RESUMEN
Few data are available on incidence of multidrug-resistant organism (MDRO) colonization and infections in mechanically ventilated patients, particularly during the COVID-19 pandemic. We retrospectively evaluated all patients admitted to the COVID-19 intensive care unit (ICU) of Hub Hospital in Milan, Italy, during October 2020âMay 2021. Microbiologic surveillance was standardized with active screening at admission and weekly during ICU stay. Of 435 patients, 88 (20.2%) had MDROs isolated ≤48 h after admission. Of the remaining patients, MDRO colonization was diagnosed in 173 (51.2%), MDRO infections in 95 (28.1%), and non-MDRO infections in 212 (62.7%). Non-MDRO infections occurred earlier than MDRO infections (6 days vs. 10 days; p<0.001). Previous exposure to antimicrobial drugs within the ICU was higher in MDRO patients than in non-MDRO patients (116/197 [58.9%] vs. 18/140 [12.9%]; p<0.001). Our findings might serve as warnings for future respiratory viral pandemics and call for increased measures of antimicrobial stewardship and infection control.
Asunto(s)
Infecciones Bacterianas , COVID-19 , Humanos , Estudios Retrospectivos , Farmacorresistencia Bacteriana Múltiple , Respiración Artificial , Pandemias , COVID-19/epidemiología , Infecciones Bacterianas/microbiologíaRESUMEN
Critically ill patients admitted to intensive care units (ICU) are highly susceptible to healthcare-associated infections caused by fungi. A prospective sequential survey of invasive fungal infections was conducted from May 2006 to April 2008 in 38 ICUs of 27 Italian hospitals. A total of 384 fungal infections (318 invasive Candida infections, three cryptococcosis and 63 mould infections) were notified. The median rate of candidaemia was 10.08 per 1000 admissions. In 15% of cases, the infection was already present at the time of admission to ICU. Seventy-seven percent of Candida infections were diagnosed in surgical patients. Candida albicans was isolated in 60% of cases, Candida glabrata and Candida parapsilosis in 13%, each. Candida glabrata had the highest crude mortality rate (60%). Aspergillus infection was diagnosed in 32 medical and 25 surgical patients. The median rate was 6.31 per 1000 admissions. Corticosteroid treatment was the major host factor. Aspergillosis was demonstrated to be more severe than candidiasis as the crude mortality rate was significantly higher (63% vs. 46%), given an equal index of severity, Simplified Acute Physiology Score (SAPS-II). The present large nationwide survey points out the considerable morbidity and mortality of invasive fungal infections in surgical as well as medical patients in ICU.
Asunto(s)
Candida/aislamiento & purificación , Candidiasis Invasiva/diagnóstico , Infección Hospitalaria/microbiología , Unidades de Cuidados Intensivos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Aspergilosis/diagnóstico , Aspergilosis/epidemiología , Aspergilosis/microbiología , Aspergilosis/mortalidad , Aspergillus/aislamiento & purificación , Aspergillus/patogenicidad , Candida/patogenicidad , Candidiasis Invasiva/epidemiología , Candidiasis Invasiva/microbiología , Candidiasis Invasiva/mortalidad , Niño , Preescolar , Enfermedad Crítica , Infección Hospitalaria/diagnóstico , Infección Hospitalaria/epidemiología , Infección Hospitalaria/mortalidad , Criptococosis/microbiología , Cryptococcus/aislamiento & purificación , Cryptococcus/patogenicidad , Femenino , Humanos , Lactante , Italia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto JovenRESUMEN
Mycoplasma hominis is commonly involved in genitourinary tract infections. We report a 59-year-old man who developed a M. hominis-associated mediastinitis following acute tonsillar infection.