Catheter-related blood stream infections caused by pathogenic bacteria in Hospital Queen Elizabeth Kota Kinabalu from 2009-2015
Blood stream infections (BSI) are the most common hospital-acquired infections. Rapid diagnosis and timely intervention are the key factors in preventing morbidity and mortality. With a mortality rate of 12% – 25%, CRBSI is the most serious nosocomial infections. This study investigated the antibiot...
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| Format: | Thesis |
| Language: | English English |
| Published: |
2018
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| Subjects: | |
| Online Access: | https://eprints.ums.edu.my/id/eprint/41374/1/24%20PAGES.pdf https://eprints.ums.edu.my/id/eprint/41374/2/FULLTEXT.pdf https://eprints.ums.edu.my/id/eprint/41374/ |
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| Summary: | Blood stream infections (BSI) are the most common hospital-acquired infections. Rapid diagnosis and timely intervention are the key factors in preventing morbidity and mortality. With a mortality rate of 12% – 25%, CRBSI is the most serious nosocomial infections. This study investigated the antibiotic susceptibility patterns, the epidemiology of BSI, the frequency of BSI pathogens and multi-drug resistant isolates, the role of ethnic variation and the prevalence of BSI. Hospital laboratory records on BSI cases of patients admitted into the intensive care unit of Hospital Queen Elizabeth and Hospital Queen Elizabeth II from 2009 to 2015 were examined and analysed. Within this period, there were 11,420 BSI cases of which, a total of 1699 or 14.9% were CRBSI. Kadazan-Dusun (26.9%, 457) was the most common ethnic group encountered in the CRBSI cases, followed by Chinese (16.1%, 274) and Bajau (15.2%, 258). The frequency of CRBSI occurs mostly for in patients in the age group of 51 - 60 which was 22.4% (380), and the age groups of 41 – 50 (16.6%, 282) and 61 – 70 (17.6%, 299). The top five organisms were Coagulase Negative Staphylococcus (282, 17.2%), Staphylococcus aureus (177, 10.8%), Pseudomonas aeruginosa (124, 7.6%), Burkholderiapseudomallei (111, 6.8%) and Klebsiellapneumoniae(111, 6.8%). A significant uptrend in antibiotic resistant patterns were observed during the study period especially for Acinetobacterbaumanii which was gaining resistance to most of the antibiotics although still susceptible to Polymxin B. Klebsiellapneumoniae also noted with increasing resistance to cefoperazone (96.2%), cefuroxime (94.4%), ciprofloxacin (57.1%) and amoxicillinclavulanic acid (87.5%). In conclusion, there is a need to continually review the antibiograms pattern periodically to formulate the best empiric antimicrobial treatment. Since there is no known study was done in Sabah, it is expected that this study will provide a microbiological basis that may be relevant to BSI in Sabah, and these informations will help clinicians in initiating the empirical antibiotic therapy based on local data and thus preventing the emergence of multi-drugs resistant microorganisms. The study will also improve our understanding on the importance of CRBSI in the Sabah hospitals. |
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