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KMID : 0383820120720040360
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Tuberculosis and Respiratory Diseases
2012 Volume.72 No. 4 p.360 ~ p.366
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Four Year Trend of Carbapenem-Resistance in Newly Opened ICUs of a University-Affiliated Hospital of South Korea
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Kim Bo-Min
Jeon Eun-Ju
Jang Ju-Young
Chung Jin-Won
Park Ji-Hoon
Choi Jae-Chol
Shin Jong-Wook
Park In-Won
Choi Byoung-Whui
Kim Jae-Yeol
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Abstract
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Background : Carbapenem-resistance is rapidly evolving among the pathogenic microbes in intensive care units (ICUs). This study aimed to determine annual trend of carbapenem-resistance in the ICU for 4 years, since the opening of a university-affiliated hospital in South Korea.
Materials and Methods : From 2005 to 2008, microbial samples from consecutive 6,772 patients were screened in the ICU. Three hundred and ninety-seven patients (5.9%) and their first isolates of carbapenem-resistant pathogens were analyzed.
Results : The percentage of patients infected with carbapenem-resistant organisms increased constantly during the initial three years (2.3% in 2005, 6.2% in 2006, 7.8% in 2007), then it declined to 6.5% in 2008. Acute Physiology and Chronic Health Evaluation (APACHE) III score at admission was 58.0±23.5, the median length of the ICU stay was 37 days, and the mortality rate was 37.5%. The sampling sites were endotracheal suction (67%), catheterized urine (17%), wound (6%) and others (10%). Bacteria with carbapenem-resistance were Pseudomonas aeruginosa (247 isolates, 62%), Acinetobacter baumannii (117 isolates, 30%), Enterobacteriaceae (12 isolates, 3%), and others (21, 5%). Of note, peak isolation of carbapenem-resistant microorganisms in medical ICU was followed by the same epidemic at surgical ICU.
Conclusion : Taken together, carbapenem-resistant pathogens are of growing concern in the ICU.
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KEYWORD
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Carbapenems, Drug Resistance, Bacterial, Intensive Care Units
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