Surveillance, control and management of infections in intensive care units in Southern Europe, Turkey and Iran - A prospective multicenter point prevalence study

被引：46

作者：

Erdem, Hakan ^{[1
]}

Inan, Asuman ^{[2
]}

Altindis, Selma ^{[3
]}

Carevic, Biljana ^{[4
]}

Askarian, Mehrdad ^{[5
]}

Cottle, Lucy ^{[6
]}

Beovic, Bojana ^{[7
]}

Csomos, Akos ^{[8
]}

Metodiev, Krassimir ^{[9
]}

Ahmetagic, Sead ^{[10
]}

Harxhi, Arjan ^{[11
]}

Raka, Lul ^{[12
,13
]}

Grozdanovski, Krsto ^{[14
]}

Nechifor, Mihai ^{[15
]}

Alp, Emine ^{[16
]}

Bozkurt, Fatma ^{[17
]}

Hosoglu, Salih ^{[17
]}

Balik, Ismail ^{[18
]}

Yilmaz, Gulden ^{[18
]}

Jereb, Matjaz ^{[7
]}

Moradi, Fatemeh ^{[19
]}

Petrov, Nikolay ^{[20
]}

Kaya, Selcuk ^{[21
]}

Koksal, Iftihar ^{[21
]}

Aslan, Turan ^{[22
]}

Elaldi, Nazif ^{[23
]}

Akkoyunlu, Yasemin ^{[22
]}

Moravveji, Seyyed Alireza ^{[24
]}

Csato, Gabor ^{[25
]}

Szedlak, Balazs ^{[26
,27
]}

Akata, Filiz ^{[28
]}

Oncu, Serkan ^{[29
]}

Grgic, Svjetlana ^{[30
]}

Cosic, Gorana ^{[31
]}

Stefanov, Chavdar ^{[32
]}

Farrokhnia, Mehrdad ^{[33
]}

Mueller, Maria ^{[34
]}

Luca, Catalina ^{[15
]}

Koluder, Nada ^{[35
]}

Korten, Volkan ^{[36
]}

Platikanov, Viliyan ^{[37
]}

Ivanova, Petja ^{[37
]}

Soltanipour, Soheil ^{[38
]}

Vakili, Mahmood ^{[39
]}

Farahangiz, Saman ^{[40
]}

Afkhamzadeh, Abdorrahim ^{[41
]}

Beeching, Nicholas ^{[6
]}

Ahmed, Salman Shaheer ^{[16
]}

Cami, Alma ^{[42
]}

Shiraly, Ramin ^{[43
]}

机构：

[1] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[2] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[3] Sakarya Univ, Fac Management, Dept Hlth Adm, Sakarya, Turkey

[4] CCS, Dept Hosp Epidemiol, Belgrade, Serbia

[5] Shiraz Univ Med Sci, Med & Nat Prod Chem Res Ctr, Sch Med, Dept Community Med, Shiraz, Iran

[6] Royal Liverpool Univ Hosp, Liverpool, Merseyside, England

[7] Univ Med Ctr, Dept Infect Dis, Ljubljana, Slovenia

[8] Semmelweis Univ, Dept Anaesthesia & Intens Care, H-1085 Budapest, Hungary

[9] Med Univ, Dept Preclin & Clin Sci, Varna, Bulgaria

[10] Univ Clin Ctr Tuzla, Dept Infect Dis, Tuzla, Bosnia & Herceg

[11] Univ Hosp Ctr Tirana, Infect Dis Serv, Tirana, Albania

[12] Univ Prishtina, Sch Med, Prishtina, Kosova, Serbia

[13] Natl Inst Publ Hlth Kosova, Prishtina, Kosova, Serbia

[14] Univ Clin Infect Dis, Dept Intens Care, Skopje, Macedonia

[15] Gr T Popa Univ Med & Pharm, Dept Pharmacol, Iasi, Romania

[16] Erciyes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kayseri, Turkey

[17] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey

[18] Ankara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, TR-06100 Ankara, Turkey

[19] Clin Res Ctr Infect Dis & Trop Med, Bandar Abbas, Iran

[20] Mil Med Acad, Dept Anaesthesiol & Intens Care, Sofia, Bulgaria

[21] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey

[22] Bezmi Alem Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[23] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey

[24] Kashan Univ Med Sci, Trauma Res Ctr, Kashan, Iran

[25] Kenezy Hosp, Dept Anesthesiol & Intens Care, Debrecen, Hungary

[26] Borsod Cty Hosp, Miskolc, Hungary

[27] Teaching Hosp, Dept Anaesthesiol & Intens Therapy, Miskolc, Hungary

[28] Trakya Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Edirne, Turkey

[29] Adnan Menderes Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Aydin, Turkey

[30] Univ Hosp Clin Infect Dis, Mostar, Bosnia & Herceg

[31] Univ Novi Sad, Fac Med, Dept Prevent & Control Dis, IPH Vojvodina, Novi Sad 21000, Serbia

[32] Univ Multiprofile Hosp Active Treatment, Dept Anesthesiol & Intens Treatment, Plovdiv, Bulgaria

[33] Kerman Univ Med Sci, Dept Internal Med, Kerman, Iran

[34] Markhot Hosp, Dept Anaesthesiol & Intens Care, Eger, Hungary

[35] Clin Infect Dis, Sarajevo, Bosnia & Herceg

[36] Marmara Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey

[37] Univ Hosp St Marina, Dept Anesthesiol & ICM, Varna, Bulgaria

[38] Guilan Univ Med Sci, Sch Med, Dept Community Med, Rasht, Iran

[39] Shahid Sadoughi Univ, Sch Med, Dept Community Med, Yazd, Iran

[40] Shiraz Univ Med Sci, Sch Med, Dept Community Med, Shiraz, Iran

[41] Kurdistan Univ Med Sci, Fac Med, Dept Community Med, Sanandaj, Iran

[42] Univ Hosp Pulm Dis, Intens Care Clin, Tirana, Albania

[43] Ilam Univ Med Sci, Dept Community Med, Yazd, Iran

[44] Univ Clin Ctr Ljubljana, Ctr Intens Internal Med, Ljubljana, Slovenia

[45] Univ Med Ctr Ljubljana, Dept Anestesiol & Surg Intens Care, Ljubljana, Slovenia

[46] Ondokuz Mayis Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Samsun, Turkey

[47] Tech Univ Munich, D-80290 Munich, Germany

来源：

JOURNAL OF INFECTION | 2014年 / 68卷 / 02期

关键词：

ICU; Infection; Turkey; Europe; Iran; Resistance; DISEASES; OUTCOMES; RESISTANCE; COUNTRIES; MORTALITY; BACTERIA; PATIENT; IMPACT;

D O I：

10.1016/j.jinf.2013.11.001

中图分类号：

R51 [传染病];

学科分类号：

100201 [内科学];

摘要：

Objective: We aimed to compare the features of intensive care units (ICUs), their antimicrobial resistance patterns, infection control policies, and distribution of infectious diseases from central Europe to Mid-West Asia. Methods: A cross-sectional point prevalence study was performed in 88 ICUs from 12 countries. Characteristics of ICUs, patient and antibiotic therapy data were collected with a standard form by infectious diseases specialists. Results: Out of 749, 305 patients at least with one infectious disease were assessed and 254 patients were reported to have coexistent medical problems. When primary infectious diseases diagnoses of the patients were evaluated, 69 had community-acquired, 61 had healthcare-associated, and 176 had hospital-acquired infections. Pneumonia was the most frequent ICU infection seen in half of the patients. Distribution of frequent pathogens was as follows: Enteric Gram-negatives (n = 62, 28.8%), Acinetobacter spp. (n = 47, 21.9%), Pseudomonas aeruginosa (n = 29, 13.5%). Multidrug resistance profiles of the infecting microorganisms seem to have a uniform pattern throughout Southern Europe and Turkey. On the other hand, active and device-associated infection surveillance was performed in Turkey more than Iran and Southeastern Europe (p < 0.05). However, designing antibiotic treatment according to culture results was highest in Southeastern Europe (p < 0.05). The most frequently used antibiotics were carbapenems (n = 92, 30.2%), followed by anti-gram positive agents (vancomycin, teicoplanin, linezolid, daptomycin, and tigecycline; n = 79, 25.9%), beta-lactam/beta lactamase inhibitors (n = 78, 25.6%), and extended-spectrum cephalosporins (n = 73, 23.9%). Conclusion: ICU features appears to have similar characteristics from the infectious diseases perspective, although variability seems to exist in this large geographical area. (C) 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

引用

页码：131 / 140

页数：10

共 24 条

[1]

Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis [J].

Allegranzi, Benedetta ;

Nejad, Sepideh Bagheri ;

Combescure, Christophe ;

Graafmans, Wilco ;

Attar, Homo ;

Donaldson, Liam ;

Pittet, Didier .

LANCET, 2011, 377 (9761) :228-241

[2]

Infectious diseases in Iran: a bird's eye view [J].

Askarian, M. ;

Ghanaie, R. Mansour ;

Karimi, A. ;

Habibzadeh, F. .

CLINICAL MICROBIOLOGY AND INFECTION, 2012, 18 (11) :1081-1088

[3]

Ventilator-Associated Pneumonia: Preventing the Inevitable [J].

Bonten, Marc J. M. .

CLINICAL INFECTIOUS DISEASES, 2011, 52 (01) :115-121

[4]

Bukhari SZ, 2012, SAUDI MED J, V33, P278

[5]

Leading infectious diseases problems in Turkey [J].

Erdem, H. ;

Akova, M. .

CLINICAL MICROBIOLOGY AND INFECTION, 2012, 18 (11) :1056-1067

[6]

Erdem H., 2012, INFECT DIS CLIN PRAC, V20, P131, DOI [10.1097/IPC.0b013e31823c4b25, DOI 10.1097/IPC.0B013E31823C4B25]

[7]

Withdrawal of Staphylococcus aureus from intensive care units in Turkey [J].

Erdem, Hakan ;

Dizbay, Murat ;

Karabey, Selma ;

Kaya, Selcuk ;

Demirdal, Tuna ;

Koksal, Iftihar ;

Inan, Asuman ;

Erayman, Ibrahim ;

Ak, Oznur ;

Ulu-Kilic, Aysegul ;

Karasahin, Omer ;

Akbulut, Ayhan ;

Elaldi, Nazif ;

Yilmaz, Gulden ;

Candevir, Aslihan ;

Gul, Hanefi Cem ;

Gonen, Ibak ;

Oncul, Oral ;

Aslan, Turan ;

Azak, Emel ;

Tekin, Recep ;

Tufan, Zeliha Kocak ;

Yenilmez, Ercan ;

Arda, Bilgin ;

Gungor, Gokay ;

Cetin, Birsen ;

Kose, Sukran ;

Turan, Hale ;

Akalin, Halis ;

Karabay, Oguz ;

Dogan-Celik, Aygul ;

Albayrak, Adem ;

Guven, Tumer ;

Celebi, Guven ;

Ozgunes, Nail ;

Ersoy, Yasemin ;

Sirmatel, Fatma ;

Oztoprak, Nefise ;

Balkan, Ilker Inanc ;

Bayazit, Fatma Nurhayat ;

Ucmak, Hasan ;

Oncu, Serkan ;

Ozdemir, Davut ;

Ozturk-Engin, Derya ;

Bitirgen, Mehmet ;

Tabak, Fehmi ;

Akata, Filiz ;

Willke, Ayse ;

Gorenek, Levent ;

Ahmed, Salman Shaheer .

AMERICAN JOURNAL OF INFECTION CONTROL, 2013, 41 (11) :1053-1058

[8]

Intensive Care in Low-Income Countries - A Critical Need [J].

Firth, Paul ;

Ttendo, Stephen .

NEW ENGLAND JOURNAL OF MEDICINE, 2012, 367 (21) :1974-1976

[9]

NOTE ON AN EXACT TREATMENT OF CONTINGENCY, GOODNESS OF FIT AND OTHER PROBLEMS OF SIGNIFICANCE [J].

FREEMAN, GH ;

HALTON, JH .

BIOMETRIKA, 1951, 38 (1-2) :141-149

[10]

Clinical and economic impact of common multidrug-resistant gram-negative bacilli [J].

Giske, Christian G. ;

Monnet, Dominique L. ;

Cars, Otto ;

Carmeli, Yehuda .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2008, 52 (03) :813-821

← 1 2 3 →