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Tubic B, Bånnsgård M, Gustavsson S, Engström M, Moreno J, Finizia C. Introduction of a Novel Patient Safety Advisory: Evaluation of Perceived Information With a Modified QPP Questionnaire-A Case-Control Study. J Patient Saf 2024; 20:490-497. [PMID: 39315753 DOI: 10.1097/pts.0000000000001269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
OBJECTIVES Adverse events (AEs) may result in serious injuries or death. AEs occur in approximately 9.2% of hospitalizations, with a potential preventability of 43.5%. The aim of this study was to examine whether use of an illustrated patient safety advisory affected information transfer to inpatients regarding how they can participate in their own care to decrease the risk of AEs. METHODS All patients in the control (n = 129) and case/intervention (n = 511) groups received verbal information from healthcare personnel. The intervention group also received the illustrated patient safety advisory, "Your safety at the hospital." Before discharge, patients completed the Quality from the Patient's Perspective questionnaire. RESULTS Mean patient age was 64.6/62.4 years in the intervention/control group, respectively, and 50% were men. Significant differences between groups were observed for most questions presented from the perceived reality of care perspective, in favor to the intervention group. Patients at surgical wards indicated higher scores on 9 of 12 Quality from the Patient's Perspective questions. Patients with hospital stays ≥4 days, at surgical wards, and living with someone else, placed higher subjective importance to questions concerning, e.g., protection/infection, nutrition, risk of falls and pressure ulcers, and discharge information. CONCLUSIONS Using an illustrated patient safety advisory to complement oral information about patient safety risks resulted in positive responses and a significant difference was demonstrated in how information is perceived. The safety advisory could be used as a tool to decrease AEs. Patients who live alone may need more focused patient safety information to encourage involvement in their own care.
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Oliveira M, Antunes W, Mota S, Madureira-Carvalho Á, Dinis-Oliveira RJ, Dias da Silva D. An Overview of the Recent Advances in Antimicrobial Resistance. Microorganisms 2024; 12:1920. [PMID: 39338594 PMCID: PMC11434382 DOI: 10.3390/microorganisms12091920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Revised: 09/15/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
Antimicrobial resistance (AMR), frequently considered a major global public health threat, requires a comprehensive understanding of its emergence, mechanisms, advances, and implications. AMR's epidemiological landscape is characterized by its widespread prevalence and constantly evolving patterns, with multidrug-resistant organisms (MDROs) creating new challenges every day. The most common mechanisms underlying AMR (i.e., genetic mutations, horizontal gene transfer, and selective pressure) contribute to the emergence and dissemination of new resistant strains. Therefore, mitigation strategies (e.g., antibiotic stewardship programs-ASPs-and infection prevention and control strategies-IPCs) emphasize the importance of responsible antimicrobial use and surveillance. A One Health approach (i.e., the interconnectedness of human, animal, and environmental health) highlights the necessity for interdisciplinary collaboration and holistic strategies in combating AMR. Advancements in novel therapeutics (e.g., alternative antimicrobial agents and vaccines) offer promising avenues in addressing AMR challenges. Policy interventions at the international and national levels also promote ASPs aiming to regulate antimicrobial use. Despite all of the observed progress, AMR remains a pressing concern, demanding sustained efforts to address emerging threats and promote antimicrobial sustainability. Future research must prioritize innovative approaches and address the complex socioecological dynamics underlying AMR. This manuscript is a comprehensive resource for researchers, policymakers, and healthcare professionals seeking to navigate the complex AMR landscape and develop effective strategies for its mitigation.
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Affiliation(s)
- Manuela Oliveira
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal; (Á.M.-C.); (D.D.d.S.)
- UCIBIO—Research Unit on Applied Molecular Biosciences, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal
| | - Wilson Antunes
- Instituto Universitário Militar, CINAMIL, Unidade Militar Laboratorial de Defesa Biológica e Química, Avenida Doutor Alfredo Bensaúde, 4 piso, do LNM, 1849-012 Lisbon, Portugal
| | - Salete Mota
- ULSEDV—Unidade Local De Saúde De Entre Douro Vouga, Unidade de Santa Maria da Feira e Hospital S. Sebastião, Rua Dr. Cândido Pinho, 4520-211 Santa Maria da Feira, Portugal
| | - Áurea Madureira-Carvalho
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal; (Á.M.-C.); (D.D.d.S.)
- UCIBIO—Applied Molecular Biosciences Unit, Forensics and Biomedical Sciences Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Ricardo Jorge Dinis-Oliveira
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal; (Á.M.-C.); (D.D.d.S.)
- UCIBIO—Research Unit on Applied Molecular Biosciences, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- FOREN—Forensic Science Experts, Avenida Dr. Mário Moutinho 33-A, 1400-136 Lisbon, Portugal
| | - Diana Dias da Silva
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University Institute of Health Sciences—CESPU, Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal; (Á.M.-C.); (D.D.d.S.)
- UCIBIO—Applied Molecular Biosciences Unit, Forensics and Biomedical Sciences Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Avenida Central de Gandra 1317, 4585-116 Gandra, Portugal
- REQUIMTE/LAQV, ESS, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal
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Anino CO, Sanga P. Usage of social media and Covid 19 vaccine hesitancy among medical students in Kericho County. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003529. [PMID: 39173009 PMCID: PMC11341036 DOI: 10.1371/journal.pgph.0003529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 07/07/2024] [Indexed: 08/24/2024]
Abstract
The recent Covid 19 pandemic revealed the global challenge posed by infectious diseases. Vaccines are a crucial tool in preventing pandemics, as evidenced by their success in controlling past outbreaks. The rise of information and communication technology has introduced social media platforms as potential game-changers in both preventing and managing future pandemics. However, these same platforms can also be a double-edged sword, hindering the uptake of essential vaccination services. This study investigated the association between social media use and vaccine hesitancy among medical students. The study was designed as an institution based cross sectional study of 423 medical students in Kenya Medical Training College and University of Kabianga in Kericho County. Stratified sampling was used to decide on the two institutions and systematic random sampling was used to select the study participants. Research administered questionnaires were used to collect data on the socio-demographic characteristics, use of social media platforms, social media campaigns, and uptake of Covid 19 vaccines. The collected data was analyzed using Statistical Package for Social Sciences version 25. Chi square was used to establish the association between the independent variables and uptake of Covid 19 vaccines. The variables that were significantly associated with hesitancy to Covid 19 vaccines were further analyzed using binary logistic regression. The confidence interval (CI) was set at 95% and statistical significance was considered at p < 0.05. The study found significant associations between vaccine hesitancy and several factors, including academic level, preferred social media platform, the influence of social media on attitudes towards vaccines, concerns about vaccine safety and efficacy, and confidence in vaccines. The findings present social media as a potential platform for promotion of vaccines utilization during pandemics when used well.
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Affiliation(s)
| | - Philip Sanga
- Department of Community Health, Maseno University, Kisumu, Kenya
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Alotaibi G. Prevalence, pandemic, preventions and policies to overcome antimicrobial resistance. Saudi J Biol Sci 2024; 31:104032. [PMID: 38854892 PMCID: PMC11157277 DOI: 10.1016/j.sjbs.2024.104032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 06/11/2024] Open
Abstract
Antimicrobial resistance (AMR) is a growing concern in Asia, and it is essential to understand the prevalence, pandemic, prevention, and policies to overcome it. According to the World Health Organization (WHO), AMR is one of the main causes of death; in 2019, it was linked to 4.95 million fatalities and caused about 1.27 million deaths. A core package of actions has been provided by WHO to help countries prioritize their needs when creating, carrying out, and overseeing national action plans on antimicrobial resistance. Using a people-cantered approach to AMR, the interventions address the needs and obstacles that individuals and patients encounter when trying to obtain healthcare. The people-cantered core package of AMR treatments seeks to improve public and policymakers; awareness and comprehension of AMR by changing the narrative of AMR to emphasize the needs of people and systemic impairments. Additionally, it backs a more comprehensive and programmatic national response to AMR, which emphasizes the value of fair and inexpensive access to high-quality healthcare services for the avoidance, identification, and management of drug-resistant diseases. The report signals increasing resistance to antibiotics in bacterial infections in humans and the need for better data. In conclusion, the prevalence of AMR in Asia is a significant public health concern, and it is crucial to implement policies and interventions to overcome it.
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Affiliation(s)
- Ghallab Alotaibi
- Department of Pharmacology, College of Pharmacy, Shaqra University, Riyadh 11961, Saudi Arabia
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Chen X, Geng S, Zhu Y, Li Q, Li Y, Yuan H, Jiang H. Impact of infection on healthcare costs and clinical outcomes in elderly hospitalized patients with multimorbidity. Heliyon 2024; 10:e31560. [PMID: 38826722 PMCID: PMC11141361 DOI: 10.1016/j.heliyon.2024.e31560] [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: 02/03/2023] [Revised: 09/10/2023] [Accepted: 05/17/2024] [Indexed: 06/04/2024] Open
Abstract
Background Elderly patients with multimorbidity are at higher risk of greater healthcare costs and poor outcomes due to decreased physical function. The aim of this study was to investigate the impact of infection on healthcare costs and poor outcomes in elderly hospitalized patients with multimorbidity. Methods We retrospectively enrolled 264 patients who met the inclusion criteria from the department of geriatrics of a large public hospital in Shanghai, China between January 2020 and December 2020. Patients were divided into two groups based on whether they had infection [infection present on admission (IPOA) or healthcare-associated infection(HAI)]. We recorded the basic information and follow-up information of all patients. The follow-up information included 30-day and 1-year all-cause readmission and mortality. Then we analyzed the association between infection and healthcare costs and clinical outcomes. Results Among 264 subjects, 47.73 % of them achieved IPOA or HAI. The 30-day poor outcomes rate was 45.45 %, and the 1-year poor outcomes rate was 78.41 %. Compared with subjects without infection, the number of drugs and the disease burden were greater in subjects with infection(P < 0.001). Subjects with infection had longer length of hospital stay(P < 0.001) and had greater healthcare cost(P < 0.001). Moreover, subjects with infection had higher poor outcomes rates of 30-day and 1-year(P < 0.001). Infection could predict greater total cost [odds ratio (OR): 1.32, 95 % CI: 1.18,1.49,P < 0.001], nursing cost(OR: 11.45, 95 % CI: 3.49,37.63,P < 0.001), and medicine cost (OR: 2.37, 95 % CI: 1.70,3.31,P < 0.001). In addition, infection was also independently associated with the 30-day poor outcomes rate(OR:3.07, 95%CI: 1.80,5.24,P < 0.001), but we found no association between infection and 1-year poor outcomes rate(OR:1.43, 95 % CI:0.73,2.79,P = 0.300) after adjustment. Conclusions Infection was a risk factor for higher healthcare cost and 30-day poor outcome rate in elderly hospitalized patients with multimorbidity.
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Affiliation(s)
- Xin Chen
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Shasha Geng
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yingqian Zhu
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qingqing Li
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yang Li
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Huixiao Yuan
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hua Jiang
- Department of Geriatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- Department of General Practice, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
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Teus JK, Mithen L, Green H, Hutton A, Fernandez R. Impact of infection prevention and control practices, including personal protective equipment, on the prevalence of hospital-acquired infections in acute care hospitals during COVID-19: a systematic review and meta-analysis. J Hosp Infect 2024; 147:32-39. [PMID: 38423134 DOI: 10.1016/j.jhin.2024.02.010] [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: 11/27/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND The COVID-19 pandemic has posed an unprecedented challenge to healthcare systems globally. Personal protective equipment has played a fundamental role in protecting healthcare workers and patients, but its effectiveness in reducing hospital-acquired infections (HAIs) during the pandemic remains a subject of debate. AIM To conduct a synthesis and meta-analysis of the best available evidence of the prevalence of HAIs using a before/after approach. METHODS A three-step search strategy was undertaken to locate published and unpublished studies. A search was performed in MEDLINE, CINAHL, Embase, PsycINFO, and Google Scholar. Screening of studies, data extraction and critical appraisal were performed by four independent reviewers. Meta-analysis was conducted using Review Manager. The review is reported in accordance with PRISMA and JBI guidelines for systematic reviews. FINDINGS Fifteen studies were included in the review. Three studies indicated a statistically significant increase in the number of positive cultures during the COVID-19 period compared to the pre-COVID-19 period. Pooled data showed a non-significant decrease in the number of patients with positive cultures in the COVID-19 period compared to pre-COVID-19. There were no significant differences in various bacterial infections except for a significant decrease in respiratory infections. Pooled data for central line-associated bloodstream infections (CLABSIs) indicated a significant increase during the COVID-19 period, but one study reported an increase in CLABSI incidence. CONCLUSION The evidence from this review demonstrates a mixed impact of the COVID-19 pandemic precautions on HAIs.
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Affiliation(s)
- J K Teus
- Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW, Australia; School of Nursing, University of Wollongong, NSW, Australia.
| | - L Mithen
- School of Nursing and Midwifery, University of Newcastle, NSW, Australia
| | - H Green
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, NSW, Australia; Centre for Transformative Nursing, Midwifery and Health Research: A JBI Affiliated Centre, NSW, Australia
| | - A Hutton
- School of Nursing and Midwifery, University of Newcastle, NSW, Australia; Centre for Transformative Nursing, Midwifery and Health Research: A JBI Affiliated Centre, NSW, Australia; School of Nursing, Johns Hopkins University, MD, USA
| | - R Fernandez
- School of Nursing and Midwifery, University of Newcastle, NSW, Australia; Centre for Transformative Nursing, Midwifery and Health Research: A JBI Affiliated Centre, NSW, Australia
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Park YS, Kim SY, Kim H, Jang SY, Park EC. Impact of financial incentives for infection prevention and management on antibiotic use: A Korea National Health Insurance cohort study. J Infect Public Health 2024; 17:362-369. [PMID: 38198969 DOI: 10.1016/j.jiph.2023.12.015] [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: 08/29/2023] [Revised: 12/10/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The Korean government implemented financial incentives to enhance infection prevention and management within general hospital settings. This study aimed to evaluate the impact of infection control compensation on antibiotic usage using a controlled interrupted time series analysis. METHODS The main unit of analysis was 270,901 inpatient episodes extracted from the Korean National Health Insurance Service Cohort Database from 2013 to 2019. The 96-month period was examined before and after the intervention, which was set to September 1, 2017, by applying a 1-year lag time after the incentive was introduced. Segmented regression was used to estimate the effects of interventions in a controlled interrupted time series. Hospitals that received nationwide financial incentives for infection prevention and management were included in the analysis. The study's primary outcome was the use of antibiotics based on the WHO Access, Watch, and Reserve (AWaRe) classification of antibiotics, and the secondary outcome was the number of days of antibiotic use as days of therapy (DOTs) per patient day (PD). RESULTS The probability of overall antibiotic use decreased between incentivized and unincentivized hospitals (odds ratio [OR], 0.922; 95% confidence interval [CI], 0.859-1.000). The difference in level change in the use of third-generation cephalosporins (OR,0.894; 95% CI, 0.817-0.977) and carbapenem (OR,0.790; 95% CI, 0.630-0.992) was significantly reduced between incentivized and unincentivized hospitals. The difference in slope change on DOTs/PD of glycopeptides was - 0.005 DOT/PDs, and that of carbapenem was - 0.003 between incentivized and unincentivized hospitals. CONCLUSION We observed that incentives for infection prevention and management have had a positive impact on some aspects of antibiotic usage. A partial decrease was observed in antibiotic use, accompanied by a modest reduction in DOTs/PD, particularly for antibiotics aimed at addressing multidrug-resistant pathogens. Further investigation is necessary to establish evidence for extending these incentives.
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Affiliation(s)
- Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Soo Young Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hyunkyu Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk-Yong Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Dos Santos TB, Dos Santos Gomes D, Dos Santos Neto AG, do Amorim Costa Gaspar LM, Droppa-Almeida D. Botanical Extracts and Compounds of Castanea Plants and Methods of Use: US20190125818A1 - The United States Patent Evaluation. Recent Pat Biotechnol 2024; 18:152-161. [PMID: 38282444 DOI: 10.2174/1872208317666230420105000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/16/2023] [Accepted: 02/27/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Bacterial infections are increasingly difficult to combat, which makes them a threat to public health on a global level. Staphylococcus aureus is considered one of the main causes of infections in hospitals, as it has a variety of virulence factors, as well as is able to produce bacterial biofilms, which, consequently, bring numerous damages to public health as a result of increased resistance to conventional antibiotics and a longer hospital stay. Therefore, the use of compounds extracted from medicinal plants is a potential pharmaceutically acceptable target, as they do not have toxicity and the potential to disrupt biofilms produced by Staphylococcus aureus already evidenced, thus revealing their relevance to our study. OBJECTIVE The objective of this work was to perform a critical analysis of a patent with natural extracts against bacterial biofilms found in the United States Patent and Trademark Office (USPTO) database, to map the possible bioactive compounds that may serve as potential future antimicrobial drugs. METHODS A technological survey was carried out to verify existing patents using natural extracts with anti-biofilm potential. For this, it was searched with the keywords: Botanical extracts AND biofilms; which were performed in the United States Patent and Trademark Office (USPTO) database. Thus, the selected patent used a non-aqueous extract partitioned and vacuum-contracted, subsequently lyophilized for assays with antimicrobial potential. Because of this, a patent was analyzed regarding its chemistry, and biological activity, followed by a critical analysis of the technology proposed in the invention. RESULTS When using the keywords Botanical extracts AND biofilms in the USPTO, it was possible to find twenty-two inventions; however, only four patents in the USPTO were in agreement with the proposal of the natural extract having antimicrobial activity and an anti-biofilm potential, of which two belonged to the same applicant with similar proposals. The key point of this invention was to enable the compounds of the Castanea sativa plant and its methods of obtaining the extract to present a significant antimicrobial action associated or not with antibiotics, promoting the development of new therapies against bacterial infections capable of disrupting biofilms. The invention developed a methodology for extracting Castanea sativa, in which pentacyclic triterpene compounds were found mostly in its leaves. Whereas for the extraction, the crude methanol extracts called extracts 224 from the ground leaves were made by maceration, filtered, combined, concentrated under pressure in rotary evaporators, and lyophilized. After that, they were resuspended in water and partitioned in succession with hexane, ethyl acetate, and butanol. The most active refined partition was the 224C extract with the solvent ethyl acetate, which was subjected to further fractionation using silica column chromatography. Resulting in the most refined extract, which was 224C-F2, capable of acting directly on the quorum sensing of bacteria, mainly Staphylococcus aureus, blocking the translation of RNAIII, including a series of exotoxins. Regarding the antimicrobial capacity against Staphylococcus aureus, it presented Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of 1.56 μg/mL-1 and > 100 μg/mL -1, respectively. CONCLUSION Given the analyzed patent, it was possible to verify the importance of alternatives to reduce the impact of bacterial biofilms, which causes damage to industries in general and to health. From this, the invention analyzed has a promising proposal with antimicrobial potential focusing on the great impact of bacterial biofilms. Therefore, natural extracts with antibiofilmic potential can help to minimize the economic losses caused to health due to these multidrug-resistant microorganisms with different virulence mechanisms.
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Odeh Z, Abatli S, Qadi M. Radiology Department: A Potential Source of Multidrug-Resistant Microorganisms: A Cross-Sectional Study at Tertiary Hospital, Palestine. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:4441338. [PMID: 38146333 PMCID: PMC10749721 DOI: 10.1155/2023/4441338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/10/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
Introduction Globally, healthcare facilities face a great challenge in the form of hospital-acquired infections (HAIs). Aside from the morbidity and mortality they cause, these illnesses are also extremely costly. Research on infection transmission in the medical field has been considerable, but not so much in the radiology department. Aim This study aims to identify the presence of multidrug-resistant (MDR) microbes on surfaces that are frequently touched in computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), plain X-ray examination rooms, and portable radiography that are susceptible to contamination as well as to investigate the potential dangers of contracting MDR organisms to patients and healthcare providers. Materials and Method. In this study, 160 swab samples were collected from the radiology department during May and June 2022. Samples were obtained from 80 predefined surfaces twice within and outside of CT and MRI examination rooms as well as from US and plain X-ray machines and portable X-ray machines. Samples were taken at 7:00 a.m. using cotton swabs following the regular cleaning procedure. Bacterial colony-forming units (CFUs) per square centimeter were calculated after swabbing a 100 cm2 surface. Results Nearly all of the surfaces tested had bacterial CFUs. The highest contamination rate was found on keyboards ranging from (1.2-8) CFU/cm2, the sides of patient tables (1.2-20) CFU/cm2, knee coil (2.4-3) CFU/cm2, and patient leg supports (1.2-8) CFU/cm2. A noticeable increase in the contamination was noticed in June compared to May, and this was consistent with the increase in the number of isolated patients in the hospital, the workload in the radiology department, and the number of patients referred to the hospital. In our study, none of the examined sites showed contamination with MDR Gram-negative bacteria such as extended-spectrum beta-lactamases producing Enterobacterales (ESPL) or Carbapenemase-producing Enterobacterales (CPE). On the other hand, methicillin-resistant Staphylococcus (MRS), vancomycin-resistant Staphylococcus (VRS), and vancomycin-resistant Enterococcus (VRE) were detected. Conclusion All of the radiology department equipment and sites could be a source of bacterial infection including MDR, so the obligatory and committed disinfection protocol must be revised and implemented in the morning and between patients.
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Affiliation(s)
- Zena Odeh
- Department of Medical and Health Sciences, Faculty of Graduate Studies, An-Najah National University, P.O. Box. 7, Nablus, State of Palestine
- Department of Radiology, An-Najah National University Hospital, Nablus, State of Palestine
| | - Safaa Abatli
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box. 7, Nablus, State of Palestine
| | - Mohammad Qadi
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box. 7, Nablus, State of Palestine
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Tossens B, Barthelme P, Briquet C, Belkhir L, Ngyuvula E, Soumillion K, Verroken A, Rodriguez-Villalobos H, Delmée M, Anantharajah A. Impact of the COVID-19 pandemic on Clostridioides difficile infection in a tertiary healthcare institution in Belgium. Acta Clin Belg 2023; 78:459-466. [PMID: 37608759 DOI: 10.1080/17843286.2023.2250624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES Clostridioides difficile infection (CDI) causes the greatest number of healthcare-associated infectious diarrhoea. CDIs are transmitted by direct and indirect patient-to-patient contact and risk increases with the use of antibiotics. Since early 2020, the COVID-19 pandemic has affected healthcare systems in many ways including substantial changes in hygiene behaviour. The aim of this study was to assess whether CDI incidence differed during the COVID-19 pandemic compared to a year before. METHODS All tests for suspected CDI cases were recorded for a hospital in Brussels, Belgium. The percentage of CDI-positive results and incidences (total and healthcare-associated (HA)-CDI)) for years 2019, 2020, 2021, and 2022 were calculated. Antibiotic consumption was analysed for years 2019 and 2020. RESULTS Since the COVID-19 pandemic struck, a significant reduction of up to 39% was observed in the number of Clostridioides difficile stool tests in our hospital. A significant decrease in the percentage of positive tests and a 50% decrease in the incidence of CDI (total and HA-CDI) was found for 2020 compared with 2019 and confirmed for years 2021 and 2022. The decrease in CDI incidence was mostly marked in haematology, nephrology, and gastroenterology units. No significant change in the use of antibiotics was found. CONCLUSION The global decrease in CDI incidence observed in our hospital was not associated with a change in the use of antibiotics. The control measures implemented to prevent COVID-19 transmission may explain a reduction in CDI incidence. An underdiagnosis of CDI cannot be excluded.
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Affiliation(s)
- Bastien Tossens
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Philippe Barthelme
- Department of Pharmacy, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Caroline Briquet
- Department of Pharmacy, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Leila Belkhir
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Eléonore Ngyuvula
- National Reference Center Clostridioides difficile, Microbiology Unit, Université Catholique de Louvain, Brussels, Belgium
| | - Kate Soumillion
- National Reference Center Clostridioides difficile, Microbiology Unit, Université Catholique de Louvain, Brussels, Belgium
| | - Alexia Verroken
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | | | - Michel Delmée
- National Reference Center Clostridioides difficile, Microbiology Unit, Université Catholique de Louvain, Brussels, Belgium
| | - Ahalieyah Anantharajah
- Department of Clinical Microbiology, Cliniques universitaires Saint-Luc, Brussels, Belgium
- National Reference Center Clostridioides difficile, Microbiology Unit, Université Catholique de Louvain, Brussels, Belgium
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11
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Tarun S, Abebe W, Mahida M, Saiman L, James W, LaRussa P, Stanberry LR. Diagnosis, Treatment, and Prevention Resources for Infectious Diseases in Sub-Saharan African Hospitals Caring for Children. Glob Pediatr Health 2023; 10:2333794X231210661. [PMID: 38024472 PMCID: PMC10647952 DOI: 10.1177/2333794x231210661] [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: 04/27/2023] [Revised: 08/30/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Objective. The Children's Hospitals in Africa Mapping Project survey was developed and implemented to assess the readiness of hospitals in sub-Saharan African to respond to emergencies, epidemics, and pandemics affecting children. Methods. This sub-study analyzed 56 survey questions that characterized the hospitals and assessed resources for diagnosis, treatment, and prevention of community-acquired infections and healthcare-associated infections (HAIs). Results. Twenty-four sites were recruited and 20 (from 15 countries) completed the survey in 2018 to 2019. Overall, 90% to 100% of sites reported that diagnostic assays were available for malaria, tuberculosis, and HIV. Periodic shortages of antibiotics, antimalarial drugs, and vaccines were reported by 45%, 25%, and 20% of sites, respectively. Sites reported formal programs for infection prevention and control (79%), monitoring HAIs (17%), and antimicrobial stewardship (53%). Conclusions. Opportunities to improve care for hospitalized African children were identified. These included resources for HAI surveillance and antimicrobial stewardship which can facilitate epidemic and pandemic preparedness.
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Affiliation(s)
| | | | - Maitry Mahida
- Columbia University Irving Medical Center, New York, NY, USA
| | - Lisa Saiman
- NewYork-Presbyterian Hospital, New York, NY, USA
- Columbia University Irving Medical Center, New York, NY, USA
| | - Wilmot James
- Columbia University, New York, NY, USA
- Brown University, Providence, RI, USA
| | - Philip LaRussa
- Columbia University Irving Medical Center, New York, NY, USA
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12
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Alwabel R, Alasmari B, Alabdulkarim A, Chachar Y, Jahdali HA, Layqah L, Baharoon S. Physician Attitude toward Their Attires and Laundering Habit Changes during the COVID-19: A Cross-Sectional Survey in a Tertiary Care Center. Avicenna J Med 2023; 13:169-175. [PMID: 37799181 PMCID: PMC10550361 DOI: 10.1055/s-0043-1770935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Background Patient safety is of utmost importance and every effort is to be made to reduce the risk of hospital-acquired infection. Contaminated attire is proposed as a mode of hospital infections spread. This study aims to assess the laundering habits, the perception of healthcare workers toward the contamination of their attire, and the effect of coronavirus disease 2019 (COVID-19) pandemic on their cleaning practices in non-operative settings. Methods This is a cross-sectional study conducted using a self-administered questionnaire which was distributed among physicians at King Abdul-Aziz Medical city, Riyadh. The questionnaire queried the physicians about their laundering habits, knowledge toward their attire, and the difference in cleaning practices after the emergence of COVID-19. Results Out of 220 questionnaires distributed, 192 physicians responded. Majority of physicians were male (54%) and were in the 20 to 30 age group. Female gender was significantly associated with the frequency of uniform washing ( p- value < 0.0001) and place of cleaning (home vs. outside home) ( p- value <0.0001). Physicians in intensive care were more likely to take off their uniforms daily before leaving the hospital compared to others ( p- value of 0.018). Most physicians did not prefer to use the hospital laundry system for cleaning their uniforms but consultants were the most to use it. COVID-19 pandemic led to changes in washing habits in 108 physicians (60%). Conclusion Majority of physicians accepted washing their uniforms multiple times per week and their washing habits increased during the COVID-19 pandemic. Female gender and younger physician both were associated with increasing washing habits.
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Affiliation(s)
- Reema Alwabel
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Bushra Alasmari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Aljawhara Alabdulkarim
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Yusra Chachar
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hamdan A. Jahdali
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Laila Layqah
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Offices Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
| | - Salim Baharoon
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
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Yan J, Yin Q, Nie H, Liang J, Liu XR, Li Y, Xiao H. Prodigiosin as an antibiofilm agent against multidrug-resistant Staphylococcus aureus. BIOFOULING 2023:1-15. [PMID: 37369552 DOI: 10.1080/08927014.2023.2226613] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
Staphylococcus aureus is known for forming bacterial biofilms that confer increased antimicrobial resistance. Combining antibiotics with antibiofilm agents is an alternative approach, but the antibiofilm ability of prodigiosin (PG), a potential antibiotic synergist, against antimicrobial-resistant (AMR) S. aureus remains to be understood. The antibiofilm activity of PG against 29 clinical AMR S. aureus strains was evaluated using crystal violet staining, and its synergistic effects with vancomycin (VAN) was confirmed using the checkerboard test. The viability and metabolic activity of biofilms and planktonic cells were also assessed. The results revealed that PG exhibited promising inhibitory activity against biofilm formation and synergistic activity with VAN. It effectively reduced the metabolic activity of biofilms and suppressed the production of exopolysaccharides, which might be attributed to the downregulation of biofilm-related genes such as sarA, agrA, and icaA. These findings suggest that PG could be used as a preventive coating or adjuvant against biofilms in clinical settings.
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Affiliation(s)
- Jing Yan
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, PR China
| | - Qi Yin
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, PR China
| | - Hao Nie
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, PR China
| | - Jinyou Liang
- Shenzhen Key Laboratory of Marine Bioresource & Eco-environmental Science, Shenzhen Engineering Laboratory for Marine Algal Biotechnology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, PR China
| | - Xiang-Ru Liu
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, PR China
| | - Yingli Li
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, PR China
| | - Hong Xiao
- Department of Health Laboratory Technology, School of Public Health, Chongqing Medical University, Chongqing, PR China
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Prajescu B, Gavriliu L, Iesanu MI, Ioan A, Boboc AA, Boboc C, Galos F. Bacterial Species and Antibiotic Resistance-A Retrospective Analysis of Bacterial Cultures in a Pediatric Hospital. Antibiotics (Basel) 2023; 12:966. [PMID: 37370285 DOI: 10.3390/antibiotics12060966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Antimicrobial resistance (AMR) has become a major healthcare concern having a rising incidence, especially in pediatric patients who are more susceptible to infections. The aim of our study was to analyze the bacterial species isolated from patients admitted to our tertiary hospital and their AMR profiles. We conducted a retrospective observational study by examining the bacterial cultures collected from pediatric patients admitted to our hospital over a period of one year. We identified the most common bacterial species from 1445 clinical isolates and their AMR patterns using standard microbiological techniques. Our analysis revealed that the most frequently isolated bacterial species were Escherichia coli (23.73%), Staphylococcus aureus (15.64%), Klebsiella species (12.04%), and Pseudomonas species (9.96%). Additionally, these species exhibited varying levels of resistance to commonly used antibiotics. Notably, we observed high rates of resistance among Gram-negative bacteria, including extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species. Among Gram-positive bacteria, we observed a high level of methicillin-resistant Staphylococcus aureus. Our findings highlight the urgent need for effective antibiotic management programs and infection control measures to address the rising incidence of AMR in pediatric hospitals. Further research is needed to identify the mechanisms of resistance in these bacterial species and to develop new strategies for preventing and treating infections caused by antibiotic-resistant bacteria in pediatric patients.
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Affiliation(s)
- Bianca Prajescu
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Liana Gavriliu
- Department for Prevention of Healthcare-Associated Infections, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
- Department of Infectious Disease, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mara Ioana Iesanu
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
- Department of Physiology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Andreea Ioan
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Anca Andreea Boboc
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Ro-mania
| | - Catalin Boboc
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
| | - Felicia Galos
- Department of Pediatrics, Marie Curie Emergency Children's Hospital, 041451 Bucharest, Romania
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Ro-mania
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15
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Sagar P, Aseem A, Banjara SK, Veleri S. The role of food chain in antimicrobial resistance spread and One Health approach to reduce risks. Int J Food Microbiol 2023; 391-393:110148. [PMID: 36868045 DOI: 10.1016/j.ijfoodmicro.2023.110148] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/14/2023] [Accepted: 02/18/2023] [Indexed: 02/26/2023]
Abstract
The incidence of antimicrobial resistance (AMR) is rapidly spreading worldwide. It is depleting the repertoire of antibiotics in use but the pace of development of new antibiotics is stagnant for decades. Annually, millions of people are killed by AMR. This alarming situation urged both scientific and civil bodies to take steps to curb AMR as a top priority. Here we review the various sources of AMR in the environment, especially focusing on the food chain. Food chain inculcates pathogens with AMR genes and serves as a conduit for its transmission. In certain countries, the antibiotics are more used in livestock than in humans. It is also used in agriculture crops of high value products. The indiscriminate use of antibiotics in livestock and agriculture increased rapid emergence of AMR pathogens. In addition, in many countries nosocomial settings are spewing AMR pathogens, which is a serious health hazard. Both the developed and low and middle income countries (LMIC) face the phenomenon of AMR. Therefore, a comprehensive approach for monitoring all sectors of life is required to identify the emerging trend of AMR in environment. AMR genes' mode of action must be understood to develop strategies to reduce risk. The new generation sequencing technologies, metagenomics and bioinformatics capabilities can be resorted to quickly identify and characterize AMR genes. The sampling for AMR monitoring can be done from multiples nodes of the food chain as envisioned and promoted by the WHO, FAO, OIE and UNEP under the One Health approach to overcome threat of AMR pathogens.
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Affiliation(s)
- Prarthi Sagar
- Drug Safety Division, ICMR-National Institute of Nutrition, Hyderabad 500007, India
| | - Ajmal Aseem
- Drug Safety Division, ICMR-National Institute of Nutrition, Hyderabad 500007, India
| | | | - Shobi Veleri
- Drug Safety Division, ICMR-National Institute of Nutrition, Hyderabad 500007, India.
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16
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Stead S, Vogt L, Antons D, Salge TO, Gecht J, Klasen M, Sopka S. Hospital resource endowments and nosocomial infections: longitudinal evidence from the English National Health Service on Clostridioides difficile between 2011 and 2019. J Hosp Infect 2023; 134:129-137. [PMID: 36750139 DOI: 10.1016/j.jhin.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To identify key factors associated with Clostridioides difficile infections (CDIs) in healthcare at the hospital organization level. DESIGN Longitudinal study covering the period 2011-2019. Hospital reports were analysed to determine the number of CDIs and several hospital-related environmental factors: financial resources (i.e., cleaning expenditure), spatial resources (i.e., number of single rooms with a private bathroom), human resources (i.e., number of physicians and nursing staff) and cultural resources (i.e., error reporting climate). The relationships between the environmental factors and CDIs were analysed in a hybrid within- and between-hospital random-effect model. SETTING A total of 129 general hospital Trusts operating in the English National Health Service (NHS). PARTICIPANTS All inpatients in 129 general hospital trusts of the NHS in the years 2011-2019, covering 120,629 cases of CDI. MAIN OUTCOME MEASURE Annual number of CDIs per hospital trust. RESULTS Single rooms were associated with fewer CDIs at the within-hospital level, but not at the between-hospital level. Similarly, more nursing staff was associated with fewer CDIs at the within-hospital level, but not at the between-hospital level. This effect was not observed for physician staffing. A different picture emerged for the protective effect of cultural resources, with a weakly significant effect of between-hospital differences, but no within-hospital effect. Financial resources were not associated with CDIs either between hospitals or within them over time. CONCLUSIONS The present study identified hospital resources with a beneficial influence on CDI rates. Healthcare organizations can use this knowledge for active CDI prevention.
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Affiliation(s)
- S Stead
- Institute for Technology and Innovation Management, RWTH Aachen University, Aachen, Germany
| | - L Vogt
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany; AIXTRA - Interdisciplinary Center for Training and Patient Safety, Medical Faculty RWTH Aachen, Aachen, Germany.
| | - D Antons
- Institute for Technology and Innovation Management, RWTH Aachen University, Aachen, Germany
| | - T O Salge
- Institute for Technology and Innovation Management, RWTH Aachen University, Aachen, Germany
| | - J Gecht
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany; AIXTRA - Interdisciplinary Center for Training and Patient Safety, Medical Faculty RWTH Aachen, Aachen, Germany
| | - M Klasen
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany; AIXTRA - Interdisciplinary Center for Training and Patient Safety, Medical Faculty RWTH Aachen, Aachen, Germany
| | - S Sopka
- Department of Anaesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany; AIXTRA - Interdisciplinary Center for Training and Patient Safety, Medical Faculty RWTH Aachen, Aachen, Germany
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17
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Chua SP, Ja’afar MH, Wong KK, Ibrahim R, Wan Yahya WNN. Guidelines on the use of disinfectants: comparison between Malaysia and other countries. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc17. [PMID: 36285325 PMCID: PMC9577908 DOI: 10.3205/dgkh000420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Aim Sanitation and cleanliness are essential factors in reducing the spread of pathogens and preventing healthcare-associated infections. Disinfectants are associated with better hygiene outcomes to reduce pathogen transmission risk and minimize risks to healthcare workers (HCWs) and patients. Methods A literature search was undertaken using the electronic databases Scopus, Web of Science, Ovid and Google Scholar. The inclusion criteria for this study are observational and original research studies dating from the five-year period 2017-2021. Other inclusion criteria are full text, English language, qualitative or quantitative studies relevant to the research question. The exclusion criteria are animal studies, systematic reviews, conference proceedings, abstracts, projection modelling studies, in-vivo or in-vitro studies, and books. Results Five study nations included the United States of America (USA), the United Kingdom (UK), China, India and South Korea, together with Malaysia. These nations have existing policies, regulations and guidelines regarding the use of disinfectants. HCWs should be aware of the national laws and guidelines that govern the purchase, distribution and use of disinfectants. They should also understand the different roles of the agencies involved, so the context for the guidance provided is clear. Coordination and collaboration across various stakeholders are required for creating solid policies. Conclusion Product research and innovation are indispensable, as appropriate personal protective equipment and safety measures for HCWs and patients have top priority in every nation. Hence, clear guidelines for handling disinfectants, in addition to health education about scientific-evidence-based disinfectants, are required.
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Affiliation(s)
- Su Peng Chua
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Hasni Ja’afar
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia,*To whom correspondence should be addressed: Mohd Hasni Ja’afar, Department of Community Health, Faculty of Medicine, National University of Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Kon Ken Wong
- Department of Medical Microbiology & Immunology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Roszita Ibrahim
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Wan Nur Nafisah Wan Yahya
- Department of Internal Medicine, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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Agyeman WY, Bisht A, Gopinath A, Cheema AH, Chaludiya K, Khalid M, Nwosu M, Konka S, Khan S. A Systematic Review of Antibiotic Resistance Trends and Treatment Options for Hospital-Acquired Multidrug-Resistant Infections. Cureus 2022; 14:e29956. [PMID: 36381838 PMCID: PMC9635809 DOI: 10.7759/cureus.29956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
Antimicrobial resistance is a major public health challenge described by the World Health Organization as one of the top 10 public health challenges worldwide. Drug-resistant microbes contribute significantly to morbidity and mortality in the hospital, especially in the critical care unit. The primary etiology of increasing antibiotic resistance is inappropriate and excessive use of antibiotics. The alarming rise of drug-resistant microbes worldwide threatens to erode our ability to treat infections with our current armamentarium of antibiotics. Unfortunately, the pace of development of new antibiotics by the pharmaceutical industry has not kept up with rising resistance to expand our options to treat microbial infections. The costs of antibiotic resistance include death and disability, extended hospital stays due to prolonged sickness, need for expensive therapies, rising healthcare expenditure, reduced productivity from time out of the workforce, and rising penury. This review sums up the common mechanisms, trends, and treatment options for hospital-acquired multidrug-resistant microbes.
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Affiliation(s)
- Walter Y Agyeman
- Internal Medicine, Piedmont Athens Regional Medical Center, Georgia, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aakash Bisht
- Internal Medicine, Government Medical College, Amritsar, Amritsar, IND
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ankit Gopinath
- Internal Medicine, Kasturba Medical College, Manipal, Manipal, IND
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ameer Haider Cheema
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Keyur Chaludiya
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maham Khalid
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Marcellina Nwosu
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Srujana Konka
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Ćirković I, Marković-Denić L, Bajčetić M, Dragovac G, Đorđević Z, Mioljević V, Urošević D, Nikolić V, Despotović A, Krtinić G, Rakić V, Janićijević I, Šuljagić V. Microbiology of Healthcare-Associated Infections: Results of a Fourth National Point Prevalence Survey in Serbia. Antibiotics (Basel) 2022; 11:1161. [PMID: 36139941 PMCID: PMC9495255 DOI: 10.3390/antibiotics11091161] [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: 07/30/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 12/03/2022] Open
Abstract
Millions of patients acquire healthcare-associated infections (HAIs) every year, putting them at risk for serious complications and prolonged hospitalization. Point prevalence surveys (PPS), guided by the European Centre for Disease Prevention and Control framework, are one of the primary methods by which countries in the European Union conduct surveillance of HAIs. Serbia, though not in the EU, implemented this approach in its national PPS. The microbiological and antimicrobial resistance (AMR) analyses comprised patients in 61 out of 65 hospitals included in the fourth PPS conducted in November 2017. A total of 515/12,380 (4.2%) of the adult patients included in the PPS had at least one HAI, with intensive care units carrying the highest prevalence of 15.9%. Urinary tract and surgical site infections were the most frequently identified types of HAIs (23.9% and 23.0%, respectively). Enterobacterales comprised almost half (47.0%) of all causative agents, most notably Klebsiella spp. (16.7%). AMR was very high for most pathogens-80.5% of nonfermentative Gram-negative bacilli were resistant to carbapenems whereas 62.9% of Enterobacterales were resistant to third generation cephalosporins. The calculated AMR index of 61% is one of the highest in Europe. Further efforts are needed to reduce the burden of HAIs in Serbia that carry very high resistance rates to antibiotics currently used in clinical practice.
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Affiliation(s)
- Ivana Ćirković
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Microbiology and Immunology, 11000 Belgrade, Serbia
| | - Ljiljana Marković-Denić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Epidemiology, 11000 Belgrade, Serbia
| | - Milica Bajčetić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Pharmacology, Clinical Pharmacology and Toxicology, 11000 Belgrade, Serbia
| | - Gorana Dragovac
- Institute of Public Health of Vojvodina, 21000 Novi Sad, Serbia
- Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Zorana Đorđević
- Department of Hospital Infection Control, University Clinical Centre of Kragujevac, 34000 Kragujevac, Serbia
| | - Vesna Mioljević
- Department of Hospital Epidemiology and Hygiene, University Clinical Centre of Serbia, 11000 Belgrade, Serbia
| | | | - Vladimir Nikolić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Institute of Epidemiology, 11000 Belgrade, Serbia
| | | | | | - Violeta Rakić
- Institute of Public Health of Serbia, 11000 Belgrade, Serbia
| | | | - Vesna Šuljagić
- Faculty of Medicine of Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
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Sarowska J, Choroszy-Krol I, Jama-Kmiecik A, Mączyńska B, Cholewa S, Frej-Madrzak M. Occurrence and Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Strains Isolated from Hospitalized Patients in Poland-A Single Centre Study. Pathogens 2022; 11:859. [PMID: 36014980 PMCID: PMC9416609 DOI: 10.3390/pathogens11080859] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 12/10/2022] Open
Abstract
The global emergence and spread of genes responsible for the production of ESBL (extended-spectrum beta-lactamases) and carbapenemases in Klebsiella pneumoniae isolates poses a serious threat to public health. The aim of this study was to retrospectively analyze the frequency of occurrence and drug resistance of selected alarm agents isolated from patients of the specialist hospital in Wrocław. A total of 13,528 clinical materials collected from patients of a specialist hospital in Wrocław were analyzed in the period from 1 January 2020 to 31 December 2020. Overall, 3894 bacterial strains were isolated from clinical materials, including 416 K. pneumoniae isolates. K. pneumoniae that showed resistance to ETP (ertapenem) and/or MEM (meropenem) were tested using phenotypic tests for the detection of KPC (carbapenemase-producing Klebsiella), MBL (metallo-β-lactamase) and OXA-48 (oxacilinase-48) carbapenemases. In the case of a positive or doubtful result of the phenotypic test, immunochromatographic tests and the CarbaNP test were performed. In total, 58 K. pneumoniae isolates resistant to 1 or more carbapenem antibiotics were isolated. Of the 58 strains, 16 (27.6%) were isolated from rectal swabs conducted on CPE (carbapenemase-producing Enterobacteriaceae) carriers. In the case of CRE (carbapenem-resistant Enterobacteriaceae) K. pneumoniae, carbapenemases were detected in 28/58 (48.3%) isolates. Notably, 23/28 K. pneumoniae isolates produced MBL/NDM (New Delhi metallo-β-lactamase) (82.1%), 5/28 produced VIM (Verona-intergon-encoded metallo-β-lactamase) (14.3%), and one produced MBL/NDM + OXA-48. Carbapenemases were detected in 13 of 16 (81.3%) carbapenem-resistant K. pneumoniae isolates derived from rectal swabs. The significant participation of CRE and CPE isolates in the infections proves the need to test patients admitted to hospital wards for their status as a CPE carrier in order to limit the emergence of new epidemic outbreaks.
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Affiliation(s)
- Jolanta Sarowska
- Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland; (J.S.); (I.C.-K.); (M.F.-M.)
| | - Irena Choroszy-Krol
- Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland; (J.S.); (I.C.-K.); (M.F.-M.)
| | - Agnieszka Jama-Kmiecik
- Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland; (J.S.); (I.C.-K.); (M.F.-M.)
| | - Beata Mączyńska
- Department of Pharmaceutical Microbiology and Parasitology, Faculty of Pharmacy, Medical University, 50-367 Wroclaw, Poland;
| | - Sylwia Cholewa
- Medical Laboratory Synevo, Fieldorfa 2, 50-049 Wroclaw, Poland;
| | - Magdalena Frej-Madrzak
- Department of Basic Sciences, Faculty of Health Sciences, Wroclaw Medical University, Chalubinskiego 4, 50-368 Wroclaw, Poland; (J.S.); (I.C.-K.); (M.F.-M.)
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21
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Laceb ZM, Diene SM, Lalaoui R, Kihal M, Chergui FH, Rolain JM, Hadjadj L. Genetic Diversity and Virulence Profile of Methicillin and Inducible Clindamycin-Resistant Staphylococcus aureus Isolates in Western Algeria. Antibiotics (Basel) 2022; 11:antibiotics11070971. [PMID: 35884225 PMCID: PMC9312111 DOI: 10.3390/antibiotics11070971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
Staphylococcusaureus causes a wide range of life-threatening infections. In this study, we determined its prevalence in the hospital environment and investigated nasal carriage among healthcare workers and patients admitted to a hospital in western Algeria. A total of 550 specimens were collected. An antibiogram was performed and the genes encoding resistance to methicillin, inducible clindamycin and toxins were sought among the 92 S. aureus isolates. The spread of clones with a methicillin- and/or clindamycin-resistance phenotype between these ecosystems was studied using genomic analysis. A prevalence of 27%, 30% and 13% of S. aureus (including 2.7%, 5% and 1.25% of MRSA) in patients, healthcare workers and the hospital environment were observed, respectively. The presence of the mecA, erm, pvl and tsst-1 genes was detected in 10.9%, 17.4%, 7.6% and 18.5% of samples, respectively. Sequencing allowed us to identify seven sequence types, including three MRSA-IV-ST6, two MRSA-IV-ST80-PVL+, two MRSA-IV-ST22-TSST-1, two MRSA-V-ST5, and one MRSA-IV-ST398, as well as many virulence genes. Here, we reported that both the hospital environment and nasal carriage may be reservoirs contributing to the spread of the same pathogenic clone persisting over time. The circulation of different pathogenic clones of MRSA, MSSA, and iMLSB, as well as the emergence of at-risk ST398 clones should be monitored.
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Affiliation(s)
- Zahoua Mentfakh Laceb
- Laboratoire de Biotechnologies, Environnement et Santé, Faculté des Sciences de la Nature et de la Vie, Université de Blida 01, BP270 Route Soumaa, Blida 09000, Algeria; (Z.M.L.); (F.H.C.)
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France; (S.M.D.); (R.L.); (J.-M.R.)
- IHU Méditerranée Infection, 13005 Marseille, France
| | - Seydina M. Diene
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France; (S.M.D.); (R.L.); (J.-M.R.)
- IHU Méditerranée Infection, 13005 Marseille, France
| | - Rym Lalaoui
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France; (S.M.D.); (R.L.); (J.-M.R.)
- IHU Méditerranée Infection, 13005 Marseille, France
| | - Mabrouk Kihal
- Laboratoire de Microbiologie Appliquée, Université Ahmed Ben Bella Oran1, BP1524 El M’naouer, Oran 31000, Algeria;
| | - Fella Hamaidi Chergui
- Laboratoire de Biotechnologies, Environnement et Santé, Faculté des Sciences de la Nature et de la Vie, Université de Blida 01, BP270 Route Soumaa, Blida 09000, Algeria; (Z.M.L.); (F.H.C.)
| | - Jean-Marc Rolain
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France; (S.M.D.); (R.L.); (J.-M.R.)
- IHU Méditerranée Infection, 13005 Marseille, France
| | - Linda Hadjadj
- Faculté de Médecine et de Pharmacie, IRD, APHM, MEPHI, Aix Marseille University, 19-21 Boulevard Jean Moulin, CEDEX 05, 13385 Marseille, France; (S.M.D.); (R.L.); (J.-M.R.)
- IHU Méditerranée Infection, 13005 Marseille, France
- Correspondence: ; Tel.: +33-4-8613-6930
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22
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Lima RM, Rathod BB, Tiricz H, Howan DHO, Al Bouni MA, Jenei S, Tímár E, Endre G, Tóth GK, Kondorosi É. Legume Plant Peptides as Sources of Novel Antimicrobial Molecules Against Human Pathogens. Front Mol Biosci 2022; 9:870460. [PMID: 35755814 PMCID: PMC9218685 DOI: 10.3389/fmolb.2022.870460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/18/2022] [Indexed: 12/22/2022] Open
Abstract
Antimicrobial peptides are prominent components of the plant immune system acting against a wide variety of pathogens. Legume plants from the inverted repeat lacking clade (IRLC) have evolved a unique gene family encoding nodule-specific cysteine-rich NCR peptides acting in the symbiotic cells of root nodules, where they convert their bacterial endosymbionts into non-cultivable, polyploid nitrogen-fixing cells. NCRs are usually 30–50 amino acids long peptides having a characteristic pattern of 4 or 6 cysteines and highly divergent amino acid composition. While the function of NCRs is largely unknown, antimicrobial activity has been demonstrated for a few cationic Medicago truncatula NCR peptides against bacterial and fungal pathogens. The advantages of these plant peptides are their broad antimicrobial spectrum, fast killing modes of actions, multiple bacterial targets, and low propensity to develop resistance to them and no or low cytotoxicity to human cells. In the IRLC legumes, the number of NCR genes varies from a few to several hundred and it is possible that altogether hundreds of thousands of different NCR peptides exist. Due to the need for new antimicrobial agents, we investigated the antimicrobial potential of 104 synthetic NCR peptides from M. truncatula, M. sativa, Pisum sativum, Galega orientalis and Cicer arietinum against eight human pathogens, including ESKAPE bacteria. 50 NCRs showed antimicrobial activity with differences in the antimicrobial spectrum and effectivity. The most active peptides eliminated bacteria at concentrations from 0.8 to 3.1 μM. High isoelectric point and positive net charge were important but not the only determinants of their antimicrobial activity. Testing the activity of shorter peptide derivatives against Acinetobacter baumannii and Candida albicans led to identification of regions responsible for the antimicrobial activity and provided insight into their potential modes of action. This work provides highly potent lead molecules without hemolytic activity on human blood cells for novel antimicrobial drugs to fight against pathogens.
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Affiliation(s)
- Rui M Lima
- Institute of Plant Biology, Biological Research Centre, ELKH, Szeged, Hungary
| | | | - Hilda Tiricz
- Institute of Plant Biology, Biological Research Centre, ELKH, Szeged, Hungary
| | - Dian H O Howan
- Department of Medical Chemistry, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | | | - Sándor Jenei
- Institute of Plant Biology, Biological Research Centre, ELKH, Szeged, Hungary
| | - Edit Tímár
- Institute of Plant Biology, Biological Research Centre, ELKH, Szeged, Hungary
| | - Gabriella Endre
- Institute of Plant Biology, Biological Research Centre, ELKH, Szeged, Hungary
| | - Gábor K Tóth
- Department of Medical Chemistry, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Éva Kondorosi
- Institute of Plant Biology, Biological Research Centre, ELKH, Szeged, Hungary
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23
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Sukhum KV, Newcomer EP, Cass C, Wallace MA, Johnson C, Fine J, Sax S, Barlet MH, Burnham CAD, Dantas G, Kwon JH. Antibiotic-resistant organisms establish reservoirs in new hospital built environments and are related to patient blood infection isolates. COMMUNICATIONS MEDICINE 2022; 2:62. [PMID: 35664456 PMCID: PMC9160058 DOI: 10.1038/s43856-022-00124-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/06/2022] [Indexed: 02/03/2023] Open
Abstract
Background Healthcare-associated infections due to antibiotic-resistant organisms pose an acute and rising threat to critically ill and immunocompromised patients. To evaluate reservoirs of antibiotic-resistant organisms as a source of transmission to patients, we interrogated isolates from environmental surfaces, patient feces, and patient blood infections from an established and a newly built intensive care unit. Methods We used selective culture to recover 829 antibiotic-resistant organisms from 1594 environmental and 72 patient fecal samples, in addition to 81 isolates from blood cultures. We conducted antibiotic susceptibility testing and short- and long-read whole genome sequencing on recovered isolates. Results Antibiotic-resistant organism burden is highest in sink drains compared to other surfaces. Pseudomonas aeruginosa is the most frequently cultured organism from surfaces in both intensive care units. From whole genome sequencing, different lineages of P. aeruginosa dominate in each unit; one P. aeruginosa lineage of ST1894 is found in multiple sink drains in the new intensive care unit and 3.7% of blood isolates analyzed, suggesting movement of this clone between the environment and patients. Conclusions These results highlight antibiotic-resistant organism reservoirs in hospital built environments as an important target for infection prevention in hospitalized patients.
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Affiliation(s)
- Kimberley V. Sukhum
- The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Erin P. Newcomer
- The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Biomedical Engineering, Washington University in St Louis, St Louis, MO USA
| | - Candice Cass
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Meghan A. Wallace
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Caitlin Johnson
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Jeremy Fine
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Steven Sax
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Margaret H. Barlet
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Carey-Ann D. Burnham
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Gautam Dantas
- The Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, MO USA
- Department of Biomedical Engineering, Washington University in St Louis, St Louis, MO USA
- Department of Molecular Microbiology, Washington University School of Medicine in St Louis, St Louis, MO USA
| | - Jennie H. Kwon
- Department of Medicine, Washington University School of Medicine in St Louis, St Louis, MO USA
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24
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La Vecchia A, Ippolito G, Taccani V, Gatti E, Bono P, Bettocchi S, Pinzani R, Tagliabue C, Bosis S, Marchisio P, Agostoni C. Epidemiology and antimicrobial susceptibility of Staphylococcus aureus in children in a tertiary care pediatric hospital in Milan, Italy, 2017-2021. Ital J Pediatr 2022; 48:67. [PMID: 35526042 PMCID: PMC9077633 DOI: 10.1186/s13052-022-01262-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent worldwide and can cause severe diseases. MRSA is associated with other antibiotic resistance. COVID-19 pandemic increased antimicrobial resistance in adult patients. Only a few data report the antimicrobial susceptibility of S. aureus in the Italian pediatric population, before and during the COVID-19 pandemic. Methods We included all the S. aureus positive samples with an available antibiogram isolated from pediatric patients (< 18 years old) in a tertiary care hospital in Milan, Italy, from January 2017 to December 2021. We collected data on demographics, antimicrobial susceptibility, and clinical history. We compared methicillin-susceptible Staphylococcus aureus (MSSA) and MRSA strains. We calculated the frequency of isolation by year. The incidence of isolates during 2020 was compared with the average year isolation frequency using the univariate Poisson test. We compared the proportion of MRSA isolates during 2020 to the average proportion of other years with the Chi-squared test. Results Our dataset included a total of 255 S. aureus isolated from 226 patients, 120 (53%) males, and 106 (47%) females, with a median age of 3.4 years (IQR 0.8 – 10.5). The mean isolation frequency per year was 51. We observed a significant decrease of isolations during 2020 (p = 0.02), but after adjusting for the total number of hospitalization per year there was no evidence that the incidence changed. Seventy-six (30%) S. aureus were MRSA. Twenty (26%) MRSA vs 23 (13%) MSSA (p = 0.02) were hospital-acquired. MRSA strains showed higher resistance to cotrimoxazole, clindamycin, macrolides, levofloxacin, gentamicin, and tetracyclin than MSSA strains. None of MRSA were resistant to linezolid and vancomycin, one was resistant to daptomycin. The proportion of MRSA did not change during the COVID-19 pandemic. The overall clindamycin resistance was high (17%). Recent antibiotic therapy was related to MRSA infection. Conclusion The proportion of MRSA did not change during the COVID-19 pandemic and remained high. Clindamycin should not be used as an empirical MRSA treatment due to its high resistance.
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Affiliation(s)
| | | | | | | | - Patrizia Bono
- Laboratory of Microbiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Bettocchi
- Pediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,De Marchi Foundation, Pediatric Area, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Raffaella Pinzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Claudia Tagliabue
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, via Francesco Sforza 9, 20122, Milan, Italy. .,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy.
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25
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McFarland AW, Elumalai A, Miller CC, Humayun A, Mills DK. Effectiveness and Applications of a Metal-Coated HNT/Polylactic Acid Antimicrobial Filtration System. Polymers (Basel) 2022; 14:1603. [PMID: 35458351 PMCID: PMC9030812 DOI: 10.3390/polym14081603] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 12/14/2022] Open
Abstract
A broad-spectrum antimicrobial respiration apparatus designed to fight bacteria, viruses, fungi, and other biological agents is critical in halting the current pandemic's trajectory and containing future outbreaks. We applied a simple and effective electrodeposition method for metal (copper, silver, and zinc) coating the surface of halloysite nanotubes (HNTs). These nanoparticles are known to possess potent antiviral and antimicrobial properties. Metal-coated HNTs (mHNTs) were then added to polylactic acid (PLA) and extruded to form an mHNT/PLA 3D composite printer filament. Our composite 3D printer filament was then used to fabricate an N95-style mask with an interchangeable/replaceable filter with surfaces designed to inactivate a virus and kill bacteria on contact, thus reducing deadly infections. The filter, made of a multilayered antimicrobial/mHNT blow spun polymer and fabric, is disposable, while the mask can be sanitized and reused. We used several in vitro means of assessing critical clinical features and assessed the bacterial growth inhibition against commonly encountered bacterial strains. These tests demonstrated the capability of our antimicrobial filament to fabricate N95 masks and filters that possessed antibacterial capabilities against both Gram-negative and Gram-positive bacteria.
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Affiliation(s)
- Antwine W. McFarland
- Molecular Science and Nanotechnology, Louisiana Tech University, Ruston, LA 71270, USA; (A.W.M.J.); (A.E.); (C.C.M.); (A.H.)
| | - Anusha Elumalai
- Molecular Science and Nanotechnology, Louisiana Tech University, Ruston, LA 71270, USA; (A.W.M.J.); (A.E.); (C.C.M.); (A.H.)
| | - Christopher C. Miller
- Molecular Science and Nanotechnology, Louisiana Tech University, Ruston, LA 71270, USA; (A.W.M.J.); (A.E.); (C.C.M.); (A.H.)
| | - Ahmed Humayun
- Molecular Science and Nanotechnology, Louisiana Tech University, Ruston, LA 71270, USA; (A.W.M.J.); (A.E.); (C.C.M.); (A.H.)
| | - David K. Mills
- Center for Biomedical Engineering and Rehabilitation Science, Louisiana Tech University, Ruston, LA 71270, USA
- School of Biological Sciences, Louisiana Tech University, Ruston, LA 71270, USA
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26
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Wang W, Sheng H, Cao D, Zhang F, Zhang W, Yan F, Ding D, Cheng N. S-nitrosoglutathione functionalized polydopamine nanoparticles incorporated into chitosan/gelatin hydrogel films with NIR-controlled photothermal/NO-releasing therapy for enhanced wound healing. Int J Biol Macromol 2022; 200:77-86. [PMID: 34973982 DOI: 10.1016/j.ijbiomac.2021.12.125] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 01/21/2023]
Abstract
Nitric oxide (NO) has aroused wide interest in the treating infected wounds due to its characteristic functionalities. However, its utilization is limited due to its volatile properties, high reactivity, direct potential toxicity, and byproducts of NO donors limited its application. Herein, endogenously NO donor S-nitrosoglutathione (GSNO) was connected covalently to polydopamine nanoparticles (PDA-GSNO NPs) to minimize the loss of NO in aqueous medium. Meanwhile, near-infrared (NIR)-controlled NO release and photothermal therapy (PTT) was obtained through the photothermal conversion by PDA. Then chitosan (CS)/gelatin (GE) biocomposite hydrogel films with preferable biocompatibility, surface hydrophilicity, hydroabsorptivity, and mechanical adhesive properties were constructed. By embedding PDA-GSNO NPs into the films, a multifunctional wound dressing was fabricated. Under NIR light irradiation, the combination of PTT, NO-releasing, and CS antibacterial agents can strengthen the in vitro antimicrobial efficacy and in vivo wound healing activities. Meanwhile, the obtained wound dressing presented good biocompatibility. This work outlines an approach for combating bacterial infections and demonstrating the possibility for synergistic NO-releasing wound healing.
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Affiliation(s)
- Wenyu Wang
- College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, PR China
| | - Huan Sheng
- College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, PR China
| | - Daihong Cao
- Department of Pathophysiology, Weifang Medical University, Weifang, Shangdong 261053, PR China
| | - Fenglian Zhang
- College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, PR China
| | - Weifen Zhang
- College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, PR China
| | - Fang Yan
- College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, PR China.
| | - Dejun Ding
- College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, PR China.
| | - Ni Cheng
- College of Pharmacy, Weifang Medical University, Weifang, Shandong 261053, PR China.
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27
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Environmental Design Strategies to Decrease the Risk of Nosocomial Infection in Medical Buildings Using a Hybrid MCDM Model. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2021:5534607. [PMID: 35126892 PMCID: PMC8814348 DOI: 10.1155/2021/5534607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/27/2021] [Indexed: 12/14/2022]
Abstract
The prevention and control of nosocomial infection (NI) are becoming increasingly difficult, and its mechanism is becoming increasingly complex. A globally aging population means that an increasing proportion of patients have a susceptible constitution, and the frequent occurrence of severe infectious diseases has also led to an increase in the cost of prevention and control of NI. Medical buildings' spatial environment design for the prevention of NI has been a hot subject of considerable research, but few previous studies have summarized the design criteria for a medical building environment to control the risk of NI. Thus, there is no suitable evaluation framework to determine whether the spatial environment of a medical building is capable of inhibiting the spread of NI. In the context of the global spread of COVID-19, it is necessary to evaluate the performance of the existing medical building environment in terms of inhibiting the spread of NI and to verify current environmental improvement strategies for the efficient and rational use of resources. This study determines the key design elements for the spatial environment of medical buildings, constructs an evaluation framework using exploratory factor analysis, verifies the complex dominant influence relationship, and prioritizes criteria in the evaluation framework using the decision-making trial and evaluation laboratory- (DEMATEL-) based analytical network process (ANP) (DANP). Using representative real cases, this study uses the technique for order preference by similarity to ideal solution (TOPSIS) to evaluate and analyze the performance with the aspiration level of reducing the NI risk. A continuous and systematic transformation design strategy for these real cases is proposed. The main contributions of this study include the following: (1) it creates a systematic framework that allows hospital decision-makers to evaluate the spatial environment of medical buildings; (2) it provides a reference for making design decisions to improve the current situation using the results of a performance evaluation; (3) it draws an influential network relation map (INRM) and the training of influence weights (IWs) for criteria. The sources of practical problems can be identified by the proposed evaluation framework, and the corresponding strategy can be proposed to avoid the waste of resources for the prevention of epidemics.
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28
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Cesarelli G, Petrelli R, Ricciardi C, D’Addio G, Monce O, Ruccia M, Cesarelli M. Reducing the Healthcare-Associated Infections in a Rehabilitation Hospital under the Guidance of Lean Six Sigma and DMAIC. Healthcare (Basel) 2021; 9:healthcare9121667. [PMID: 34946394 PMCID: PMC8700897 DOI: 10.3390/healthcare9121667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
The reduction of healthcare-associated infections (HAIs) is one of the most important issues in the healthcare context for every type of hospital. In three operational units of the Scientific Clinical Institutes Maugeri SpA SB, a rehabilitation hospital in Cassano delle Murge (Italy), some corrective measures were introduced in 2017 to reduce the occurrence of HAIs. Lean Six Sigma was used together with the Define, Measure, Analyze, Improve, Control (DMAIC) roadmap to analyze both the impact of such measures on HAIs and the length of hospital stay (LOS) in the Rehabilitative Cardiology, Rehabilitative Neurology, Functional Recovery and Rehabilitation units in the Medical Center for Intensive Rehabilitation. The data of 2415 patients were analyzed, considering the phases both before and after the introduction of the measures. The hospital experienced a LOS reduction in both patients with and without HAIs; in particular, Cardiology had the greatest reduction for patients with infections (-7 days). The overall decrease in HAIs in the hospital was 3.44%, going from 169 to 121 cases of infections. The noteworthy decrease in LOS implies an increase in admissions and in the turnover indicator of the hospital, which has a positive impact on the hospital management as well as on costs.
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Affiliation(s)
- Giuseppe Cesarelli
- Department of Chemical, Materials and Production Engineering, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy; (C.R.); (M.C.)
- Scientific Clinical Institute Maugeri sb SPA, Via Generale Bellomo, 73/75, 70124 Bari, Italy; (R.P.); (G.D.); (O.M.); (M.R.)
- Correspondence:
| | - Rita Petrelli
- Scientific Clinical Institute Maugeri sb SPA, Via Generale Bellomo, 73/75, 70124 Bari, Italy; (R.P.); (G.D.); (O.M.); (M.R.)
| | - Carlo Ricciardi
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy; (C.R.); (M.C.)
- Scientific Clinical Institute Maugeri sb SPA, Via Generale Bellomo, 73/75, 70124 Bari, Italy; (R.P.); (G.D.); (O.M.); (M.R.)
| | - Giovanni D’Addio
- Scientific Clinical Institute Maugeri sb SPA, Via Generale Bellomo, 73/75, 70124 Bari, Italy; (R.P.); (G.D.); (O.M.); (M.R.)
| | - Orjela Monce
- Scientific Clinical Institute Maugeri sb SPA, Via Generale Bellomo, 73/75, 70124 Bari, Italy; (R.P.); (G.D.); (O.M.); (M.R.)
| | - Maria Ruccia
- Scientific Clinical Institute Maugeri sb SPA, Via Generale Bellomo, 73/75, 70124 Bari, Italy; (R.P.); (G.D.); (O.M.); (M.R.)
| | - Mario Cesarelli
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, Via Claudio 21, 80125 Naples, Italy; (C.R.); (M.C.)
- Scientific Clinical Institute Maugeri sb SPA, Via Generale Bellomo, 73/75, 70124 Bari, Italy; (R.P.); (G.D.); (O.M.); (M.R.)
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New L, Goodridge D, Kappel J, Lawson J, Dobson R, Penz E, Groot G, Gjevre J. Improving hospital safety for patients with chronic kidney disease: a mixed methods study. BMC Nephrol 2021; 22:318. [PMID: 34556044 PMCID: PMC8461959 DOI: 10.1186/s12882-021-02499-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People living with chronic kidney disease (CKD) require complex medical management and may be frequently hospitalized. Patient safety incidents during hospitalization can result in serious complications which may negatively affect health outcomes. There has been limited examination of how these patients perceive their own safety. OBJECTIVES This study compared the safety perceptions of patients hospitalized with CKD using two approaches: (a) the Patient Measure of Safety (PMOS) questionnaire and (b) qualitative interviews. The study objectives were to: (1) assess concordance between qualitative and quantitative data on safety perceptions and (2) better understand safety as perceived by study participants. METHODS A cross-sectional convergent mixed methods design was used. Integration at the reporting level occurred by weaving together patient narratives and survey domains through the use of a joint display. Interview data were merged with results of the PMOS on a case-by-case basis for analysis to assess for concordance or discordance between these approaches to safety data collection. RESULTS Of the 30 inpatients with CKD, almost one quarter (23.3 %) of participants reported low levels of perceived safety in hospitals. Four major themes emerged from the interviews: receiving safe care; expecting to be taken care of; expecting to be cared for; and reporting safety concerns. Suboptimal communication, delays in care and concerns about technical aspects of care were common to both forms of data collection. Concordance was noted between qualitative and quantitative data with respect to communication/teamwork, respect and dignity, staff roles, and ward type/lay-out. While interviews allowed for participants to share specific concerns related to safety about quality of interpersonal interactions, use of the questionnaire alone did not capture this concern. CONCLUSIONS Safety issues are a concern for in-patients with CKD. Both quantitative and qualitative approaches provided important and complementary insights into these issues. Narratives were mostly concordant with questionnaire scores. Findings from this mixed methods study suggest that communication, interpersonal interactions, and delays in care were more concerning for participants than technical aspects of care. Eliciting the concerns of people with CKD in a systematic fashion, either through interviews or a survey, ensures that hospital safety improvement efforts focus on issues important to patients.
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Affiliation(s)
- Lucia New
- Health Sciences Program, College of Medicine, University of Saskatchewan, Saskatoon, SK Canada
| | - Donna Goodridge
- Department of Medicine, College of Medicine, University of Saskatchewan, 103 Hospital Drive, SK S7N OW8 Saskatoon, Canada
| | - Joanne Kappel
- Department of Medicine, Saskatchewan Health Authority, Saskatoon, Saskatchewan Canada
| | - Joshua Lawson
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan Canada
| | - Roy Dobson
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK Canada
| | - Erika Penz
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan Canada
| | - Gary Groot
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan Canada
| | - John Gjevre
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan Canada
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Hunter ND, Hoet AE, van Balen J, Stull JW. Longitudinal environmental Staphylococcus contamination in a new small animal veterinary hospital and utility of cleaning checklists. Zoonoses Public Health 2021; 68:947-954. [PMID: 34379895 DOI: 10.1111/zph.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/06/2020] [Accepted: 07/31/2021] [Indexed: 01/06/2023]
Abstract
Staphylococci are inhabitants of skin and mucous membranes with Staphylococcus pseudintermedius (SP) and Staphylococcus aureus (SA) serving as important pathogens for animals and people, respectively. Previous research has identified the environment as potentially important in hospital-associated infections and zoonotic transmission in veterinary settings. The objective of this pilot study was to determine the longitudinal prevalence over repeated samplings of environmental coagulase-positive Staphylococcus (CPS) in a new veterinary hospital and evaluate associations between contamination and environmental and clinical (caseload, cleaning checklists and staff numbers) factors. Cleaning and disinfection compliance, based on staff-completed checklists, were reviewed for the three shifts immediately prior to sampling. We hypothesized that over time, environmental contamination would increase as the clinic developed and caseload increased and compliance to cleaning checklists would decrease with increasing caseload. Over 18 months, 351 environmental samples were collected at five sampling times (sampling occurred before opening the hospital and every 3 to 6 months thereafter). Overall contamination with CPS was 30.8% (108/351), with SA (16.8%) and SP (13.1%) identified from the contaminated surfaces. Overall, methicillin-resistant strains (MRSA and MRSP) were infrequently recovered (combined n = 3; <1%). Point prevalence of CPS contamination was relatively stable over the study period (22.5%-28.4%), with the exception of an increase at the fourth sampling (52.9%). Cleaning compliance varied over the study period (57.9%-100%); the lowest reported cleaning coincided with the highest proportion of CPS contamination. The most commonly contaminated surfaces were chairs (7/15; 46.7%), examination tables (19/47; 40.4%) and computers (12/35; 34.3%); these items were infrequently included on cleaning lists. Surfaces not included in the checklist were 2.3 times more likely to be contaminated by CPS than those that were included (OR: 2.3, CI 95%: 1.02 -5.35, p-value=.04). MRSA and MRSP were rarely isolated from the environment in the newly opened hospital, indicating it may take time for resistant strains to enter the environment and persist on surfaces. This study identified the possible utility of cleaning checklists for directing cleaning practices and reducing the environmental contamination.
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Affiliation(s)
- Noelle D Hunter
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Armando E Hoet
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Joany van Balen
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
| | - Jason W Stull
- The Ohio State University College of Veterinary Medicine, Columbus, Ohio, USA
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Konstantinovski MM, Veldkamp KE, Lavrijsen APM, Bosch T, Kraakman MEM, Nooij S, Claas ECJ, Gooskens J. Hospital transmission of borderline oxacillin-resistant Staphylococcus aureus evaluated by whole-genome sequencing. J Med Microbiol 2021; 70. [PMID: 34269673 PMCID: PMC8493421 DOI: 10.1099/jmm.0.001384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Staphylococcus aureus is a major cause of hospital infections worldwide. Awareness towards methicillin-resistant S. aureus (MRSA) infections is high but attention towards borderline oxacillin-resistant S. aureus (BORSA) is limited, possibly due to an underestimated clinical relevance, presumption of low incidence and diagnostic limitations. Gap statement BORSA surveillance has not been routinely implemented, and thus consensus with regard to a definition and infection control measures is lacking. Aim Our goals were to investigate the occurrence, molecular characteristics and clinical manifestations of BORSA infections in the hospital setting. Methodology Following an increased incidence in 2016, BORSA cases in 2014/2016 (in our institution) were more specifically evaluated. Medical records were reviewed to investigate epidemiological links, clinical characteristics and outcomes. Resistance and virulence markers were assessed by whole genome sequencing (WGS). Conventional methods: amplified fragment length polymorphism (AFLP) ; multilocus sequence typing (MLST) and multiple locus variable-number tandem repeat analysis (MLVA) were compared with core genome MLST (cgMLST) and whole-genome single nucleotide polymorphism (wgSNP) analysis to confirm genetic clusters. Results From 2009 to 2013, BORSA comprised 0.1 % of all clinical S. aureus strains. In 2016, the incidence was six-fold higher in comparison to the baseline. Whole-genome SNP and cgMLST confirmed two BORSA clusters among patients with dermatological conditions. Patients with BORSA presented with skin infections, and one case developed a severe invasive infection with a fatal outcome. Infection control measures successfully prevented further transmission in both clusters. WGS findings showed that BORSA strains carried multiple resistance and virulence genes with increased pathogenic potential. Conclusion WGS and cgMLST effectively characterized and confirmed BORSA clusters among at-risk patients with clinical manifestations ranging from mild skin infections to life-threatening bacteraemia. Clinical awareness and active monitoring are therefore warranted for the timely implementation of infection control measures to prevent BORSA transmission in high-risk patients.
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Affiliation(s)
| | - Karin Ellen Veldkamp
- Medical Microbiology Department, Leiden University Medical Center, Leiden, Netherlands
| | | | - Thijs Bosch
- Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment, de Bilt, Netherlands
| | - Margriet E M Kraakman
- Medical Microbiology Department, Leiden University Medical Center, Leiden, Netherlands
| | - Sam Nooij
- Medical Microbiology Department, Leiden University Medical Center, Leiden, Netherlands
| | - Eric C J Claas
- Medical Microbiology Department, Leiden University Medical Center, Leiden, Netherlands
| | - Jairo Gooskens
- Medical Microbiology Department, Leiden University Medical Center, Leiden, Netherlands
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Teixeira H, Freitas A, Sarmento A, Nossa P, Gonçalves H, Pina MDF. Spatial Patterns in Hospital-Acquired Infections in Portugal (2014-2017). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094703. [PMID: 33925064 PMCID: PMC8124660 DOI: 10.3390/ijerph18094703] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hospital-Acquired Infections (HAIs) represent the most frequent adverse event associated with healthcare delivery and result in prolonged hospital stays and deaths worldwide. AIM To analyze the spatial patterns of HAI incidence from 2014 to 2017 in Portugal. METHODS Data from the Portuguese Discharge Hospital Register were used. We selected episodes of patients with no infection on admission and with any of the following HAI diagnoses: catheter-related bloodstream infections, intestinal infections by Clostridium difficile, nosocomial pneumonia, surgical site infections, and urinary tract infections. We calculated age-standardized hospitalization rates (ASHR) by place of patient residence. We used empirical Bayes estimators to smooth the ASHR. The Moran Index and Local Index of Spatial Autocorrelation (LISA) were calculated to identify spatial clusters. RESULTS A total of 318,218 HAIs were registered, with men accounting for 49.8% cases. The median length of stay (LOS) was 9.0 days, and 15.7% of patients died during the hospitalization. The peak of HAIs (n = 81,690) occurred in 2015, representing 9.4% of the total hospital admissions. Substantial spatial inequalities were observed, with the center region presenting three times the ASHR of the north. A slight decrease in ASHR was observed after 2015. Pneumonia was the most frequent HAI in all age groups. CONCLUSION The incidence of HAI is not randomly distributed in the space; clusters of high risk in the central region were seen over the entire study period. These findings may be useful to support healthcare policymakers and to promote a revision of infection control policies, providing insights for improved implementation.
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Affiliation(s)
- Hugo Teixeira
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (A.F.); (H.G.)
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, 4200-135 Porto, Portugal; (A.S.); (M.d.F.P.)
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- Correspondence: or
| | - Alberto Freitas
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (A.F.); (H.G.)
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - António Sarmento
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, 4200-135 Porto, Portugal; (A.S.); (M.d.F.P.)
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- Department of Infectious Diseases, Centro Hospitalar Universitário de São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Paulo Nossa
- CEGOT, Centre of Studies in Geography and Spatial Planning, University of Coimbra, 3004-530 Coimbra, Portugal;
- Department of Geography and Tourism, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Hernâni Gonçalves
- MEDCIDS—Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal; (A.F.); (H.G.)
- CINTESIS—Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
| | - Maria de Fátima Pina
- INEB—Instituto de Engenharia Biomédica, Universidade do Porto, 4200-135 Porto, Portugal; (A.S.); (M.d.F.P.)
- i3S—Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
- ICICT/FIOCRUZ, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde/Fundação Oswaldo Cruz, 21040-900 Rio De Janeiro, Brazil
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Vrancianu CO, Dobre EG, Gheorghe I, Barbu I, Cristian RE, Chifiriuc MC. Present and Future Perspectives on Therapeutic Options for Carbapenemase-Producing Enterobacterales Infections. Microorganisms 2021; 9:730. [PMID: 33807464 PMCID: PMC8065494 DOI: 10.3390/microorganisms9040730] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 12/26/2022] Open
Abstract
Carbapenem-resistant Enterobacterales (CRE) are included in the list of the most threatening antibiotic resistance microorganisms, being responsible for often insurmountable therapeutic issues, especially in hospitalized patients and immunocompromised individuals and patients in intensive care units. The enzymatic resistance to carbapenems is encoded by different β-lactamases belonging to A, B or D Ambler class. Besides compromising the activity of last-resort antibiotics, CRE have spread from the clinical to the environmental sectors, in all geographic regions. The purpose of this review is to present present and future perspectives on CRE-associated infections treatment.
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Affiliation(s)
- Corneliu Ovidiu Vrancianu
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania; (C.O.V.); (E.G.D.); (I.B.); (M.C.C.)
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Elena Georgiana Dobre
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania; (C.O.V.); (E.G.D.); (I.B.); (M.C.C.)
| | - Irina Gheorghe
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania; (C.O.V.); (E.G.D.); (I.B.); (M.C.C.)
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Ilda Barbu
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania; (C.O.V.); (E.G.D.); (I.B.); (M.C.C.)
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
| | - Roxana Elena Cristian
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania;
| | - Mariana Carmen Chifiriuc
- Microbiology Immunology Department, Faculty of Biology, University of Bucharest, 050095 Bucharest, Romania; (C.O.V.); (E.G.D.); (I.B.); (M.C.C.)
- The Research Institute of the University of Bucharest, 050095 Bucharest, Romania
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Campestre C, De Luca V, Carradori S, Grande R, Carginale V, Scaloni A, Supuran CT, Capasso C. Carbonic Anhydrases: New Perspectives on Protein Functional Role and Inhibition in Helicobacter pylori. Front Microbiol 2021; 12:629163. [PMID: 33815311 PMCID: PMC8017301 DOI: 10.3389/fmicb.2021.629163] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/22/2021] [Indexed: 12/12/2022] Open
Abstract
Our understanding of the function of bacterial carbonic anhydrases (CAs, EC 4.2.1.1) has increased significantly in the last years. CAs are metalloenzymes able to modulate CO2, HCO3 - and H+ concentration through their crucial role in catalysis of reversible CO2 hydration (CO2 + H2O ⇄ HCO3 - + H+). In all living organisms, CA activity is linked to physiological processes, such as those related to the transport and supply of CO2 or HCO3 -, pH homeostasis, secretion of electrolytes, biosynthetic processes and photosynthesis. These important processes cannot be ensured by the very low rate of the non-catalyzed reaction of CO2 hydration. It has been recently shown that CAs are important biomolecules for many bacteria involved in human infections, such as Vibrio cholerae, Brucella suis, Salmonella enterica, Pseudomonas aeruginosa, and Helicobacter pylori. In these species, CA activity promotes microorganism growth and adaptation in the host, or modulates bacterial toxin production and virulence. In this review, recent literature in this research field and some of the above-mentioned issues are discussed, namely: (i) the implication of CAs from bacterial pathogens in determining the microorganism growth and virulence; (ii) the druggability of these enzymes using classical CA inhibitors (CAIs) of the sulfonamide-type as examples; (iii) the role played by Helicobacter pylori CAs in the acid tolerance/adaptation of the microbe within the human abdomen; (iv) the role of CAs played in the outer membrane vesicles spawned by H. pylori in its planktonic and biofilm phenotypes; (v) the possibility of using H. pylori CAIs in combination with probiotic strains as a novel anti-ulcer treatment approach. The latter approach may represent an innovative and successful strategy to fight gastric infections in the era of increasing resistance of pathogenic bacteria to classical antibiotics.
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Affiliation(s)
- Cristina Campestre
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Viviana De Luca
- Department of Biology, Agriculture and Food Sciences, National Research Council (CNR), Institute of Biosciences and Bioresources, Naples, Italy.,Proteomics and Mass Spectrometry Laboratory, Institute for the Animal Production System in the Mediterranean Environment, National Research Council (ISPAAM-CNR), Naples, Italy
| | - Simone Carradori
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Rossella Grande
- Department of Pharmacy, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Vincenzo Carginale
- Department of Biology, Agriculture and Food Sciences, National Research Council (CNR), Institute of Biosciences and Bioresources, Naples, Italy
| | - Andrea Scaloni
- Proteomics and Mass Spectrometry Laboratory, Institute for the Animal Production System in the Mediterranean Environment, National Research Council (ISPAAM-CNR), Naples, Italy
| | - Claudiu T Supuran
- Section of Pharmaceutical and Nutraceutical Sciences, Polo Scientifico, Department of NEUROFARBA, University of Florence, Sesto Fiorentino, Italy
| | - Clemente Capasso
- Department of Biology, Agriculture and Food Sciences, National Research Council (CNR), Institute of Biosciences and Bioresources, Naples, Italy
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Vella V, Galgani I, Polito L, Arora AK, Creech CB, David MZ, Lowy FD, Macesic N, Ridgway JP, Uhlemann AC, Bagnoli F. Staphylococcus aureus Skin and Soft Tissue Infection Recurrence Rates in Outpatients: A Retrospective Database Study at 3 US Medical Centers. Clin Infect Dis 2020; 73:e1045-e1053. [PMID: 33197926 PMCID: PMC8423503 DOI: 10.1093/cid/ciaa1717] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/10/2020] [Indexed: 01/15/2023] Open
Abstract
Background Staphylococcusaureus skin and soft tissue infections (SA-SSTIs) are common in healthcare and community settings, and recurrences occur at variable frequency, even after successful initial treatment. Knowing the exact burden and timing of recurrent disease is critical to planning and evaluating interventions to prevent recurrent SSTIs. Methods In this retrospective study, SSTI cases in patients aged ≥18 years at 3 US medical centers (Columbia, Chicago, Vanderbilt) between 2006 and 2016 were analyzed according to a biennial cohort design. Index SSTIs (with or without key comorbidities), either microbiologically confirmed to be SA-SSTI or not microbiologically tested (NMT-SSTI), were recorded within 1 calendar year and followed up for 12 months for recurrent infections. The number of index cases, proportion of index cases with ≥1 recurrence(s), time to first recurrence, and number of recurrences were collected for both SA-SSTI and NMT-SSTI events. Results In the most recent cohorts, 4755 SSTI cases were reported at Columbia, 2873 at Chicago, and 6433 at Vanderbilt. Of these, 452, 153, and 354 cases were confirmed to be due to S. aureus. Most cases were reported in patients without key comorbidities. Across centers, 16.4%–19.0% (SA-SSTI) and 11.0%–19.2% (NMT-SSTI) of index cases had ≥1 recurrence(s). In patients without key comorbidities, more than 60% of index SSTIs with recurrences had only 1 recurrence, half of which occurred in the first 3 months following primary infection. Conclusions SA-SSTI recurrences are common among healthy adults and occur in at least 1 in 6 individuals during the 1 year following the primary event.
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Affiliation(s)
| | | | - Letizia Polito
- GSK, Siena, Italy.,Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - C Buddy Creech
- Vanderbilt Vaccine Research Program, Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael Z David
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Franklin D Lowy
- Department of Medicine, Columbia University Medical Center, New York, New York, USA.,Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York, USA
| | - Nenad Macesic
- Department of Medicine, Columbia University Medical Center, New York, New York, USA.,Central Clinical School, Monash University, Melbourne, Australia
| | - Jessica P Ridgway
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Anne-Catrin Uhlemann
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
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The intersection of hand hygiene, infusion pump contamination, and high alarm volume in the health care environment. Am J Infect Control 2020; 48:1311-1314. [PMID: 32305430 DOI: 10.1016/j.ajic.2020.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Researchers have found that lack of hand hygiene and environmental contamination are sources of infection transmission in the health care environment. One factor that may lead to lack of hand hygiene is alarm fatigue, the sensory overload that results when clinicians are exposed to an excessive number of alarms, causing them to silence alarms without taking proper precautions. In this study, we report hand hygiene compliance and infusion pump contamination in the context of infusion pump alarm prevalence. METHODS Health care worker hand hygiene audits were conducted to determine percent compliance. Cultures were obtained from infusion pumps to determine environmental contamination. The frequency of alarms from August 4, 2019 to September 7, 2019 was determined. RESULTS Hand hygiene compliance ranged from 50% to 87%. Pump contamination ranged from 20% to 70% per unit. A total of 116, 872 infusion pump alarms sounded in the hospital. DISCUSSION Pumps were contaminated primarily with skin flora. This was demonstrated in the context of poor hand hygiene compliance and a high number of alarms, indicative of alarm fatigue. CONCLUSIONS The intersection of a high prevalence of infusion pump alarms and poor hand hygiene resulting in bacterial contamination of pumps could be a source of health care-associated infection transmission for patients.
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Wu YH, Chen CJ, Wu HY, Chen I, Chang YH, Yang PH, Wang TY, Chen LC, Liu KT, Yeh IJ, Wu DC, Hou MF, Liu HL, Su WH. Plastic wrap combined with alcohol wiping is an effective method of preventing bacterial colonization on mobile phones. Medicine (Baltimore) 2020; 99:e22910. [PMID: 33126347 PMCID: PMC7598847 DOI: 10.1097/md.0000000000022910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/14/2020] [Accepted: 09/25/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Using mobile phones for communication in emergency departments is a common practice; however, several studies have demonstrated that they may act as vectors for bacteria and viruses. This study evaluated the effectiveness of plastic wrapping in decreasing bacterial contamination on mobile phone surfaces. METHOD We used culture dishes and a luminometer to detect bacterial colonies and contamination on the phone surfaces. RESULT Our experiment showed that bacterial colonies exist on mobile phones before and after work. We found that wiping with 75% alcohol sanitizers effectively reduces the number of colonies on either a mobile phone or a temporary plastic covering. In addition, we found that bacterial colonies do not contaminate or adhere to plastic wrap any easier than to mobile phones. CONCLUSION These results demonstrated the effectiveness of plastic wrap for protecting mobile phone surfaces against bacterial colonization. In addition, applying a layer of plastic wrap protects the phone from potential damage due to the alcohol.
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Affiliation(s)
- Yen-Hung Wu
- Department of Emergency Medicine, Kaohsiung Medical University Hospital
- Graduate Institute of Clinical Medicine, College of Medicine
| | | | | | - I Chen
- Division of Financial Management
| | | | - Pei-Hsuan Yang
- Department of Nursing, Department of Renal Care, School of Nursing, Fooyin University
| | - Tzu-Yi Wang
- Department of Emergency Medicine, Kaohsiung Medical University Hospital
| | - Li-Chin Chen
- Department of Nursing, Kaohsiung Medical University
| | - Kuan-Ting Liu
- Department of Emergency Medicine, Kaohsiung Medical University Hospital
| | - I-Jeng Yeh
- Department of Emergency Medicine, Kaohsiung Medical University Hospital
- Graduate Institute of Clinical Medicine, College of Medicine
| | - Deng-Chyang Wu
- Division of Gastroenterology, Department of Internal Medicine
- Cell Therapy and Research Center, Kaohsiung Medical University Hospital
- Regenerative Medicine and Cell Therapy Research Center
| | - Ming-Feng Hou
- Department of Superintendent office, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Liang Liu
- Department of Emergency Medicine, Kaohsiung Medical University Hospital
| | - Wen-Hui Su
- Department of Superintendent office, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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The burden of bacteremic and non-bacteremic Gram-negative infections: A prospective multicenter cohort study in a low-resistance country. J Infect 2020; 81:895-901. [PMID: 33031834 DOI: 10.1016/j.jinf.2020.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 11/23/2022]
Abstract
Objectives There is a global increase in infections caused by Gram-negative bacteria. The majority of research is on bacteremic Gram-negative infections (GNI), leaving a knowledge gap on the burden of non-bacteremic GNI. Our aim is to describe characteristics and determine the burden of bacteremic and non-bacteremic GNI in hospitalized patients in the Netherlands. Methods We conducted a prospective cohort study of patients in eight hospitals with microbiologically confirmed GNI, between June 2013 and November 2015. In each hospital the first five adults meeting the eligibility criteria per week were enrolled. We estimated the national incidence and mortality of GNI by combining the cohort data with a national surveillance database for antimicrobial resistance. Results 1,954 patients with GNI were included of which 758 (39%) were bloodstream infections (BSI). 243 GNI (12%) involved multi-drug resistant pathogens. 30-day mortality rate was 11.1% (n = 217) Estimated national incidences of non-bacteremic GNI and bacteremic GNI in hospitalized adults were 74 (95% CI 58 - 89) and 86 (95% CI 72-100) per 100,000 person years, yielding estimated annual numbers of 30-day all-cause mortality deaths of 1,528 (95% CI 1,102-1,954) for bacteremic and 982 (95% CI 688 - 1,276) for non-bacteremic GNI. Conclusion GNI form a large mortality burden in a low-resistance country. A third of the associated mortality occurs after non-bacteremic GNI.
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Lara HH, Lopez-Ribot JL. Inhibition of Mixed Biofilms of Candida albicans and Methicillin-Resistant Staphylococcus aureus by Positively Charged Silver Nanoparticles and Functionalized Silicone Elastomers. Pathogens 2020; 9:E784. [PMID: 32992727 PMCID: PMC7600790 DOI: 10.3390/pathogens9100784] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/16/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022] Open
Abstract
Both bacterial and fungal organisms display the ability to form biofilms; however, mixed bacterial/fungal biofilms are particularly difficult to control and eradicate. The opportunistic microbial pathogens Candida albicans and Staphylococcus aureus are among the most frequent causative agents of healthcare-acquired infections, and are often co-isolated forming mixed biofilms, especially from contaminated catheters. These mixed species biofilms display a high level of antibiotic resistance; thus, these infections are challenging to treat resulting in excess morbidity and mortality. In the absence of effective conventional antibiotic treatments, nanotechnology-based approaches represent a promising alternative for the treatment of highly recalcitrant polymicrobial biofilm infections. Our group has previously reported on the activity of pure positively charged silver nanoparticles synthesized by a novel microwave technique against single-species biofilms of C. albicans and S. aureus. Here, we have expanded our observations to demonstrate that that silver nanoparticles display dose-dependent activity against dual-species C. albicans/S. aureus biofilms. Moreover, the same nanoparticles were used to functionalize catheter materials, leading to the effective inhibition of the mixed fungal/bacterial biofilms. Overall, our results indicate the potent activity of silver nanoparticles against these cross-kingdom biofilms. More studies are warranted to examine the ability of functionalized catheters in the prevention of catheter-related bloodstream infections.
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Affiliation(s)
- Humberto H. Lara
- Department of Biology and South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Jose L. Lopez-Ribot
- Department of Biology and South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, TX 78249, USA
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Vrachnaki O, Vergadi E, Ioannidou E, Galanakis E. Determinants of low uptake of vaccination against influenza, measles, and hepatitis B among healthcare professionals in Greece: a multicenter cross-sectional study. Hum Vaccin Immunother 2020; 16:2663-2669. [PMID: 32401656 DOI: 10.1080/21645515.2020.1741311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Vaccination is recommended for healthcare professionals (HCPs) to protect them against vaccine-preventable diseases (VPDs); however, uptake rates are low. This study aimed to evaluate HCPs' influenza, hepatitis B, and measles vaccine uptake in all healthcare levels in Crete, Greece. We conducted a questionnaire-based, cross-sectional multicenter study in 2018, including HCPs employed at 18 primary care centers and 3 hospitals. Overall, 2,246 HCPs responded (57.2% of the target population). The influenza vaccine uptake rate was 36.1% (810/2,246), with the annual vaccination rate at 14.8% (332/2,246) over the previous 5 years. Concurrently, the hepatitis B 3-dose vaccine uptake rate was 60.3% (1,316/2,181). Among the participating HCPs, 70.7% (1,457/2,061) had measles immunity due to previous illness (959/2,061, 46.5%), a 2-dose vaccination scheme (461/2,061, 22.4%), or serological confirmation (37/2,061, 1.8%). Vaccine uptake rates differed between groups depending on age, profession, and workplace setting. Logistic regression analysis revealed that risk factors for no influenza vaccine uptake during the previous season were younger age (≤45 years; odds ratio [OR] 1.35, 95% confidence interval [CI]: 1.08-1.66), profession other than physician (OR 2.94, 95%CI: 2.09-4.12), and working in hospitals (OR 1.39, 95%CI 1.02-1.89). Older age (>45 years) was an independent risk factor for not receiving a measles (OR 26.74, 95%CI: 17.41-41.06) or hepatitis B vaccine (OR 1.36, 95%CI 1.09-1.7). Working in primary care was an independent risk factor for not getting a hepatitis B vaccine (OR 1.52, 95%CI: 1.15-2.1). Our findings indicate that individualized and targeted interventions should be implemented to increase vaccine uptake among HCPs.
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Affiliation(s)
- Olga Vrachnaki
- Department of Paediatrics, Heraklion University Hospital , Heraklion, Greece
| | - Eleni Vergadi
- Department of Paediatrics, Heraklion University Hospital , Heraklion, Greece.,Department of Paediatrics, Medical School, University of Crete , Heraklion, Greece
| | - Eleni Ioannidou
- Department of Internal Medicine, Rethymnon General Hospital , Rethymnon, Greece
| | - Emmanouil Galanakis
- Department of Paediatrics, Heraklion University Hospital , Heraklion, Greece.,Department of Paediatrics, Medical School, University of Crete , Heraklion, Greece
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Melegari G, Iseppi R, Mariani M, Giuliani E, Caciagli V, Bertellini E, Messi P, Barbieri A. Keyboard Contamination in Intensive Care Unit: Is Cleaning Enough? Prospective Research of In Situ Effectiveness of a Tea Tree Oil (KTEO) Film. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1323:91-102. [PMID: 32914396 DOI: 10.1007/5584_2020_575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
After the SARS-CoV-2 pandemic, disinfection practices and microbial load reduction have become even more important and rigorous. To determine the contamination of keyboard surface and the relative risk to transfer healthcare-associated pathogens to susceptible patients, as it frequently happens in Intensive Care Unit (ICU), a standard keyboard (SK), a cleanable keyless keyboard (KK) with smooth surface and a standard keyboard coated with a 3 M Tegaderm® film added with active essential oil (tea tree oil) (KTEO) were tested. S. aureus, including MRSA strains, were detected in ICU, with values ranging from 15% to 57%. Gram negative strains belonging to the Enterobacteriaceae family were also found with values ranging from 14% to 71%. Similar Gram positive and Gram negative strains were found on all surfaces, but with low percentage, and only environmental bacteria were detected using the settling plates method. The Microbial Challenge Test performed on KTEO showed high rates of decrease for all the pathogens with statistical significance both at 24 and 48 h (p = 0.003* and p = 0.040*, respectively). Our results suggest that the use of KTEO may be a feasible strategy for reducing the transmission of pathogens in health care setting and may be complementary to surface cleaning protocols.
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Affiliation(s)
- Gabriele Melegari
- Department of Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria di Modena, Modena, Italy.
| | - Ramona Iseppi
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Martina Mariani
- Department Department of Medical, Surgical, Maternal-Child and Adult Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrico Giuliani
- Department Department of Medical, Surgical, Maternal-Child and Adult Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Valeria Caciagli
- School of Anaesthesia and Intensive Care of University of Modena and Reggio Emilia, Modena, Italy
| | - Elisabetta Bertellini
- Department of Anaesthesia and Intensive Care, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Patrizia Messi
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Alberto Barbieri
- School of Anaesthesia and Intensive Care of University of Modena and Reggio Emilia, Modena, Italy
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Wall S. Prevention of antibiotic resistance - an epidemiological scoping review to identify research categories and knowledge gaps. Glob Health Action 2019; 12:1756191. [PMID: 32475304 PMCID: PMC7782542 DOI: 10.1080/16549716.2020.1756191] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/10/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Antibiotics have become the cornerstone for the treatment of infectious diseases and contributed significantly to the dramatic global health development during the last 70 years. Millions of people now survive what were previously life-threatening infections. But antibiotics are finite resources and misuse has led to antibiotic resistance and reduced efficacy within just a few years of introduction of each new antibiotic. The World Health Organization rates antibiotic resistance as a 'global security threat' impacting on global health, food security and development and as important as terrorism and climate change. OBJECTIVES This paper explores, through a scoping review of the literature published during the past 20 years, the magnitude of peer-reviewed and grey literature that addresses antibiotic resistance and specifically the extent to which "prevention" has been at the core. The ultimate aim is to identify know-do gaps and strategies to prevent ABR. METHODS The review covers four main data bases, Web of Science, Medline, Scopus and Ebsco searched for 2000-17. The broader research field "antibiotic OR antimicrobial resistance" gave 431,335 hits. Narrowing the search criteria to "Prevention of antibiotic OR antimicrobial resistance" resulted in 1062 remaining titles. Of these, 622 were unique titles. After screening of the 622 titles for relevance, 420 abstracts were read, and of these 282 papers were read in full. An additional 53 references were identified from these papers, and 64 published during 2018 and 2019 were also included. The final scoping review database thus consisted of 399 papers. RESULTS A thematic structure emerged when categorizing articles in different subject areas, serving as a proxy for interest expressed from the research community. The research area has been an evolving one with about half of the 399 papers published during the past four years of the study period. Epidemiological modelling needs strengthening and there is a need for more and better surveillance systems, especially in lower- and middle-income countries. There is a wealth of information on the local and national uses and misuses of antibiotics. Educational and stewardship programmes basically lack evidence. Several studies address knowledge of the public and prescribers. The lessons for policy are conveyed in many alarming reports from national and international organizations. CONCLUSIONS Descriptive rather than theoretical ambitions have characterized the literature. If we want to better understand and explain the antibiotic situation from a behavioural perspective, the required approaches are lacking. A framework for an epidemiological causal web behind ABR is suggested and may serve to identify entry points for potential interventions.
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Affiliation(s)
- Stig Wall
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement. BMC Pregnancy Childbirth 2019; 19:488. [PMID: 31823747 PMCID: PMC6905111 DOI: 10.1186/s12884-019-2656-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 12/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Although Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. The study aimed to measure the QoC for different MNH services in two selected public health facilities of Bangladesh. This study also documented the specific areas of each care which needs intervention. METHODS The study was conducted in two district-level public health facilities-a district hospital (DH) and a mother and child welfare centre (MCWC). A total of 228 cases of MNH services were observed by using contextualized checklist 'Standards-based Management and Recognition (S-BMR)' for 8 selected MNH care services. For scoring, performed activities were calculated as percentages of the total recommended activities and categorized as high (> 80%), moderate (50 to 80%), and low (< 50%). RESULTS Overall QoC scores were moderate for each DH (54.8%), and MCWC (56.1%). In DH, the QoC score was high for blood transfusion (80.3%); moderate for maternal complications management (77.0%), caesarean section (CS) (65.6%), infection prevention (64.3%), sick newborn care (54.1%), and normal vaginal delivery (NVD) (52.6%); and low for antenatal care (ANC) (25.6%) and postnatal care (PNC) (19.0%). In MCWC, the QoC scores were high for infection prevention (83.0%); moderate for CS (76.5%) and NVD (59.8%); and low for ANC (36.9%) and PNC (24.5%). CONCLUSIONS In the study facilities, the QoC for MNH services is found to be unsatisfactory, particularly for ANC and PNC. Urgent initiative needs to be taken by introducing contextualized quality monitoring tools at health facilities, along with training of the care providers and introducing a quality monitoring system.
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Hanger HC, Bloor M. Inpatient healthcare-associated bloodstream infections in older people. Intern Med J 2019; 49:1173-1177. [PMID: 31507044 DOI: 10.1111/imj.14430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 03/06/2019] [Accepted: 03/11/2019] [Indexed: 11/29/2022]
Abstract
This retrospective study describes inpatient healthcare-associated bloodstream infections (HABSI) in older adults and explores whether urinary catheters (presence/insertion/removal) were related to HABSI events. One hundred and sixty-seven HABSI events were identified, predominantly (124, 74%) with Gram-negative bacteria. HABSI was attributed to a urinary source in 110 patients (66%), with over half (63, 57%) of these associated with urinary catheters. Catheter-associated HABSI may be avoidable and potential preventative strategies are discussed.
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Affiliation(s)
- H Carl Hanger
- Older Persons Health Specialist Service, Burwood Hospital, Christchurch, New Zealand
| | - Michelle Bloor
- Older Persons Health Specialist Service, Burwood Hospital, Christchurch, New Zealand
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Gargiullo L, Del Chierico F, D’Argenio P, Putignani L. Gut Microbiota Modulation for Multidrug-Resistant Organism Decolonization: Present and Future Perspectives. Front Microbiol 2019; 10:1704. [PMID: 31402904 PMCID: PMC6671974 DOI: 10.3389/fmicb.2019.01704] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/10/2019] [Indexed: 01/10/2023] Open
Abstract
The emergence of antimicrobial resistance (AMR) is of great concern to global public health. Treatment of multi-drug resistant (MDR) infections is a major clinical challenge: the increase in antibiotic resistance leads to a greater risk of therapeutic failure, relapses, longer hospitalizations, and worse clinical outcomes. Currently, there are no validated treatments for many MDR or pandrug-resistant (PDR) infections, and preventing the spread of these pathogens through hospital infection control procedures and antimicrobial stewardship programs is often the only tool available to healthcare providers. Therefore, new solutions to control the colonization of MDR pathogens are urgently needed. In this narrative review, we discuss current knowledge of microbiota-mediated mechanisms of AMR and strategies for MDR colonization control. We focus particularly on fecal microbiota transplantation for MDR intestinal decolonization and report updated literature on its current clinical use.
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Affiliation(s)
- Livia Gargiullo
- Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department, Bambino Gesù Children’s Hospital, IRCSS, Rome, Italy
| | | | - Patrizia D’Argenio
- Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department, Bambino Gesù Children’s Hospital, IRCSS, Rome, Italy
| | - Lorenza Putignani
- Human Microbiome Unit and Parasitology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Bergman NJ. Historical background to maternal-neonate separation and neonatal care. Birth Defects Res 2019; 111:1081-1086. [PMID: 31148388 DOI: 10.1002/bdr2.1528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 11/09/2022]
Abstract
Maternal-neonate separation after birth is standard practice in the modern obstetric care. This is however a relatively new phenomenon, and its origins are described. Around 1890, two obstetricians in France expanded on a newly invented egg hatchery as a method of caring for preterm newborns. Mothers provided basic care, until incubators became part of commercial exhibitions that excluded them. After some 40 years hospitals accepted incubators, and adopted the strict separation of mothers from babies observed at the exhibitions. The introduction of artificial infant formula made the separation practical, and this also became normal practice rather than breastfeeding. Incubators and formula were unquestioned standard practices before randomized controlled trials were introduced, and therefore never subjected to such trials. The introduction of Kangaroo Care began 40 years ago in Colombia, now as a novel intervention. Recent trials do in fact show that maternal-neonate separation is detrimental to mothers and babies. Recent scientific discoveries such as the microbiome, epigenetics, and neuroimaging provide the scientific explanations that have not been available before, suggesting that skin-to-skin contact and breastfeeding are defining for the basic reproductive biology of human beings.
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Affiliation(s)
- Nils J Bergman
- Department of Neonatology, Karolinska Institute, Stockholm, Sweden
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Cabral J, Ag R. Blue Light Disinfection in Hospital Infection Control: Advantages, Drawbacks, and Pitfalls. Antibiotics (Basel) 2019; 8:antibiotics8020058. [PMID: 31067733 PMCID: PMC6627448 DOI: 10.3390/antibiotics8020058] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/27/2019] [Accepted: 05/02/2019] [Indexed: 01/09/2023] Open
Abstract
Hospital acquired infections (HAIs) are a serious problem that potentially affects millions of patients whenever in contact with hospital settings. Worsening the panorama is the emergence of antimicrobial resistance by most microorganisms implicated in HAIs. Therefore, the improvement of the actual surveillance methods and the discovery of alternative approaches with novel modes of action is vital to overcome the threats created by the emergence of such resistances. Light therapy modalities represent a viable and effective alternative to the conventional antimicrobial treatment and can be preponderant in the control of HAIs, even against multidrug resistant organisms (MDROs). This review will initially focus on the actual state of HAIs and MDROs and which methods are currently available to fight them, which is followed by the exploration of antimicrobial photodynamic therapy (aPDT) and antimicrobial blue light therapy (aBLT) as alternative approaches to control microorganisms involved in HAIs. The advantages and drawbacks of BLT relatively to aPDT and conventional antimicrobial drugs as well as its potential applications to destroy microorganisms in the healthcare setting will also be discussed.
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Affiliation(s)
- João Cabral
- Division of Microbiology, Department of Pathology, Porto Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
| | - Rodrigues Ag
- Division of Microbiology, Department of Pathology, Porto Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
- CINTESIS-Center for Health Technology and Services Research, 4200-450 Porto, Portugal.
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Hand hygiene: Sounds easy, but not when it comes to implementation. J Infect Public Health 2019; 12:301-303. [DOI: 10.1016/j.jiph.2019.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Cleaning Staff's Attitudes about Hand Hygiene in a Metropolitan Hospital in Australia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061067. [PMID: 30934579 PMCID: PMC6466087 DOI: 10.3390/ijerph16061067] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/01/2019] [Accepted: 03/12/2019] [Indexed: 02/04/2023]
Abstract
Background: In 2009, the National Hand Hygiene Initiative (NHHI) was implemented in hospitals across Australia with the aim of improving hand hygiene practices and reducing healthcare-associated infections. Audits conducted post-implementation showed the lowest rates of compliance with hand hygiene practices are among operational staff including hospital cleaners. There is limited information about hand hygiene issues in hospital cleaners to inform development of evidence-based interventions to improve hand hygiene compliance in this group. Aim: This qualitative study was undertaken to explore the attitudes of hospital cleaning staff regarding hand hygiene and the National Hand Hygiene Initiative. Methodology: Focus groups were conducted with 12 cleaning staff at a large Australian hospital implementing the National Hand Hygiene Initiative. Findings: Hospital cleaners recognise the importance of hand hygiene in preventing healthcare-associated infections. Cleaners cite peer support, leadership, and the recognition and reward of those excelling in hand hygiene as strong motivators. Barriers to optimal hand hygiene practice include the presence of multiple conflicting guidelines, hand hygiene “overload” and a lack of contextualised education programs. This exploratory qualitative study reveals three themes about attitudes of hospital cleaning staff towards hand hygiene. These themes are: (1) “The culture of hand hygiene: It’s drummed into us”; (2) “Reminders and promotion for hand hygiene: We just need a big ‘Please wash your hands’ sign”; and (3) “The personal value of hand hygiene: Like he said, it’s second nature to us”. Conclusion: Hand-hygiene messages and training need to be more consistent and contextualised to achieve improvements in hand hygiene practices in hospital cleaning staff in Australia.
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Handaya AY, Werdana VAP. Adherence to preoperative hand hygiene and sterile gowning technique among consultant surgeons, surgical residents, and nurses: a pilot study at an academic medical center in Indonesia. Patient Saf Surg 2019; 13:11. [PMID: 30899331 PMCID: PMC6410512 DOI: 10.1186/s13037-019-0193-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/01/2019] [Indexed: 02/08/2023] Open
Abstract
Background Healthcare-associated infections (HAI) is a major problem for patient safety and surgical site infection (SSI) is a type of HAI and the most common form of infection related to surgical health care. Transmission of microorganisms can be minimized by aseptic procedures. The main objective of this study is to compare adherence to preoperative sterile gowning and hand hygiene technique among consultant surgeons, surgical residents, and nurses. Methods This research was conducted by observing the implementation of the pre-operative sterile gowning and hand hygiene technique of abdominal surgery by consultant surgeons, surgical residents, and nurses using aseptic instrument tests of the Objective Structured Clinical Examination (OSCE) Faculty of Medicine Universitas Gadjah Mada from August 10, 2018 to September 10, 2018. Observations were made when participants performed hand scrubbing, gowning, and donning the gloves procedures. The observer completed mobile online forms, so that the medical personnel under observation did not know that they were being observed. Results Twelve consultant surgeons, 16 surgical residents, and 12 nurses were observed. All of the medical personnel showed a good score with total percentage mean 83.58%. The highest total mean score was achieved by consultant surgeons (86.39%), but mean score did not vary significantly between medical personnel (p = .091). In the hand scrubbing procedure, scrub the nail and palm using brush side and the skin of hand and arm using sponge side, in both hands had the lowest mean score (1.82 ± 1.152 of the maximum score of 4). While in the gowning procedure, taking and unfolding the sterile gown had the lowest mean score (1.97 ± .158 of the maximum score of 2). In the donning the glove procedure, grasping left glove with right hand and putting the glove over the left hand in opposite direction procedure had the lowest mean score (1.97 ± .158 of the maximum score of 2). Conclusions The mean score of each group of health personnel in each section showed good results. Comparison of hand hygiene and gowning procedure performance between groups of health personnel did not show significant differences. However, larger scale research is needed after this pilot study.
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Affiliation(s)
- Adeodatus Yuda Handaya
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta, 55281 Indonesia
| | - Victor Agastya Pramudya Werdana
- Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta, 55281 Indonesia
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