RESUMO
Exacerbation due to antimicrobial-drug-resistant bacteria among chronic obstructive pulmonary disease (AECOPD) patients contributes to mortality and morbidity. We examined the prevalence of the bacterial organisms and trends in drug resistance in AECOPD. In this retrospective study, between January 2016 to December 2020, among 3027 AECOPD patients, 432 (14.3%) had bacteria isolated. The regression and generalized estimating equations (GEE) were used for trends in the resistance patterns over five years, adjusting for age, gender, and comorbidities. Klebsiella pneumoniae (32.4%), Pseudomonas aeruginosa (17.8%), Acinetobacter baumannii (14.4%), Escherichia coli (10.4%), and Staphylococcus aureus (2.5%) were common. We observed high levels of drug resistance in AECOPD patients admitted to ICU (87.8%) and non-ICU (86.5%). A Cox proportional hazard analysis, observed infection with Acinetobacter baumannii and female sex as independent predictors of mortality. Acinetobacter baumannii had 2.64 (95% confidence interval (CI): 1.08−6.43) higher odds of death, compared to Klebsiella pneumoniae. Females had 2.89 (95% CI: 1.47−5.70) higher odds of death, compared to males. A high proportion of bacterial AECOPD was due to drug-resistant bacteria. An increasing trend in drug resistance was observed among females.
RESUMO
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a multidrug resistant organism recognized as major cause of infections ranging from relatively minor skin and soft tissue infections to life-threatening systemic infections. Contact transmission from health care personnel (HCP) to the patients provides the main mode of transmission of MRSA. Screening of HCPs colonized with MRSA may aid in preventing spread of this organism. METHODS: Two samples were collected from 200 HCP which included sample from anterior nares and web spaces of both hands. Identification of Staphylococcus aureus and MRSA strains were done as per standard operating protocol. Results were compiled, tabulated, and all data were subjected to SPSS, version 17.0 software for analysis. RESULTS: About 25.5% (51 HCPs) were carriers of S aureus and among them 6.5% (13 HCPs) were carriers of MRSA. Among the MRSA carriers, 28.4% were physicians, followed by nursing interns (21.1%), MBBS interns (9%), nurses (5.4%), and others, that is, physiotherapist, housekeeping staff, and helping staff (37.5%). CONCLUSIONS: In spite of having infection control policies in place, MRSA carriage rate was 6.5%. This signifies the importance of periodic systematic screening of all HCPs and decolonization, which may help in eliminating the burden of MRSA carrier status and spread of infection in the health care setting.
