{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T15:50:16Z","timestamp":1695570616263},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":4264,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2003,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S019594170008348X_abs1\"><jats:title>Objective:<\/jats:title><jats:p>To determine the incidence of acquired infection, and the incidence, risk factors, and molecular typing of multidrug-resistant bacterial organisms (MROs) colonizing respiratory secretions or the oropharynx of patients in an extended-care area of the emergency department (ED) in a tertiary-care university hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S019594170008348X_abs2\"><jats:title>Methods:<\/jats:title><jats:p>A case-control study was conducted regarding risk factors for colonization with MROs in ED patients from July 1996 to August 1998. The most prevalent MRO strains were determined using plasmid and genomic analysis with PFGE.<\/jats:p><\/jats:sec><jats:sec id=\"S019594170008348X_abs3\"><jats:title>Results:<\/jats:title><jats:p>MROs colonized 59 (25.4%) of 232 ED patients and 173 controls. The mean ED length of stay for the 59 cases was 13.9 days versus 9.8 days for the 173 controls. The mean length of stay prior to the first isolation of MROs was 9.9 days. MRO species included<jats:italic>Acinetobacter baumannii, Staphylococcus aureus,<\/jats:italic>and<jats:italic>Pseudomonas aeruginosa.<\/jats:italic>The rate of hospital-acquired infection was 32.7 per 1,000 ED patient-days. The case fatality rate was significantly higher for cases. Univariate analysis identified mechanical ventilation, nebulization, nasogastric intubation, urinary catheterization, antibiotic therapy, and number of antibiotics as risk factors for MRO colonization. Multivariate regression analysis found that mechanical ventilation and nasogastric intubation independently predicted MRO colonization. Endemic clones were identified by PFGE in ED patients and were also found in patients in other parts of the hospital.<\/jats:p><\/jats:sec><jats:sec id=\"S019594170008348X_abs4\"><jats:title>Conclusions:<\/jats:title><jats:p>Prolonged stay in the ED posed a risk for colonization with MROs and for contracting nosocomial infections, both of which were associated with increased mortality. Patients colonized with antibiotic-resistant<jats:italic>A. baumannii<\/jats:italic>may serve as a reservoir for spread in this hospital.<\/jats:p><\/jats:sec>","DOI":"10.1086\/502210","type":"journal-article","created":{"date-parts":[[2006,3,10]],"date-time":"2006-03-10T22:45:05Z","timestamp":1142030705000},"page":"351-355","source":"Crossref","is-referenced-by-count":14,"title":["Impact of Antibiotic-Resistant Pathogens Colonizing the Respiratory Secretions of Patients in an Extended-Care Area of the Emergency Department"],"prefix":"10.1017","volume":"24","author":[{"given":"S\u00f4nia R. P. 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