pseudomonas aeruginosa acquisition on an intensive care unit relationship between antibiotic selective pressure and patients environment铜绿假单胞菌收购在重症监护室抗生素选择压力和病人的环境之间的关系.pdfVIP

Boyer et al. Critical Care 2011, 15:R55 /content/15/1/R55 RESEARCH Open Access Pseudomonas aeruginosa acquisition on an intensive care unit: relationship between antibiotic selective pressure and patients’ environment 1,5*† 2,3,4† 2,3,4 5,6 1 Alexandre Boyer , Adélaïde Doussau , Rodolphe Thiébault , Anne Gaëlle Venier , Van Tran , 6 7 1 1 1 5,6 Hélène Boulestreau , Cécile Bébéar , Frédéric Vargas , Gilles Hilbert , Didier Gruson , Anne Marie Rogues Abstract Introduction: The purpose of this study was to investigate the relationship among Pseudomonas aeruginosa acquisition on the intensive care unit (ICU), environmental contamination and antibiotic selective pressure against P. aeruginosa. Methods: An open, prospective cohort study was carried out in a 16-bed medical ICU where P. aeruginosa was endemic. Over a six-month period, all patients without P. aeruginosa on admission and with a length of stay 72 h were included. Throat, nasal, rectal, sputum and urine samples were taken on admission and at weekly intervals and screened for P. aeruginosa. All antibiotic treatments were recorded daily. Environmental analysis included weekly tap water specimen culture and the presence of other patients colonized with P. aeruginosa. Results: A total of 126 patients were included, comprising 1,345 patient-days. Antibiotics were given to 106 patients (antibiotic selective pressure for P. aeruginosa in 39). P. aeruginosa was acquired by 20 patients (16%) and was isolated from 164/536 environmental samples (31%). Two conditions were independently associated with P. aeruginosa