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Makale Tam Makale Uluslararası 2021

Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey

Rehab El-Sokkary, Serhat Uysal, Hakan Erdem, Ravina Kullar, Abdullah Umut Pekok, Fatma Amer, Svjetlana Grgic, Biljana Carevic, Amani El-Kholy, Anna Liskova, MEHMET ÖZDEMİR, Ejaz Ahmed Khan, Yesim Uygun-Kizmaz, Nenad Pandak, Nirav Pandya, Jurica Arapovic, Rıdvan KARAALİ, Nefise Oztoprak, Michael M. Petrov, Rami Alabadla, Handan Alay, Jehan Ali El Kholy, Caroline Landelle, Reham Khedr, Dhruv Mamtora, Gorana Dragovac, Ricardo Fernandez, Emine Unal Evren, Lul Raka, Antonio Cascio, Nicolas Dauby, Ahsen Oncul, ŞAFAK ÖZER BALIN, YASEMİN ÇAĞ, Natalia Dirani, MUSTAFA DOĞAN, Irina Magdalena Dumitru, Maha Ali Gad, Ilad Alavi Darazam, Behrouz Naghili, Rosa Fontana Del Vecchio, Monica Licker, Andrea Marino, Nasim Akhtar, Mostafa Kamal, Goffredo Angioni, Deana Medic, Aliye Esmaoglu, Szabo Balint Gergely, Andre Silva-Pinto, Lurdes Santos, Ionela Larisa Miftode, RECEP TEKİN, Phunsup Wongsurakiat, Mumtaz Ali Khan, Yesim Kurekci, Hema Prakash Pilli, Krsto Grozdanovski, Egidia Miftode, Rusmir Baljic, Haluk Vahabolgu, Jordi Rello

European Journal of Clinical Microbiology and Infectious Diseases Cilt 40 · ss. 2323–2334 · 01.11.2021
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Özet

Evaluating trends in antibiotic resistance is a requisite. The study aimed to analyze the profile of multidrug-resistant organisms (MDROs) among hospitalized patients with bacteremia in intensive care units (ICUs) in a large geographical area. This is a 1-month cross-sectional survey for blood-borne pathogens in 57 ICUs from 24 countries with different income levels: lower-middle-income (LMI), upper-middle-income (UMI), and high-income (HI) countries. Multidrug-resistant (MDR), extensively drug-resistant (XDR), or pan-drug-resistant isolates were searched. Logistic regression analysis determined resistance predictors among MDROs. Community-acquired infections were comparable to hospital-acquired infections particularly in LMI (94/202; 46.5% vs 108/202; 53.5%). Although MDR (65.1%; 502/771) and XDR (4.9%; 38/771) were common, no pan-drug-resistant isolate was recovered. In total, 32.1% of MDR were Klebsiella pneumoniae, and 55.3% of XDR were Acinetobacter baumannii. The highest MDR and XDR rates were in UMI and LMI, respectively, with no XDR revealed from HI. Predictors of MDR acquisition were male gender (OR, 12.11; 95% CI, 3.025-15.585) and the hospital-acquired origin of bacteremia (OR, 2.643; 95%CI, 1.462-3.894), and XDR acquisition was due to bacteremia in UMI (OR, 3.344; 95%CI, 1.189-5.626) and admission to medical-surgical ICUs (OR, 1.481; 95% CI, 1.076-2.037). We confirm the urgent need to expand stewardship activities to community settings especially in LMI, with more paid attention to the drugs with a higher potential for resistance. Empowering microbiology laboratories and reports to direct prescribing decisions should be prioritized. Supporting stewardship in ICUs, the mixed medical-surgical ones in particular, is warranted.

Anahtar kelimeler

INFECTIONS MULTIDRUG-RESISTANCE COUNTRIES Infection control Stewardship Low- and upper-middle and high income Pan drug resistance XDR

Atıf için künye

El-Sokkary, R., Uysal, S., Erdem, H., Kullar, R., Pekok, A. U., Amer, F., Grgic, S., Carevic, B., El-Kholy, A., Liskova, A., ÖZDEMİR, M., Khan, E. A., Uygun-Kizmaz, Y., Pandak, N., Pandya, N., Arapovic, J., KARAALİ, R., Oztoprak, N., Petrov, M. M., … Rello, J. (2021). Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey. European Journal of Clinical Microbiology and Infectious Diseases, 40, 2323–2334. https://doi.org/10.1007/s10096-021-04288-1

BibTeX 
@article{elsokkary2021-242742,
  author = {El-Sokkary, Rehab and Uysal, Serhat and Erdem, Hakan and Kullar, Ravina and Pekok, Abdullah Umut and Amer, Fatma and Grgic, Svjetlana and Carevic, Biljana and El-Kholy, Amani and Liskova, Anna and ÖZDEMİR, MEHMET and Khan, Ejaz Ahmed and Uygun-Kizmaz, Yesim and Pandak, Nenad and Pandya, Nirav and Arapovic, Jurica and KARAALİ, Rıdvan and Oztoprak, Nefise and Petrov, Michael M. and Alabadla, Rami and Alay, Handan and El Kholy, Jehan Ali and Landelle, Caroline and Khedr, Reham and Mamtora, Dhruv and Dragovac, Gorana and Fernandez, Ricardo and Evren, Emine Unal and Raka, Lul and Cascio, Antonio and Dauby, Nicolas and Oncul, Ahsen and BALIN, ŞAFAK ÖZER and ÇAĞ, YASEMİN and Dirani, Natalia and DOĞAN, MUSTAFA and Dumitru, Irina Magdalena and Gad, Maha Ali and Darazam, Ilad Alavi and Naghili, Behrouz and Del Vecchio, Rosa Fontana and Licker, Monica and Marino, Andrea and Akhtar, Nasim and Kamal, Mostafa and Angioni, Goffredo and Medic, Deana and Esmaoglu, Aliye and Gergely, Szabo Balint and Silva-Pinto, Andre and Santos, Lurdes and Miftode, Ionela Larisa and TEKİN, RECEP and Wongsurakiat, Phunsup and Khan, Mumtaz Ali and Kurekci, Yesim and Pilli, Hema Prakash and Grozdanovski, Krsto and Miftode, Egidia and Baljic, Rusmir and Vahabolgu, Haluk and Rello, Jordi},
  title = {Profiles of multidrug-resistant organisms among patients with bacteremia in intensive care units: an international ID-IRI survey},
  journal = {European Journal of Clinical Microbiology and Infectious Diseases},
  year = {2021},
  volume = {40},
  pages = {2323--2334},
  issn = {0934-9723},
  doi = {10.1007/s10096-021-04288-1},
  url = {https://akademik.atauni.edu.tr/yayinlar/242742-profiles-of-multidrug-resistant-organisms-among-patients-with-bacteremia-in}
}