Analysis of Intensive Care Units (ICUs) Blood stream Infections (BSI) in Kafkas University Health Research and Application Hospital

Objectives: Sepsis is one of the most important cause of admission in Intensive Care Units, probably due to the more severe illnesses of hospitalized patients and to the persistently high incidence of nosocomial infections. However, despite the availability of potential antibiotics and refined supportive care the mortality of septic patients remains high, with overall estimates of about 30% and increasing to 50% when associated with shock. In this study, our aim is to determine retrospectively the epidemiology of blood stream infections occurred in Intensive Care Units of Kafkas University Health Research and Application Hospital and to present the first data from this university hospital. Materials and Methods: Total 1004 blood culture bottle were sent to Microbiology Laboratory of Kafkas University Health Research and Application Hospital between January 2013 to January 2015. All bottles were placed into Automated BACTEC 9050 Blood Culture System. After the positive bottles were detected by machine, the bacteria were identified and antibiotic susceptibility test were performed by using both BD Phoneix Microorganism Identification System and KirbyBauer Disk Diffusion method. Results: Total 202 positive samples were detected and the biggest part of total positive samples (n:164, 81.2%) were sent by Internal Intensive Care Unit. The identified bacteria were MRCNS (n:67, 33.2%), MSCNS (n:42, 20.8%), MRSA (n:29, 14.3%), E.coli (n:23, 11.3%), MSSA (n:16, 7.9%), P.aeruginosa (n:9, 4.5%), Enterococcus spp (n:9, 4.5%), K.pneumoniae (n:4, 1.9%), A.baumannii (n:1, 0.5%), Proteus mirabilis (n:1, 0.5%), Stenotrophomonas maltophilia (n:1, 0.5%), respectively. Additionally Extended-Spectrum Beta-Lactamase (ESBL) were detected as positive in 7 E.coli. Conclusions: Gram negative bacteria are still important. However; in recent years, coagulase negative staphylococci are the most detected bacteria in Intensive Care Units. For this reason, increased MRCNS rate may restrict antibiotic options and lead increasing the usage of glyco- peptides prophylactically. It is necessary to perform active surveillance studies, obey standard infection control measures and develop an appropriate antibiotic policy for decreasing the frequency of resistant microorganisms, due to the changes in microorganism types in ICUs and their antibiotic susceptibilities

Analysis of Intensive Care Units (ICUs) Blood stream Infections (BSI) in Kafkas University Health Research and Application Hospital

Objectives: Sepsis is one of the most important cause of admission in Intensive Care Units, probably due to the more severe illnesses of hospitalized patients and to the persistently high incidence of nosocomial infections. However, despite the availability of potential antibiotics and refined supportive care the mortality of septic patients remains high, with overall estimates of about 30% and increasing to 50% when associated with shock. In this study, our aim is to determine retrospectively the epidemiology of blood stream infections occurred in Intensive Care Units of Kafkas University Health Research and Application Hospital and to present the first data from this university hospital. Materials and Methods: Total 1004 blood culture bottle were sent to Microbiology Laboratory of Kafkas University Health Research and Application Hospital between January 2013 to January 2015. All bottles were placed into Automated BACTEC 9050 Blood Culture System. After the positive bottles were detected by machine, the bacteria were identified and antibiotic susceptibility test were performed by using both BD Phoneix Microorganism Identification System and KirbyBauer Disk Diffusion method. <div>Results: Total 202 positive samples were detected and the biggest part of total positive samples (n:164, 81.2%) were sent by Internal Intensive Care Unit. The identified bacteria were MRCNS (n:67, 33.2%), MSCNS (n:42, 20.8%), MRSA (n:29, 14.3%), E.coli (n:23, 11.3%), MSSA (n:16, 7.9%), P.aeruginosa (n:9, 4.5%), Enterococcus spp (n:9, 4.5%), K.pneumoniae (n:4, 1.9%), A.baumannii (n:1, 0.5%), Proteus mirabilis (n:1, 0.5%), Stenotrophomonas maltophilia (n:1, 0.5%), respectively. Additionally Extended-Spectrum Beta-Lactamase (ESBL) were detected as positive in 7 E.coli. </div><div>Conclusions: Gram negative bacteria are still important. However; in recent years, coagulase negative staphylococci are the most detected bacteria in Intensive Care Units. For this reason, increased MRCNS rate may restrict antibiotic options and lead increasing the usage of glyco- peptides prophylactically. It is necessary to perform active surveillance studies, obey standard infection control measures and develop an appropriate antibiotic policy for decreasing the frequency of resistant microorganisms, due to the changes in microorganism types in ICUs and their antibiotic susceptibilities. </div

Factors leading to dissemination of cutaneous anthrax: an international ID-IRI study

Background: Although anthrax is a rare zoonotic infection, it still causes significant mortality and morbidity. In this multicenter study, which is the largest anthrax case series ever reported, we aimed to describe the factors leading to dissemination of cutaneous anthrax.Methods: Adult patients with cutaneous anthrax from 16 referral centers were pooled. The study had a retrospective design, and included patients treated between January 1, 1990 and December 1, 2019. Probable, and confirmed cases based upon CDC anthrax 2018 case definition were included in the study. A descriptive statistical analysis was performed for all variables.Results: A total of 141 cutaneous anthrax patients were included. Of these, 105 (74%) patients had probable and 36 (26%) had confirmed diagnosis. Anthrax meningitis and bacteremia occurred in three and six patients, respectively. Sequelae were observed in three patients: cicatricial ectropion followed by ocular anthrax (n = 2) and movement restriction on the left hand after surgical intervention (n = 1). One patient had gastrointestinal anthrax. The parameters related to poor outcome (p &lt; 0.05) were fever, anorexia, hypoxia, malaise/fatigue, cellulitis, fasciitis, lymphadenopathy, leukocytosis, high CRP and creatinine levels, longer duration of antimicrobial therapy, and combined therapy. The last two were seemingly the consequences of dissemination rather than being the reasons. The fatality rate was 1.4%.Conclusions: Rapid identification of anthrax is crucial for prompt and effective treatment. Systemic symptoms, disseminated local infection, and high inflammatory markers should alert the treating physicians for the dissemination of the disease. (c) 2022 The Authors. Published by Elsevier Ltd