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Surveillance study of bloodstream infections, antimicrobial use, and resistance patterns among intensive care unit patients: A retrospective cross-sectional study

M. Ababneh, Mohammad Al Domi, Abeer M. Rababa’h

International Journal of Critical Illness and Injury Science, 2022

1,051 participants · 2 citations

Abstract

Background: Bloodstream infections (BSIs) are one of the most critical illnesses requiring intensive care unit (ICU) admission. This study assessed patterns of antimicrobial use and resistance in ICU patients with BSIs. Methods: Inpatients admitted to the ICU and who received at least one antimicrobial agent between January 1, 2017, and December 31, 2019, were included in the study. Electronic patients' medical records were used to collect patients' demographic, clinical, and microbiological data. Results: A total of 1051 patients were enrolled in the study, where 650 patients (61.84%) were treated with three or more antimicrobial agents. The most frequently used antimicrobials were piperacillin/tazobactam followed by teicoplanin, meropenem, and levofloxacin. The most predominant multidrug-resistant pathogens were Acinetobacter baumannii, followed by Escherichia coli, Methicillin-resistant Staphylococcus aureus (MRSA), Klebsiella pneumonia, and Pseudomonas aeruginosa. Conclusions: The administration of the antimicrobials among ICU patients was highly based on a combination of three or more broad-spectrum agents. MDR pathogens were found to be highly prevalent among ICU patients with BSI. Therefore, we suggest recommending that hospital policies should apply the antimicrobial stewardship protocols, infection control, and implement antimicrobial de-escalation protocol to reduce the harm pressure of antimicrobial resistance.

How strong is the evidence?

Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 1,051 participants or records.

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