Are the Intensive Care Units the Only Reservoir of Resistant Microorganisms?

Sa？etak Objectives: The aim of this study is to identify the frequency and epidemiological characteristics of infections caused by multidrug-resistant microorganisms and examine possible risk factors responsible for colonisation and infections with these pathogens. Study design: Cross-sectional study. Participants and methods: The study included 185 participants treated in the ICU of the Clinic for Anesthesiology, Resuscitation and Intensive Care during 2016 and 2017, who were colonised or had infection caused by multidrug-resistant hospital microorganisms. The participants’ demographic and clinical data were taken from the medical records and microbiological protocol. Results: Prior to the admission at the ICU, 49.2% of the participants were colonised and 31.4% of them were infected by the resistant pathogen. The most common isolated pathogen was Acinetobacter baumannii. 60.5% of the participants were colonised at the ICU, 59.4% of them had infection prior to the admission at the ICU. Primary disease, surgical treatment and time spent in hospital ward favoured colonisation and infection prior to the admission at the ICU, while critical condition, artificial airway, mechanical ventilation, surgical intervention and time spent on ICU are considered risk factors responsible for colonisation and infection at the ICU. The difference between the incidence of infections between surgical and non-surgical patients was not found. Conclusion: ICUs are not the only reservoirs of resistant pathogens. A part of the patients is colonised or infected at the admission to the ICU, the other part got infected or colonised at the ICU. The isolates are usually Gram-negative bacteria. The most common is Acinetobacter baumanii. Colonisation and infection at hospital wards and ICUs are under the influence of the nature and severity of a disease, exposure to invasive therapeutic procedures and staying in surroundings with high prevalence of resistant microorganisms