Acquisition of XXXX -resistant Gram-negative bacilli in intensive care unit: Predictors and molecular epidemiology.

@entity1 @entity796 @entity14346 @entity7120 @entity2893 @entity581 @entity3400 @entity7100
OBJECTIVES: We had for aim to determine the risk factors for acquiring @entity2893 -intermediate or -resistant Gram-negative bacilli (CR-GNB) in an intensive care unit (ICU) and to identify the resistance mechanisms involved. @entity1 AND METHODS: We conducted an observational prospective cohort study during 6 months in medical and surgical ICUs of the Besan  on Teaching Hospital. @entity1 with acquired CR-GNB were @entity1 whose cultures (screening or diagnosis) became positive more than 48h after admission to the ICU. The risk factors for ICU-acquired CR-GNB were determined by multivariate logistic regression. CR-GNB isolates were typed by pulsed-field gel electrophoresis (PFGE) and screened for resistance mechanisms with phenotypic and genotypic tests. RESULTS: Twenty-three of the 347 included @entity1 had acquired a CR-GNB. The multivariate analysis revealed significant associations between this acquisition and the duration of previous treatments with @entity3400 - @entity7120 (adjusted odds ratio [aOR], 1.13, P=0.02) and @entity581 (aOR, 1.62; P=0.005), but not with carbapenems. The CR-GNB strains were identified as @entity796 (n=10), @entity14346 (n=7), and @entity7100 (n=6). No acquired carbapenemase-producing strain was identified. PFGE typing identified 1 multiple clone among @entity796 isolates (4 @entity1 ), whereas for the other bacteria, all the strains were different. CONCLUSION: Our study results suggest that the strategy to prevent the emergence and spread of CR-GNB should not be limited to the sole restriction of @entity2893 use in ICU settings.
