Inter-ICU antibiogram variability and implications for empiric antibiotic strategies

E. Shirazi, L. Samiian, Nicholas Namias, Daniel H Kett, Danny Sleeman, Enrique Ginzburg, K. O'Neill

Research output: Contribution to journalArticle

Abstract

Objective: To determine if the incidence and antibiotic susceptibility of key bacterial pathogens vary between ICUs in a single teaching hospital. Methods: Culture and susceptibility results were collected prospectively for 3 months (April - June, 1999) in each of the Surgical, Trauma, and Medical ICUs. Complete antibiograms were generated. Antibiograms for selected organisms and antibiotics are presented due to space limitations. Differences in incidence and susceptibility between units was analyzed with χ2. Alpha was set at .05 for significance. Results:Number of admissions: MICU, 138; SICU, 127; TICU, 140. Acinetobacter varied in incidence between units (MICU 16, SICU 3, TICU 36, p<.05)- its susceptibility to cefotaxime was 88%(MICU) vs. 17%(TICU)(p<.05). Enterococcus sp. were common in all 3 units (MICU 15, SICU 26, TICU 27)- vancomycin resistance varied (MICU 0%, SICU 31%, TICU 11%, p<.05). Pseudomonas sp. were common in all 3 units (MICU 21, SICU 12, TICU 31) - susceptibility to ceftazidime varied (MICU 67%, SICU 83%, TICU 94%, p<.05)as did susceptibility to ciprofloxacin and levofloxacin (MICU 67%, SICU 33%, TICU 90%, p<.05).Klebsiella was uncommon in the MICU (MICU 4; SICU 9; TICU 16), but 100% susceptible to all antibiotics tested (in the MICU)except ampicillin (25% susceptible); it was highly resistant in the TICU (antibiotic/%resistant: ticar/clav/50%, piperacillin/62%, ceftazidime/50%, gentamicin/56%). Conclusions: The incidence and susceptibilities of key pathogens vary between ICUs in a single hospital. Each ICU functions under varying restrictions and "crop-rotation" policies for antibiotic use. This may impact the unit specific antibiogram. To adequately cover the most frequently recovered pathogens, one should consider the ICU specific antibiogram in developing strategies for empiric antibiotic use.

Original languageEnglish
JournalCritical Care Medicine
Volume27
Issue number12 SUPPL.
StatePublished - Dec 1 1999

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Microbial Sensitivity Tests
Anti-Bacterial Agents
Ceftazidime
Incidence
Vancomycin Resistance
Ticarcillin
Levofloxacin
Piperacillin
Acinetobacter
Klebsiella
Cefotaxime
Enterococcus
Ampicillin
Ciprofloxacin
Pseudomonas
Gentamicins
Teaching Hospitals
Wounds and Injuries

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Inter-ICU antibiogram variability and implications for empiric antibiotic strategies. / Shirazi, E.; Samiian, L.; Namias, Nicholas; Kett, Daniel H; Sleeman, Danny; Ginzburg, Enrique; O'Neill, K.

In: Critical Care Medicine, Vol. 27, No. 12 SUPPL., 01.12.1999.

Research output: Contribution to journalArticle

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title = "Inter-ICU antibiogram variability and implications for empiric antibiotic strategies",
abstract = "Objective: To determine if the incidence and antibiotic susceptibility of key bacterial pathogens vary between ICUs in a single teaching hospital. Methods: Culture and susceptibility results were collected prospectively for 3 months (April - June, 1999) in each of the Surgical, Trauma, and Medical ICUs. Complete antibiograms were generated. Antibiograms for selected organisms and antibiotics are presented due to space limitations. Differences in incidence and susceptibility between units was analyzed with χ2. Alpha was set at .05 for significance. Results:Number of admissions: MICU, 138; SICU, 127; TICU, 140. Acinetobacter varied in incidence between units (MICU 16, SICU 3, TICU 36, p<.05)- its susceptibility to cefotaxime was 88{\%}(MICU) vs. 17{\%}(TICU)(p<.05). Enterococcus sp. were common in all 3 units (MICU 15, SICU 26, TICU 27)- vancomycin resistance varied (MICU 0{\%}, SICU 31{\%}, TICU 11{\%}, p<.05). Pseudomonas sp. were common in all 3 units (MICU 21, SICU 12, TICU 31) - susceptibility to ceftazidime varied (MICU 67{\%}, SICU 83{\%}, TICU 94{\%}, p<.05)as did susceptibility to ciprofloxacin and levofloxacin (MICU 67{\%}, SICU 33{\%}, TICU 90{\%}, p<.05).Klebsiella was uncommon in the MICU (MICU 4; SICU 9; TICU 16), but 100{\%} susceptible to all antibiotics tested (in the MICU)except ampicillin (25{\%} susceptible); it was highly resistant in the TICU (antibiotic/{\%}resistant: ticar/clav/50{\%}, piperacillin/62{\%}, ceftazidime/50{\%}, gentamicin/56{\%}). Conclusions: The incidence and susceptibilities of key pathogens vary between ICUs in a single hospital. Each ICU functions under varying restrictions and {"}crop-rotation{"} policies for antibiotic use. This may impact the unit specific antibiogram. To adequately cover the most frequently recovered pathogens, one should consider the ICU specific antibiogram in developing strategies for empiric antibiotic use.",
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T1 - Inter-ICU antibiogram variability and implications for empiric antibiotic strategies

AU - Shirazi, E.

AU - Samiian, L.

AU - Namias, Nicholas

AU - Kett, Daniel H

AU - Sleeman, Danny

AU - Ginzburg, Enrique

AU - O'Neill, K.

PY - 1999/12/1

Y1 - 1999/12/1

N2 - Objective: To determine if the incidence and antibiotic susceptibility of key bacterial pathogens vary between ICUs in a single teaching hospital. Methods: Culture and susceptibility results were collected prospectively for 3 months (April - June, 1999) in each of the Surgical, Trauma, and Medical ICUs. Complete antibiograms were generated. Antibiograms for selected organisms and antibiotics are presented due to space limitations. Differences in incidence and susceptibility between units was analyzed with χ2. Alpha was set at .05 for significance. Results:Number of admissions: MICU, 138; SICU, 127; TICU, 140. Acinetobacter varied in incidence between units (MICU 16, SICU 3, TICU 36, p<.05)- its susceptibility to cefotaxime was 88%(MICU) vs. 17%(TICU)(p<.05). Enterococcus sp. were common in all 3 units (MICU 15, SICU 26, TICU 27)- vancomycin resistance varied (MICU 0%, SICU 31%, TICU 11%, p<.05). Pseudomonas sp. were common in all 3 units (MICU 21, SICU 12, TICU 31) - susceptibility to ceftazidime varied (MICU 67%, SICU 83%, TICU 94%, p<.05)as did susceptibility to ciprofloxacin and levofloxacin (MICU 67%, SICU 33%, TICU 90%, p<.05).Klebsiella was uncommon in the MICU (MICU 4; SICU 9; TICU 16), but 100% susceptible to all antibiotics tested (in the MICU)except ampicillin (25% susceptible); it was highly resistant in the TICU (antibiotic/%resistant: ticar/clav/50%, piperacillin/62%, ceftazidime/50%, gentamicin/56%). Conclusions: The incidence and susceptibilities of key pathogens vary between ICUs in a single hospital. Each ICU functions under varying restrictions and "crop-rotation" policies for antibiotic use. This may impact the unit specific antibiogram. To adequately cover the most frequently recovered pathogens, one should consider the ICU specific antibiogram in developing strategies for empiric antibiotic use.

AB - Objective: To determine if the incidence and antibiotic susceptibility of key bacterial pathogens vary between ICUs in a single teaching hospital. Methods: Culture and susceptibility results were collected prospectively for 3 months (April - June, 1999) in each of the Surgical, Trauma, and Medical ICUs. Complete antibiograms were generated. Antibiograms for selected organisms and antibiotics are presented due to space limitations. Differences in incidence and susceptibility between units was analyzed with χ2. Alpha was set at .05 for significance. Results:Number of admissions: MICU, 138; SICU, 127; TICU, 140. Acinetobacter varied in incidence between units (MICU 16, SICU 3, TICU 36, p<.05)- its susceptibility to cefotaxime was 88%(MICU) vs. 17%(TICU)(p<.05). Enterococcus sp. were common in all 3 units (MICU 15, SICU 26, TICU 27)- vancomycin resistance varied (MICU 0%, SICU 31%, TICU 11%, p<.05). Pseudomonas sp. were common in all 3 units (MICU 21, SICU 12, TICU 31) - susceptibility to ceftazidime varied (MICU 67%, SICU 83%, TICU 94%, p<.05)as did susceptibility to ciprofloxacin and levofloxacin (MICU 67%, SICU 33%, TICU 90%, p<.05).Klebsiella was uncommon in the MICU (MICU 4; SICU 9; TICU 16), but 100% susceptible to all antibiotics tested (in the MICU)except ampicillin (25% susceptible); it was highly resistant in the TICU (antibiotic/%resistant: ticar/clav/50%, piperacillin/62%, ceftazidime/50%, gentamicin/56%). Conclusions: The incidence and susceptibilities of key pathogens vary between ICUs in a single hospital. Each ICU functions under varying restrictions and "crop-rotation" policies for antibiotic use. This may impact the unit specific antibiogram. To adequately cover the most frequently recovered pathogens, one should consider the ICU specific antibiogram in developing strategies for empiric antibiotic use.

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