Timing and clinical risk factors for early acquisition of gut pathogen colonization with multidrug resistant organisms in the intensive care unit

AbstractBackgroundMicrobiome restitution therapies are being developed to prevent gut pathogen colonization among patients in the intensive care unit (ICU) and in other select populations. If preventive therapies are to be effective, they must be administered prior to pathogen acquisition. The timing and risk factors for early acquisition of gut pathogen colonization (within 72  h) are currently unknown and could be helpful to guide ICU trial design.MethodsThis was a prospective cohort study. Patients in the ICU had deep rectal swabs performed within 4  h of ICU admission and exactly 72 h later. Early gut pathogen colonization was classified as thenew presence (based on culture of rectal swabs) of one or more of the following organisms of interest: methicillin-resistantStaphylococcus aureus (MRSA), vancomycin-resistant (VRE), and Gram-negative bacteria that showed multidrug resistance (MDR) or third generation Cephalosporin resistance (Ceph-R). Clinical risk factors for early acquisition of gut pathogen colonization were captured using the Acute Physiology and Chronic Health Evaluation IV (APACHE IV) scoring system.FindingsAmong 131 patients who were swabbed at ICU admission and 72  h later, the rates of gut pathogen colonization at ICU admission were 11.4%, 10.6%, 38.6%, and 8.3% for MRSA, VRE, MDR and Ceph-R Gram-negatives respectively. Among the patients who were negative for a given pathogen at ICU admission, the rates of early acquisition of gut pathogen colonization...
Source: Gut Pathogens - Category: Microbiology Source Type: research