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Piperacillin-Tazobactam role in blood stream infections (CLABSI) from a surgical Trauma intensive care unit

PT4.5 (Piperacillin/tazobactam)

Gram-negative central line-associated bloodstream infection in a surgical trauma intensive care unit

In the current clinical study, investigators reviewed data related to central line-associated blood stream infections (CLABSI) from a surgical trauma intensive care unit (ICU), with aim to identify patient risk factors, pathogens, and treatment interventions. The authors performed a retrospective review of surgical ICU patients who met the Centers for Disease Control (CDC) definition for Gram-negative CLABSI over a period of 7 years, and evaluated demographics, pathogens, interventions, and outcomes.

The analysis included 40 patients (72.5% male) with an average age of 49.9 ± 19 years. The findings showed that the average duration of central venous line was 11 ± 5.9 days, with average period from line placement to positive culture was 9.4 ± 6.8 days. The most common organisms were Enterobacter species (37.5%) with 17.8% of all cultured organisms considered multidrug resistant (MDR). Of note, piperacillin-tazobactam (67.5%) was identified as the antibiotic used most commonly. Overall mortality rate was 22.5%. Eleven patients who developed a recurrence did so at 10.7 ± 8 days and were similar to those without recurrence.

"Predominant pathogens associated with surgical trauma ICU CLABSI in the study were different from those Gram-negative bacteria seen in other studies in the general hospital population"

The authors thus reported that predominant pathogens associated with surgical trauma ICU CLABSI in the study were different from those Gram-negative bacteria seen in other studies in the general hospital population. It is suggested that further investigation into risk factors for infection and relapse would help to minimize such consequences. Particularly, an understanding of appropriate placement and use of the central line and clarifying optimal duration of therapy seem important in improving the clinical outcomes.

Source: Duane TM, Kikhia RM, Wolfe LG, Ober J, Tessier JM. Understanding Gram-negative Central Line-Associated Blood Stream Infection in a Surgical Trauma ICU. Am Surg. 2015 Aug;81(8):816-9.