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GOLFERA MARCO, TOSCANO FABRIZIO, CEVENINI GABRIELE, DE MARCO MARIAF, PORCHIA BARBARAR, SERAFINI ANDREA, CERIALE EMMA, LENZI DANIELE, MESSINA GABRIELE. Predicting Healthcare-associated Infections: are Point of Prevalence Surveys data useful? JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E304-E309. [PMID: 35968075 PMCID: PMC9351422 DOI: 10.15167/2421-4248/jpmh2022.63.2.1496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 04/08/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Since 2012, the European Centre for Disease Prevention and Control (ECDC) promotes a point prevalence survey (PPS) of HAIs in European acute care hospitals. Through a retrospective analysis of 2012, 2015 and 2017 PPS of HAIs performed in a tertiary academic hospital in Italy, we developed a model to predict the risk of HAI. METHODS Following ECDC protocol we surveyed 1382 patients across three years. Bivariate logistic regression analyses were conducted to assess the relationship between HAI and several variables. Those statistically significant were included in a stepwise multiple regression model. The goodness of fit of the latter model was assessed with the Hosmer-Lemeshow test, ultimately constructing a probability curve to estimate the risk of developing HAIs. RESULTS Three variables resulted statistically significant in the stepwise logistic regression model: length of stay (OR 1.03; 95% CI: 1.02-1.05), devices breaking the skin (i.e. peripheral or central vascular catheter, OR 4.38; 95% CI: 1.52-12.63), urinary catheter (OR 4.71; 95% CI: 2.78-7.98). CONCLUSION PPSs are a convenient and reliable source of data to develop HAIs prediction models. The differences found between our results and previously published studies suggest the need of developing hospital-specific databases and predictive models for HAIs.
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Affiliation(s)
- MARCO GOLFERA
- Post Graduate School of Public Health, University of Siena, Italy
| | - FABRIZIO TOSCANO
- Post Graduate School of Public Health, University of Siena, Italy
| | | | | | | | - ANDREA SERAFINI
- Post Graduate School of Public Health, University of Siena, Italy
- Medical Management, “Misericordia” Hospital, AUSL Sud-Est Grosseto, Italy
| | - EMMA CERIALE
- Public Hygiene and Nutrition, “Ruffolo” Hospital, Siena, Italy
| | - DANIELE LENZI
- Medical Management, “Le Scotte” Teaching Hospital, Siena, Italy
| | - GABRIELE MESSINA
- Department of Molecular and Developmental Medicine, University of Siena, Italy
- Correspondence: Gabriele Messina, Department of Molecular and Developmental Medicine Area of Public Health. Via A. Moro, 2 Siena, 53100 Italy. Tel.: (+39) 0577-23-5423 - Fax: (+39) 0577-234090 - E-mail:
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Mustafa F, Koekemoer L, Green RJ, Turner AC, Becker P, van Biljon G. Successful antibiotic stewardship in hospitalised children in a developing nation. J Glob Antimicrob Resist 2020; 23:217-220. [DOI: 10.1016/j.jgar.2020.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/05/2020] [Accepted: 09/12/2020] [Indexed: 10/23/2022] Open
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Saleem Z, Hassali MA, Godman B, Versporten A, Hashmi FK, Saeed H, Saleem F, Salman M, Rehman IU, Khan TM. Point prevalence surveys of antimicrobial use: a systematic review and the implications. Expert Rev Anti Infect Ther 2020; 18:897-910. [PMID: 32394754 DOI: 10.1080/14787210.2020.1767593] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: In view of increasing concerns with antimicrobial resistance (AMR), the World Health Organization (WHO) instituted a Global Action Plan (GAP) to address this. Area covered: One of the strategies to achieve the goals of GAP is to conduct regular surveillance of antimicrobial use through point prevalence surveys (PPS). In this review, PubMed, EBSCO, Proquest, Cinahl, and Scopus were searched for PPS of antimicrobial use published in English between January 2000 and December 2019. After systematic database screening of 2,893 articles, 60 PPS met the inclusion criteria and consequently were incorporated in this systematic review. Expert opinion: This review highlighted that most of the PPS were conducted in upper-middle and high-income countries. Prevalence of antimicrobial use was significantly higher in non-European hospitals compared with European hospitals. The domination of third-generation cephalosporin and fluoroquinolones use across all the regions suggests substantial use of broad-spectrum antimicrobials across countries. Among all identified regions around the world, India was the region where the highest use of antimicrobials was observed. Although PPS is a useful tool to assess the pattern of antimicrobial use and provides a robust baseline; however, a standardized surveillance method is needed. In order to optimize antimicrobial use, more efforts are required to improve antimicrobial use.
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Affiliation(s)
- Zikria Saleem
- School of Pharmaceutical Sciences, Universiti Sains Malaysia , George Town, Malaysia.,Faculty of Pharmacy, The University of Lahore , Lahore, Pakistan
| | - Mohamed Azmi Hassali
- School of Pharmaceutical Sciences, Universiti Sains Malaysia , George Town, Malaysia
| | - Brian Godman
- Health Economics Centre, University of Liverpool Management School , Liverpool, UK.,Department of Clinical Pharmacology, Karolinska Institute , Stockholm, Sweden.,Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University , Glasgow, UK
| | - Ann Versporten
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp , Antwerp, Belgium
| | | | - Hamid Saeed
- University College of Pharmacy, University of the Punjab , Lahore, Pakistan
| | - Fahad Saleem
- Faculty of Pharmacy and Health Sciences, University of Balochistan , Quetta, Pakistan
| | - Muhammad Salman
- Faculty of Pharmacy, The University of Lahore , Lahore, Pakistan
| | - Inayat Ur Rehman
- Department of Pharmacy, Abdul Wali Khan University Mardan , Mardan, Pakistan.,School of Pharmacy, Monash University Malaysia , Bandar Sunway, Malaysia
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences , Lahore, Pakistan
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Elhajji FD, Al-Taani GM, Anani L, Al-Masri S, Abdalaziz H, Qabba'h SH, Al Bawab AQ, Scott M, Farren D, Gilmore F, Versporten A, Goossens H, Aldeyab MA. Comparative point prevalence survey of antimicrobial consumption between a hospital in Northern Ireland and a hospital in Jordan. BMC Health Serv Res 2018; 18:849. [PMID: 30419895 PMCID: PMC6233602 DOI: 10.1186/s12913-018-3656-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/28/2018] [Indexed: 12/04/2022] Open
Abstract
Background To assess antimicrobial prescribing in a Northern Ireland hospital (Antrim Area Hospital (AAH)) and compare them with those of a hospital in Jordan (Specialty Hospital). Methods Using the Global-PPS approach, the present study surveyed patients admitted to the hospital in 2015, the prescribed antibiotics, and a set of quality control indicators related to antibiotics. Results Ultimately, 444 and 112 inpatients in the AAH and the Specialty Hospital, respectively, were surveyed. For the medical group, 165 inpatients were prescribed 239 antibiotics in the AAH, while 44 patients in the Specialty Hospital were prescribed 65 antibiotics. In relation to the surgical group, 34 inpatients treated for infection were prescribed 66 antibiotics in the AAH, while 41 patients in the Specialty Hospital treated for infection were prescribed 56 antibiotics. For the medical patients, the most frequently prescribed antibiotics in the AAH were a combination of penicillins (18.8%) and penicillins with extended spectrum (18.8%). For the surgical patients, the most frequently prescribed antibiotics in the AAH were imidazole derivatives (24.2%). For the medical and surgical patients in the Specialty Hospital, the most frequently prescribed antibiotics were third-generation cephalosporins (26.2 and 37.5%, respectively). In medical patients, compliance to guidelines was 92.2% in the Specialty Hospital compared to 72.0% in the AAH (p < 0.001). In surgical patients, compliance to guidelines was 92.7% in the Specialty Hospital compared to 81.8% in the AAH (p = 0.012). Conclusions The present study highlighted differences in the utilisation of antimicrobials between two hospitals in two distinct regions and benchmarked antibiotic prescriptions across two hospitals.
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Affiliation(s)
- Feras Darwish Elhajji
- Department of Clinical Pharmacy & Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
| | | | - Lana Anani
- The Pharmacy Department, The Specialty Hospital, Amman, Jordan
| | - Sahar Al-Masri
- Quality & Medication Management, The Specialty Hospital, Amman, Jordan
| | - Haneen Abdalaziz
- Department of Clinical Pharmacy & Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | | | | | - Michael Scott
- Northern Health and Social Care Trust, Antrim, Ballymena, Northern Ireland, UK
| | - David Farren
- Northern Health and Social Care Trust, Antrim, Ballymena, Northern Ireland, UK
| | - Fiona Gilmore
- Northern Health and Social Care Trust, Antrim, Ballymena, Northern Ireland, UK
| | - Ann Versporten
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Mamoon A Aldeyab
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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Antimicrobial photodynamic effect of phenothiazinic photosensitizers in formulations with ethanol on Pseudomonas aeruginosa biofilms. Photodiagnosis Photodyn Ther 2015; 13:291-296. [PMID: 26315922 DOI: 10.1016/j.pdpdt.2015.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/05/2015] [Accepted: 08/20/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND DATA Methylene blue (MB) and toluidine blue (TB) are recognized as safe photosensitizers (Ps) for use in humans. The clinical effectiveness of the antimicrobial photodynamic therapy with MB and TB needs to be optimized, and ethanol can increase their antimicrobial effect. Formulations of MB and TB containing ethanol were evaluated for their ability to produce singlet oxygen and their antibacterial effect on Pseudomonas aeruginosa biofilms. METHODS Photoactivated formulations were prepared by diluting the Ps (250 μM) in buffered water (pH 5.6, sodium acetate/acetic acid), 10% ethanol (buffer: ethanol, 90:10), or 20% ethanol (buffer: ethanol, 80:20). Biofilms also were exposed to the buffer, 10% ethanol, or 20% ethanol without photoactivation. Untreated biofilm was considered the control group. The production of singlet oxygen in the formulations was measured based on the photo-oxidation of 1,3-diphenylisobenzofuran. The photo-oxidation and CFU (log10) data were evaluated by two-way ANOVA and post-hoc Tukey's tests. RESULTS In all the formulations, compared to TB, MB showed higher production of singlet oxygen. In the absence of photoactivation, neither the buffer nor the 10% ethanol solution showed any antimicrobial effect, while the 20% ethanol solution significantly reduced bacterial viability (P=0.009). With photoactivation, only the formulations containing MB and both 10% and 20% ethanol solutions significantly reduced the viability of P. aeruginosa biofilms when compared with the control. CONCLUSIONS MB formulations containing ethanol enhanced the antimicrobial effect of the photodynamic therapy against P. aeruginosa biofilms in vitro.
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