title: Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  Critically ill polytrauma patients are at particularly high risk for Gram-negative sepsis.
authors.affiliation: University of the Witwatersrand, Johannesburg, South Africa. vascular@telkomsa.net.
authors.forename: Jayandiran
authors.initials: J
authors.lastname: Pillai
authors.forename: Ceyhan
authors.initials: C
authors.lastname: Yazicioglu
authors.forename: Steve
authors.initials: S
authors.lastname: Moeng
authors.forename: Thomas
authors.initials: T
authors.lastname: Rangaka
authors.forename: Taalib
authors.initials: T
authors.lastname: Monareng
authors.forename: Raja
authors.initials: R
authors.lastname: Jayakrishnan
authors.forename: Martin
authors.initials: M
authors.lastname: Veller
authors.forename: Daniella
authors.initials: D
authors.lastname: Pinkus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000453:epidemiology*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013019:South Africa / Q000453:epidemiology; D014947:Wounds and Injuries / Q000150:complications*; D055815:Young Adult