Association between Antimicrobial Administration and Nasal Carriage of Pseudomonas aeruginosa and Candida Species in ICU Patients

Abstract

Background: Patients admitted to the intensive care unit (ICU) often develop hospitalacquired infections (HAI).

Objective: We started an active surveillance culture (ASC) to monitor bacterial or fungal carriage in the ICU of our hospital and retrospectively evaluated in this study.

Materials and Method: ASC was performed using a nasal swab culture when the patients were admitted to the ICU, regardless of whether the patients had any infectious diseases. If the patients continued to stay in the ICU for the following week or later, ASC was performed regularly once a week until discharge.

Results: When comparing the bacteria isolated from nasal swab cultures at the time of ICU admission, Pseudomonas aeruginosa, which sometimes develops drug resistance and can cause HAI, was isolated more frequently from ASC the following factors for increased isolation of Pseudomonas aeruginosa week or later. Antipseudomonal penicillin and antifungals were independent risk for increased isolation of Candida species. Considering that most ICU patients are administered antimicrobials, it was suggested that using antimicrobials during long-term ICU stays affects the nasal bacterial flora of ICU patients.

Conclusion: ASC would help understand the nasal carriage status and changes in the bacterial flora of ICU patients, supporting taking measures against drug-resistant bacteria.