1
|
Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, Todi SK, Mohan A, Hegde A, Jagiasi BG, Krishna B, Rodrigues C, Govil D, Pal D, Divatia JV, Sengar M, Gupta M, Desai M, Rungta N, Prayag PS, Bhattacharya PK, Samavedam S, Dixit SB, Sharma S, Bandopadhyay S, Kola VR, Deswal V, Mehta Y, Singh YP, Myatra SN. Guidelines for Antibiotics Prescription in Critically Ill Patients. Indian J Crit Care Med 2024; 28:S104-S216. [PMID: 39234229 PMCID: PMC11369928 DOI: 10.5005/jp-journals-10071-24677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/20/2024] [Indexed: 09/06/2024] Open
Abstract
How to cite this article: Khilnani GC, Tiwari P, Mittal S, Kulkarni AP, Chaudhry D, Zirpe KG, et al. Guidelines for Antibiotics Prescription in Critically Ill Patients. Indian J Crit Care Med 2024;28(S2):S104-S216.
Collapse
Affiliation(s)
- Gopi C Khilnani
- Department of Pulmonary, Critical Care and Sleep Medicine, PSRI Hospital, New Delhi, India
| | - Pawan Tiwari
- Department of Pulmonary, Critical Care and Sleep Medicine, AIIMS, New Delhi, India
| | - Saurabh Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, AIIMS, New Delhi, India
| | - Atul P Kulkarni
- Division of Critical Care Medicine, Department of Anaesthesia, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Dhruva Chaudhry
- Department of Pulmonary and Critical Care Medicine, University of Health Sciences, Rohtak, Haryana, India
| | - Kapil G Zirpe
- Department of Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Subhash K Todi
- Department of Critical Care, AMRI Hospital, Kolkata, West Bengal, India
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, AIIMS, New Delhi, India
| | - Ashit Hegde
- Department of Medicine & Critical Care, P D Hinduja National Hospital, Mumbai, India
| | - Bharat G Jagiasi
- Department of Critical Care, Kokilaben Dhirubhai Ambani Hospital, Navi Mumbai, Maharashtra, India
| | - Bhuvana Krishna
- Department of Critical Care Medicine, St John's Medical College and Hospital, Bengaluru, India
| | - Camila Rodrigues
- Department of Microbiology, P D Hinduja National Hospital, Mumbai, India
| | - Deepak Govil
- Department of Critical Care and Anesthesia, Medanta – The Medicity, GuruGram, Haryana, India
| | - Divya Pal
- Department of Critical Care and Anesthesia, Medanta – The Medicity, GuruGram, Haryana, India
| | - Jigeeshu V Divatia
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Manju Sengar
- Department of Medical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Mansi Gupta
- Department of Pulmonary Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Mukesh Desai
- Department of Immunology, Pediatric Hematology and Oncology Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Narendra Rungta
- Department of Critical Care & Anaesthesiology, Rajasthan Hospital, Jaipur, India
| | - Parikshit S Prayag
- Department of Transplant Infectious Diseases, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
| | - Pradip K Bhattacharya
- Department of Critical Care Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Srinivas Samavedam
- Department of Critical Care, Ramdev Rao Hospital, Hyderabad, Telangana, India
| | - Subhal B Dixit
- Department of Critical Care, Sanjeevan and MJM Hospital, Pune, Maharashtra, India
| | - Sudivya Sharma
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Susruta Bandopadhyay
- Department of Critical Care, AMRI Hospitals Salt Lake, Kolkata, West Bengal, India
| | - Venkat R Kola
- Department of Critical Care Medicine, Yashoda Hospitals, Hyderabad, Telangana, India
| | - Vikas Deswal
- Consultant, Infectious Diseases, Medanta - The Medicity, Gurugram, Haryana, India
| | - Yatin Mehta
- Department of Critical Care and Anesthesia, Medanta – The Medicity, GuruGram, Haryana, India
| | - Yogendra P Singh
- Department of Critical Care, Max Super Speciality Hospital, Patparganj, New Delhi, India
| | - Sheila N Myatra
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| |
Collapse
|
2
|
Al Banna MH, Khan MSI, Rezyona H, Seidu AA, Abid MT, Ara T, Kundu S, Ahinkorah BO, Hagan, Jr. JE, Tareq MA, Begum MR, Chowdhury MFT, Schack T. Assessment of Food Safety Knowledge, Attitudes and Practices of Food Service Staff in Bangladeshi Hospitals: A Cross-Sectional Study. Nutrients 2022; 14:nu14122540. [PMID: 35745271 PMCID: PMC9227153 DOI: 10.3390/nu14122540] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 12/04/2022] Open
Abstract
Food safety knowledge, attitudes and practices among hospital food service staff are crucial in the prevention of foodborne disease outbreaks, as hospitalized patients are more vulnerable to potential hazards. This study, therefore, sought to assess the food safety knowledge, attitudes and practices of food service staff in Bangladeshi hospitals. A cross-sectional study was conducted among 191 food service staff from seven different hospitals in Dhaka and Chattogram from October 2021 to March 2022 using pretested questionnaires. Multiple linear regression was used to identify the factors associated with the food safety knowledge, attitudes and practices. The findings showed moderate knowledge but high levels of attitudes and practices of food safety among hospital food handlers. Food safety knowledge was significantly higher among males, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations. Moreover, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations had more positive attitudes and better practices regarding food safety. Hospital management should consider these factors for enhancing food handlers’ knowledge and increase training and supervision on food safety practices to reduce foodborne diseases and outbreaks.
Collapse
Affiliation(s)
- Md. Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.H.A.B.); (M.S.I.K.); (M.A.T.)
| | - Md Shafiqul Islam Khan
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.H.A.B.); (M.S.I.K.); (M.A.T.)
| | - Humayra Rezyona
- Department of Food and Nutrition, College of Home Economics, Azimpur, Dhaka 1205, Bangladesh; (H.R.); (T.A.)
| | - Abdul-Aziz Seidu
- Department of Real Estate Management, Takoradi Technical University, Takoradi P.O. Box 256, Ghana;
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi P.O. Box 256, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville 4811, Australia
| | - Mohammad Tazrian Abid
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.T.A.); or (S.K.)
| | - Tasnu Ara
- Department of Food and Nutrition, College of Home Economics, Azimpur, Dhaka 1205, Bangladesh; (H.R.); (T.A.)
| | - Satyajit Kundu
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.T.A.); or (S.K.)
- School of Public Health, Southeast University, Nanjing 210009, China
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney 2007, Australia;
| | - John Elvis Hagan, Jr.
- Department of Health, Physical Education & Recreation, College of Education Studies, University of Cape Coast, Cape Coast PMB TF0494, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany;
- Correspondence:
| | - Md. Abu Tareq
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh; (M.H.A.B.); (M.S.I.K.); (M.A.T.)
| | - Musammet Rasheda Begum
- Department of Agricultural Economics and Social Sciences, Chattogram Veterinary and Animal Sciences University, Chattogram 4225, Bangladesh;
| | | | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Postfach 10 01 31, 33501 Bielefeld, Germany;
| |
Collapse
|
3
|
Prevalence, Molecular Diversity, and Antimicrobial Resistance Patterns of Pathogenic Bacteria Isolated From Medical Foods, Food Staff, Cooking Instruments, and Clinical Samples in a Teaching Hospital in Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2017. [DOI: 10.5812/archcid.62421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
4
|
Lazarević K, Stojanović D, Bogdanović DC, Dolićanin ZĆ. Hygiene Training of Food Handlers in Hospital Settings: Important Factor in the Prevention of Nosocomial Infections. Cent Eur J Public Health 2013; 21:146-9. [DOI: 10.21101/cejph.a3843] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
5
|
Boschi T, Aquilini D, Degl'Innocenti R, Aleo A, Romani C, Nicoletti P, Buonomini MI, Marconi P, Bilei S, Mammina C, Nastasi A. Cluster of cases of Salmonella enterica serotype Rissen infection in a general hospital, Italy, 2007. Zoonoses Public Health 2011; 57:518-22. [PMID: 19912602 DOI: 10.1111/j.1863-2378.2009.01272.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In 2007, three strains of Salmonella enterica serotype Rissen (S. Rissen) were isolated in the laboratory of diagnostic microbiology of the General Hospital of Prato, Tuscany, Italy, over a 1 month and half interval of time. The first isolate was recovered on January 26 from an outpatient with enteritis. Then, two strains were isolated on February 16 and March 11 respectively, from central venous catheters of patients who were being hospitalized in two departments of the Hospital. An epidemiologically linked cluster of cases of salmonellosis was suspected. The three strains were submitted to single enzyme-amplified fragment length polymorphism (SE-AFLP) and XbaI macrorestriction and pulsed-field gel electrophoresis (PFGE) that yielded undistinguishable profiles. Epidemiological investigations failed to identify a common source of infection within the Hospital. Moreover, the third patient had been exclusively total parenteral nutrition fed since his admission with a stomach cancer diagnosis. The first patient had a community-acquired infection, but the source of her illness was uncertain. Twenty-five further isolates identified in the years 2004-2007 in the same geographical area showed distinctly different PFGE and SE-AFLP patterns. The three patients seemed to represent a cluster of epidemiologically unrelated cases caused by a previously never recognized S. Rissen strain. Rapid subtyping of isolates is essential in the early investigation of potential outbreaks, but synthesis of conventional and molecular epidemiological investigation and availability of surveillance data is often critical to prevent the initiation of time-consuming, expensive and ineffective further investigations and control interventions.
Collapse
Affiliation(s)
- T Boschi
- Nucleo Operativo Infezioni Ospedaliere, General Hospital of Prato, Prato, Italy
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Recognition and prevention of hospital-associated enteric infections in the intensive care unit. Crit Care Med 2010; 38:S324-34. [PMID: 20647790 DOI: 10.1097/ccm.0b013e3181e69f05] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The objectives of this article were to review the causes and extent of hospital-associated infectious diarrhea and associated risks in the general hospital ward and intensive care unit (ICU), to compare microorganisms with similar symptoms to aid in recognition that will lead to timely and appropriate treatment and control measures, and to propose infection prevention protocols that could decrease human process errors in the ICU. This literature review describes epidemiology, comparison of microbial characteristics for potential hospital-associated enteric pathogens, diagnosis, and prevention, especially if important in the ICU, and particularly in regard to Clostridium difficile. Enteric organisms that most commonly cause hospital-associated infectious diarrhea in acute care settings and the ICU are C. difficile, rotavirus, and norovirus, although others may also be important, particularly in developing countries. To recognize and control infectious diarrhea successfully in the ICU, intensivists should be aware that epidemiology, risks, and prevention measures may differ between these microorganisms. In addition, intensivists should be ready to implement systems changes related to notification, isolation precautions and prevention, and environmental cleaning in the ICU.
Collapse
|
7
|
Knowledge, attitudes and self-reported practices of food service staff regarding food hygiene in Edirne, Turkey. Food Control 2009. [DOI: 10.1016/j.foodcont.2008.08.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
Frank C, Buchholz U, Maaß M, Schröder A, Bracht KH, Domke PG, Rabsch W, Fell G. Protracted outbreak of S. Enteritidis PT 21c in a large Hamburg nursing home. BMC Public Health 2007; 7:243. [PMID: 17854497 PMCID: PMC2194771 DOI: 10.1186/1471-2458-7-243] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 09/13/2007] [Indexed: 11/18/2022] Open
Abstract
Background During August 2006, a protracted outbreak of Salmonella (S.) Enteritidis infections in a large Hamburg nursing home was investigated. Methods A site visit of the home was conducted and food suppliers' premises tested for Salmonella. Among nursing home residents a cohort study was carried out focusing on foods consumed in the three days before the first part of the outbreak. Instead of relying on residents' memory, data from the home's patient food ordering system was used as exposure data. S. Enteritidis isolates from patients and suspected food vehicles were phage typed and compared. Results Within a population of 822 nursing home residents, 94 case patients among residents (1 fatality) and 17 among staff members were counted 6 through 29 August. The outbreak peaked 7 through 9 August, two days after a spell of very warm summer weather. S. Enteritidis was consistently recovered from patients' stools throughout the outbreak. Among the food items served during 5 through 7 August, the cohort study pointed to afternoon cake on all three days as potential risk factors for disease. Investigation of the bakery supplying the cake yielded S. Enteritidis from cakes sampled 31 August. Comparison of the isolates by phage typing demonstrated both isolates from patients and the cake to be the exceedingly rare phage type 21c. Conclusion Cake (various types served on various days) contaminated with S. Enteritidis were the likely vehicle of the outbreak in the nursing home. While the cakes were probably contaminated with low pathogen dose throughout the outbreak period, high ambient summer temperatures and failure to keep the cake refrigerated led to high pathogen dose in cake on some days and in some of the housing units. This would explain the initial peak of cases, but also the drawn out nature of the outbreak with cases until the end of August. Suggestions are made to nursing homes, aiding in outbreak prevention. Early outbreak detection is crucial, such that counter measures can be swift and drawn-out outbreaks of nosocomial food-borne infections avoided.
Collapse
Affiliation(s)
- Christina Frank
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Udo Buchholz
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Monika Maaß
- Institute for Hygiene and the Environment, Hamburg, Germany
| | | | | | | | - Wolfgang Rabsch
- National Reference Centre for Salmonella and other Enteric Pathogens, Robert Koch Institute, Wernigerode, Germany
| | - Gerhard Fell
- Institute for Hygiene and the Environment, Hamburg, Germany
| |
Collapse
|
9
|
Buccheri C, Casuccio A, Giammanco S, Giammanco M, La Guardia M, Mammina C. Food safety in hospital: knowledge, attitudes and practices of nursing staff of two hospitals in Sicily, Italy. BMC Health Serv Res 2007; 7:45. [PMID: 17407582 PMCID: PMC1852552 DOI: 10.1186/1472-6963-7-45] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 04/03/2007] [Indexed: 11/13/2022] Open
Abstract
Background Food hygiene in hospital poses peculiar problems, particularly given the presence of patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. Moreover, in nosocomial outbreaks of infectious intestinal disease, the mortality risk has been proved to be significantly higher than the community outbreaks and highest for foodborne outbreaks. On the other hand, the common involvement in the role of food handlers of nurses or domestic staff, not specifically trained about food hygiene and HACCP, may represent a further cause of concern. The purpose of this study was to evaluate knowledge, attitudes, and practices concerning food safety of the nursing staff of two hospitals in Palermo, Italy. Association with some demographic and work-related determinants was also investigated. Methods The survey was conducted, by using a semi-structured questionnaire, in March-November 2005 in an acute general hospital and a paediatric hospital, where nursing staff is routinely involved in food service functions. Results Overall, 401 nurses (279, 37.1%, of the General Hospital and 122, 53.5%, of the Paediatric Hospital, respectively) answered. Among the respondents there was a generalized lack of knowledge about etiologic agents and food vehicles associated to foodborne diseases and proper temperatures of storage of hot and cold ready to eat foods. A general positive attitude towards temperature control and using clothing and gloves, when handling food, was shared by the respondents nurses, but questions about cross-contamination, refreezing and handling unwrapped food with cuts or abrasions on hands were frequently answered incorrectly. The practice section performed better, though sharing of utensils for raw and uncooked foods and thawing of frozen foods at room temperatures proved to be widely frequent among the respondents. Age, gender, educational level and length of service were inconsistently associated with the answer pattern. More than 80% of the respondent nurses did not attend any educational course on food hygiene. Those who attended at least one training course fared significantly better about some knowledge issues, but no difference was detected in both the attitude and practice sections. Conclusion Results strongly emphasize the need for a safer management of catering in the hospitals, where non professional food handlers, like nursing or domestic staff, are involved in food service functions.
Collapse
Affiliation(s)
- Cecilia Buccheri
- Division of Physiology and Human Nutrition, Department of Medicine, Pneumology, Physiology and Human Nutrition, University, Via A. Elia, 90127 Palermo, Italy
| | - Alessandra Casuccio
- Department of Clinical Neurosciences, University, Via L. Giuffrè, 90127 Palermo, Italy
| | - Santo Giammanco
- Division of Physiology and Human Nutrition, Department of Medicine, Pneumology, Physiology and Human Nutrition, University, Via A. Elia, 90127 Palermo, Italy
| | - Marco Giammanco
- Division of Physiology and Human Nutrition, Department of Medicine, Pneumology, Physiology and Human Nutrition, University, Via A. Elia, 90127 Palermo, Italy
| | - Maurizio La Guardia
- Division of Physiology and Human Nutrition, Department of Medicine, Pneumology, Physiology and Human Nutrition, University, Via A. Elia, 90127 Palermo, Italy
| | - Caterina Mammina
- Department of Hygiene and Microbiology "G. D'Alessandro", University, Via del Vespro 133, 90127 Palermo, Italy
| |
Collapse
|
10
|
Abstract
Acute infectious diarrhea is a yearly occurrence for most Americans, and is associated with 1 million hospitalizations and about 6000 deaths in the United States annually. Up to 80% of acute infectious diarrhea is caused by noroviruses, which produce a clinically mild illness with a predictable short course and good outcome that make laboratory testing and antimicrobial treatment unnecessary. Most diarrhea-causing bacteria and protozoa can cause a clinical illness "like norovirus"; when they do so in healthy adults neither specialized testing nor antimicrobials is required. The presence or absence of epidemiologic evidence (such as travel, hospitalization, antibiotic use, other exposures)and clinical evidence (such as diarrhea frequency and duration, severity of abdominal pain and fever, character of stool, presence of chronic illness or immune deficiency) can change the probability of "not norovirus" from as low as 8% to as high as 100%. Such probabilities guide the use of laboratory testing and antimicrobial therapy in patients who have acute infectious diarrhea.
Collapse
Affiliation(s)
- Richard Goodgame
- Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Room 525-D, Houston, TX 77030, USA.
| |
Collapse
|