Methicillin-Resistant Staphylococcus aureus: The Effects Are More Than Skin Deep

Impact of lockdown due to COVID-19 pandemic in changes of prevalence of predictive psychiatric disorders among children and adolescents in Bangladesh

Lockdown, isolation, quarantine and social distancing are proved to be only effective measures to prevent and tackle COVID-19 till date. Unfortunately, these measures have caused physical, economical and mental health problems. Children and adolescents are not immune to the adverse mental health effect due to the new changes. Research around the globe shows children and adolescents are suffering from an increased number of depressive symptoms, clinginess, inattention, irritability and worry. This cross-sectional online-based survey type study was aimed to get a snapshot of the prevalence of predictive psychiatric disorders in the child and adolescent population in Bangladesh before and during lockdown. Validated Bangla parent version of Strengths and Difficulties Questionnaire was used to assess the psychopathology among subjects. Total sample was 552 aged from 4-17 years. Boy-girl ratio was 1.3:1. Prevalence of any predictive psychiatric disorder before lockdown was 20.5 % and within lockdown was 39.7 % and the difference was highly significant (P < 0.001). Prevalence of emotional, conduct disorder and hyperactivity were also increased significantly during the lockdown period than before. Conduct disorder and hyperactivity were more prevalent among boys both before and within lockdown. In contrast, prevalence of emotional disorder was higher among girls before lockdown but within the lockdown period, the boy-girl prevalence was almost the same. This study shows the new extreme measures to tackle COVID-19 has a disaster impact on mental health of children and adolescents. Subsequent studies and support should be developed to prevent conditions getting worse.

Psychological burden of quarantine in children and adolescents: A rapid systematic review and proposed solutions

As COVID-19 grips the world, many people are quarantined or isolated resulting in adverse consequences for the mental health of youth. This rapid review takes into account the impact of quarantine on mental health of children and adolescents, and proposes measures to improve psychological outcomes of isolation. Three electronic databases including PubMed, Scopus, and ISI Web of Science were searched. Two independent reviewers performed title and abstract screening followed by full-text screening. This review article included 10 studies. The seven studies before onset of COVID 19 about psychological impact of quarantine in children have reported isolation, social exclusion stigma and fear among the children. The most common diagnoses were acute stress disorder, adjustment disorder, grief, and post-traumatic stress disorder. Three studies during the COVID-19 pandemic reported restlessness, irritability, anxiety, clinginess and inattention with increased screen time in children during quarantine. These adverse consequences can be tackled through carefully formulated multilevel interventions.

Evaluation in general practice of the patient's feelings about a recent hospitalization and isolation for a multidrug-resistant infection

BACKGROUND

Isolation precautions used against multidrug-resistant (MDR) organisms are responsible for many emotional side effects. We evaluated patient's feeling after a hospitalization for an MDR infection.

METHODS

We conducted a qualitative study that included 11 interviews from August 2017 to June 2018. We used phenomenology and verbatim transcription analysis was performed using NVivo software. Patients reported mainly negative feelings. Among them, 4 main themes were expressed: a desire to "be free from carriage," self-questioning regarding its nosocomial origin, the reduction of the therapeutic arsenal, and the expression of many fears especially relapse.

RESULTS

For most of the participants (n = 6/11), the type of bacteria that colonized their digestive tract was precisely known including the MDR characteristics of the infection. Participants were convinced that the infection was strongly linked to the hospital and considered it as nosocomial that led to anxiety, especially regarding the origin of the infection and the absence of formal source of infection.

CONCLUSIONS

MDR infections are negatively impacting patient's lived experience even after hospital discharge, partly owing to prior implementation of isolation precautions. We need to improve communication between specialists and general practitioners to reassure the patient and his surroundings regarding the anxiety resulting from such hospitalization.

Prevention Strategies for Recurrent Community-Associated Staphylococcus aureus Skin and Soft Tissue Infections

PURPOSE OF REVIEW

Staphylococcus aureus skin and soft tissue infections (SSTI) are a major source of morbidity. More than half of patients experiencing SSTI will have at least one recurrent infection. These infections frequently cluster in households. Given the burden these infections pose to patients and healthcare, prevention strategies are of major clinical importance and represent an active area of research. Bacterial colonization is frequently an early and critical step in the pathogenesis of infection. As such, strategies to prevent reinfection have aimed to decrease staphylococcal colonization of the skin and mucus membranes, a process referred to as decolonization.

RECENT FINDINGS

Treatment of acute SSTI with incision and drainage and systemic antibiotics is the mainstay of therapy for healing of the acute infection. Systemic antibiotics also provide benefit through reduced incidence of recurrent SSTI. Education for patients and families regarding optimization of personal and household hygiene measures, and avoidance of sharing personal hygiene items, is an essential component in prevention efforts. For patients experiencing recurrent SSTI, or in households in which multiple members have experienced SSTI, decolonization should be recommended for all household members. A recommended decolonization regimen includes application of intranasal mupirocin and antiseptic body washes with chlorhexidine or dilute bleach water baths. For patients who continue to experience recurrent SSTI, periodic decolonization should be considered. Personal decolonization with topical antimicrobials and antiseptics reduces the incidence of recurrent S. aureus SSTI. Future avenues for investigation include strategies for household environmental decontamination as well as manipulation of the host microbiota.