Antimicrobial resistance profiles and mortality rates in intensive care unit patients having central line associated blood stream infection: a temporal analysis

重症监护病房中心静脉导管相关血流感染患者的抗菌药物耐药谱和死亡率:一项时间分析

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Abstract

BACKGROUND: Patients with indwelling devices in the intensive care unit (ICU) face a heightened risk of infections, particularly central-line associated blood stream infection (CLABSI). With the aim of enhancing ICU prevention strategies, this study assessed CLABSI incidence, key pathogens, and their resistence profiles. METHOD: The retrospective study analyzed patients with central line catheter (CLC) from 2021 to 2023. Patients' demographic details, CLC site, ICU stay, and blood culture reports including resistance were analyzed. RESULTS: Among 3,761 patients, CLABSI incidence rates were 6.18 (n=18, 2021), 1.69 (n=15, 2022), and 3.75 (n=42, 2023) per 1,000 CL days. The predominant GNB included Klebsiella pneumoniae (25.3%), Acinetobacter baumannii (16%), and Pseudomonas aeruginosa (9.33%), while GPC included Enterococcus species (5.33%) and Staphylococcus aureus (2.66%). Klebsiella (K.) pneumoniae and Pseudomonas (P.) ae ru ginosa exhibited rising resistance to cephalosporins, carbapenems, BL-BLIs, and monobactams. Acinetobacter (A.) baumannii showed decreased resistance to carbapenems and BL-BLIs. Staphylococcus (S.) aureus exhibited decreased resistance to macrolides and lincosamides, while Enterococcus species showed increased resistance to macrolides and penicillin. Candida species (21.3%) were isolated in 2022, with one case of Candida auris in 2023. Multidrug-resistant (MDR) CLABSIs had statistically significantly higher mortality (p=0.042). DISCUSSION: GNB showed increased resistance to cephalosporins, carbapenems, and BL-BLIs. In contrast, S. aureus demonstrated decreased resistance to lincosamides, while Enterococcus showed rising resistance to macrolides and penicillin, raising concern about treatment. CONCLUSION: These findings emphasize the urgent need for targeted stewardship against CLABSI.

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