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Ul Haq I, Khan TA, Krukiewicz K. Etiology, pathology, and host-impaired immunity in medical implant-associated infections. J Infect Public Health 2024; 17:189-203. [PMID: 38113816 DOI: 10.1016/j.jiph.2023.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/20/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023] Open
Abstract
Host impaired immunity and pathogens adhesion factors are the key elements in analyzing medical implant-associated infections (MIAI). The infection chances are further influenced by surface properties of implants. This review addresses the medical implant-associated pathogens and summarizes the etiology, pathology, and host-impaired immunity in MIAI. Several bacterial and fungal pathogens have been isolated from MIAI; together, they form cross-kingdom species biofilms and support each other in different ways. The adhesion factors initiate the pathogen's adherence on the implant's surface; however, implant-induced impaired immunity promotes the pathogen's colonization and biofilm formation. Depending on the implant's surface properties, immune cell functions get slow or get exaggerated and cause immunity-induced secondary complications resulting in resistant depression and immuno-incompetent fibro-inflammatory zone that compromise implant's performance. Such consequences lead to the unavoidable and straightforward conclusion for the downstream transformation of new ideas, such as the development of multifunctional implant coatings.
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Affiliation(s)
- Ihtisham Ul Haq
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland; Joint Doctoral School, Silesian University of Technology, Akademicka 2A, 44-100 Gliwice, Poland; Programa de Pós-graduação em Inovação Tecnológica, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil.
| | - Taj Ali Khan
- Division of Infectious Diseases & Global Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States; Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar, Pakistan.
| | - Katarzyna Krukiewicz
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland; Centre for Organic and Nanohybrid Electronics, Silesian University of Technology, Konarskiego 22B, 44-100 Gliwice, Poland.
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Temsegen W, Gorems K, Mekonnen M, Fufa D, Kassa T. Fecal Carriage of Extended-Spectrum β-Lactamase and Carbapenemase-Producing Enterobacteriaceae Among Oncology and Non-Oncology Patients at Jimma Medical Center in Ethiopia: A Comparative Cross-Sectional Study. Cancer Manag Res 2023; 15:1217-1231. [PMID: 37933318 PMCID: PMC10625765 DOI: 10.2147/cmar.s422376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023] Open
Abstract
Purpose Extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Enterobacteriaceae (CPE) are among the major threats to global health because of their encoded protection against key antibiotics. Methods A comparative cross-sectional study was conducted among oncology and non-oncology patient groups (1:1; n = 214) on a consecutive sampling approach. Stool or rectal swab was collected from June 2021 to November 2021 and screened for ESBL-PE and CPE using ChromID-ESBL media. Confirmation for the enzymes was made by using combination disc and modified carbapenem inactivation methods, respectively. Disk diffusion method was used to determine antimicrobial susceptibility testing following the recommendations of CLSI 2022. SPSS software version 23 was used for data analysis. Results Fecal carriage prevalence of ESBL-PE was found in 90 (84.1%) of oncology participants and in 77 (71.9%) of non-oncology patients (p = 0.032). Escherichia coli was the most common ESBL-PE isolate in 82 (62.5%) and 68 (88.3%) of oncology and non-oncology patients, followed by Klebsiella oxytoca [15 (11.5%) versus 6 (7.8%)], respectively. Out of the total ESBL-PE isolates from both oncology and non-oncology patient groups, the maximum level of resistance was observed against ciprofloxacin 177 (86.3%), trimethoprim-sulfamethoxazole 103 (80.3%), tetracycline 97 (75.8%), whereas enhanced susceptibility was appreciated to tigecycline 200 (97.6%), meropenem 162 (79.0%), and ertapenem 145 (70.7%) with no significant difference between oncology and non-oncology group. Carbapenemase-producing isolates from oncology patients were 12 (11.2%), whereas it was 4 (3.7%) (p = 0.611) from non-oncology group. Bacterial isolates from oncology in this study showed a trend of multiple drug resistance of 113 (88.3%). Conclusion The results revealed alarmingly high carriage rates of ESBL and CPE among all study participants. Moreover, the isolates showed increased resistance rates to alternative drugs and had multiple antibiotic-resistant patterns. Hence, it is important to emphasize strict adherence to antimicrobial stewardship program as well as infection prevention and control practices.
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Affiliation(s)
- Wubalech Temsegen
- School of Medical Laboratory Science, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
- Microbiology Diagnostic Laboratory Unit of Jimma Medical Center, Jimma, Ethiopia
| | - Kasahun Gorems
- Microbiology Diagnostic Laboratory Unit of Jimma Medical Center, Jimma, Ethiopia
- Department of Microbiology, Immunology and Parsitology, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mekidim Mekonnen
- School of Medical Laboratory Science, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Diriba Fufa
- Department of Pediatrics & Child Health, School of Medicine, Jimma University, Jimma, Ethiopia
| | - Tesfaye Kassa
- School of Medical Laboratory Science, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
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Gerçeker GÖ, Bektaş M, Aydınok Y, Ören H, Ellidokuz H, Olgun N. The effect of virtual reality on pain, fear, and anxiety during access of a port with huber needle in pediatric hematology-oncology patients: Randomized controlled trial. Eur J Oncol Nurs 2020; 50:101886. [PMID: 33321461 DOI: 10.1016/j.ejon.2020.101886] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Port needle insertions are painful and distressing for Pediatric Hematology-Oncology patients. Virtual Reality (VR) can be used during needle-related procedures in these patients. This study aimed to investigate the effect of VR distraction during access to the venous port with a Huber needle in reducing needle-related pain, fear, and anxiety of children and adolescents with cancer. METHODS This randomized controlled study used a parallel trial design guided by the CONSORT checklist. The sample of children (n = 42) was allocated to the VR group (n = 21) and the control group (n = 21). Port needle-related pain was assessed using the Wong-Baker Faces Pain Rating Scale after the procedure. Before and after the port needle insertion procedure, anxiety and fear assessed using self- and parent-report using the Children's Anxiety Meter and Child Fear Scale. The primary outcome was the patient-reported pain scores after the procedure and fear and anxiety scores before and after the procedure. Pain, anxiety, and fear scores of the two groups and within groups were analyzed and also Spearman correlation analysis was used. RESULTS Self-reported pain scores of patients in the VR and control group were 2.4 ± 1.8 and 5.3 ± 1.8, respectively. This study found a statistically significant difference between groups in pain scores (p < .001). A statistically significant difference was found between groups according to the self- and parent-reported fear and anxiety scores after the procedure. Self-reported fear scores in the VR and control group were 0.8 ± 0.9, 2.0 ± 1.0, self-reported anxiety scores were 2.9 ± 2.0, 5.4 ± 2.0, respectively (p < .001). CONCLUSION Virtual reality is an effective distraction method in reducing port needle-related pain, fear, and anxiety in Pediatric Hematology-Oncology patients. ClinicalTrials.gov NCT04093154.
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Affiliation(s)
- Gülçin Özalp Gerçeker
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, 35340, Turkey.
| | - Murat Bektaş
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, 35340, Turkey.
| | - Yeşim Aydınok
- Ege University Hospital, Department of Paediatric Hematology-Oncology, Izmir, Turkey.
| | - Hale Ören
- Dokuz Eylül University Hospital, Department of Paediatric Hematology, Izmir, Turkey.
| | - Hülya Ellidokuz
- Dokuz Eylül University Hospital, Institue of Oncology, Izmir, Turkey.
| | - Nur Olgun
- Dokuz Eylül University Hospital, Department of Paediatric Oncology, Izmir, Turkey.
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Özalp Gerçeker G, Yardımcı F, Aydınok Y. Central Line-Associated Bloodstream Infections in Children With Hematologic and Oncologic Diseases: First Prevalence Results From a University Hospital. J Pediatr Oncol Nurs 2019; 36:327-336. [PMID: 31027430 DOI: 10.1177/1043454219844226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Central line-associated bloodstream infections (CLABSIs) are still a major cause of morbidity and mortality in pediatric hematology-oncology patients in many countries. This cross-sectional study was a retrospective review of CLABSI in inpatient pediatric hematology-oncology cases with long-term central venous catheter at the Pediatric Hematology Department from January 2013 to June 2014. Characteristics of CLABSI events in pediatric patients with hematologic malignancies and related nonmalignant hematologic conditions are documented. CLABSI developed in 61.8% (n = 21) of the 34 hospitalized patients included in the study. The CLABSI rate was 7.8 per 1,000 inpatient central venous catheter days. Coagulase-negative staphylococci was the predominant pathogen in 47.6% of the patients with CLABSI. The high rate of CLABSI requires prevention strategies to reduce CLABSI immediately. This study provides guidance in prioritizing strategies for reducing rates of infection.
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Medboua-Benbalagh C, Touati A, Kermas R, Gharout-Sait A, Brasme L, Mezhoud H, Touati D, Guillard T, de Champs C. Fecal Carriage of Extended-Spectrum β-Lactamase-ProducingEnterobacteriaceaeStrains Is Associated with Worse Outcome in Patients Hospitalized in the Pediatric Oncology Unit of Beni-Messous Hospital in Algiers, Algeria. Microb Drug Resist 2017; 23:757-763. [DOI: 10.1089/mdr.2016.0153] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Abdelaziz Touati
- Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, Bejaia, Algérie
| | - Rachida Kermas
- Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, Bejaia, Algérie
| | - Alima Gharout-Sait
- Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, Bejaia, Algérie
| | - Lucien Brasme
- Laboratoire de Bactériologie–Virologie-Hygiène Hospitalière, CHU Reims, Hôpital Robert DEBRE, Reims, France
- EA4687 SFR CAP-Santé [FED 4231], Université de Reims-Champagne-Ardenne, Reims, France
| | - Halima Mezhoud
- Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, Bejaia, Algérie
| | - Djamila Touati
- Laboratoire Mère et Enfant, CHU Beni-Messous, Alger, Algérie
| | - Thomas Guillard
- Laboratoire de Bactériologie–Virologie-Hygiène Hospitalière, CHU Reims, Hôpital Robert DEBRE, Reims, France
- EA4687 SFR CAP-Santé [FED 4231], Université de Reims-Champagne-Ardenne, Reims, France
| | - Christophe de Champs
- Laboratoire de Bactériologie–Virologie-Hygiène Hospitalière, CHU Reims, Hôpital Robert DEBRE, Reims, France
- EA4687 SFR CAP-Santé [FED 4231], Université de Reims-Champagne-Ardenne, Reims, France
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Gerçeker GÖ, Yardımcı F, Aydınok Y. Randomized controlled trial of care bundles with chlorhexidine dressing and advanced dressings to prevent catheter-related bloodstream infections in pediatric hematology-oncology patients. Eur J Oncol Nurs 2017; 28:14-20. [DOI: 10.1016/j.ejon.2017.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 11/28/2022]
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Al Balushi KA, Alzaabi MA, Alghafri F. Prescribing Pattern of Antifungal Medications at a Tertiary Care Hospital in Oman. J Clin Diagn Res 2016; 10:FC27-FC30. [PMID: 28208876 DOI: 10.7860/jcdr/2016/23591.9005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 09/21/2016] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Inappropriate use of antifungal agents is implicated in the global burden of antifungal resistance, adverse outcomes like persistent infections, unnecessary exposure and increased cost. Data collection from time to time is to be done in order to have a check on the resistance/sensitivity pattern of the commonly prescribed antifungal drugs. AIM To describe the pattern of antifungal drug prescription and administration to patients attending a university hospital in Oman. MATERIALS AND METHODS This was a descriptive, retrospective cross-sectional study conducted at Sultan Qaboos University Hospital (SQUH), a university hospital in Oman that covered the electronic patient's data for a period of one year (January 2013 to December 2013). The study included inpatients and outpatients of all ages and both genders attending SQUH and receiving antifungal medications at the study period. Frequencies and percentages were reported for categorical variables, while the mean and standard deviation were used to summarize the data for continuous variables. RESULTS A total of 1353 antifungal drug prescriptions were prescribed for 244 patients. More than half of all antifungal drug prescriptions were prescribed by haematology, infectious disease and family medicine departments. The majority of patients to whom these drugs were prescribed were diagnosed to have infectious diseases followed by prophylactic use in leukaemias and immunocompromised conditions. Fluconazole was the most commonly prescribed antifungal drug (n=715, 52.8%) followed by nystatin and voriconazole (n=233; 17.2% and n=152; 11.2%, respectively). CONCLUSION This study will help in understanding antifungal prescription practices and help in directing future studies and also in developing local policies for appropriate use of antifungal drugs.
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Affiliation(s)
- Khalid A Al Balushi
- Associate Professor, Department of Pharmacology and Clinical Pharmacy, Sultan Qaboos University , Al Khodh, Oman
| | - Mohammed A Alzaabi
- Associate Professor, Department of Pharmacology and Clinical Pharmacy, Sultan Qaboos University , Al Khodh, Oman
| | - Fatma Alghafri
- Biomedical Scientist, Department of Pathology, Sultan Qaboos University , Al Khodh, Oman
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Papp ZE, Horváth MA, Rat N, Băilă L. The Care of Central Venous Catheters in the Oncopediatric Department. JOURNAL OF INTERDISCIPLINARY MEDICINE 2016. [DOI: 10.1515/jim-2016-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Introduction: Childhood cancer, with its major psycho-social and health impact, needs long-term chemotherapy. Increasing the intensity of treatment results in improved outcomes of hematological malignancies and solid tumors. As cytostatics have a vascular irritating effect and multiple peripheric venous punctures cause pain, insertion of a long-term central venous catheter (CVC) during chemotherapy is often necessary.
Materials and methods: All pediatric patients (aged below 18 years) with hematologic and malignant pathologies who underwent CVC insertion at the Pediatric Hemato-oncology Department of the County Emergency Clinical Hospital of Tîrgu Mureș in the February 2014 – May 2016 period were enrolled in the study.
Results: We recorded 24 cases who received central venous catheters, out of which 14 patients received tunneled CVC, 7 patients port CVC, and 3 patients received initially tunneled CVC which was changed with port CVC. Tunneled catheters were preserved in average for 186.06 days and portacaths for 256.6 days. For infection prophylaxis and treatment every child received adequate antibiotic medication.
Conclusions: The use of central lines in pediatric hemato-oncology is accessible and benefic not only for increasing patient comfort, but also to ease the nurses' work, who are often overburdened.
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Affiliation(s)
- Zsuzsanna Erzsébet Papp
- Department of Pediatrics, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
| | - Mária-Adrienne Horváth
- Department of Pediatrics, County Emergency Clinical Hospital, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
| | - Nora Rat
- Clinic of Cardiology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
| | - Lucian Băilă
- Department of Anesthesy and Intensive Therapy, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
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