Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been...Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been well studied yet.In the present study,we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients.Methods:This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan,China.Data of cases were collected through electronic medical records system.This study was focused on cases with bacterial culture records.Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model.Results:Of the 2891 patients,370 patients have bacterial culture results,and MDROs were isolated in 38 patients.Respiratory tract infections(67.3%)were the most common hospital acquired infections.Variables independently associated with MDRO infections were dyspnea at admission(odds ratio(OR)4.74;95%confidence interval(CI)2.06-10.88;P<0.001),intensive care unit(ICU)admission(OR 5.02;95%CI 1.99-12.63;P<0.01),and invasive mechanical ventilation(OR 5.13;95%CI 2.15-12.27;P<0.001),adjusted for age and gender.MDROs infection was also a significant risk factor of death for the patients,adjusted for age,gender,severity of illness,ICU admission and mechanical ventilation(OR 1.12,95%CI:0.43-2.96,P=0.817).Conclusion:In our study,dyspnea at admission,ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections,and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients.展开更多
Objective:To investigate different Musa sp.leave extracts of hexane,ethyl acetate and methanol were evaluated for antibacterial activity against multi-drug resistant pathogens causing nosocomial infection by agar well...Objective:To investigate different Musa sp.leave extracts of hexane,ethyl acetate and methanol were evaluated for antibacterial activity against multi-drug resistant pathogens causing nosocomial infection by agar well diffusion method and also antioxidant activities.Methods:The four different Musa species leaves were extracted with hexane,ethyl acetate and methanol.Antibacterial susceptibility test,minimum inhibitory concentration and minimum inhibitory bacterial concentration were determined by agar well diffusion method.Total phenolic content and in vitro antioxidant activity was determined.Results:All the Musa sp.extracts showed moderate antibacterial activities expect Musa paradisiaca with the inhibition zone ranging from 8.0 to 18.6 mm.Among four species ethyl acetate extracts of Musa paradisiaca showed highest activity against tested pathogens particularly E.coli,P.aeruginosa and Citrobacter sp.The minimum inhibitory concentrations were within the value of 15.63-250μg/ml.and minimum bactericidal concentrations were ranging from 31.25-250μg/mL.Antioxidant activity of Musa acuminate exhibited maximum activity among other three Musa species.Conclusions:The present study concluded that among the different Musa species,Musa paradisiaca displayed efficient antibacterial activity followed by Musa acuminata against multidrug resistant nosocomial infection causing pathogens.Further,an extensive study is needed to identify the bioactive compounds,mode of action and toxic effect in.vivo of Musa sp.展开更多
This prospective study was carried out to assess the sensitivity and resistance pattern of lactose non-fermenting Escherichia coli from July 2018 to December 2018 in the Laboratory of Microbiology at Luanda Medical Ce...This prospective study was carried out to assess the sensitivity and resistance pattern of lactose non-fermenting Escherichia coli from July 2018 to December 2018 in the Laboratory of Microbiology at Luanda Medical Center, Angola. Out of 1170 patient, a total of 120 urine specimens infected with Escherichia coli (>105 CFU/ml) were collected according to the routine protocol of urinalysis. Among these 120 isolates, 25 (21%) isolates were determined as “atypical”, lactose non-fermenting E. colis trains. The twenty-five lactose non-fermenting Escherichia coli strains isolated from urine samples in Luanda Medical Center were declared as Multiple Drugs-Resistant strains with high resistance to Cefalexine (100%), Cefuroxime (100%), Ceftriaxone (92%), Gentamycin (92%), Ciprofloxacin (72%) and Amoxiciclin/Clavulanic (80%). The alarming resistance level to the first-choice drugs for the treatment of urinary tract infections caused by non-fermentative lactose E. coli was observed.展开更多
Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to...Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to May 2020 were selected for the study,of which 73 carried drug-resistant bacteria.Results:The risk factor network of people infected with multidrug resistant bacteria is higher than that of people infected with non-multidrug resistant bacteria,and the interaction between risk factors of the former is stronger.Conclusion:Antibiotics must be used appropriately after surgery.When the elderly was abnormal in indicators such as fever and procalcitonin in the ward,they should be considered as high-risk groups of MDRO infection.They need special care and preventive measures.展开更多
Bacteriophages have a potentially important role to play in reducing the global incidence of Hospital Acquired Infection (HAI). Their use should be focused on reducing the use and over-use of antibiotics as part of in...Bacteriophages have a potentially important role to play in reducing the global incidence of Hospital Acquired Infection (HAI). Their use should be focused on reducing the use and over-use of antibiotics as part of integrated control measures in conjunction with various vaccination, sanitation procedures and prophylactic and treatment regimens. Bacteriophages offer exquisite specificity and efficacy in killing target bacterial strains, a phenomenon known for almost 100 years. However, their efficacy with respect to broad-spectrum antibiotics is poor due to the highly strain-selective nature of their killing and their rapid elimination from the body. Bacteriophage killing is a naturally-occurring process capable of limiting and eliminating bacterial populations in humans. This is achieved through exponential amplification of their number, if and when, they encounter a target bacterium. Unfortunately, processes employed for their commercial production today do not meet the same rigour as dictated for pharmaceutical products. Batch-to-batch reproducibility and molecular definition of target and phage strains must be demanded before their clinical use can become widespread. Elsewhere, historical data have demonstrated safety in humans beyond any doubt. Because patients continue to die in our healthcare centers internationally, the use of bacteriophage to help fight HAI should be reassessed. Here, relevant literature is reviewed.展开更多
Background: Healthcare-associated infections affect hundreds of millions of patients worldwide. Children have greater susceptibility to healthcare-associated infections due to the immaturity of their immune system. Co...Background: Healthcare-associated infections affect hundreds of millions of patients worldwide. Children have greater susceptibility to healthcare-associated infections due to the immaturity of their immune system. Contact precautions aim to promote safety, protection and prevention of contamination. Thus, the objective of this study was to verify adherence to contact precaution measures, as well as compliance to the use of personal protective equipment. Methods: This cross-sectional observational study was carried out from July to October 2019 using a checklist to evaluate health professionals’ adherence to hand hygiene procedures and the use of gloves and surgical gowns when assisting children on contact precautions. Results: A total of 941 observations were carried out in a total of 300.532 hours. Hand hygiene was performed before and after contact with the patient in 58.84% and 75.09% of the cases, respectively and a surgical gown was used in 86.40% of the cases. The use of gloves was the variable most adhered to by professionals (87.57%). Intensive care unit professionals were the care workers who most complied with the regulation regarding hand hygiene after contact with the patient (p = 0.009) and the use of the surgical gown (p < 0.001). The correct hand hygiene technique was the recommendation with least adherence. Non-compliance to the hand hygiene technique was statistically significant among intensive care unit professionals (p = 0.002). Conclusions: Adherence to hand hygiene before contact with the patient and compliance with the hand hygiene technique were neglected by most professionals. However, there was good adherence to the use of surgical gloves and gowns, as well as high compliance to the techniques of removing these items. .展开更多
AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance...AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.展开更多
Objective:To understand the pathogenic bacteria isolated from patients and their drug resistance changes in general ICU of the Affiliated Hospital of Hebei University,so as to provide reference for appropriate selecti...Objective:To understand the pathogenic bacteria isolated from patients and their drug resistance changes in general ICU of the Affiliated Hospital of Hebei University,so as to provide reference for appropriate selection of antibiotics in clinical practice.Methods:A retrospective investigation was conducted to analyze the bacteriological distribution and drug resistance of nosocomial pathogens isolated from the specimens of hospitalized patients in the comprehensive ICU of the hospital from 2019 to 2021.The US technology BD Phoenix 100 automatic bacterial identification analyzer was used for bacterial identification of the pathogen samples,disk diffusion method was used for drug susceptibility test,and SPSS 22.0 software was used to analyze the trend of drug resistance.Results:A total of 970 strains of nosocomial pathogens were detected in the three years.The main pathogens were Acinetobacter baumannii(133 strains,13.71%),Klebsiella pneumoniae(106 strains,10.93%),Pseudomonas aeruginosa(83 strains,8.56%),Escherichia coli(76 strains,7.84%)and Enterococcus faecium(69 strains,7.11%).The resistance rate of Acinetobacter baumannii to antibiotics was high.Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli had low resistance rates to carbapenems.The situation of bacterial drug resistance is still serious.Conclusion:The drug resistance of pathogenic bacteria collected from Class III Grade A Hospital’s patients to antibiotics was generally high.Therefore,clinical departments should strengthen the inspection of specimens of infection and drug sensitivity test in order to grasp the resistance mechanisms and drug resistance of pathogenic bacteria changes,and select appropriate antimicrobial agents according to the test results.Besides,the formation of drug-resistant strains also needs to be prevented,and the treatment of patients with severe infection needs to be improved.展开更多
Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present no...Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics Department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infections associated with the care remain frequent in our service and dominated by the infections of the operating site. Isolated organisms were all resistant to amoxicillin in 88.88% case ciprofloxacin.展开更多
AIM To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis(N-SBP) given the rising importance of multidrug-resistant(MDR) bacteria.METHODS A literature search was performed ...AIM To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis(N-SBP) given the rising importance of multidrug-resistant(MDR) bacteria.METHODS A literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15 th of November 2016, using the following search strategy: "spontaneous" AND "peritonitis".RESULTS The initial search through electronic databases retrieved 2556 records. After removing duplicates, 1958 records remained. One thousand seven hundred and thirty-five of them were excluded on the basis of the screening of titles and abstract, and the ensuing number of remaining articles was 223. Of these records, after careful evaluation, only 9 were included in the qualitative analysis. The overall proportion of MDR bacteria turned out to be from 22% to 73% of cases across the studies.CONCLUSION N-SBP is caused, in a remarkable proportion, by MDR pathogens. This should prompt a careful re-assessment of guidelines addressing the treatment of this clinical entity.展开更多
Bacterial infections are highly prevalent and a frequent cause of hospitalization and short-term mortality in patients with cirrhosis. Due to their negative impact on survival, antibiotic prophylaxis for bacterial inf...Bacterial infections are highly prevalent and a frequent cause of hospitalization and short-term mortality in patients with cirrhosis. Due to their negative impact on survival, antibiotic prophylaxis for bacterial infections in high-risk subgroups of patients with cirrhosis has been the standard of care for decades. Patients with prophylaxis indications include those at risk for a first episode of spontaneous bacterial peritonitis(SBP) due to a low ascitic fluid protein count and impaired liver and kidney function, patients with a prior episode of SBP and those with an episode of gastrointestinal bleeding. Only prophylaxis due to gastrointestinal bleeding has a known and short-time duration. All other indications imply longlasting exposure to antibiotics-once the threshold requirement for initiating prophylaxis is met-without standardized criteria for re-assessing antibiotic interruption. Despite the fact that the benefit of antibiotic prophylaxis in reducing bacterial infections episodes and mortality has been thoroughly reported, the extended use of antibiotics in patients with cirrhosis has also had negative consequences, including the emergence of multi-drug resistant bacteria.Currently, it is not clear whether restricting the use of broad and fixed antibiotic regimens, tailoring the choice of antibiotics to local bacterial epidemiology or selecting non-antibiotic strategies will be the preferred antibiotic prophylaxis strategy for patients with cirrhosis in the future.展开更多
AIM To determine risk factors, causative organisms and antimicrobial resistance of bacterial infections following living-donor liver transplantation(LDLT) in cirrhotic patients.METHODS This prospective study included ...AIM To determine risk factors, causative organisms and antimicrobial resistance of bacterial infections following living-donor liver transplantation(LDLT) in cirrhotic patients.METHODS This prospective study included 45 patients with hepatitis C virus-related end-stage liver disease who underwent LDLT at Ain Shams Center for Organ Transplant, Cairo, Egypt from January 2014 to November 2015. Patients were followed-up for the first 3 mo after LDLT for detection of bacterial infections. All patients were examined for the possible risk factors suggestive of acquiring infection pre-, intra-and post-operatively. Positive cultures based on clinical suspicion and patterns of antimicrobial resistance were identified. RESULTS Thirty-three patients(73.3%) suffered from bacterial infections; 21 of them had a single infection episode, and 12 had repeated infection episodes. Bile was the most common site for both single and repeated episodes of infection(28.6% and 27.8%, respectively). The most common isolated organisms were gramnegative bacteria. Acinetobacter baumannii was the most common organism isolated from both single and repeated infection episodes(19% and 33.3%, respectively), followed by Escherichia coli for repeated infections(11.1%), and Pseudomonas aeruginosa for single infections(19%). Levofloxacin showed high sensitivity against repeated infection episodes(P = 0.03). Klebsiella, Acinetobacter and Pseudomonas were multi-drug resistant(MDR). Pre-transplant hepatocellular carcinoma(HCC) and duration of drain insertion(in days) were independent risk factors for the occurrence of repeated infection episodes(P = 0.024).CONCLUSION MDR gram-negative bacterial infections are common post-LDLT. Pre-transplant HCC and duration of drain insertion were independent risk factors for the occurrence of repeated infection episodes.展开更多
The adoption by health professionals to the practice of patient isolation is a decision that reduces patients’ risks of occupational exposure to potentially contaminated biological material and prevents nosocomial in...The adoption by health professionals to the practice of patient isolation is a decision that reduces patients’ risks of occupational exposure to potentially contaminated biological material and prevents nosocomial infections. Verify the compliance of health professionals to the practices of contact precautions in patients colonized by microorganisms in a teaching hospital. This was a prospective observational cohort study in a special-sized hospital located in southeastern Brazil. The observation of health professionals in delivery of health care to patients with contact precaution was performed regarding hand hygiene, use of overcoat, glove, and mask. We carried out 1502 observations involving the following professional categories: nursing technicians and/or nursing assistants (n = 1028;68.4%), nurses (n = 200;13.3%), physical therapists (n = 185;12.3%), and physicians (n = 89;5.9%), totaling 971.8 hours. Regarding the level of compliance of professionals to contact precaution practices with hand hygiene after the procedures, the use of overcoats, gloves, and masks, all were statistically significant (p Klebsiella pneumoniae was the most positive pathogen identified in laboratory tests. This study provided the mapping of the compliance of health professionals to the practices of contact precautions in order to support a safer management of patient care reducing the risks of Healthcare-Associated Infections (HAI). This study also showed that health professionals are using practice management to deal with their behavior to protect their health.展开更多
基金supported by Clinical Toxicology Grants from Chinese Society of Toxicology(No.CST2020CT604).
文摘Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been well studied yet.In the present study,we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients.Methods:This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan,China.Data of cases were collected through electronic medical records system.This study was focused on cases with bacterial culture records.Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model.Results:Of the 2891 patients,370 patients have bacterial culture results,and MDROs were isolated in 38 patients.Respiratory tract infections(67.3%)were the most common hospital acquired infections.Variables independently associated with MDRO infections were dyspnea at admission(odds ratio(OR)4.74;95%confidence interval(CI)2.06-10.88;P<0.001),intensive care unit(ICU)admission(OR 5.02;95%CI 1.99-12.63;P<0.01),and invasive mechanical ventilation(OR 5.13;95%CI 2.15-12.27;P<0.001),adjusted for age and gender.MDROs infection was also a significant risk factor of death for the patients,adjusted for age,gender,severity of illness,ICU admission and mechanical ventilation(OR 1.12,95%CI:0.43-2.96,P=0.817).Conclusion:In our study,dyspnea at admission,ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections,and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients.
基金Supported by K.S.Rangasamy College of Arts and Science,Tiruchengode,Tamil Nadu,India with project No.(KSBCAS/PG/RD/MB/2011-12/08)
文摘Objective:To investigate different Musa sp.leave extracts of hexane,ethyl acetate and methanol were evaluated for antibacterial activity against multi-drug resistant pathogens causing nosocomial infection by agar well diffusion method and also antioxidant activities.Methods:The four different Musa species leaves were extracted with hexane,ethyl acetate and methanol.Antibacterial susceptibility test,minimum inhibitory concentration and minimum inhibitory bacterial concentration were determined by agar well diffusion method.Total phenolic content and in vitro antioxidant activity was determined.Results:All the Musa sp.extracts showed moderate antibacterial activities expect Musa paradisiaca with the inhibition zone ranging from 8.0 to 18.6 mm.Among four species ethyl acetate extracts of Musa paradisiaca showed highest activity against tested pathogens particularly E.coli,P.aeruginosa and Citrobacter sp.The minimum inhibitory concentrations were within the value of 15.63-250μg/ml.and minimum bactericidal concentrations were ranging from 31.25-250μg/mL.Antioxidant activity of Musa acuminate exhibited maximum activity among other three Musa species.Conclusions:The present study concluded that among the different Musa species,Musa paradisiaca displayed efficient antibacterial activity followed by Musa acuminata against multidrug resistant nosocomial infection causing pathogens.Further,an extensive study is needed to identify the bioactive compounds,mode of action and toxic effect in.vivo of Musa sp.
文摘This prospective study was carried out to assess the sensitivity and resistance pattern of lactose non-fermenting Escherichia coli from July 2018 to December 2018 in the Laboratory of Microbiology at Luanda Medical Center, Angola. Out of 1170 patient, a total of 120 urine specimens infected with Escherichia coli (>105 CFU/ml) were collected according to the routine protocol of urinalysis. Among these 120 isolates, 25 (21%) isolates were determined as “atypical”, lactose non-fermenting E. colis trains. The twenty-five lactose non-fermenting Escherichia coli strains isolated from urine samples in Luanda Medical Center were declared as Multiple Drugs-Resistant strains with high resistance to Cefalexine (100%), Cefuroxime (100%), Ceftriaxone (92%), Gentamycin (92%), Ciprofloxacin (72%) and Amoxiciclin/Clavulanic (80%). The alarming resistance level to the first-choice drugs for the treatment of urinary tract infections caused by non-fermentative lactose E. coli was observed.
文摘Objective:To investigate the influencing factors of multi-drug resistant bacterial infections in patients with severe disease and establish a predictive model.Methods:207 infected patients in our hospital from 2018 to May 2020 were selected for the study,of which 73 carried drug-resistant bacteria.Results:The risk factor network of people infected with multidrug resistant bacteria is higher than that of people infected with non-multidrug resistant bacteria,and the interaction between risk factors of the former is stronger.Conclusion:Antibiotics must be used appropriately after surgery.When the elderly was abnormal in indicators such as fever and procalcitonin in the ward,they should be considered as high-risk groups of MDRO infection.They need special care and preventive measures.
文摘Bacteriophages have a potentially important role to play in reducing the global incidence of Hospital Acquired Infection (HAI). Their use should be focused on reducing the use and over-use of antibiotics as part of integrated control measures in conjunction with various vaccination, sanitation procedures and prophylactic and treatment regimens. Bacteriophages offer exquisite specificity and efficacy in killing target bacterial strains, a phenomenon known for almost 100 years. However, their efficacy with respect to broad-spectrum antibiotics is poor due to the highly strain-selective nature of their killing and their rapid elimination from the body. Bacteriophage killing is a naturally-occurring process capable of limiting and eliminating bacterial populations in humans. This is achieved through exponential amplification of their number, if and when, they encounter a target bacterium. Unfortunately, processes employed for their commercial production today do not meet the same rigour as dictated for pharmaceutical products. Batch-to-batch reproducibility and molecular definition of target and phage strains must be demanded before their clinical use can become widespread. Elsewhere, historical data have demonstrated safety in humans beyond any doubt. Because patients continue to die in our healthcare centers internationally, the use of bacteriophage to help fight HAI should be reassessed. Here, relevant literature is reviewed.
文摘Background: Healthcare-associated infections affect hundreds of millions of patients worldwide. Children have greater susceptibility to healthcare-associated infections due to the immaturity of their immune system. Contact precautions aim to promote safety, protection and prevention of contamination. Thus, the objective of this study was to verify adherence to contact precaution measures, as well as compliance to the use of personal protective equipment. Methods: This cross-sectional observational study was carried out from July to October 2019 using a checklist to evaluate health professionals’ adherence to hand hygiene procedures and the use of gloves and surgical gowns when assisting children on contact precautions. Results: A total of 941 observations were carried out in a total of 300.532 hours. Hand hygiene was performed before and after contact with the patient in 58.84% and 75.09% of the cases, respectively and a surgical gown was used in 86.40% of the cases. The use of gloves was the variable most adhered to by professionals (87.57%). Intensive care unit professionals were the care workers who most complied with the regulation regarding hand hygiene after contact with the patient (p = 0.009) and the use of the surgical gown (p < 0.001). The correct hand hygiene technique was the recommendation with least adherence. Non-compliance to the hand hygiene technique was statistically significant among intensive care unit professionals (p = 0.002). Conclusions: Adherence to hand hygiene before contact with the patient and compliance with the hand hygiene technique were neglected by most professionals. However, there was good adherence to the use of surgical gloves and gowns, as well as high compliance to the techniques of removing these items. .
文摘AIM To report the results of the International Nosocomial Infection Control Consortium(INICC) study conducted in Quito, Ecuador.METHODS A device-associated healthcare-acquired infection(DAHAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units(ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network(CDC/NHSN) definitions and INICC methods. RESULTS We followed 776 ICU patients for 4818 bed-days. The central line-associated bloodstream infection(CLABSI) rate was 6.5 per 1000 central line(CL)-days, the ventilator-associated pneumonia(VAP) rate was 44.3 per 1000 mechanical ventilator(MV)-days, and the catheterassociated urinary tract infection(CAUTI) rate was 5.7 per 1000 urinary catheter(UC)-days. CLABSI and CAUTI rates in our ICUs were similar to INICC rates [4.9(CLABSI) and 5.3(CAUTI)] and higher than NHSN rates [0.8(CLABSI) and 1.3(CAUTI)]- although device use ratios for CL and UC were higher than INICC and CDC/NSHN's ratios. By contrast, despite the VAP rate was higher than INICC(16.5) and NHSN's rates(1.1), MV DUR was lower in our ICUs. Resistance of A. baumannii to imipenem and meropenem was 75.0%, and of Pseudomonas aeruginosa to ciprofloxacin and piperacillin-tazobactam was higher than 72.7%, all them higher than CDC/NHSN rates. Excess length of stay was 7.4 d for patients with CLABSI, 4.8 for patients with VAP and 9.2 for patients CAUTI. Excess crude mortality in ICUs was 30.9% for CLABSI, 14.5% for VAP and 17.6% for CAUTI. CONCLUSION DA-HAI rates in our ICUs from Ecuador are higher than United States CDC/NSHN rates and similar to INICC international rates.
基金In-Hospital Fund Project of Affiliated Hospital of Hebei University:Analysis of Nosocomial Infection in Intensive Care Unit(2019Q030)。
文摘Objective:To understand the pathogenic bacteria isolated from patients and their drug resistance changes in general ICU of the Affiliated Hospital of Hebei University,so as to provide reference for appropriate selection of antibiotics in clinical practice.Methods:A retrospective investigation was conducted to analyze the bacteriological distribution and drug resistance of nosocomial pathogens isolated from the specimens of hospitalized patients in the comprehensive ICU of the hospital from 2019 to 2021.The US technology BD Phoenix 100 automatic bacterial identification analyzer was used for bacterial identification of the pathogen samples,disk diffusion method was used for drug susceptibility test,and SPSS 22.0 software was used to analyze the trend of drug resistance.Results:A total of 970 strains of nosocomial pathogens were detected in the three years.The main pathogens were Acinetobacter baumannii(133 strains,13.71%),Klebsiella pneumoniae(106 strains,10.93%),Pseudomonas aeruginosa(83 strains,8.56%),Escherichia coli(76 strains,7.84%)and Enterococcus faecium(69 strains,7.11%).The resistance rate of Acinetobacter baumannii to antibiotics was high.Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli had low resistance rates to carbapenems.The situation of bacterial drug resistance is still serious.Conclusion:The drug resistance of pathogenic bacteria collected from Class III Grade A Hospital’s patients to antibiotics was generally high.Therefore,clinical departments should strengthen the inspection of specimens of infection and drug sensitivity test in order to grasp the resistance mechanisms and drug resistance of pathogenic bacteria changes,and select appropriate antimicrobial agents according to the test results.Besides,the formation of drug-resistant strains also needs to be prevented,and the treatment of patients with severe infection needs to be improved.
文摘Introduction: Healthcare-associated infections (HAIs) are a public health issue. An infection is said to be associated with the care if it occurs during or after the care of a patient, and if it was neither present nor incubation at the beginning of the care. Objective: The purpose of this work was to study the bacteriology of infections associated with obstetric care in the gynecology-obstetrics department of CHU Gabriel Touré. Patients and Methods: This is an epidemiological, descriptive, analytical study conducted in the gynecology-obstetrics department of the CHU Gabriel Touré, from April 11th, 2016 to August 29th, 2016 (5 months). Data collection focused on the clinical and laboratory characteristics of healthcare-associated infections in patients during their hospitalization. Included in the study were any patients hospitalized in the Gynecology and Obstetrics Department who agreed to participate in the study. The criteria used to diagnose the associated infection were those of the Atlanta CDC. Operative wound monitoring was done up to the 30th postoperative day. Results: We have recorded 200 patients, out of whom 138 were operated on and 23 cases of bacterial infection associated with care (11.50%). The average age of the patients was 32.52 years ± 13.36 years against 29.36 years ± 10.28 years for the patients who did not present the infection. Seven point five percent of the evacuated patients had an infection associated with care. The most common types of infection were surgical site infection (60.86%), urinary tract infection (26.08%), endometritis and sepsis with 13.04% each. The isolated organisms were all resistant to Amoxicillin, to Amoxicillin + Clavulanic acid (88.88%) and to Ciprofloxacin (77.77%). The average duration of hospitalization for patients who developed the infection was 14.70 days. The lethality was 1.50%. The average cost of management of patients who developed the surgical site infection was 119,837 FCFA. Conclusion: The bacterial infections associated with the care remain frequent in our service and dominated by the infections of the operating site. Isolated organisms were all resistant to amoxicillin in 88.88% case ciprofloxacin.
文摘AIM To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis(N-SBP) given the rising importance of multidrug-resistant(MDR) bacteria.METHODS A literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15 th of November 2016, using the following search strategy: "spontaneous" AND "peritonitis".RESULTS The initial search through electronic databases retrieved 2556 records. After removing duplicates, 1958 records remained. One thousand seven hundred and thirty-five of them were excluded on the basis of the screening of titles and abstract, and the ensuing number of remaining articles was 223. Of these records, after careful evaluation, only 9 were included in the qualitative analysis. The overall proportion of MDR bacteria turned out to be from 22% to 73% of cases across the studies.CONCLUSION N-SBP is caused, in a remarkable proportion, by MDR pathogens. This should prompt a careful re-assessment of guidelines addressing the treatment of this clinical entity.
文摘Bacterial infections are highly prevalent and a frequent cause of hospitalization and short-term mortality in patients with cirrhosis. Due to their negative impact on survival, antibiotic prophylaxis for bacterial infections in high-risk subgroups of patients with cirrhosis has been the standard of care for decades. Patients with prophylaxis indications include those at risk for a first episode of spontaneous bacterial peritonitis(SBP) due to a low ascitic fluid protein count and impaired liver and kidney function, patients with a prior episode of SBP and those with an episode of gastrointestinal bleeding. Only prophylaxis due to gastrointestinal bleeding has a known and short-time duration. All other indications imply longlasting exposure to antibiotics-once the threshold requirement for initiating prophylaxis is met-without standardized criteria for re-assessing antibiotic interruption. Despite the fact that the benefit of antibiotic prophylaxis in reducing bacterial infections episodes and mortality has been thoroughly reported, the extended use of antibiotics in patients with cirrhosis has also had negative consequences, including the emergence of multi-drug resistant bacteria.Currently, it is not clear whether restricting the use of broad and fixed antibiotic regimens, tailoring the choice of antibiotics to local bacterial epidemiology or selecting non-antibiotic strategies will be the preferred antibiotic prophylaxis strategy for patients with cirrhosis in the future.
文摘AIM To determine risk factors, causative organisms and antimicrobial resistance of bacterial infections following living-donor liver transplantation(LDLT) in cirrhotic patients.METHODS This prospective study included 45 patients with hepatitis C virus-related end-stage liver disease who underwent LDLT at Ain Shams Center for Organ Transplant, Cairo, Egypt from January 2014 to November 2015. Patients were followed-up for the first 3 mo after LDLT for detection of bacterial infections. All patients were examined for the possible risk factors suggestive of acquiring infection pre-, intra-and post-operatively. Positive cultures based on clinical suspicion and patterns of antimicrobial resistance were identified. RESULTS Thirty-three patients(73.3%) suffered from bacterial infections; 21 of them had a single infection episode, and 12 had repeated infection episodes. Bile was the most common site for both single and repeated episodes of infection(28.6% and 27.8%, respectively). The most common isolated organisms were gramnegative bacteria. Acinetobacter baumannii was the most common organism isolated from both single and repeated infection episodes(19% and 33.3%, respectively), followed by Escherichia coli for repeated infections(11.1%), and Pseudomonas aeruginosa for single infections(19%). Levofloxacin showed high sensitivity against repeated infection episodes(P = 0.03). Klebsiella, Acinetobacter and Pseudomonas were multi-drug resistant(MDR). Pre-transplant hepatocellular carcinoma(HCC) and duration of drain insertion(in days) were independent risk factors for the occurrence of repeated infection episodes(P = 0.024).CONCLUSION MDR gram-negative bacterial infections are common post-LDLT. Pre-transplant HCC and duration of drain insertion were independent risk factors for the occurrence of repeated infection episodes.
文摘The adoption by health professionals to the practice of patient isolation is a decision that reduces patients’ risks of occupational exposure to potentially contaminated biological material and prevents nosocomial infections. Verify the compliance of health professionals to the practices of contact precautions in patients colonized by microorganisms in a teaching hospital. This was a prospective observational cohort study in a special-sized hospital located in southeastern Brazil. The observation of health professionals in delivery of health care to patients with contact precaution was performed regarding hand hygiene, use of overcoat, glove, and mask. We carried out 1502 observations involving the following professional categories: nursing technicians and/or nursing assistants (n = 1028;68.4%), nurses (n = 200;13.3%), physical therapists (n = 185;12.3%), and physicians (n = 89;5.9%), totaling 971.8 hours. Regarding the level of compliance of professionals to contact precaution practices with hand hygiene after the procedures, the use of overcoats, gloves, and masks, all were statistically significant (p Klebsiella pneumoniae was the most positive pathogen identified in laboratory tests. This study provided the mapping of the compliance of health professionals to the practices of contact precautions in order to support a safer management of patient care reducing the risks of Healthcare-Associated Infections (HAI). This study also showed that health professionals are using practice management to deal with their behavior to protect their health.