Subject(s)
Air , Asthma/complications , Barotrauma/etiology , Spinal Canal/diagnostic imaging , Spinal Diseases/etiology , Adolescent , Asthma/physiopathology , Barotrauma/physiopathology , Epidural Space , Humans , Male , Mediastinal Emphysema/diagnostic imaging , Mediastinal Emphysema/etiology , Pulmonary Alveoli/injuries , Rupture, Spontaneous , Spinal Diseases/diagnostic imaging , Subcutaneous Emphysema/etiology , Tomography, X-Ray ComputedABSTRACT
An outbreak of multidrug-resistant Acinetobacter baumannii (MRAB) occurred over the course of a 27-week period in our adult polyvalent intensive care unit (ICU). Twenty-one patients were affected, and 72 strains were identified from different clinical samples. The strains were resistant to all antibiotics except for colistin and ampicillin/sulbactam. Forty-nine MRAB strains collected from 18 patients were analysed by pulsed-field gel electrophoresis (PFGE). This analysis revealed four highly-related PFGE types (genetic similarity index >90%) termed 1, 2, 3 and 4, that were isolated in 13, seven, one, and three patients, respectively. A single PFGE type was identified from five of ten patients with successive isolation of MRAB; in the other five patients, two or three PFGE types were detected. This suggested phased evolution of PFGE types 2, 3 and 4 from PFGE type 1. Global mortality was high (13 patients; 62%). Non-survivors had higher APACHE II scores than survivors on the date that MRAB was isolated (OR = 1.57; 95% CI [1.02, 2.44]). The outbreak was controlled after implementation of an extensive infection control program.
Subject(s)
Acinetobacter Infections/epidemiology , Acinetobacter Infections/microbiology , Acinetobacter baumannii/drug effects , Cross Infection/epidemiology , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial , Infection Control/methods , Intensive Care Units/statistics & numerical data , APACHE , Acinetobacter Infections/drug therapy , Acinetobacter Infections/mortality , Acinetobacter baumannii/genetics , Adult , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Cluster Analysis , Cross Infection/drug therapy , Cross Infection/mortality , Disease Outbreaks , Drug Resistance, Multiple, Bacterial/genetics , Electrophoresis, Gel, Pulsed-Field , Genotype , Humans , Microbial Sensitivity Tests , Survival AnalysisABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Jejunal Diseases/complications , Diverticulum/complications , Shock, Hemorrhagic/etiology , Gastrointestinal Hemorrhage/etiologyABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Serotonin Syndrome/diagnosis , Clomipramine/adverse effects , Critical Illness , Nitroglycerin/therapeutic useABSTRACT
No disponible
Subject(s)
Male , Middle Aged , Humans , Peritonitis/microbiology , Enterobacter/pathogenicity , Enterobacteriaceae Infections/complicationsABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Middle Aged , Pneumonia/complications , Myocardial Infarction/complications , Coronary Disease/complicationsSubject(s)
Magnetic Resonance Imaging , Raloxifene Hydrochloride/adverse effects , Sagittal Sinus Thrombosis/diagnosis , Selective Estrogen Receptor Modulators/adverse effects , Anticoagulants/therapeutic use , Female , Heparin/therapeutic use , Humans , Middle Aged , Postural Balance , Reflex, Abnormal , Sagittal Sinus Thrombosis/chemically induced , Sagittal Sinus Thrombosis/drug therapy , Sensation Disorders/etiologyABSTRACT
No disponible
Subject(s)
Middle Aged , Humans , Pneumonia/complications , Pneumonia/diagnosis , Pneumonia/therapy , Chlamydophila pneumoniae/isolation & purification , Adrenal Cortex Hormones/therapeutic use , Tracheostomy/methods , Respiratory Insufficiency/complications , Respiratory Insufficiency/diagnosis , Immunoelectrophoresis/methods , Clarithromycin/therapeutic use , Chlamydia Infections/complications , Biomarkers/analysis , Hypercholesterolemia/complications , Diagnosis, DifferentialSubject(s)
Anesthesia , Critical Illness , Electroencephalography , Monitoring, Physiologic , Aged , Female , Humans , Reproducibility of ResultsABSTRACT
No disponible
No disponible
Subject(s)
Humans , Male , Middle Aged , Pneumonia/complications , Coronary Disease/complications , Chlamydophila pneumoniae/isolation & purification , Anti-Bacterial Agents/therapeutic useABSTRACT
No disponible
Subject(s)
Female , Aged , Humans , Anesthesia , Critical Illness , Electroencephalography , Monitoring, Physiologic , Reproducibility of ResultsABSTRACT
No disponible