Active surveillance for multidrug-resistant Gram-negative bacteria in the intensive care unit

作者：Abbott Iain J^*; Jenney Adam W J; Spelman Denis W; Pilcher David V; Sidjabat Hanna E; Richardson Leisha J; Paterson David L; Peleg Anton Y

来源：Pathology, 2015, 47(6): 575-579.

DOI：10.1097/PAT.0000000000000302

• Active screening culture
• active surveillance
• antibiotic resistance
• intensive care unit
• rectal swab
• multidrug-resistant Gram-negative bacteria

A short-term program of performing serial active screening cultures (ASC) in the intensive care unit was instituted to establish a method for the detection of antibiotic-resistant Gram-negative bacteria (GNB) and the local rates of colonisation. Of all submitted ASC, 25.9% (30/116 collected swabs) isolated an antibiotic-resistant GNB. ChromID ESBL agar (bioMerieux, France) identified the majority of these organisms, with the additional antibiotic-impregnated media [MacConkey agar (MCA) with ciprofloxacin, MCA with gentamicin and MCA with ceftazidime] adding limited benefit. Compared to swabs performed on admission, 37.8% (14/37) of patients cultured a new antibiotic-resistant isolate on discharge. Serial screening in intensive care has the ability to identify patients with unrecognised colonisation with antibiotic-resistant GNB; however, the increase in the laboratory workload and logistical challenges in the collection of the surveillance swabs may limit this program's expansion.

• 出版日期2015-10