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R2259 Catheter-related bacteraemia in intensive care unit patients
S654 strong-positive, indicating a higher ratio in the strong-positive (P < 0.01). The cases of cerebrovascular disorder were found in 25.4% of negative and 38.5% in strong-positive (P = 0.42). Conclusion: The strong-positive patients for C. pneumoniae antibody were significantly older in age compared to the negative, and significantly more of the strong-positve patients died within 2 years of the measurement as compared to the negative. Although statistically not significant, there were more cases of cerebrovascular disorder in the strong-positive cases.
R2258 Evaluation of nosocomial infections in the hospitalised patients of intensive care unit of a university hospital, Kashan, Iran A. Khorshidi (Kashan, IR) Background and Objective: Nosocomial infections is a great problem in hospital that increased cost, duration of hospitalisation and mortality, Regarding to inaccessibility to accurate information of NI and the bacterial agents. antibiotic resistance pattern in Hospital University of Kashan (Iran), this study was done from May 2005 to Apr 2006. Material and Methods: This descriptive study was conducted by evaluation of all files of admitted patients of ICU in Central Hospital University of Kashan from May 2005 to April 2006, after of finding of infection cases according to symptoms with or without positive culture, The results and demographic characteristic were registered then results of research were presented by descriptive analysis. Results: Research showed that prevalence of nosocomial infections in ICU was (10.12%) (39 cases of 289 Persons) range of aged in hospitalised infection was 75−45 years. The most prevalence of NI was: respiratory infections (56.59%), UTI (26.58%), Bacterimia (6.52%), surgical wound infections (4.3%). The most common Pathogen were determined: Escherichia coli (23.3%), Pseudomonas and Enterobacter (20%), Klebsiella (16.60%), Staphylococcus aureus (13.3%). E. coli and Pseudomonas showed the most resistance to ciprofloxacin, cefteriaxon, ceftazidim, amikacin, gentomycin, imipenem. Conclusion: Considering the high prevalence and increasing of antibiotics resistance particularly in ICU comparing with others studies, it is necessary to consider the predisposing factors of nosocomial infectons in ICU like appropriate use of medical equipment, prevention of Irrational prescription of antibiotics and sedative and regarding improved attention to hygienic principles. Incidentally It is better that Procedure of treatment start on the last information of bacterial agents and antibacterial resistance patterns and suggested to organised an Infection Control Committee in this Center. R2259 Catheter-related bacteraemia in intensive care unit patients J. Komarnicka, H. Grezlikowska, E. Naumiuk, A. Sledzinska, A. Samet, M. Wujtewicz (Gdansk, PL) Objectives: Analysis of aetiology and clinical characteristics of central venous catheter-related bacteraemia (CRB). Methods: Microbiological results of proven CRB (isolation of the same pathogen from blood culture and from catheter tip) in patients hospitalised in 12-bed Intensive Care Unit in tertiary care hospital were evaluated, in the period from January 2003 to September 2006. Catheter tips – 3 cm, were examined by Maki technique. Blood cultures were performed in BacT/Alert automated system. Results: From 1th January 2003 to 30rd September 2006, 2442 blood cultures were performed (16.5% positive). 36 of 84 examined catheter tips were positive. 15 patients were considered as proven CRB and two of them had more than one CRB during hospitalisation (total 17 CRB). Aetiological agents were: 8 coagulase negative staphylococci (CNS), 2 A. baumannii, 2 S. maltophilia, 2 Candida albicans, 1 E. cloacae, 1 P. aeruginosa and 1 E. faecalis. In further 10 patients only catheter tip was positive, without a blood culture: 4 CNS, 1 Candida sp.
17th ECCMID / 25th ICC, Abstracts accepted for publication only 1 C. albicans, 1 E. cloacae, 1 E. faecalis, 1 A. baumannii and 1 P. mirabilis. In patients with proven CRB six suffered from sepsis and nine had fever only. All infections were nosocomial. Conclusion: Most of isolated aetiological agents were multiresistant hospital pathogens (except E. faecalis). Because of small number of proven CRB prospective surveillance is essential as well as examining of every catheter tip in situation of removal due to suspicion of infection. R2260 Epidemiology and antibiotic resistance of bacterial isolates from patients with bacteraemia in an intensive care unit E. Ikonomopoulou, P. Georgakoloulos, P. Michail, S. Paratiras, G. Stavropoulou, C. Verra, V. Dondou, A. Regli (Patras, GR) Objectives: The aim of this study was to carry out the prevalence and the antibiotic resistance of bacterial isolates from patients with bacteraemia in the intensive care unit (ICU) of our hospital. Methods: Blood cultures from ICU patients were performed using the Bactec 9120 (Becton Dickinson) and the Bact – alert (bioM´erieux) during 2003 and 2004–2005 respectively. The identification and the antimicrobial resistance of bacterial isolates were carried out by the VITEK system (bioM´erieux). MBL production was performed by E-test (Imipenem, Imipenem and EDTA). Colistin sensitivity was performed by E-test (AB–Biodisc). Results: During a three year period (2003 –2005) 155 patients (99 males/56 females) hospitalised in our ICU and 30 (19.4%) had one or more episodes of bacteraemia. A total of 53 bacterial strains were isolated. The most prevalent pathogen was P. aeruginosa 14 (26.4%) followed by K. pneumoniae 8 (15%), Coag− staphylococci 8 (15%), Acinetobacter baumannii 7 (13.2%), Candida spp. 6 (11.3%), E. faecalis 3 (5.7%), Stenotrophomonas maltophilia 3 (5.7%), S. aureus 2 (3.8%) and E. coli 2 (3.8%). 5 P. aeruginosa strains produced MBLs and 4 K. pneumoniae strains produced ESBL. Resistance rates of P. aeruginosa and K. pneumoniae for commonly used drugs respectively were: amikacin 21.5%/0%, aztreonam 36%/12.5%, cefepime 29%/50%, ceftazidime 21.5%/50%, ciprofloxacin 21.5%/75%, imipenem and meropenem 36%/0%, piperacillin/tazobactam 36%/12.5%. All Acinetobacter baumannii strains were multiresistant (resistance rate: 83% to amikacin, cefepime, imipenem and 100% to aztreonam, piperacillin/ tazobactam, gentamycin, netimicin, tobramycin and ceftazidime). All Acinetobacter baumannii strains were sensitive to Colistin. Among staphylococci all isolates were resistant to oxacillin but they were susceptible to glycopeptides. Candida spp. (C. albicans 4 strains, 1 strain C. sake and 1 strain C. glabrata) were sensitive to Amphotericin B, Fluconazole and Flucytocine. Conclusions: Bacteraemia happens in 19.4% of ICU patients and multiresistant strains are mainly responsible so we must be careful in antibiotic usage in order not to increase the antibiotic resistance of bacterial isolates. R2261 Venous access ports. Prospective study to analyse use-related complications A. Serrera, M. Alonso, J.L. del Pozo, S. Hernaez, A. Martinez, I. Bilbao, A. Aguinaga, A. Ramos, J. Leiva (Pamplona, ES) Objectives: Venous access ports (VAP) are used in patients receiving long parenteral treatments. The aim of this prospective and observational study was to analyse the complications of VAP use, and to describe the role of different culture techniques for diagnosing VAP-related infection. Methods: Over a 12-month period all VAPs removed in our hospital were microbiologically examined by the following procedures: culture of the catheter tip (sonication method). Culture of the internal lumen of the port (chamber swabbing and septum sonication). Besides, a macroscopic analysis with search for deposits inside the reservoir was performed. We also analysed the records of all patients (age, sex, clinical diagnosis, underlying conditions, date of VAP insertion and removal, number of days in use, reasons for removal and all significant events during treatment).
R2258 Evaluation of nosocomial infections in the hospitalised patients of intensive care unit of a university hospital, Kashan, Iran A. Khorshidi (Kashan, IR) Background and Objective: Nosocomial infections is a great problem in hospital that increased cost, duration of hospitalisation and mortality, Regarding to inaccessibility to accurate information of NI and the bacterial agents. antibiotic resistance pattern in Hospital University of Kashan (Iran), this study was done from May 2005 to Apr 2006. Material and Methods: This descriptive study was conducted by evaluation of all files of admitted patients of ICU in Central Hospital University of Kashan from May 2005 to April 2006, after of finding of infection cases according to symptoms with or without positive culture, The results and demographic characteristic were registered then results of research were presented by descriptive analysis. Results: Research showed that prevalence of nosocomial infections in ICU was (10.12%) (39 cases of 289 Persons) range of aged in hospitalised infection was 75−45 years. The most prevalence of NI was: respiratory infections (56.59%), UTI (26.58%), Bacterimia (6.52%), surgical wound infections (4.3%). The most common Pathogen were determined: Escherichia coli (23.3%), Pseudomonas and Enterobacter (20%), Klebsiella (16.60%), Staphylococcus aureus (13.3%). E. coli and Pseudomonas showed the most resistance to ciprofloxacin, cefteriaxon, ceftazidim, amikacin, gentomycin, imipenem. Conclusion: Considering the high prevalence and increasing of antibiotics resistance particularly in ICU comparing with others studies, it is necessary to consider the predisposing factors of nosocomial infectons in ICU like appropriate use of medical equipment, prevention of Irrational prescription of antibiotics and sedative and regarding improved attention to hygienic principles. Incidentally It is better that Procedure of treatment start on the last information of bacterial agents and antibacterial resistance patterns and suggested to organised an Infection Control Committee in this Center. R2259 Catheter-related bacteraemia in intensive care unit patients J. Komarnicka, H. Grezlikowska, E. Naumiuk, A. Sledzinska, A. Samet, M. Wujtewicz (Gdansk, PL) Objectives: Analysis of aetiology and clinical characteristics of central venous catheter-related bacteraemia (CRB). Methods: Microbiological results of proven CRB (isolation of the same pathogen from blood culture and from catheter tip) in patients hospitalised in 12-bed Intensive Care Unit in tertiary care hospital were evaluated, in the period from January 2003 to September 2006. Catheter tips – 3 cm, were examined by Maki technique. Blood cultures were performed in BacT/Alert automated system. Results: From 1th January 2003 to 30rd September 2006, 2442 blood cultures were performed (16.5% positive). 36 of 84 examined catheter tips were positive. 15 patients were considered as proven CRB and two of them had more than one CRB during hospitalisation (total 17 CRB). Aetiological agents were: 8 coagulase negative staphylococci (CNS), 2 A. baumannii, 2 S. maltophilia, 2 Candida albicans, 1 E. cloacae, 1 P. aeruginosa and 1 E. faecalis. In further 10 patients only catheter tip was positive, without a blood culture: 4 CNS, 1 Candida sp.
17th ECCMID / 25th ICC, Abstracts accepted for publication only 1 C. albicans, 1 E. cloacae, 1 E. faecalis, 1 A. baumannii and 1 P. mirabilis. In patients with proven CRB six suffered from sepsis and nine had fever only. All infections were nosocomial. Conclusion: Most of isolated aetiological agents were multiresistant hospital pathogens (except E. faecalis). Because of small number of proven CRB prospective surveillance is essential as well as examining of every catheter tip in situation of removal due to suspicion of infection. R2260 Epidemiology and antibiotic resistance of bacterial isolates from patients with bacteraemia in an intensive care unit E. Ikonomopoulou, P. Georgakoloulos, P. Michail, S. Paratiras, G. Stavropoulou, C. Verra, V. Dondou, A. Regli (Patras, GR) Objectives: The aim of this study was to carry out the prevalence and the antibiotic resistance of bacterial isolates from patients with bacteraemia in the intensive care unit (ICU) of our hospital. Methods: Blood cultures from ICU patients were performed using the Bactec 9120 (Becton Dickinson) and the Bact – alert (bioM´erieux) during 2003 and 2004–2005 respectively. The identification and the antimicrobial resistance of bacterial isolates were carried out by the VITEK system (bioM´erieux). MBL production was performed by E-test (Imipenem, Imipenem and EDTA). Colistin sensitivity was performed by E-test (AB–Biodisc). Results: During a three year period (2003 –2005) 155 patients (99 males/56 females) hospitalised in our ICU and 30 (19.4%) had one or more episodes of bacteraemia. A total of 53 bacterial strains were isolated. The most prevalent pathogen was P. aeruginosa 14 (26.4%) followed by K. pneumoniae 8 (15%), Coag− staphylococci 8 (15%), Acinetobacter baumannii 7 (13.2%), Candida spp. 6 (11.3%), E. faecalis 3 (5.7%), Stenotrophomonas maltophilia 3 (5.7%), S. aureus 2 (3.8%) and E. coli 2 (3.8%). 5 P. aeruginosa strains produced MBLs and 4 K. pneumoniae strains produced ESBL. Resistance rates of P. aeruginosa and K. pneumoniae for commonly used drugs respectively were: amikacin 21.5%/0%, aztreonam 36%/12.5%, cefepime 29%/50%, ceftazidime 21.5%/50%, ciprofloxacin 21.5%/75%, imipenem and meropenem 36%/0%, piperacillin/tazobactam 36%/12.5%. All Acinetobacter baumannii strains were multiresistant (resistance rate: 83% to amikacin, cefepime, imipenem and 100% to aztreonam, piperacillin/ tazobactam, gentamycin, netimicin, tobramycin and ceftazidime). All Acinetobacter baumannii strains were sensitive to Colistin. Among staphylococci all isolates were resistant to oxacillin but they were susceptible to glycopeptides. Candida spp. (C. albicans 4 strains, 1 strain C. sake and 1 strain C. glabrata) were sensitive to Amphotericin B, Fluconazole and Flucytocine. Conclusions: Bacteraemia happens in 19.4% of ICU patients and multiresistant strains are mainly responsible so we must be careful in antibiotic usage in order not to increase the antibiotic resistance of bacterial isolates. R2261 Venous access ports. Prospective study to analyse use-related complications A. Serrera, M. Alonso, J.L. del Pozo, S. Hernaez, A. Martinez, I. Bilbao, A. Aguinaga, A. Ramos, J. Leiva (Pamplona, ES) Objectives: Venous access ports (VAP) are used in patients receiving long parenteral treatments. The aim of this prospective and observational study was to analyse the complications of VAP use, and to describe the role of different culture techniques for diagnosing VAP-related infection. Methods: Over a 12-month period all VAPs removed in our hospital were microbiologically examined by the following procedures: culture of the catheter tip (sonication method). Culture of the internal lumen of the port (chamber swabbing and septum sonication). Besides, a macroscopic analysis with search for deposits inside the reservoir was performed. We also analysed the records of all patients (age, sex, clinical diagnosis, underlying conditions, date of VAP insertion and removal, number of days in use, reasons for removal and all significant events during treatment).