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Erschienen in: Intensive Care Medicine 1/2009

01.01.2009 | Original

Surveillance of microbial resistance in European Intensive Care Units: a first report from the Care-ICU programme for improved infection control

verfasst von: Håkan Hanberger, Dilek Arman, Hans Gill, Vlastimil Jindrák, Smilja Kalenic, Andrea Kurcz, Monica Licker, Paul Naaber, Elizabeth A. Scicluna, Václav Vanis, Sten M. Walther

Erschienen in: Intensive Care Medicine | Ausgabe 1/2009

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Abstract

Purpose

To report initial results from a European ICU surveillance programme focussing on antibiotic consumption, microbial resistance and infection control.

Methods

Thirty-five ICUs participated during 2005. Microbial resistance, antibiotic consumption and infection control stewardship measures were entered locally into a web-application. Results were validated locally, aggregated by project leaders and fed back to support local audit and benchmarking.

Results

Median (range) antibiotic consumption was 1,254 (range 348–4,992) DDD per 1,000 occupied bed days. The proportion of MRSA was median 11.6% (range 0–100), for ESBL phenotype of E. coli and K. pneumoniae 3.9% (0–80) and 14.3% (0–77.8) respectively, and for carbapenem-resistant P. aeruginosa 22.5% (0–100). Screening on admission for alert pathogens was commonly omitted, and there was a lack of single rooms for isolation.

Conclusions

The surveillance programme demonstrated wide variation in antibiotic consumption, microbial resistance and infection control measures. The programme may, by providing rapid access to aggregated results, promote local and regional audit and benchmarking of antibiotic use and infection control practices.
Literatur
1.
Zurück zum Zitat Vincent JL (2000) Microbial resistance: lessons from the EPIC study European Prevalence of Infection. Intensive Care Med 26(suppl 1):S3–S8PubMedCrossRef Vincent JL (2000) Microbial resistance: lessons from the EPIC study European Prevalence of Infection. Intensive Care Med 26(suppl 1):S3–S8PubMedCrossRef
2.
Zurück zum Zitat Hanberger H, Diekema D, Fluit A, Jones R, Struelens M, Spencer R, Wolff M (2001) Surveillance of antibiotic resistance in European ICUs. J Hosp Infect 48:161–176PubMedCrossRef Hanberger H, Diekema D, Fluit A, Jones R, Struelens M, Spencer R, Wolff M (2001) Surveillance of antibiotic resistance in European ICUs. J Hosp Infect 48:161–176PubMedCrossRef
3.
Zurück zum Zitat Deplano A, Denis O, Poirel L, Hocquet D, Nonhoff C, Byl B, Nordmann P, Vincent JL, Struelens MJ (2005) Molecular characterization of an epidemic clone of panantibiotic-resistant Pseudomonas aeruginosa. J Clin Microbiol 43:1198–1204PubMedCrossRef Deplano A, Denis O, Poirel L, Hocquet D, Nonhoff C, Byl B, Nordmann P, Vincent JL, Struelens MJ (2005) Molecular characterization of an epidemic clone of panantibiotic-resistant Pseudomonas aeruginosa. J Clin Microbiol 43:1198–1204PubMedCrossRef
4.
Zurück zum Zitat Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D (2006) Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 34:344–353PubMedCrossRef Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D (2006) Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 34:344–353PubMedCrossRef
5.
Zurück zum Zitat Wroblewska MM, Rudnicka J, Marchel H, Luczak M (2006) Multidrug-resistant bacteria isolated from patients hospitalised in intensive care units. Int J Antimicrob Agents 4:285–289CrossRef Wroblewska MM, Rudnicka J, Marchel H, Luczak M (2006) Multidrug-resistant bacteria isolated from patients hospitalised in intensive care units. Int J Antimicrob Agents 4:285–289CrossRef
6.
Zurück zum Zitat Gastmeier P, Sohr D, Geffers C, Behnke M, Ruden H (2007) Risk factors for death due to nosocomial infection in intensive care unit patients: findings from the Krankenhaus Infektions Surveillance System. Infect Control Hosp Epidemiol 4:466–472CrossRef Gastmeier P, Sohr D, Geffers C, Behnke M, Ruden H (2007) Risk factors for death due to nosocomial infection in intensive care unit patients: findings from the Krankenhaus Infektions Surveillance System. Infect Control Hosp Epidemiol 4:466–472CrossRef
7.
Zurück zum Zitat Hanberger H, Burman LG, Cars O, Erlandsson M, Gill H, Nilsson LE, Nordlinder D, Walther SM, ICU STRAMA Study Group (2007) Low antibiotic resistance rates in Staphylococcus aureus, Escherichia coli and Klebsiella spp but not in Enterobacter spp and Pseudomonas aeruginosa: a prospective observational study in 14 Swedish ICUs over a 5-year period. Acta Anaesthesiol Scand 51:937–941PubMedCrossRef Hanberger H, Burman LG, Cars O, Erlandsson M, Gill H, Nilsson LE, Nordlinder D, Walther SM, ICU STRAMA Study Group (2007) Low antibiotic resistance rates in Staphylococcus aureus, Escherichia coli and Klebsiella spp but not in Enterobacter spp and Pseudomonas aeruginosa: a prospective observational study in 14 Swedish ICUs over a 5-year period. Acta Anaesthesiol Scand 51:937–941PubMedCrossRef
8.
Zurück zum Zitat Tato M, Coque TM, Ruíz-Garbajosa P, Pintado V, Cobo J, Sader HS, Jones RN, Baquero F, Cantón R (2007) Complex clonal and plasmid epidemiology in the first outbreak of Enterobacteriaceae infection involving VIM-1 metallo-beta-lactamase in Spain: toward endemicity? Clin Infect Dis 45:1171–1178PubMedCrossRef Tato M, Coque TM, Ruíz-Garbajosa P, Pintado V, Cobo J, Sader HS, Jones RN, Baquero F, Cantón R (2007) Complex clonal and plasmid epidemiology in the first outbreak of Enterobacteriaceae infection involving VIM-1 metallo-beta-lactamase in Spain: toward endemicity? Clin Infect Dis 45:1171–1178PubMedCrossRef
9.
Zurück zum Zitat Damas P, Ledoux D, Nys M, Monchi M, Wiesen P, Beauve B, Preiser JC (2008) Intensive care unit acquired infection and organ failure. Intensive Care Med 34:856–864PubMedCrossRef Damas P, Ledoux D, Nys M, Monchi M, Wiesen P, Beauve B, Preiser JC (2008) Intensive care unit acquired infection and organ failure. Intensive Care Med 34:856–864PubMedCrossRef
10.
Zurück zum Zitat Brun-Buisson C (2008) ICU-acquired infections and sepsis: more of a deadly duo. Intensive Care Med 34:793–795 Brun-Buisson C (2008) ICU-acquired infections and sepsis: more of a deadly duo. Intensive Care Med 34:793–795
11.
Zurück zum Zitat Monnet DL (2000) Toward multinational antimicrobial resistance surveillance systems in Europe. Int J Antimicrob Agents 15:91–101PubMedCrossRef Monnet DL (2000) Toward multinational antimicrobial resistance surveillance systems in Europe. Int J Antimicrob Agents 15:91–101PubMedCrossRef
12.
Zurück zum Zitat Hanberger H, Arman D, Gill H, Kalenic S, Naaber P, Scicluna E, Suetens C (2008) CARE-ICU—Controlling Antibiotic REsistance in Intensive Care Units—First report from a web-based program for improved infection control in European ICUs. In: Programme of the 18th European congress of clinical microbiology and infectious diseases, Barcelona Hanberger H, Arman D, Gill H, Kalenic S, Naaber P, Scicluna E, Suetens C (2008) CARE-ICU—Controlling Antibiotic REsistance in Intensive Care Units—First report from a web-based program for improved infection control in European ICUs. In: Programme of the 18th European congress of clinical microbiology and infectious diseases, Barcelona
13.
Zurück zum Zitat Hanberger H, Erlandsson M, Burman LG, Cars O, Gill H, Lindgren S, Nilsson LE, Olsson-Liljequist B, Walther S, the ICU-STRAMA Study Group (2004) High antibiotic susceptibility among bacterial pathogens in Swedish ICUs. Report from a nation-wide surveillance program using TA90 as a novel index of susceptibility. Scand J Infect Dis 36:24–30PubMedCrossRef Hanberger H, Erlandsson M, Burman LG, Cars O, Gill H, Lindgren S, Nilsson LE, Olsson-Liljequist B, Walther S, the ICU-STRAMA Study Group (2004) High antibiotic susceptibility among bacterial pathogens in Swedish ICUs. Report from a nation-wide surveillance program using TA90 as a novel index of susceptibility. Scand J Infect Dis 36:24–30PubMedCrossRef
14.
Zurück zum Zitat Hanberger H, Monnet DL, Nilsson LE (2005) Intensive care unit. In: Gould I, van der Meer J (eds) Antibiotic policies. Theory and practice. Kluwer Academic/Plenum Publishers, New York, pp 261–271CrossRef Hanberger H, Monnet DL, Nilsson LE (2005) Intensive care unit. In: Gould I, van der Meer J (eds) Antibiotic policies. Theory and practice. Kluwer Academic/Plenum Publishers, New York, pp 261–271CrossRef
15.
Zurück zum Zitat Erlandsson M, Burman LG, Cars O, Gill H, Nilsson LE, Walther SM, Hanberger H, the STRAMA ICU Study Group (2007) Prescription of antibiotic agents in Swedish intensive care units is empiric and precise. Scand J Infect Dis 39:63–69PubMedCrossRef Erlandsson M, Burman LG, Cars O, Gill H, Nilsson LE, Walther SM, Hanberger H, the STRAMA ICU Study Group (2007) Prescription of antibiotic agents in Swedish intensive care units is empiric and precise. Scand J Infect Dis 39:63–69PubMedCrossRef
16.
Zurück zum Zitat de With K, Bergner J, Buhner R, de With K, Bergner J, Bühner R, Dörje F, Gonnermann C, Haber M, Hartmann M, Rothe U, Strehl E, Steib-Bauert M, Kern WV et al (2004) Antibiotic use in German university hospitals 1998–2000 (Project INTERUNI-II). Int J Antimicrob Agents 24:213–221PubMedCrossRef de With K, Bergner J, Buhner R, de With K, Bergner J, Bühner R, Dörje F, Gonnermann C, Haber M, Hartmann M, Rothe U, Strehl E, Steib-Bauert M, Kern WV et al (2004) Antibiotic use in German university hospitals 1998–2000 (Project INTERUNI-II). Int J Antimicrob Agents 24:213–221PubMedCrossRef
17.
Zurück zum Zitat Muller A, Monnet DL, Talon D, Hénon T, Bertrand X (2006) Discrepancies between prescribed daily doses and WHO defined daily doses of antibacterials at a university hospital. Br J Clin Pharmacol 61:585–591PubMedCrossRef Muller A, Monnet DL, Talon D, Hénon T, Bertrand X (2006) Discrepancies between prescribed daily doses and WHO defined daily doses of antibacterials at a university hospital. Br J Clin Pharmacol 61:585–591PubMedCrossRef
18.
Zurück zum Zitat Meyer E, Schwab F, Gastmeier P, Rueden H, Daschner FD, Jonas D (2006) Stenotrophomonas maltophilia and antibiotic use in German intensive care units: data from Project SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units). J Hosp Infect 64:238–243PubMedCrossRef Meyer E, Schwab F, Gastmeier P, Rueden H, Daschner FD, Jonas D (2006) Stenotrophomonas maltophilia and antibiotic use in German intensive care units: data from Project SARI (Surveillance of Antimicrobial Use and Antimicrobial Resistance in German Intensive Care Units). J Hosp Infect 64:238–243PubMedCrossRef
19.
Zurück zum Zitat Loeffler JM, Garbino J, Lew D, Harbarth S, Rohner P (2003) Antibiotic consumption, bacterial resistance and their correlation in a Swiss University Hospital and its adult intensive care units. Scand J Infect Dis 35:843–850PubMedCrossRef Loeffler JM, Garbino J, Lew D, Harbarth S, Rohner P (2003) Antibiotic consumption, bacterial resistance and their correlation in a Swiss University Hospital and its adult intensive care units. Scand J Infect Dis 35:843–850PubMedCrossRef
20.
Zurück zum Zitat Lemmen SW, Häfner H, Kotterik S, Lütticken R, Töpper R (2000) Influence of an infectious disease service on antibiotic prescription behaviour and selection of multiresistant pathogens. Infection 28:384–387PubMedCrossRef Lemmen SW, Häfner H, Kotterik S, Lütticken R, Töpper R (2000) Influence of an infectious disease service on antibiotic prescription behaviour and selection of multiresistant pathogens. Infection 28:384–387PubMedCrossRef
21.
Zurück zum Zitat Monnet DL SC, Jepsen OB (2000) Overall antimicrobial use and control strategies in intensive care units from 6 European countries. Abstract; 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections. CDC/SHEA, Atlanta Monnet DL SC, Jepsen OB (2000) Overall antimicrobial use and control strategies in intensive care units from 6 European countries. Abstract; 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections. CDC/SHEA, Atlanta
22.
Zurück zum Zitat Goldmann DA, Weinstein RA, Wenzel RP, Tablan OC, Duma RJ, Gaynes RP, Schlosser J, Martone WJ (1996) Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals. A challenge to hospital leadership. JAMA 275:234–240PubMedCrossRef Goldmann DA, Weinstein RA, Wenzel RP, Tablan OC, Duma RJ, Gaynes RP, Schlosser J, Martone WJ (1996) Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals. A challenge to hospital leadership. JAMA 275:234–240PubMedCrossRef
23.
Zurück zum Zitat Björholt I, Haglind E (2004) Cost-savings achieved by eradication of epidemic methicillin-resistant Staphylococcus aureus (EMRSA)-16 from a large teaching hospital. Eur J Clin Microbiol Infect Dis 23:688–695PubMedCrossRef Björholt I, Haglind E (2004) Cost-savings achieved by eradication of epidemic methicillin-resistant Staphylococcus aureus (EMRSA)-16 from a large teaching hospital. Eur J Clin Microbiol Infect Dis 23:688–695PubMedCrossRef
24.
Zurück zum Zitat Lucet J-C, Paoletti X, Lolom I, Paugam-Burtz C, Trouillet J-L, Timsit J-F, Deblangy C, Andremont A, Regnier B (2005) Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units. Intensive Care Med 31:1051–1057 Lucet J-C, Paoletti X, Lolom I, Paugam-Burtz C, Trouillet J-L, Timsit J-F, Deblangy C, Andremont A, Regnier B (2005) Successful long-term program for controlling methicillin-resistant Staphylococcus aureus in intensive care units. Intensive Care Med 31:1051–1057
25.
Zurück zum Zitat Raineri E, Crema L, De Silvestri A, Acquarolo A, Albertario F, Carnevale G, Latronico N, Petrosillo N, Tinelli C, Zoncada A, Pan A (2007) Meticillin-resistant Staphylococcus aureus control in an intensive care unit: a 10 year analysis. J Hosp Infect 67:308–315PubMedCrossRef Raineri E, Crema L, De Silvestri A, Acquarolo A, Albertario F, Carnevale G, Latronico N, Petrosillo N, Tinelli C, Zoncada A, Pan A (2007) Meticillin-resistant Staphylococcus aureus control in an intensive care unit: a 10 year analysis. J Hosp Infect 67:308–315PubMedCrossRef
26.
Zurück zum Zitat Nulens E, Broex E, Ament A, Deurenberg RH, Smeets E, Scheres J, van Tiel FH, Gordts B, Stobberingh EE (2008) Cost of the meticillin-resistant Staphylococcus aureus search and destroy policy in a Dutch University Hospital. J Hosp Infect 68:301–307PubMedCrossRef Nulens E, Broex E, Ament A, Deurenberg RH, Smeets E, Scheres J, van Tiel FH, Gordts B, Stobberingh EE (2008) Cost of the meticillin-resistant Staphylococcus aureus search and destroy policy in a Dutch University Hospital. J Hosp Infect 68:301–307PubMedCrossRef
27.
Zurück zum Zitat Harbarth S, Fankhauser C, Schrenzel J, Christenson J, Gervaz P, Bandiera-Clerc C, Renzi G, Vernaz N, Sax H, Pittet D (2008) Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 299:1149–1157PubMedCrossRef Harbarth S, Fankhauser C, Schrenzel J, Christenson J, Gervaz P, Bandiera-Clerc C, Renzi G, Vernaz N, Sax H, Pittet D (2008) Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 299:1149–1157PubMedCrossRef
28.
Zurück zum Zitat Cepeda JA, Whitehouse T, Cooper B, Hails J, Jones K, Kwaku F, Taylor L, Hayman S, Cookson B, Shaw S, Kibbler C, Singer M, Bellingan G, Wilson AP (2005) Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study. Lancet 365:295–304PubMed Cepeda JA, Whitehouse T, Cooper B, Hails J, Jones K, Kwaku F, Taylor L, Hayman S, Cookson B, Shaw S, Kibbler C, Singer M, Bellingan G, Wilson AP (2005) Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study. Lancet 365:295–304PubMed
29.
Zurück zum Zitat Humphreys H (2008) Can we do better in controlling and preventing methicillin-resistant Staphylococcus aureus (MRSA) in the intensive care unit (ICU)? Eur J Clin Microbiol Infect Dis 27:409–413 Feb 13 (Epub ahead of print)PubMedCrossRef Humphreys H (2008) Can we do better in controlling and preventing methicillin-resistant Staphylococcus aureus (MRSA) in the intensive care unit (ICU)? Eur J Clin Microbiol Infect Dis 27:409–413 Feb 13 (Epub ahead of print)PubMedCrossRef
30.
Zurück zum Zitat Landman D, Bratu S, Alam M, Quale J (2005) Citywide emergence of Pseudomonas aeruginosa strains with reduced susceptibility to polymyxin B. J Antimicrob Chemother 55:954–957PubMedCrossRef Landman D, Bratu S, Alam M, Quale J (2005) Citywide emergence of Pseudomonas aeruginosa strains with reduced susceptibility to polymyxin B. J Antimicrob Chemother 55:954–957PubMedCrossRef
31.
Zurück zum Zitat Falagas ME, Bliziotis IA (2007) Pandrug-resistant Gram-negative bacteria: the dawn of the post-antibiotic era? Int J Antimicrob Agents 29:630–636PubMedCrossRef Falagas ME, Bliziotis IA (2007) Pandrug-resistant Gram-negative bacteria: the dawn of the post-antibiotic era? Int J Antimicrob Agents 29:630–636PubMedCrossRef
32.
Zurück zum Zitat Jonas D, Meyer E, Schwab F, Grundmann H (2008) Genodiversity of resistant Pseudomonas aeruginosa isolates in relation to antimicrobial usage density and resistance rates in intensive care units. Infect Control Hosp Epidemiol 29:350–357PubMedCrossRef Jonas D, Meyer E, Schwab F, Grundmann H (2008) Genodiversity of resistant Pseudomonas aeruginosa isolates in relation to antimicrobial usage density and resistance rates in intensive care units. Infect Control Hosp Epidemiol 29:350–357PubMedCrossRef
33.
Zurück zum Zitat Carmeli Y, Troillet N, Eliopoulos GM, Samore MH (1999) Emergence of antibiotic-resistant Pseudomonas aeruginosa: comparison of risks associated with different anti-pseudomonal agents. Antimicrob Agents Chemother 43:1379–1382PubMed Carmeli Y, Troillet N, Eliopoulos GM, Samore MH (1999) Emergence of antibiotic-resistant Pseudomonas aeruginosa: comparison of risks associated with different anti-pseudomonal agents. Antimicrob Agents Chemother 43:1379–1382PubMed
34.
Zurück zum Zitat Peña C, Guzmán A, Suarez C, Dominguez MA, Tubau F, Pujol M, Gudiol F, Ariza J (2007) Effects of carbapenem exposure on the risk for digestive tract carriage of intensive care unit-endemic carbapenem-resistant Pseudomonas aeruginosa strains in critically ill patients. Antimicrob Agents Chemother 51:1967–1971PubMedCrossRef Peña C, Guzmán A, Suarez C, Dominguez MA, Tubau F, Pujol M, Gudiol F, Ariza J (2007) Effects of carbapenem exposure on the risk for digestive tract carriage of intensive care unit-endemic carbapenem-resistant Pseudomonas aeruginosa strains in critically ill patients. Antimicrob Agents Chemother 51:1967–1971PubMedCrossRef
35.
Zurück zum Zitat Erlandsson M, Gill H, Nilsson LE, Giske, Jonas, Nordlinder D, Walther SM, Hanberger H (2008) Antibiotic susceptibility patterns and clones of Pseudomonas aeruginosa from patients in Swedish ICUs. Scand J Infect Dis 40:487–494 Erlandsson M, Gill H, Nilsson LE, Giske, Jonas, Nordlinder D, Walther SM, Hanberger H (2008) Antibiotic susceptibility patterns and clones of Pseudomonas aeruginosa from patients in Swedish ICUs. Scand J Infect Dis 40:487–494
36.
Zurück zum Zitat Bonten MJ, Weinstein RA (2006) Antibiotic cycling in intensive care units: the value of organized chaos? Crit Care Med 34:549–551PubMedCrossRef Bonten MJ, Weinstein RA (2006) Antibiotic cycling in intensive care units: the value of organized chaos? Crit Care Med 34:549–551PubMedCrossRef
Metadaten
Titel
Surveillance of microbial resistance in European Intensive Care Units: a first report from the Care-ICU programme for improved infection control
verfasst von
Håkan Hanberger
Dilek Arman
Hans Gill
Vlastimil Jindrák
Smilja Kalenic
Andrea Kurcz
Monica Licker
Paul Naaber
Elizabeth A. Scicluna
Václav Vanis
Sten M. Walther
Publikationsdatum
01.01.2009
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 1/2009
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1237-y

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