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Int J Infect Dis. 2015 Feb;31:31-4. doi: 10.1016/j.ijid.2014.12.022. Epub 2014 Dec 17.

The impact of hospital-acquired infections with multidrug-resistant bacteria in an oncology intensive care unit.

Author information

1
Department of Infectious Disease, Instituto Nacional de Cancerología, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 México, D.F., Mexico. Electronic address: patcornejo@yahoo.com.
2
Department of Infectious Disease, Instituto Nacional de Cancerología, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 México, D.F., Mexico.
3
Department of Critical Care Medicine, Instituto Nacional de Cancerología, Mexico City, Mexico.

Abstract

OBJECTIVE:

To describe overall site-specific hospital-acquired infection (HAI) rates and to describe the microbiological and antibiotic resistance profiles of infecting pathogens, together with their impact on multidrug-resistant (MDR) bacteria-associated mortality.

METHODS:

We conducted a 5-year retrospective descriptive study of HAI in patients in the intensive care unit (ICU) of a cancer center in Mexico from January 2007 to December 2011. The following information was collected: patient characteristics and comorbidities, data related to the neoplasm and its treatment, microbiology, and the resistance pattern of all isolates.

RESULTS:

During the study period, 1418 patients were admitted to the ICU; 134 of them developed 159 infections, with an incidence of 11.2/100 hospitalized patients and 32.2/per 1000 patient-days. Two hundred sixty-six microorganisms were isolated. The overall prevalence of MDR-HAI was 39.5%. The most frequent organisms were as follows: 54 (20%) Escherichia coli (94.4% of these were extended-spectrum beta-lactamase producers), 32 (12%) Staphylococcus aureus (90.6% of these were methicillin-resistant), 32 (12%) Enterococcus faecium (18.7% of these were vancomycin-resistant), and 20 (6%) Acinetobacter baumannii (all were MDR). Among patients admitted to the ICU, 252 (17.8%) died. Death was related to the HAI in 58 (23%) of these patients (p<0.001) and 51 (88%) had a MDR organism isolated (p=0.05).

CONCLUSIONS:

The emergence of MDR bacteria poses a difficult task for physicians, who have limited therapeutic options. Critically ill cancer patients admitted to the ICU are at major risk of a bacterial MDR-HAI that will impact adversely on mortality.

KEYWORDS:

Cancer; Hospital-acquired infection; Intensive care unit; Mortality; Multidrug-resistant bacteria; Surveillance

PMID:
25528484
DOI:
10.1016/j.ijid.2014.12.022
[Indexed for MEDLINE]
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