Charmaine T. Gallano Group 2 Antimicrobial Resistance Clusters Are Common in the ICU Neil M.

Ampel, MD reviewing Vlek ALM et al. Clin Infect Dis 2013 Jul 1. A retrospective study involving two intensive care units at a single large medical center identified resistance outbreaks in 69% of bacterial species-groups. Antimicrobial resistance in the intensive care unit (ICU) is a global concern. Such resistance may emerge through several mechanisms, including horizontal transfer of genetic elements within and between species. The occurrence of three recognized outbreaks of antibiotic-resistant bacterial infections in two ICUs at a single medical center in the U.K. over a 10-year period prompted a detailed examination. The ensuing retrospective study involved all patients admitted to either of the ICUs between 2002 and 2009. Data were analyzed using SaTScan, which can identify clusters of illness over space and time. Twenty-six bacterial species-groups were modeled and linked to resistance to the 16 most frequently prescribed antibiotics. Overall, 9428 unique bacterial isolates from patients were analyzed. After temporal adjustment, clusters of antimicrobial resistance were detected for 18 of the 26 bacterial species-groups (69%) and for 31 of 180 combinations of bacterial species-group and antibiotic use (17%). Moreover, such resistance clusters occurred in multiple species for 7 of the 16 antibiotics studied (44%). - See more at: http://www.jwatch.org/na31314/2013/06/06/antimicrobial-resistanceclusters-are-common-icu#sthash.CgKpdvOA.dpuf