Unit:
Library of the School of Health SciencesΚατεύθυνση Σύνδρομο μετά Νοσηλεία στη ΜΕΘ
Author:
Tasoulis Athanasios
Supervisors info:
Σεραφείμ Νανάς, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βασιλειάδης Ιωάννης, Επικ. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αναστάσιος Φιλίππου, Επικ. Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ο αποικισμός με πολυανθεκτικά μικρόβια σε Κέντρο Αποκατάστασης
Translated title:
XDR or PDR (extensively / multidrug-resistant drug-resistan) Gram Negatives colonization in a rehabilitation center
Summary:
Backround: Carriage of XDR or PDR (extensively / multidrug-resistant drug-resistan) Gram Negatives serves as an important reservoir for horizontal dissemination in health – care facilities and as a source for subsequent clinical infection in carriers. The aim of this study was to describe the natural history of colonization by XDR or PDR in patients dischared to a rehabilitation center.
Clinical importance: future strategies, indication of antibacterial treatment
Methods: Patients were screened by rectal swabs, urine, tracheal aspirate or decubitus ulcer/wound cultures on selective plates (CHROM agar KPC) for XDR/PDR Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumonia at admission. Removed isolates were submitted to identification and susceptibility testing. Patients were assigned to one of the following groups: Group A, those colonized by any of the above, were cohorted and placed on strict contact isolation precautions; Group B, those not colonized and Group C, those hose cultures results were pending. Patients in the latter group were re-assigned to either Group A or B, depending on culture results. Patients in Surveillance culture were performed every 15 days for patients in Group B and every 2 months and 3 days before discharge in Group A. Patients who became colonized during their stay, were re-assigned to Group A and were transferred to dedicated groups. Those initially colonized who had 3 consecutive negative cultures were re-assigned to Group B and were relocated to other rooms.
Results: A total 380 patients have been included in our study and 139 of them (37%) were colonized with XDR/PDR isolate while 241 (63%) were not. From those patients that they were screened before discharge (Ν=266) 109 (41%) were colonized. 37 patients were clear of colonization after a mean duration of stay 2,5±1 months
Conclusions: A significant proportion of patients admitted to a rehabilitation center in Greece were colonized with XDR/PDR bacteria. ‘’Clearene’’ of colonization without any intervention is uncommon and it may occur after prolonged period of time. Screening and isolation precaution measures are of paramount importance for the prevention of dissemination of these pathogenes in rehabilitation centers.
Main subject category:
Health Sciences
Keywords:
Colonization,XDR ή PDR gram negative, Rehabilitation center
