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Pain Management 2018
Internal Medicine 2018
International Journal of Anesthesiology & Pain Medicine
ISSN: 2471-982X
Page 85
March 26-28, 2018
Vienna, Austria
JOINT EVENT
7
t h
E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Internal Medicine and Patient Care
&
6
t h
E d i t i o n o f I n t e r n a t i o n a l C o n f e r e n c e o n
Pain Management
Volume 4
Introduction:
Infections contribute a significant proportion of
morbidity and mortality worldwide. While many infections are
successfully managed with antimicrobial therapy, there are
increasing rates of antimicrobial resistance (AMR) with higher
rates in certain patient populations such as those admitted to
intensive care units (ICU). The global threat of AMR is especially
concerning in low resource environments where there are limited
antibiotic options.
Methods:
We conducted a retrospective, observational study of
all patients hospitalized in the ICU of a tertiary referral hospital in
Rwanda over a two-year period (January 2015 – December 2016).
We collected data on diagnosis, ICU length of stay, mortality and
hospital length of stay. We collected data on microorganism,
site of culture, antimicrobial resistance pattern and antibiotics
prescribed.
Results:
Over a two-year period, 307 patients were admitted to the
ICU.Themeanagewas36years(standarddeviation(sd)18.6days)
and 171 (56%) patients were male. Most patients were admitted
from the main operating theater (n=138, 45%) or emergency
department (n=97, 32%). The most common admitting diagnoses
were sepsis (n=116, 34%), head trauma (n= 91, 27%), polytrauma
(n= 27and obstetric complications (n=26, 8%). The most common
antibiotics administered were cephalosporins (n=277, 97%) and
metronidazole (n=156, 55%). Themean length of ICU stay was 6.2
days (sd- 7.2 days) and the mean length of hospital stay was 21.0
days (sd- 30.4 days). The ICU mortality was 45% and in-hospital
mortality was 51%. A total of 244 samples were collected from
331 patients. The samples were from blood (n=95, 39%), tracheal
aspirate (n=12, 0.5%), wound (n=39, 16%), urine (n=76, 31%), and
other (n=24, 10%). There were 104 (43%) positive samples. The
most common organisms isolated were
Klebsiella
(n=30, 29%),
Acinetobacter
(n=20, 19%),
E.coli
(n=16, 15%),
Proteus
(n=15,
14%),
Citrobacter
(n=8, 8%),
S.aureus
(n=7, 7%),
Pseudomonas
(n=5, 5%), and other (n=9, 9%). Of Klebisella isolates, 100% and
76% were resistant to ceftriaxone and cefotaxime, respectively.
Of E.coli isolates, 86% and 71% were resistant to ceftriaxone and
cefotaxime, respectively. All
Acinetobacter
isolates were resistant
to ceftriaxone and cefotaxime, respectively.
Conclusion:
There is an alarming rate of antimicrobial resistance
to commonly used antibiotics in the ICU. Expanding antibiotic
options and strengthening antimicrobial stewardship are critical
for patient care.
mvukipaul@gmail.comInfections in a tertiary referral hospital intensive care unit
in Rwanda
Mvukiyehe Jean Paul
1
, Jennifer Rickard
2
and
Ruhato Paulin Banguti
1
1
University of Rwanda, Rwanda
2
Minnesota University, USA
Int J Anesth Pain Med 2018, Volume 4
DOI: 10.21767/2471-982X-C1-003