ABSTRACT
BACKGROUND: A global rise in multidrug-resistant (MDR) nosocomial infections has led to a significant increase in morbidity and mortality. MDR Gram-negative bacteria (GNB) are recognised for rapidly developing drug resistance. Despite Pseudomonas aeruginosa being the second most common GNB isolated from healthcare associated infections, the magnitude of MDR P. aeruginosa (MDR-PA) has not been evaluated in Qatar. AIM: To assess the prevalence and antimicrobial susceptibility patterns of MDR-PA from 5 major hospitals in Qatar. METHODS: A total of 2533 P. aeruginosa clinical isolates were collected over a one-year period. MDR-PA was defined as resistance to at least one agent of ≥ 3 antibiotic classes. Clinical and demographic data were collected prospectively. FINDINGS: The overall prevalence of MDR-PA isolates was 8.1% (205/2533); the majority of isolates were from patients exposed to antibiotics during 90 days prior to isolation (85.4 %, 177/205), and the infections were mainly hospital-acquired (95.1%, 195/205) with only 4.9% from the community. The majority of MDR-PA isolates were resistant to cefepime (96.6%, 198/205), ciprofloxacin, piperacillin/tazobactam (91%, 186/205), and meropenem (90%, 184/205). Patient comorbidities with MDR-PA were diabetes mellitus (47.3%, n=97), malignancy (17.1%, n=35), end-stage renal disease (13.7%, n=28) and heart failure (10.7%, n=22). CONCLUSION: There was a significant prevalence of MDR-PA in Qatar, primarily from healthcare facilities and associated with prior antibiotic treatment. There was an alarming level of antimicrobial resistance to carbapenems. Our results are part of a national surveillance of MDR to establish effective containment plans.
ABSTRACT
AIM: To determine degree of public awareness regarding the activities and health care professionals that comprise intensive care units (ICUs) in the autonomous community of Castilla y León. DESIGN: Questionaire in the form of a true-false test dealing with a) description of an ICU; b) description of ICU patients, and c) degrees and qualifications held by ICU physicians. LOCATION: Waiting rooms of outpatient clinics and ICUs of 9 hospitals in Castilla y León. SUBJECTS AND METHODS: During the period from 1 October 2003 to 29 February 2004, there were surveyed a group of those persons accompanying outpatients arriving for appointments (OP, n = 2,293), and a group comprised of relatives of ICU patients (ICU, n = 727) upon discharge from the ICU. RESULTS: The average age of those subjects surveyed was 45.6 years old. 62.1% were women and 52.8% had received education through secondary level or higher. Of the 1,354 analyzed OP questionnaires, 27.7%, 25.5% and 48.4% responded correctly to questions A, B and C, respectively. Of the 284 analyzed ICU questionnaires, 38.6%, 41.0%, and 63.5% responded correctly to questions A, B and C, respectively. Differences between results from the two surveyed groups were statistically significant, and the best results from the ICU group were found among those subjects whose family members had remained in ICU for 2 days or more. CONCLUSIONS: In the described scope, of the citizens of Castilla y León, 27.7% know as it is a ICU, 25.5% know what type of patients usually is entered there, and 48.4% recognize their doctors like ICU specialists specifically. These knowledge improve significantly after having some relative entered in ICU for more than 2 days.
Subject(s)
Critical Care , Intensive Care Units , Surveys and Questionnaires , Adult , Female , Humans , Male , Middle Aged , Public Opinion , SpainABSTRACT
Objetivo. Determinar el nivel de conocimiento que los ciudadanos de Castilla y León tienen sobre las Unidades de Cuidados Intensivos (UCI), su actividad y sus profesionales. Diseño. Encuesta de tipo test con respuestas falsas y verdaderas ante las siguientes preguntas: a) ¿cómo es una UCI?; b) ¿qué tipo de pacientes suelen ingresar en la UCI?, y c) ¿qué titulación tienen sus médicos? Ámbito. Las salas de espera de las consultas externas (CCEE) y de las UCI de 9 hospitales de Castilla-León. Personas y métodos. Del 1 de octubre de 2003 al 29 de febrero de 2004, fueron encuestados los acompañantes de los enfermos citados en las CCEE (grupo CCEE, n = 2.293) y los familiares de los enfermos ingresados en la UCI (grupo UCI, n = 727) en el momento del alta de la UCI. Resultados. Los encuestados tenían una edad media de 45,6 años, un 62,1% eran mujeres y un 52,8% tenían estudios medios o superiores. De las 1.354 encuestas analizadas del grupo CCEE, la tasa de respuesta correcta fue del 27,7% a la pregunta A, del 25,5% a la pregunta B y del 48,4% a la pregunta C. De las 284 encuestas analizadas del grupo UCI, la tasa de respuesta correcta fue del 38,6% para la pregunta A, del 41,0% para la pregunta B y del 63,5% para la pregunta C. Las diferencias entre ambos grupos de encuestados fueron estadísticamente significativas, y el mejor nivel de conocimiento del grupo UCI se observó entre los familiares de los pacientes ingresados en la UCI durante dos o más días. Conclusiones. En el ámbito descrito, de los ciudadanos de Castilla y León, el 27,7% conoce cómo es una UCI, el 25,5% sabe qué tipo de pacientes se suelen ingresar en ella y el 48,4% reconoce a sus médicos como especialistas específicamente de UCI. Estos conocimientos mejoran significativamente tras tener algún familiar ingresado en la UCI durante más de 2 días
Aim. To determine degree of public awareness regarding the activities and health care professionals that comprise intensive care units (ICUs) in the autonomous community of Castilla y León. Design. Questionaire in the form of a true-false test dealing with a) description of an ICU; b) description of ICU patients, and c) degrees and qualifications held by ICU physicians. Location. Waiting rooms of outpatient clinics and ICUs of 9 hospitals in Castilla y León. Subjects and methods. During the period from 1 October 2003 to 29 February 2004, there were surveyed a group of those persons accompanying outpatients arriving for appointments (OP, n = 2,293), and a group comprised of relatives of ICU patients (ICU, n = 727) upon discharge from the ICU. Results. The average age of those subjects surveyed was 45.6 years old. 62.1% were women and 52.8% had received education through secondary level or higher. Of the 1,354 analyzed OP questionnaires, 27.7%, 25.5% and 48.4% responded correctly to questions A, B and C, respectively. Of the 284 analyzed ICU questionnaires, 38.6%, 41.0%, and 63.5% responded correctly to questions A, B and C, respectively. Differences between results from the two surveyed groups were statistically significant, and the best results from the ICU group were found among those subjects whose family members had remained in ICU for 2 days or more. Conclusions. In the described scope, of the citizens of Castilla y León, 27.7% know as it is a ICU, 25.5% know what type of patients usually is entered there, and 48.4% recognize their doctors like ICU specialists specifically. These knowledge improve significantly after having some relative entered in ICU for more than 2 days
