{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T23:30:28Z","timestamp":1750894228051},"reference-count":23,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,7]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Data on antimicrobial resistance (AMR) and association with outcomes in resource-variable intensive care units (ICU) are lacking. Data currently available are limited to large, urban centers. We attempted to understand this locally through a dual-purpose, retrospective study. Cohort A consisted of adult and pediatric patients who had blood, urine, or cerebrospinal fluid cultures obtained from 2016 to 2020. A total of 3,013 isolates were used to create the Kijabe Hospital\u2019s first antibiogram. Gram-negative organisms were found to be less than 50% susceptible to third- and fourth-generation cephalosporins, 67% susceptible to piperacillin\u2013tazobactam, 87% susceptible to amikacin, and 93% susceptible to meropenem. We then evaluated the association between AMR and clinical characteristics, management, and outcomes among ICU patients (Cohort B). Demographics, vital signs, laboratory results, management data, and outcomes were obtained. Antimicrobial resistance was defined as resistance to one or more antimicrobials. Seventy-six patients were admitted to the ICU with bacteremia during this time. Forty complete paper charts were found for review. Median age was 34\u2009years (interquartile range, 9\u201351), 26 patients were male (65%), and 28 patients were older than 18\u2009years (70%). Septic shock was the most common diagnosis (<jats:italic>n<\/jats:italic> = 22, 55%). Six patients had AMR bacteremia; <jats:italic>Escherichia coli<\/jats:italic> was most common (<jats:italic>n<\/jats:italic> = 3, 50%). There was not a difference in mortality between patients with AMR versus non-AMR infections (<jats:italic>P<\/jats:italic> = 0.54). This study found a prevalence of AMR. There was no association between AMR and outcomes among ICU patients. More studies are needed to understand the impact of AMR in resource-variable settings.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0311","type":"journal-article","created":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T20:38:21Z","timestamp":1683664701000},"page":"1227-1234","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of Antimicrobial Resistance and Association with Patient Outcomes in a Rural Kenyan Hospital"],"prefix":"10.4269","volume":"108","author":[{"given":"Ian C.","family":"Drobish","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Department of Pediatrics, University of California San Diego, San Diego, California;"},{"name":"Critical Care Medicine Department, NIH Clinical Center; Bethesda, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Immaculate K.","family":"Barasa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Otieno","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses Odhiambo","family":"Osoo","sequence":"additional","affiliation":[{"name":"Department of Research, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solomon K.","family":"Thuo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaya S.","family":"Belknap","sequence":"additional","affiliation":[{"name":"Department of Outpatient Medicine, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna McLain","family":"Shirk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Taylor","family":"McClanahan","sequence":"additional","affiliation":[{"name":"Bessemer Pediatrics, Bessemer, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Irungu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Riunga","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aga Khan University Hospital, Nairobi, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faith","family":"Lelei","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, AIC Kijabe Hospital, Kijabe, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina E.","family":"Rudd","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. Jason","family":"Brotherton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, AIC Kijabe Hospital, Kijabe, Kenya;"},{"name":"Department of Internal Medicine, AIC Kijabe Hospital, Kijabe, Kenya;"},{"name":"Department of Critical Care Medicine, The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"200","article-title":"Global, regional, and national sepsis incidence and mortality, 1990\u20132017: analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020"},{"key":"b2","series-title":"Global Action Plan on Antimicrobial Resistance","year":"2015"},{"key":"b3","series-title":"Afr J Lab Med","first-page":"432","article-title":"A review of antimicrobial resistance in East 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