title: Four Year Trend of Carbapenem-Resistance in Newly Opened ICUs of a University-Affiliated Hospital of South Korea.
abstract: BACKGROUND
  Carbapenem-resistance is rapidly evolving among the pathogenic microbes in intensive care units (ICUs). This study aimed to determine annual trend of carbapenem-resistance in the ICU for 4 years, since the opening of a university-affiliated hospital in South Korea.
  
  
  METHODS
  From 2005 to 2008, microbial samples from consecutive 6,772 patients were screened in the ICU. Three hundred and ninety-seven patients (5.9%) and their first isolates of carbapenem-resistant pathogens were analyzed.
  
  
  RESULTS
  The percentage of patients infected with carbapenem-resistant organisms increased constantly during the initial three years (2.3% in 2005, 6.2% in 2006, 7.8% in 2007), then it declined to 6.5% in 2008. Acute Physiology and Chronic Health Evaluation (APACHE) III score at admission was 58.0±23.5, the median length of the ICU stay was 37 days, and the mortality rate was 37.5%. The sampling sites were endotracheal suction (67%), catheterized urine (17%), wound (6%) and others (10%). Bacteria with carbapenem-resistance were Pseudomonas aeruginosa (247 isolates, 62%), Acinetobacter baumannii (117 isolates, 30%), Enterobacteriaceae (12 isolates, 3%), and others (21, 5%). Of note, peak isolation of carbapenem-resistant microorganisms in medical ICU was followed by the same epidemic at surgical ICU.
  
  
  CONCLUSIONS
  Taken together, carbapenem-resistant pathogens are of growing concern in the ICU.
authors.affiliation: Division of Pulmonary and Allergy, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Bo Min
authors.initials: BM
authors.lastname: Kim
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Jeon
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Jihoon
authors.initials: J
authors.lastname: Park
authors.forename: Jae Chol
authors.initials: JC
authors.lastname: Choi
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Shin
authors.forename: In Won
authors.initials: IW
authors.lastname: Park
authors.forename: Byoung Whui
authors.initials: BW
authors.lastname: Choi
authors.forename: Jae Yeol
authors.initials: JY
authors.lastname: Kim