Your browser doesn't support javascript.
loading
Prevalence of Antimicrobial Resistance and Association with Patient Outcomes in a Rural Kenyan Hospital.
Drobish, Ian C; Barasa, Immaculate K; Otieno, George; Osoo, Moses Odhiambo; Thuo, Solomon K; Belknap, Kaya S; Shirk, Arianna McLain; McClanahan, S Taylor; Irungu, Elizabeth; Riunga, Felix; Lelei, Faith; Rudd, Kristina E; Brotherton, B Jason.
Afiliación
  • Drobish IC; Department of Internal Medicine, Department of Pediatrics, University of California San Diego, San Diego, California.
  • Barasa IK; Critical Care Medicine Department, NIH Clinical Center; Bethesda, Maryland.
  • Otieno G; Department of Pediatrics, AIC Kijabe Hospital, Kijabe, Kenya.
  • Osoo MO; Department of Internal Medicine, AIC Kijabe Hospital, Kijabe, Kenya.
  • Thuo SK; Department of Research, AIC Kijabe Hospital, Kijabe, Kenya.
  • Belknap KS; Department of Laboratory Medicine, AIC Kijabe Hospital, Kijabe, Kenya.
  • Shirk AM; Department of Outpatient Medicine, AIC Kijabe Hospital, Kijabe, Kenya.
  • McClanahan ST; Department of Pediatrics, AIC Kijabe Hospital, Kijabe, Kenya.
  • Irungu E; Bessemer Pediatrics, Bessemer, Alabama.
  • Riunga F; Department of Pharmacy, AIC Kijabe Hospital, Kijabe, Kenya.
  • Lelei F; Department of Infectious Diseases, Aga Khan University Hospital, Nairobi, Kenya.
  • Rudd KE; Department of Family Medicine, AIC Kijabe Hospital, Kijabe, Kenya.
  • Brotherton BJ; Department of Critical Care Medicine, The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Am J Trop Med Hyg ; 108(6): 1227-1234, 2023 06 07.
Article en En | MEDLINE | ID: mdl-37160272
Data on antimicrobial resistance (AMR) and association with outcomes in resource-variable intensive care units (ICU) are lacking. Data currently available are limited to large, urban centers. We attempted to understand this locally through a dual-purpose, retrospective study. Cohort A consisted of adult and pediatric patients who had blood, urine, or cerebrospinal fluid cultures obtained from 2016 to 2020. A total of 3,013 isolates were used to create the Kijabe Hospital's first antibiogram. Gram-negative organisms were found to be less than 50% susceptible to third- and fourth-generation cephalosporins, 67% susceptible to piperacillin-tazobactam, 87% susceptible to amikacin, and 93% susceptible to meropenem. We then evaluated the association between AMR and clinical characteristics, management, and outcomes among ICU patients (Cohort B). Demographics, vital signs, laboratory results, management data, and outcomes were obtained. Antimicrobial resistance was defined as resistance to one or more antimicrobials. Seventy-six patients were admitted to the ICU with bacteremia during this time. Forty complete paper charts were found for review. Median age was 34 years (interquartile range, 9-51), 26 patients were male (65%), and 28 patients were older than 18 years (70%). Septic shock was the most common diagnosis (n = 22, 55%). Six patients had AMR bacteremia; Escherichia coli was most common (n = 3, 50%). There was not a difference in mortality between patients with AMR versus non-AMR infections (P = 0.54). This study found a prevalence of AMR. There was no association between AMR and outcomes among ICU patients. More studies are needed to understand the impact of AMR in resource-variable settings.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bacteriemia / Antibacterianos Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Child / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: Am J Trop Med Hyg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Bacteriemia / Antibacterianos Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adult / Child / Female / Humans / Male País/Región como asunto: Africa Idioma: En Revista: Am J Trop Med Hyg Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos