Literature DB >> 9790198

Antibiotic susceptibility in the surgical intensive care unit compared with the hospital-wide antibiogram.

D Kaufman1, C E Haas, R Edinger, G Hollick.   

Abstract

OBJECTIVE: To compare the antibiotic susceptibility of bacterial isolates from patients in the surgical intensive care unit (SICU) with hospital-wide bacterial susceptibility.
DESIGN: Retrospective cohort analytic study.
SETTING: Eight-bed SICU in a university-affiliated teaching hospital. PATIENTS: All hospitalized patients with culture results positive for microorganisms.
INTERVENTIONS: None. MAIN OUTCOME MEASURES: Antibiotic susceptibility data were collected retrospectively for all bacterial isolates from SICU patients during July 1, 1994, to June 30, 1995. All duplicate and surveillance cultures were eliminated from the data set. Susceptibility testing was conducted using our standard laboratory methods. Results were compared with the hospital-wide antibiogram (HWA) for the same time period. Comparisons were made using the chi(2) test with Yates correction or the Fisher exact test, as appropriate. Staphylococcus aureus (HWA, n=494; SICU, n=71) was significantly less susceptible to oxacillin (51% vs 28%; P<.001), ciprofloxacin (50% vs 25%; P<.001), erythromycin (46% vs 23%; P<.001), and clindamycin (51% vs 27%; P<.001) in the SICU. Coagulase-negative staphylococci (HWA, n=339; SICU, n=37) were significantly less susceptible to oxacillin (33% vs 16%; P=.04) and clindamycin (57% vs 34%; P=.02). Pseudomonas aeruginosa (HWA, n=513; SICU, n=96) was less susceptible to imipenem (85% vs 74%, P=.01) and more susceptible to ticarcillin-clavulanic acid (88% vs 100%, P<.001) in the SICU. Escherichia coli (HWA, n=474; SICU, n=36) was more susceptible to most penicillin-derivative antibiotics in the SICU (ampicillin [68% vs 83%, P=.06], ticarcillin [65% vs 86%, P=.01], mezlocillin [76% vs 95%, P=.01], and ticarcillin-clavulanic acid [88% vs 100%, P=.02]).
CONCLUSIONS: The 2 most commonly isolated bacterial pathogens in the SICU (S aureus and P aeruginosa) had significantly different susceptibility patterns compared with the HWA. Surprisingly, E coli isolated in the SICU tended to be more susceptible to penicillin-derivative antibiotics. These data indicate that empiric antibiotic choices in the SICU may be better guided by unit-specific antibiograms.

Entities:  

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Year:  1998        PMID: 9790198     DOI: 10.1001/archsurg.133.10.1041

Source DB:  PubMed          Journal:  Arch Surg        ISSN: 0004-0010


  15 in total

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2.  Cumulative Antimicrobial Susceptibility Data from Intensive Care Units at One Institution: Should Data Be Combined?

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5.  Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.

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6.  Variation in antibiotic susceptibility of uropathogens by age among ambulatory pediatric patients.

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Review 9.  The antibiogram: key considerations for its development and utilization.

Authors:  William R Truong; Levita Hidayat; Michael A Bolaris; Lee Nguyen; Jason Yamaki
Journal:  JAC Antimicrob Resist       Date:  2021-05-25

10.  Comparison of hospital-wide and age and location - stratified antibiograms of S. aureus, E. coli, and S. pneumoniae: age- and location-stratified antibiograms.

Authors:  Sanjeev K Swami; Ritu Banerjee
Journal:  Springerplus       Date:  2013-02-22
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