Kivonat:
INTRODUCTION: Intensive care units are favourable environment
for infections, many of them are caused by antibiotic
resistant bacteria. AIM: Identifying risk factors of ICU-
acquired multiresistant infections. METHOD: We performed
observational study on two academic intensive care units (a
multidisciplinary and a surgical ICU) between 01/09/2014 and
30/11/2015. Patients with a first infection caused by
predefined organisms (P. aeruginosa, E. coli, K. pneumoniae,
A. baumanni, S. aureus, S. epidermidis, E. faecium, E.
faecalis or their multiresistant homologues) verified >/=48 h
following admission were divided into two groups according to
multiresistant (MRB) and non-multiresistant (n-MRB) bacteria.
Prevalence of diabetes, COPD, smoking, alcoholism, acute
surgery, malignancy were recorded. Their role was evaluated
on pooled populations. Illness severity was marked by SAPS-II
at admission and SOFA-score on day of positive culture. We
also noted the length of stay, mechanical ventilation,
antibiotic treatment. RESULTS: Multidisciplinary ICU had 627,
the surgical 1096 admissions. On the formal unit MRB group
had 41 (48.1%), the n-MRB had 38 (51.9%) patients. On the
latter unit 31 (54.4%) and 26 (45.6%) patients were involved.
Smoking favoured multiresistant bacteria (RR 1.44 CI95% 1.04-
2.0; p = 0.048). In case of malignancies n-MRB were more
prominent (RR of MRB 0.68 CI95% 0.47-0.97; p = 0.026), other
comorbidities had no significant impact. Illness severity
scores did not differ at any of the ICUs. Preceding length of
stay, days on mechanical ventilation or on antibiotics were
similar in each group on both ICUs. CONCLUSION: Smoking was
revealed as a risk factor for MRB on our ICUs. We were not
able to identify time-dependent risk factors. Orv Hetil.
2017; 158(32): 1259-1268.