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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Infections, antibiotic treatment and mortality in patients admitted to ICUs in countries considered to have high levels of antibiotic resistance compared to those with low levels
BMC Infectious Diseases, Volume 14, No. 1, Article 513, Year 2014
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Description
Background: Antimicrobial resistance is an increasing concern in ICUs worldwide. Infection with an antibiotic resistant (ABR) strain of an organism is associated with greater mortality than infection with the non-resistant strain, but there are few data assessing whether being admitted to an intensive care unit (ICU) with high levels of antimicrobial resistance is associated with a worse outcome than being admitted to an ICU with low rates of resistance. The aim of this study was, therefore, to compare the characteristics of infections and antibiotic treatments and patient outcomes in patients admitted to ICUs in countries considered as having high levels of antibiotic resistance and those admitted to ICUs in countries considered as having low levels of antibiotic resistance.Methods: Data from the large, international EPIC II one-day point prevalence study on infections in patients hospitalized in ICUs were used. For the current study, we compared the data obtained from patients from two groups of countries: countries with reported MRSA rates of ≥ 25% (highABR: Greece, Israel, Italy, Malta, Portugal, Spain, and Turkey) and countries with MRSA rates of < 5% (lowABR: Denmark, Finland, Netherlands, Norway, and Sweden).Results: On the study day, 1187/2204 (53.9%) patients in the HighABR ICUs were infected and 255/558 (45.7%) in the LowABR ICUs (P < 0.01). Patients in the HighABR ICUs were more severely ill than those in the LowABR ICUs, as reflected by a higher SAPS II score (35.6 vs 32.7, P < 0.05) and had longer median ICU (12 days vs 5 days) and hospital (24 days vs 16 days) lengths of stay. They also had higher crude ICU (20.0% vs 15.4%) and hospital (27.0% vs 21.5%) mortality rates (both P < 0.05). However, after multivariable adjustment and matched pair analysis there were no differences in ICU or hospital mortality rates between High or LowABR ICU patients overall or among those with infections.Conclusions: Being hospitalized in an ICU in a region with high levels of antimicrobial resistance is not associated per se with a worse outcome. © 2014 Hanberger et al.; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4181425/bin/12879_2014_3832_MOESM1_ESM.pdf
https://efashare.b-cdn.net/share/pmc/articles/PMC4181425/bin/12879_2014_3832_MOESM2_ESM.pdf
Authors & Co-Authors
Hanberger, Häkan
Sweden, Linkoping
Linköpings Universitet
Antonelli, Massimo M.
Italy, Rome
Università Cattolica Del Sacro Cuore, Campus Di Roma
Lipman, Jeffrey
Australia, Brisbane
Royal Brisbane and Women's Hospital
Pickkers, Peter P.
Netherlands, Nijmegen
Radboud University Medical Center
Netherlands, Enschede
Medisch Spectrum Twente Mst
Léone, Marc
France, Marseille
Ap-hm Assistance Publique - Hôpitaux de Marseille
Rello, Jordi
Spain, Cerdanyola Del Valles
Universitat Autònoma de Barcelona
Spain, Tarragona
Hospital Universitario Joan Xxiii de Tarragona
Sakr, Yasser L.
Germany, Jena
Friedrich-schiller-universität Jena
Walther, Sten Mikael
Sweden, Linkoping
Linköpings Universitet
Vanhems, Philippe V.
France, Lyon
Hopital Edouard Herriot
Vincent, Jean Louis
Belgium, Brussels
Université Libre de Bruxelles
Harjola, Veli Pekka
Finland, Helsinki
Helsinki University Hospital
Michalopoulos, Argyris S.
Greece, Athens
Henry Dunant Hospital
Mouloudi, Eleni K.
Greece, Athens
Hippokration General Hospital
Myrianthefs, Pavlos M.
Greece, Athens
Kat Hospital
Koulenti, Despoina
Greece, Athens
Kat Hospital
Sprung, Charles L.
Israel, Jerusalem
Hadassah University Medical Centre
Bassetti, Matteo
Italy, Genoa
Irccs San Martino Polyclinic Hospital
Morelli, Andrea
Italy, Catania
Azienda Ospedaliero Universitaria Policlinico G.rodolico - San Marco
Della-Rocca, Giorgio
Unknown Affiliation
Borg, Michael A.
Italy, Udine
Università Degli Studi Di Udine
de Pont, Anne Cornélie Jm M.
Malta, Msida
St. Luke's Hospital Malta
Rosseel, Peter M.J.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Bakker, Jan
Unknown Affiliation
Kuiper, Michaël A.
Netherlands, Zwolle
Isala Clinics
Bergmans, Dennis C.J.J.
Netherlands, Groningen
Universitair Medisch Centrum Groningen
Groeneveld, Arie Bastiaan Johan
Netherlands, Maastricht
Maastricht Universitair Medisch Centrum+
Póvoa, Pedro R.
Portugal, Lisbon
Hospital de São José
Dias, Cicero
Portugal, Lisbon
Hospital de Pulido Valente
Amaro, Pedro
Unknown Affiliation
Moreno, Rui Paulo
Unknown Affiliation
Matos, Ricardo
Unknown Affiliation
Bustamante-Munguira, Elena
Spain, Valencia
Hospital Arnau de Vilanova
Martinón-Torres, Federico
Unknown Affiliation
Estella-García, Ángel
Spain, Tarragona
Hospital Verge de la Cinta
Martín-Delgado, María Cruz
Unknown Affiliation
Solé-Violán, Jordi
Spain, Madrid
Hospital General Universitario Gregorio Marañón
García-Fuentes, Carlos
Spain, Sevilla
Hospital Universitario de Valme
Agvald-Öhman, Christina
Unknown Affiliation
Akan, Mert Can
Turkey, Izmir
Dokuz Eylül Üniversitesi
Topeli, Arzu
Turkey, Ankara
Gazi Üniversitesi
Toǧal, Tǔrkan
Turkey, Ankara
Hacettepe Üniversitesi
Akıncı, İbrahim Özkan
Turkey, Istanbul
İstanbul University-cerrahpaşa Cerrahpaşa Faculty of Medicine
Çakar, Nahit
Turkey, Istanbul
İstanbul University-cerrahpaşa Cerrahpaşa Faculty of Medicine
Demirkiran, Oktay
Turkey, Istanbul
İstanbul University-cerrahpaşa Cerrahpaşa Faculty of Medicine
Ülger, Fatma Esra Bahadır
Unknown Affiliation
Team, Suubi+Adherence Field
Turkey, Selçuklu
Selçuk Üniversitesi
Statistics
Citations: 20
Authors: 46
Affiliations: 166
Identifiers
Doi:
10.1186/1471-2334-14-513
ISSN:
14712334
Research Areas
Health System And Policy
Study Design
Cross Sectional Study