Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa

  • Jayandiran Pillai University of the Witwatersrand, Johannesburg, South Africa
  • Ceyhan Yazicioglu University of the Witwatersrand, Johannesburg, South Africa
  • Steve Moeng University of the Witwatersrand, Johannesburg, South Africa
  • Thomas Rangaka University of the Witwatersrand, Johannesburg, South Africa
  • Taalib Monareng University of the Witwatersrand, Johannesburg, South Africa
  • Raja Jayakrishnan University of the Witwatersrand, Johannesburg, South Africa
  • Martin Veller University of the Witwatersrand, Johannesburg, South Africa
  • Daniella Pinkus University of the Witwatersrand, Johannesburg, South Africa
Keywords: Multidrug resistance, ICU, Pseudomonas aeruginosa, Klebsiella species, Acinetobacterbaumanni, Staphylococcus aureus

Abstract

Introduction: 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.

Conclusion: Critically ill polytrauma patients are at particularly high risk for Gram-negative sepsis.

Published
2015-07-30
How to Cite
1.
Pillai J, Yazicioglu C, Moeng S, Rangaka T, Monareng T, Jayakrishnan R, Veller M, Pinkus D (2015) Prevalence and patterns of infection in critically ill trauma patients admitted to the trauma ICU, South Africa. J Infect Dev Ctries 9:736-742. doi: 10.3855/jidc.5865
Section
Original Articles