim of the study is to assess the incidence of DAI and to determine the microorganisms and resistance patterns of the pathogens.

Methods

All microbiological tests of DAI patients in the ICU between January 2007 and November 2008 were analyzed. All microorganisms isolated from patients were recorded and their resistance patterns were also ascertained.

Results

Sixty-nine patients were diagnosed as DAI using the criteria of the Centers for Disease Control. Ventilator-associated pneumonia (VIP) was the most frequent, with an incidence of 49.3% (n = 35), followed by catheter-associated urinary tract infection (CR-UTI) (n = 20) and central venous catheter-associated bloodstream infection (CVC-BSI) (n = 15) with an incidence of 28.9% and 21.8%, respectively. The most frequent pathogens in VIP cases were Pseudomonas aeruginosa in 57% of cases (80% of which were resistant to fluoroquinolones), enterobacteriaceae species in 22% of the cases (50% of which were resistant to ceftriaxone) and Staphylococcus aureus in 8% of the cases (100% of which were methicillin resistant). The most frequent pathogens in CR-UTI cases were enterobactericeae in 60% of cases (70% of which were resistant to ceftriaxone), enterococci species in 25% of the cases (none of the enterococci was resistant to vancomycine) and P. aeruginosa in 15% of cases (100% of which were resistant to flouroquinolones). The most frequent pathogens in CVC-BSI cases were coagulase-negative staphylococci in 66% of cases (75% of which were methicillin resistant), S. aureus in 20% of the cases (85% of which were resistant to methicilline) and enterobacteriaceae species in 14% of cases (30% of which were ceftriaxone).

Conclusion

DAI increase the mortality and morbidity rates in the ICU. Therefore it is important to know the possible pathogen microorganisms and their resistance patterns for the success of the selection of the ampiric antibiotic treatment.