Frequency of release of multidrug-resistant microorganisms and mortality in surgical intensive care
Despite the fact that the frequency of infections caused by multidrug-resistant microorganisms is increasing steadily, this does not lead to an increase in the mortality of patients in the intensive care unit and intensive care surgical profile.
Despite the fact that the frequency of infections caused by multidrug-resistant microorganisms is increasing steadily, this does not lead to an increase in mortality in patients in the intensive care unit and the intensive care unit (ICU) of the surgical profile - such data was presented at the 97th American College of Surgery (American College of Surgeons) Clinical Congress.
Despite the constant increase in the severity of the illnesses recorded in ICU patients, as well as the increase in the overall frequency of infections and the frequency of excretion of resistant microorganisms, the relationship of these problems with the results of infectious disease in the ICU remains unclear.
In a retrospective study, all cases of infections in surgical intensive care were recorded over a period of 10 years. A total of 799 resistant pathogens (257 Gram-positive microorganisms, 542 Gram-negative) out of 3024 pathogens identified in total were identified, which caused 1493 cases of nosocomial infections in ICU. The resistant microorganisms were methicillin-resistant strains of Staphylococcus aureus (MRSA), strains resistant to vancomycin Enterococcus spp. (VRE), as well as gram-negative microorganisms resistant to all members of the same class of antimicrobial agents.
Compared to patients whose infections were caused by antibiotic-sensitive drugs, ICU patients with infections caused by resistant microorganisms had a higher body mass index (p = 0.007), a higher score on APACHE II scale (p less than 0.001), they underwent more transplantation procedures (p less than 0.001), more transfusions (p less than 0.001), more hemodialysis (p less than 0.001), a prescription longer antibiotics (p less than 0.001) and longer hospital stays (p less than 0.001). These patients had a higher mortality rate (33% vs 23%, p less than 0.001).
The most commonly identified pathogens were MRSA and Pseudomonas aeruginosa, which represented 55% and 27% of the total population of resistant microorganisms, respectively. Pathogens are most often excreted through sputum, blood and urine.
Although infections caused by resistant pathogens caused a higher mortality rate compared to diseases caused by susceptible microorganisms, the overall mortality rate in surgical ICU during the study period regularly decreased - from 9.3% in 2000 to 5.4%. in 2009
According to the researchers, the contribution of infections caused by resistant microorganisms to the overall mortality rate in surgical units is generally insignificant. At the same time, a number of certain factors could not be taken into account in the analysis. For example, the susceptibility of pathogens can change over time, which should affect their distribution in the "susceptible" or "resistant" groups.