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首页> 外文期刊>Southern African Journal of Critical Care >Spectrum of microbial growth and antimicrobial usage in an intensive-care unit of a tertiary-care hospital in Trinidad, West Indies
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Spectrum of microbial growth and antimicrobial usage in an intensive-care unit of a tertiary-care hospital in Trinidad, West Indies

机译：西印度群岛特立尼达一家三级护理医院的重症监护室中微生物生长和抗菌药物使用的频谱

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BACKGROUND. Intensive-care units (ICUs) are a source of multidrug-resistant organisms, owing to the indiscriminate usage of broad-spectrum antimicrobial drugs. In such settings, one must be aware of the spectrum of microbes and pattern of antibiotic usage. OBJECTIVES. To evaluate the spectrum, susceptibility and resistance patterns of microbes found in ICU patients in a tertiary-care teaching hospital in Trinidad, and to quantify antimicrobial usage. METHODS. All adult patients (>15 years of age) admitted to the ICU for >48 h who developed nosocomial infections conforming to the Centers for Disease Control and Prevention criteria were included. Demographic data and clinical data, including specimens sent, isolates grown, antimicrobial sensitivity and resistance patterns, the usage of antimicrobials and patient outcomes, were recorded. Variables such as age, admission white blood cell count, duration of first antibiotic used, length of ICU stay, length of hospital stay, organ support and total comorbidities were analysed. Antimicrobial usage was quantified as the defined daily dosage per 1 000 patient-days. RESULTS. A total of 153 patients with 287 microbiological specimens were studied. The mean patient age was 48.4 years, and the mean ICU length of stay was 7.9 days. The most common admitting diagnoses were sepsis and multiple trauma. Staphylococcus aureus was the most common isolate from blood and central venous lines, and Pseudomonas aeruginosa from tracheal aspirates and wound swabs. Non-survivors had significantly higher age, leucocyte count and organ support requirements, and shorter lengths of stay. Cefuroxime was the most-used antimicrobial in the unit. CONCLUSION. The usage pattern of antimicrobials did not correlate with susceptibility in most instances. There is a need to improve antimicrobial usage by implementing antimicrobial-stewardship programmes to establish an antimicrobial protocol and guidelines for usage in the ICU.
机译：背景。由于不加选择地使用广谱抗菌药物，因此重症监护病房（ICU）是耐多药生物的来源。在这种情况下，必须意识到微生物的谱图和抗生素的使用方式。目标为了评估特立尼达的一家三级教学医院在ICU患者中发现的微生物的光谱，药敏性和耐药性模式，并量化抗菌药物的使用。方法。纳入所有ICU住院时间> 48小时的成人患者（> 15岁），这些患者发生了符合疾病控制与预防中心标准的医院内感染。记录人口统计数据和临床数据，包括送出的标本，生长的分离株，抗菌药物的敏感性和耐药性模式，抗菌药物的使用情况和患者预后。分析变量，例如年龄，入院白细胞计数，首次使用抗生素的持续时间，ICU住院时间，住院时间，器官支持和总合并症。抗菌药物的使用被量化为每千个患者日定义的每日剂量。结果。共研究了153例患者的287个微生物标本。患者平均年龄为48.4岁，平均ICU住院天数为7.9天。最常见的承认诊断是败血症和多发性创伤。金黄色葡萄球菌是最常见的血液和中央静脉系统分离物，而铜绿假单胞菌则来自气管抽吸物和伤口拭子。非幸存者的年龄，白细胞计数和器官支持需求明显更高，并且住院时间更短。头孢呋辛是该单元中使用最广泛的抗菌剂。结论。在大多数情况下，抗菌药物的使用方式与药敏性无关。有必要通过实施抗菌管理程序来建立抗菌药物协议和在ICU中使用的指南来改善抗菌药物的使用。

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