Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa

Introduction: The aim of this study was to determine if any patterns of infection or bacterial resistance existed in critically ill polytrauma patients admitted to the intensive care unit (ICU) at the CM Johannesburg Academic Hospital (CMJAH). Methods: This was a prospective, single-center study of...

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Main Authors: Jayandiran Pillai, Ceyhan Yazicioglu, Steve Moeng, Thomas Rangaka, Taalib Monareng, Raja Jayakrishnan, Martin Veller, Daniella Pinkus
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2015-07-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/5865
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author Jayandiran Pillai
Ceyhan Yazicioglu
Steve Moeng
Thomas Rangaka
Taalib Monareng
Raja Jayakrishnan
Martin Veller
Daniella Pinkus
author_facet Jayandiran Pillai
Ceyhan Yazicioglu
Steve Moeng
Thomas Rangaka
Taalib Monareng
Raja Jayakrishnan
Martin Veller
Daniella Pinkus
author_sort Jayandiran Pillai
collection DOAJ
description Introduction: The aim of this study was to determine if any patterns of infection or bacterial resistance existed in critically ill polytrauma patients admitted to the intensive care unit (ICU) at the CM Johannesburg Academic Hospital (CMJAH). Methods: This was a prospective, single-center study of patient laboratory records of 73 critically injured polytrauma patients admitted to an ICU. The data collected from each patient, beginning with admission and extending until discharge from the ICU, included age, gender, admission hemoglobin levels, injury severity score, length of ICU stay, microbiological cultures and sensitivity (MCS), and types and numbers of surgical procedures. Results: Upon admission to the ICU, the injury severity score (ISS) was 40.86 (± 15.64). In total, 73.98% of the patients required the use of a ventilator during their ICU stay. The most prevalent organisms isolated from specimens were Pseudomonas aeruginosa (30.1%), Klebsiella species (25.7%), Acinetobacterbaumanni (16.4%), and Staphylococcus aureus (5.8%). Multi-drug resistance (MDR) was identified in 63% of patients, with Klebsiella (73.91%) and Pseudomonas (65.21%) occurring most frequently. Multivariate analysis showed MDR to be the only significant predictor associated with a higher risk for hospital mortality when age, gender, ventilation, duration of ICU stay, ISS score, and the number of surgeries undergone was taken into account. Conclusion: Critically ill polytrauma patients are at particularly high risk for Gram-negative sepsis.
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spelling doaj-art-b9ec5c8ab2914ebfaa88ca74b0fe62d42025-08-20T02:57:18ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802015-07-0190710.3855/jidc.5865Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South AfricaJayandiran Pillai0Ceyhan Yazicioglu1Steve Moeng2Thomas Rangaka3Taalib Monareng4Raja Jayakrishnan5Martin Veller6Daniella Pinkus7University of the Witwatersrand, Johannesburg, South AfricaUniversity of the Witwatersrand, Johannesburg, South AfricaUniversity of the Witwatersrand, Johannesburg, South AfricaUniversity of the Witwatersrand, Johannesburg, South AfricaUniversity of the Witwatersrand, Johannesburg, South AfricaUniversity of the Witwatersrand, Johannesburg, South AfricaUniversity of the Witwatersrand, Johannesburg, South AfricaUniversity of the Witwatersrand, Johannesburg, South AfricaIntroduction: The aim of this study was to determine if any patterns of infection or bacterial resistance existed in critically ill polytrauma patients admitted to the intensive care unit (ICU) at the CM Johannesburg Academic Hospital (CMJAH). Methods: This was a prospective, single-center study of patient laboratory records of 73 critically injured polytrauma patients admitted to an ICU. The data collected from each patient, beginning with admission and extending until discharge from the ICU, included age, gender, admission hemoglobin levels, injury severity score, length of ICU stay, microbiological cultures and sensitivity (MCS), and types and numbers of surgical procedures. Results: Upon admission to the ICU, the injury severity score (ISS) was 40.86 (± 15.64). In total, 73.98% of the patients required the use of a ventilator during their ICU stay. The most prevalent organisms isolated from specimens were Pseudomonas aeruginosa (30.1%), Klebsiella species (25.7%), Acinetobacterbaumanni (16.4%), and Staphylococcus aureus (5.8%). Multi-drug resistance (MDR) was identified in 63% of patients, with Klebsiella (73.91%) and Pseudomonas (65.21%) occurring most frequently. Multivariate analysis showed MDR to be the only significant predictor associated with a higher risk for hospital mortality when age, gender, ventilation, duration of ICU stay, ISS score, and the number of surgeries undergone was taken into account. Conclusion: Critically ill polytrauma patients are at particularly high risk for Gram-negative sepsis. https://jidc.org/index.php/journal/article/view/5865Multidrug resistanceICUPseudomonas aeruginosaKlebsiella speciesAcinetobacterbaumanniStaphylococcus aureus
spellingShingle Jayandiran Pillai
Ceyhan Yazicioglu
Steve Moeng
Thomas Rangaka
Taalib Monareng
Raja Jayakrishnan
Martin Veller
Daniella Pinkus
Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa
Journal of Infection in Developing Countries
Multidrug resistance
ICU
Pseudomonas aeruginosa
Klebsiella species
Acinetobacterbaumanni
Staphylococcus aureus
title Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa
title_full Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa
title_fullStr Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa
title_full_unstemmed Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa
title_short Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa
title_sort prevalence and patterns of infection in critically ill trauma patients admitted to the trauma icu south africa
topic Multidrug resistance
ICU
Pseudomonas aeruginosa
Klebsiella species
Acinetobacterbaumanni
Staphylococcus aureus
url https://jidc.org/index.php/journal/article/view/5865
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