Is There a Relationship Between Rectal Colonization and Nosocomial Infection of Patients in Intensive Care Unit?

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dc.authorid0000-0002-7210-1084en_US
dc.authorid0000-0003-3799-1090en_US
dc.contributor.authorYesilbag, Zuhal
dc.contributor.authorCagatay, Arif Atahan
dc.contributor.authorKaradeniz, Asli
dc.contributor.authorBasaran, Seniha
dc.contributor.authorOrhun, Gunseli
dc.contributor.authorErgin Ozcan, Perihan
dc.contributor.authorOzsut, Halit
dc.contributor.authorEraksoy, Haluk
dc.date.accessioned2024-07-12T21:52:11Z
dc.date.available2024-07-12T21:52:11Z
dc.date.issued2015en_US
dc.departmentMaltepe Üniversitesien_US
dc.description.abstractNosocomial infections caused by multidrug-resistant (MDR) microorganisms are a major problem in intensive care units (ICUs) with high mortality and morbidity rates and the prior colonization is an important risk factor for these infections. The aim of this study was to investigate the prevalence of rectal colonization of MDR microorganisms and the association between the microorganisms that caused colonization and infection in the patients with nosocomial infections in ICUs. Rectal swabs were obtained on the day of 0, 3, 7, 14, 21 and weekly thereafter from 80 patients over 18 years of age hospitalized in ICU for more than 48 hours, and cultured for vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL)- producing gram-negative bacilli (GNB) and carbapenem-resistant enteric and nonenteric bacilli. Patients whose rectal swabs were not obtained on admission (on the day of 0), were excluded even they were hospitalized more than 48 hours. Bile esculin agar containing 64 mu g/mL ceftazidime and 6 mu g/mL vancomycin, chromogenic MRSA agar and blood agar media, MacConkey agar containing 1 mg/L cefitazidime and ceftriaxone, and 5 mL tryptic soy broth media containing 10 mu g imipenem and meropenem discs were used for identification. Identification of GNB was determined by conventional methods and ESBL production was determined by double-disc synergy test. Patients have been followed up for nosocomial infections. Bacterial identification and antibiotic susceptibility tests were performed with standard microbiological methods. In 37 (46%) of the 80 patients, at least one MDR microorganism was isolated in rectal swab cultures on the day of 0. The most common microorganisms were ESBL-positive E.coli (19%), followed by ESBL-positive K.pneumoniae (13%), carbapenem-resistant P.aeruginosa (10%), ESBL-positive K.oxytoca (3%), MRSA (1%), VRE (1%), carbapenem-resistant Acinetobacter sp. (1%) and carbapenem-resistant K.pneumoniae (1%), respectively. The number of microorganisms isolated from rectal swab cultures on the following days have increased, and on the 7th day, the rate of the patients with rectal colonization ascended to 72%. Out of 80 patients, 52 (65%) had nosocomial infections in the follow-up and the mean duration of infection development was 11.8 +/- 9.9 days in these patients. Patients with and without rectal colonization were compared in terms of subsequent nosocomial infection rates. While no statistically significant difference has been detected between two groups on the day of 0, patients with rectal colonization detected on the day of 3 and 7, had a significantly higher incidence of nosocomial infections (p= 0.02, p= 0.01). Among the patients with ESBL-positive GNB, carbapenem-resistant K.pneumoniae, carbapenem-resistant P.aeruginosa and VRE infections, the same microorganisms have been isolated in the rectal swab cultures taken before the development of infection. This result was statistically significant for each of these microorganisms (p= 0.00 - 0.03). However, such a correlation was not observed for Acinetobacter infections. Since MRSA infections developed in only two patients, no istatistical analysis has been done for this microorganism. In conclusion, our data suggest that MDR microorganisms that cause nosocomial infections, initially colonize the gastrointestinal tract, and early detection of colonized patients in ICUs may help an effective infection control by preventing the spread. of these resistant microorganisms.en_US
dc.identifier.endpage339en_US
dc.identifier.issn0374-9096
dc.identifier.issue3en_US
dc.identifier.pmid26313275en_US
dc.identifier.scopusqualityQ4en_US
dc.identifier.startpage327en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12415/8354
dc.identifier.volume49en_US
dc.identifier.wosWOS:000360254000003en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.language.isotren_US
dc.publisherANKARA MICROBIOLOGY SOCen_US
dc.relation.ispartofMIKROBIYOLOJI BULTENIen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmzKY02929
dc.subjectRectal colonizationen_US
dc.subjectnosocomial infectionen_US
dc.subjectsurveillance culturesen_US
dc.subjectintensive care uniten_US
dc.titleIs There a Relationship Between Rectal Colonization and Nosocomial Infection of Patients in Intensive Care Unit?en_US
dc.typeArticle
dspace.entity.typePublication

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