title: Active surveillance for multidrug-resistant Gram-negative bacteria in the intensive care unit.
abstract: A short-term program of performing serial active screening cultures (ASC) in the intensive care unit was instituted to establish a method for the detection of antibiotic-resistant Gram-negative bacteria (GNB) and the local rates of colonisation. Of all submitted ASC, 25.9% (30/116 collected swabs) isolated an antibiotic-resistant GNB. ChromID ESBL agar (bioMérieux, France) identified the majority of these organisms, with the additional antibiotic-impregnated media [MacConkey agar (MCA) with ciprofloxacin, MCA with gentamicin and MCA with ceftazidime] adding limited benefit. Compared to swabs performed on admission, 37.8% (14/37) of patients cultured a new antibiotic-resistant isolate on discharge. Serial screening in intensive care has the ability to identify patients with unrecognised colonisation with antibiotic-resistant GNB; however, the increase in the laboratory workload and logistical challenges in the collection of the surveillance swabs may limit this program's expansion.
authors: 1The Alfred Hospital, Melbourne, Vic 2Royal Brisbane and Women's Hospital, Brisbane, Qld 3Department of Microbiology, Monash University, Melbourne, Vic, Australia.
authors: Iain J
authors: IJ
authors: Abbott
authors: Adam W J
authors: AW
authors: Jenney
authors: Denis W
authors: DW
authors: Spelman
authors: David V
authors: DV
authors: Pilcher
authors: Hanna E
authors: HE
authors: Sidjabat
authors: Leisha J
authors: LJ
authors: Richardson
authors: David L
authors: DL
authors: Paterson
authors: Anton Y
authors: AY
authors: Peleg
mesh_terms: D015331:Cohort Studies; D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D004352:Drug Resistance, Microbial; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D007362:Intensive Care Units