To identify risk factors for A. baumannii infection in patients hospitalized in an Intensive Care Unit (ICU) of a tertiary public hospital in Paraná, Brazil, a retrospective paired case-control study (ratio 1:2) ...To identify risk factors for A. baumannii infection in patients hospitalized in an Intensive Care Unit (ICU) of a tertiary public hospital in Paraná, Brazil, a retrospective paired case-control study (ratio 1:2) was conducted from January 2018 to December 2020. Patients in the case group were hospitalized in the ICU with A. baumanni (n = 68 cases) and were compared with patients in the control group, without infection by A. baumannii (n = 136). Both were matched by age (±10 years), sex, and ICU stay (±5 days). Conditional multiple logistic regression was used to determine statistically significant risk factors based on the results of bivariate analyses. Mortality was higher in infected (cases) than in non-infected patients (51.5% vs. 39.7%). The incidence and bacterial resistance increased annually. At bivariate analysis, cases had longer hospital stays (median 35 vs. 22 days, p A. baumannii and antimicrobial resistance. There is need for surveillance, and constant evaluation of control actions. Risk factors were colonization, previous hospitalization, and hospitalization time. This is essential for the decision-making of professionals and optimization of prevention, control, and therapeutic management actions.展开更多
Over the last three decades, Acinetobacter has gained importance as a leading nosocomial pathogen, partly due to its impressive genetic capabilities to acquire resistance and partly due to high selective pressure, esp...Over the last three decades, Acinetobacter has gained importance as a leading nosocomial pathogen, partly due to its impressive genetic capabilities to acquire resistance and partly due to high selective pressure, especially in critical care units. This low-virulence organism has turned into a multidrug resistant pathogen and now alarming healthcare providers worldwide. Acinetobacter baumanni(A. baumannii) is a major species, contributing about 80% of all Acinetobacter hospital-acquired infections. It disseminates antibiotic resistance by virtue of its extraordinary ability to accept or donate resistance plasmids. The procedures for breaking the route of transmission are still proper hand washing and personal hygiene(both the patient and the healthcare professional), reducing patient's biofilm burden from skin, and judicious use of antimicrobial agents. The increasing incidence of extended-spectrum beta-lactamases and carbapenemases in A. baumannii leaves almost no cure for these "bad bugs".To control hospital outbreaks of multidrug resistantAcinetobacter infection, we need to contain their dissemination or require new drugs or a rational combination therapy. The optimal treatment for multidrug-resistant A. baumannii infection has not been clearly established, and empirical therapy continues to require knowledge of susceptibility patterns of isolates from one's own institution. This review mainly focused on general features and introduction to A. baumannii and its epidemiological status, potential sources of infection, risk factors, and strategies to control infection to minimize spread.展开更多
INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefor...INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission展开更多
Objective: To explore the risk factors of nosocomial infection in severe craniocerebral trauma and the way of prevention.Methods: The clinical data of 387 patients with severe craniocerebral trauma were reviewed.Resul...Objective: To explore the risk factors of nosocomial infection in severe craniocerebral trauma and the way of prevention.Methods: The clinical data of 387 patients with severe craniocerebral trauma were reviewed.Results: The total nosocomial infection rate of this study was 22.99 %. Pulmonary nosocomial infection presented most frequently. The G bacilli were the most common infectious bacteria. The mortality rate of the infection group was 38.20 %.Conclusions: Complications of nosocomial infection affect the prognosis of craniocerebral trauma patients. Nosocomial infection is related to the age of the patients, craniocerebral trauma severity, unreasonable utilization of antibiotics and invasive operations, such as tracheal cannula, mechanical ventilation, urethral catheterization and deep venous catheterization. Patients with severe craniocerebral trauma should be carefully treated and nursed to avoid nosocomial infection. In order to reduce the rate of nosocomial infection, intensive measurement should be adopted.展开更多
文摘To identify risk factors for A. baumannii infection in patients hospitalized in an Intensive Care Unit (ICU) of a tertiary public hospital in Paraná, Brazil, a retrospective paired case-control study (ratio 1:2) was conducted from January 2018 to December 2020. Patients in the case group were hospitalized in the ICU with A. baumanni (n = 68 cases) and were compared with patients in the control group, without infection by A. baumannii (n = 136). Both were matched by age (±10 years), sex, and ICU stay (±5 days). Conditional multiple logistic regression was used to determine statistically significant risk factors based on the results of bivariate analyses. Mortality was higher in infected (cases) than in non-infected patients (51.5% vs. 39.7%). The incidence and bacterial resistance increased annually. At bivariate analysis, cases had longer hospital stays (median 35 vs. 22 days, p A. baumannii and antimicrobial resistance. There is need for surveillance, and constant evaluation of control actions. Risk factors were colonization, previous hospitalization, and hospitalization time. This is essential for the decision-making of professionals and optimization of prevention, control, and therapeutic management actions.
文摘Over the last three decades, Acinetobacter has gained importance as a leading nosocomial pathogen, partly due to its impressive genetic capabilities to acquire resistance and partly due to high selective pressure, especially in critical care units. This low-virulence organism has turned into a multidrug resistant pathogen and now alarming healthcare providers worldwide. Acinetobacter baumanni(A. baumannii) is a major species, contributing about 80% of all Acinetobacter hospital-acquired infections. It disseminates antibiotic resistance by virtue of its extraordinary ability to accept or donate resistance plasmids. The procedures for breaking the route of transmission are still proper hand washing and personal hygiene(both the patient and the healthcare professional), reducing patient's biofilm burden from skin, and judicious use of antimicrobial agents. The increasing incidence of extended-spectrum beta-lactamases and carbapenemases in A. baumannii leaves almost no cure for these "bad bugs".To control hospital outbreaks of multidrug resistantAcinetobacter infection, we need to contain their dissemination or require new drugs or a rational combination therapy. The optimal treatment for multidrug-resistant A. baumannii infection has not been clearly established, and empirical therapy continues to require knowledge of susceptibility patterns of isolates from one's own institution. This review mainly focused on general features and introduction to A. baumannii and its epidemiological status, potential sources of infection, risk factors, and strategies to control infection to minimize spread.
基金Scientific Research Foundation,State Health Commission,No.96-2-128
文摘INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission
文摘Objective: To explore the risk factors of nosocomial infection in severe craniocerebral trauma and the way of prevention.Methods: The clinical data of 387 patients with severe craniocerebral trauma were reviewed.Results: The total nosocomial infection rate of this study was 22.99 %. Pulmonary nosocomial infection presented most frequently. The G bacilli were the most common infectious bacteria. The mortality rate of the infection group was 38.20 %.Conclusions: Complications of nosocomial infection affect the prognosis of craniocerebral trauma patients. Nosocomial infection is related to the age of the patients, craniocerebral trauma severity, unreasonable utilization of antibiotics and invasive operations, such as tracheal cannula, mechanical ventilation, urethral catheterization and deep venous catheterization. Patients with severe craniocerebral trauma should be carefully treated and nursed to avoid nosocomial infection. In order to reduce the rate of nosocomial infection, intensive measurement should be adopted.
