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Bender RG, Sirota SB, Swetschinski LR, Dominguez RMV, Novotney A, Wool EE, Ikuta KS, Vongpradith A, Rogowski ELB, Doxey M, Troeger CE, Albertson SB, Ma J, He J, Maass KL, A.F.Simões E, Abdoun M, Abdul Aziz JM, Abdulah DM, Abu Rumeileh S, Abualruz H, Aburuz S, Adepoju AV, Adha R, Adikusuma W, Adra S, Afraz A, Aghamiri S, Agodi A, Ahmadzade AM, Ahmed H, Ahmed A, Akinosoglou K, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Alemi H, Al-Gheethi AAS, Ali A, Ali SSS, Alqahtani JS, AlQudah M, Al-Tawfiq JA, Al-Worafi YM, Alzoubi KH, Amani R, Amegbor PM, Ameyaw EK, Amuasi JH, Anil A, Anyanwu PE, Arafat M, Areda D, Arefnezhad R, Atalell KA, Ayele F, Azzam AY, Babamohamadi H, Babin FX, Bahurupi Y, Baker S, Banik B, Barchitta M, Barqawi HJ, Basharat Z, Baskaran P, Batra K, Batra R, Bayileyegn NS, Beloukas A, Berkley JA, Beyene KA, Bhargava A, Bhattacharjee P, Bielicki JA, Bilalaga MM, Bitra VR, Brown CS, Burkart K, Bustanji Y, Carr S, Chahine Y, Chattu VK, Chichagi F, Chopra H, Chukwu IS, Chung E, Dadana S, Dai X, Dandona L, Dandona R, Darban I, Dash NR, Dashti M, Dashtkoohi M, Dekker DM, Delgado-Enciso I, Devanbu VGC, Dhama K, Diao N, Do THP, Dokova KG, Dolecek C, Dziedzic AM, Eckmanns T, Ed-Dra A, Efendi F, Eftekharimehrabad A, Eyre DW, Fahim A, Feizkhah A, Felton TW, Ferreira N, Flor LS, Gaihre S, Gebregergis MW, Gebrehiwot M, Geffers C, Gerema U, Ghaffari K, Goldust M, Goleij P, Guan SY, Gudeta MD, Guo C, Gupta VB, Gupta I, Habibzadeh F, Hadi NR, Haeuser E, Hailu WB, Hajibeygi R, Haj-Mirzaian A, Haller S, Hamiduzzaman M, Hanifi N, Hansel J, Hasnain MS, Haubold J, Hoan NQ, Huynh HH, Iregbu KC, Islam MR, Jafarzadeh A, Jairoun AA, Jalili M, Jomehzadeh N, Joshua CE, Kabir MA, Kamal Z, Kanmodi KK, Kantar RS, Karimi Behnagh A, Kaur N, Kaur H, Khamesipour F, Khan MN, Khan suheb MZ, Khanal V, Khatab K, Khatib MN, Kim G, Kim K, Kitila ATT, Komaki S, Krishan K, Krumkamp R, Kuddus MA, Kurniasari MD, Lahariya C, Latifinaibin K, Le NHH, Le TTT, Le TDT, Lee SW, LEPAPE A, Lerango TL, Li MC, Mahboobipour AA, Malhotra K, Mallhi TH, Manoharan A, Martinez-Guerra BA, Mathioudakis AG, Mattiello R, May J, McManigal B, McPhail SM, Mekene Meto T, Mendez-Lopez MAM, Meo SA, Merati M, Mestrovic T, Mhlanga L, Minh LHN, Misganaw A, Mishra V, Misra AK, Mohamed NS, Mohammadi E, Mohammed M, Mohammed M, Mokdad AH, Monasta L, Moore CE, Motappa R, Mougin V, Mousavi P, Mulita F, Mulu AA, Naghavi P, Naik GR, Nainu F, Nair TS, Nargus S, Negaresh M, Nguyen HTH, Nguyen DH, Nguyen VT, Nikolouzakis TK, Noman EA, Nri-Ezedi CA, Odetokun IA, Okwute PG, Olana MD, Olanipekun TO, Olasupo OO, Olivas-Martinez A, Ordak M, Ortiz-Brizuela E, Ouyahia A, Padubidri JR, Pak A, Pandey A, Pantazopoulos I, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Peprah P, Pham HT, Poddighe D, Pollard A, Ponce-De-Leon A, Prakash PY, Prates EJS, Quan NK, Raee P, Rahim F, Rahman M, Rahmati M, Ramasamy SK, Ranjan S, Rao IR, Rashid AM, Rattanavong S, Ravikumar N, Reddy MMRK, Redwan EMM, Reiner RC, Reyes LF, Roberts T, Rodrigues M, Rosenthal VD, Roy P, Runghien T, Saeed U, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahoo SS, Sahu M, Sakshaug JW, Salami AA, Saleh MA, Salehi omran H, Sallam M, Samadzadeh S, Samodra YL, Sanjeev RK, Sarasmita MA, Saravanan A, Sartorius B, Saulam J, Schumacher AE, Seyedi SA, Shafie M, Shahid S, Sham S, Shamim MA, Shamshirgaran MA, Shastry RP, Sherchan SP, Shiferaw D, Shittu A, Siddig EE, Sinto R, Sood A, Sorensen RJD, Stergachis A, Stoeva TZ, Swain CK, Szarpak L, Tamuzi JL, Temsah MH, Tessema MBT, Thangaraju P, Tran NM, Tran NH, Tumurkhuu M, Ty SS, Udoakang AJ, Ulhaq I, Umar TP, Umer AA, Vahabi SM, Vaithinathan AG, Van den Eynde J, Walson JL, Waqas M, Xing Y, Yadav MK, Yahya G, Yon DK, Zahedi Bialvaei A, Zakham F, Zeleke AM, Zhai C, Zhang Z, Zhang H, Zielińska M, Zheng P, Aravkin AY, Vos T, Hay SI, Mosser JF, Lim SS, Naghavi M, Murray CJL, Kyu HH. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021. THE LANCET. INFECTIOUS DISEASES 2024; 24:974-1002. [PMID: 38636536 PMCID: PMC11339187 DOI: 10.1016/s1473-3099(24)00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020-21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. METHODS We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. FINDINGS Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325-364) incident episodes of LRI, or 4350 episodes (4120-4610) per 100 000 population, and 2·18 million deaths (1·98-2·36), or 27·7 deaths (25·1-29·9) per 100 000. 502 000 deaths (406 000-611 000) were in children younger than 5 years, among which 254 000 deaths (197 000-320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1-104·0) episodes and 505 000 deaths (454 000-555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6-49·3] episodes) and Mycoplasma spp (25·3 million [23·5-27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000-459 000]) and K pneumoniae (176 000 [158 000-194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9-46·9), from 56·5 deaths (51·3-61·9) to 32·9 deaths (29·9-35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1-18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8-78·9) decline in the number of influenza deaths and a 66·7% (56·6-75·3) decline in the number of RSV deaths. INTERPRETATION Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. FUNDING Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).
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Zhang M, Wu S, Ibrahim MI, Noor SSM, Mohammad WMZW. Significance of Ongoing Training and Professional Development in Optimizing Healthcare-associated Infection Prevention and Control. JOURNAL OF MEDICAL SIGNALS & SENSORS 2024; 14:13. [PMID: 39100741 PMCID: PMC11296567 DOI: 10.4103/jmss.jmss_37_23] [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: 08/30/2023] [Revised: 10/17/2023] [Accepted: 10/25/2023] [Indexed: 08/06/2024]
Abstract
The employees who work in infection prevention and control (IPC) are very important in the field of health-care because they are committed to protecting patients, staff, and visitors from the risk of acquiring infections while in the hospital. The complexity of infection control in hospitals is alwaysgrowing in tandem with the rapid developments that are being made in medical technology andpractices. IPC personnel are required to maintain vigilance and continually improve their monitoringof the entire health-care process due to the ongoing development of IPC guidelines and regulations, the fluctuating infection risks, and the emergence of new infectious diseases. As a result, individuals involved in the prevention and control of infections in health-care settings absolutely need to participate in continual training and professional development. This reviewemphasizes the need of relevant professionals to engage in ongoing training and professional development to maintain their skills in the area of healthcare-associated infection control and prevention. Personnel working in IPC may more effectively react to newly discovered health risks andmake certain that hospital infection (HI) management gets the appropriate attention if they have atimely and in-depth awareness of best practices. They are better able to maintain their composure, react correctly, and deliver the most effective infection control and prevention techniques for the health-care system, all while increasing awareness about the significance of effective HI management.
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Affiliation(s)
- Maojie Zhang
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Department of Infection Management, The First Affiliated Hospital of Guizhou Traditional Chinese Medicine University, Guiyang, China
| | - Shengwei Wu
- Department of Infection Management, The First Affiliated Hospital of Guizhou Traditional Chinese Medicine University, Guiyang, China
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Siti Suraiya Md Noor
- Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Wan Mohd Zahiruddin Wan Mohammad
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Ismael YH, Pacheco E Castilho HG, Zhen F, Yamaguto GE, Moriya VL, Maestri AC, Kussen GMB, Nogueira MB, Petterle R, Shimidt ALA, Moreira FN, da Silva Nogueira K, Raboni SM. Clinical and microbiological profile of health care-associated infections in a tertiary hospital: Comparison between a cohort of hospitalized patients during prepandemic and COVID-19 pandemic periods. Am J Infect Control 2024; 52:712-718. [PMID: 38181901 DOI: 10.1016/j.ajic.2023.12.018] [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: 09/13/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND During the COVID-19 pandemic, health service practices underwent significant changes, impacting the occurrence of health care-associated infections (HAIs). This study presents the epidemiology of bacterial infections and compares clinical data on nosocomial infections in hospitalized patients before and during the pandemic. METHODS A unicentric, observational, retrospective cohort study was conducted with descriptive analyses on the microorganism identification and resistance profile. Patient's clinical data who had hospital-acquired infection (HAI), during their hospitalization in a tertiary hospital before and during the COVID-19 pandemic was compared by descriptive and inferential analyses. RESULTS A total of 1,581 bacteria were isolated from 1,183 hospitalized patients. Among patients coinfected with COVID-19, there was a statistically significant increase in HAI-related deaths (P < .001) and HAI caused by multidrug-resistant organisms (P < .001), mainly by Acinetobacter baumannii and Staphylococcus aureus. A higher odds ratio of HAI-related deaths compared to the prepandemic period was observed (odds ratio 6.98 [95% confidence interval 3.97-12.64]). CONCLUSIONS The higher incidence of multidrug-resistant bacteria and increased deaths due to HAI, especially in patients with COVID-19 coinfection, might be related to various factors such as increased workload, broad-spectrum antibiotic use, and limited resources. The pandemic has changed the profile of circulating bacteria and antimicrobial resistance. Prevention strategies should be considered to reduce the impact of these infections.
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Affiliation(s)
- Youssef H Ismael
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Felipe Zhen
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Guilherme E Yamaguto
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Vitor L Moriya
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Adriane C Maestri
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Gislene M B Kussen
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Meri B Nogueira
- Virology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Ricardo Petterle
- Department of Integrative Medicine, Universidade Federal do Paraná, Curitiba, Brazil
| | - Ana L A Shimidt
- Hospital Infection Control Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Fabíola N Moreira
- Hospital Infection Control Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Keite da Silva Nogueira
- Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Sonia M Raboni
- Infectious Diseases Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
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Issa M, Kalliri V, Euteneuer S, Krümpelmann A, Seitz A, Sommerburg O, Westhoff JH, Syrbe S, Lenga P, Grutza M, Scherer M, Neumann JO, Baumann I, Unterberg AW, El Damaty A. The association of COVID-19 pandemic with the increase of sinogenic and otogenic intracranial infections in children: a 10-year retrospective comparative single-center study. Neurosurg Rev 2024; 47:205. [PMID: 38713418 PMCID: PMC11076320 DOI: 10.1007/s10143-024-02442-9] [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: 10/08/2023] [Revised: 03/26/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE Otitis media and sinusitis are common childhood infections, typically mild with good outcomes. Recent studies show a rise in intracranial abscess cases in children, raising concerns about a link to COVID-19. This study compares a decade of data on these cases before and after the pandemic. METHODS This retrospective comparative analysis includes pediatric patients diagnosed with otitis media and sinusitis, who later developed intracranial abscesses over the past decade. We collected comprehensive data on the number of cases, patient demographics, symptoms, treatment, and outcomes. RESULTS Between January 2013 and July 2023, our center identified 10 pediatric patients (median age 11.1years, range 2.2-18.0 years, 60% male) with intracranial abscesses from otitis media and sinusitis. Of these, 7 cases (70%, median age 9.7 years, range 2.2-18.0 years) occurred since the onset of the COVID-19 pandemic, while the remaining 3 cases (30%, median age 13.3 years, range 9.9-16.7 years) were treated before the pandemic. No significant differences were found in otolaryngological associations, surgical interventions, preoperative symptoms, lab findings, or postoperative antibiotics between the two groups. All patients showed positive long-term recovery. CONCLUSION This study reveals 5-fold increase of pediatric otogenic and sinogenic intracranial abscess cases in the last three-years since the onset of the COVID-19 pandemic. While further investigation is needed, these findings raise important questions about potential connections between the pandemic and the severity of otitis media and sinusitis complications in children. Understanding these associations can improve pediatric healthcare management during infectious disease outbreaks.
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Affiliation(s)
- Mohammed Issa
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany.
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
| | - Vasiliki Kalliri
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Sara Euteneuer
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Otorhinolaryngology, Heidelberg University Hospital, Heidelberg, Germany
| | - Arne Krümpelmann
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Angelika Seitz
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Deptartment of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Olaf Sommerburg
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Jens H Westhoff
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Steffen Syrbe
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Center for Pediatric and Adolescent Medicine, Department I, University Hospital Heidelberg, Heidelberg, Germany
| | - Pavlina Lenga
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Martin Grutza
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Moritz Scherer
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Jan-Oliver Neumann
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Ingo Baumann
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Otorhinolaryngology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas W Unterberg
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
| | - Ahmed El Damaty
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany
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Wang X, Li S, Huo D, Zhu Z, Wang W, He H, Zhang Q, Li J, Wang X. Nosocomial Infections After Pediatric Congenital Heart Disease Surgery: Data from National Center for Cardiovascular Diseases in China. Infect Drug Resist 2024; 17:1615-1623. [PMID: 38694890 PMCID: PMC11061562 DOI: 10.2147/idr.s457991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 04/23/2024] [Indexed: 05/04/2024] Open
Abstract
Purpose Infection prevention and control (IPC) has a significant impact on the prognosis after pediatric cardiac surgery. This study aimed to provide surveillance data on the incidence and density of various infections during the COVID-19 epidemic and explore the influence of multi-drug resistant organisms (MDRO) on in-hospital prognosis after congenital heart disease surgery. Methods This single-center retrospective study included pediatric patients who underwent cardiac surgery between 2021 and 2022. The results of the postoperative bacterial and fungal cultures and antimicrobial stewardship were collected. The demographic characteristics (age and weight), operation-related parameters (RACHS-1 grade, duration of cardiopulmonary bypass, and aortic cross clamp), and surgical outcomes (extracorporeal membrane oxygenation, delayed sternal closure, mortality, duration of mechanical ventilation, length of intensive care unit stay and hospital stay, and hospitalization costs) of MDRO and non-MDRO patients were compared. Results A total of 4776 patients were included. There were 101 infectious culture results after the operation, with a nosocomial infection rate of 2.1%. There were 40 MDRO specimens from 36 patients, 50 non-MDRO specimens from 30 patients, and 11 fungal specimens from 10 patients. The incidence of pneumonia was 1.5%, with a ventilator-associated pneumonia incidence density of 7.2/1000 patient-days. The incidence of sepsis was 0.4%, with a catheter-related bloodstream infection incidence density of 0.24/ 1000 patient-days. The incidence density of catheter-associated tract infection was 0.45/ 1000 patient-days. The incidence of surgical site infection was 0.06%. The culture proportion before commencing antibiotics was 93% and the antibiotic consumption intensity was 30.7 DDD/100 bed-days. The length of intensive care unit stay in MDRO infection patients increased compared with that in non-MDRO infection patients, 30 (18,52) vs 17 (7,62) days, p=0.05). Conclusion The IPC performance of Fuwai Hospital achieved satisfactory results. MDRO infection can lead to prolonged intensive care unit stay.
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Affiliation(s)
- Xiaofeng Wang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Beijing, People’s Republic of China
- School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Shuo Li
- Department of Infection Control, Peking University First Hospital, Beijing, People’s Republic of China
| | - Da Huo
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, People’s Republic of China
| | - Zhiyuan Zhu
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Beijing, People’s Republic of China
- School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Wenlong Wang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Beijing, People’s Republic of China
- School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Hongxia He
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Beijing, People’s Republic of China
- School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Qian Zhang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Beijing, People’s Republic of China
- School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
| | - Jiantao Li
- School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
- Department of Infection Control, National Center for Cardiovascular Disease and Fuwai Hospital, Beijing, People’s Republic of China
| | - Xu Wang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Beijing, People’s Republic of China
- School of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
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Balducci M, Locatelli E, Barbieri MG, Ferrighi E, Scardina S, Barrile G, Sganga F, Mattioli I, Remelli F, Maggi S, Volpato S, Trevisan C. SARS-CoV-2 vaccination and risk of infectious diseases in hospitalized older patients. Eur Geriatr Med 2024; 15:509-517. [PMID: 38182805 DOI: 10.1007/s41999-023-00902-x] [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: 09/05/2023] [Accepted: 11/15/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE Vaccinations, for example flu vaccine, may be a cause of cross-reactive immunostimulation that prevents a larger spectrum of infections. However, whether SARS-CoV-2 vaccinations may also determine this effect is unclear. This study aims, first, to assess the incidence of infections at hospital admission and during the hospitalization in older inpatients vaccinated and unvaccinated against SARS-CoV-2; second, to compare length of hospital stay and in-hospital mortality between vaccinated and unvaccinated individuals. METHODS This retrospective study included 754 older inpatients admitted to the Geriatrics and Orthogeriatrics Units of the University Hospital of Ferrara (Italy) between March 2021 and November 2021. Sociodemographic and health-related data, and the diagnosis of infections at hospital admission and during hospitalization were collected from medical records. RESULTS The sample's mean age was 87.2 years, 59.2% were females, and 75.5% were vaccinated against SARS-CoV-2. Vaccinated individuals had 36% lower odds of intra-hospital infections (OR = 0.64, 95%CI 0.44-0.94) and 39% lower in-hospital death (HR = 0.61, 95%CI 0.39-0.95), also after adjusting for potential confounders, while no significant results emerged about infections at hospital admission. Considering the hospitalization's endpoints, SARS-CoV-2 vaccination was associated with a lower probability of being transferred to long-term care or other hospital departments than returning home (OR = 0.63, 95%CI 0.40-0.99). CONCLUSIONS In older inpatients, SARS-CoV-2 vaccination seems to be associated with a lower likelihood of intra-hospital infectious diseases not caused by SARS-CoV-2 and all-cause in-hospital mortality. The vaccination coverage in the older population could limit not only the onset and severity of COVID-19 but also the occurrence of other infectious diseases.
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Affiliation(s)
- Marco Balducci
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Edoardo Locatelli
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Maria Giorgia Barbieri
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Elena Ferrighi
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Serena Scardina
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Giulia Barrile
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Federica Sganga
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Irene Mattioli
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Francesca Remelli
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy.
| | - Stefania Maggi
- Institute of Neuroscience - Aging Branch, National Research Council, Padua, Italy
| | - Stefano Volpato
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
| | - Caterina Trevisan
- Department of Medical Science, University of Ferrara, Via Aldo Moro 8, 44124, Ferrara, Italy
- Geriatrics and Orthogeriatrics Unit, Azienda Ospedaliero-Universitaria of Ferrara, Ferrara, Italy
- Aging Research Center, Karolinska Institutet, Stockholm, Sweden
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Feng Y, Zhang H, Zhang B, Zhou Y, Yuan H. Impact of normalized COVID-19 prevention and control measures on lower respiratory tract infection pathogenesis in hospitalized children. Front Public Health 2024; 12:1367614. [PMID: 38476493 PMCID: PMC10927715 DOI: 10.3389/fpubh.2024.1367614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Objective This study aimed to investigate the epidemiological characteristics of common pathogens contributing to childhood lower respiratory tract infections (LRTIs) in Xiangtan City, Hunan Province before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods A total of 11,891 enrolled patients, aged 1 month to 14 years, diagnosed with LRTIs and admitted to Xiangtan Central Hospital from January 2018 to December 2021 were retrospectively reviewed in this study. Specifically, the epidemiological characteristics of these pathogens before and during the COVID-19 pandemic were analyzed. Results There was a significant decrease in the number of children hospitalized with LRTIs during the COVID-19 pandemic (2020-2021) compared to data from 2018 to 2019 (before the COVID-19 pandemic). Of these cases, 60.01% (7,136/11,891) were male and 39.99% (4,755/11,891) were female. 78.9% (9,381/11,891) cases occurred in children under 4 years of age. The average pathogen detection rate among 11,891 hospitalized LRTIs children was 62.19% (7,395/11,891), with the average pathogen detection rate of 60.33% (4,635/7,682) and 65.57% (2,670/4,209) before and during COVID-19 pandemic, respectively. The detection rates of adenovirus (ADV), bordetella pertussis (BP) and moraxella catarrhalis (M. catarrhalis) decreased dramatically, while the detection rates of influenza viruses (IFV), parainfluenza viruses (PIV), respiratory syncytial virus (RSV), haemophilus influenzae (H. influenzae), streptococcus pneumoniae (S. pneumoniae), and staphylococcus aureus (S. aureus) increased significantly during the COVID-19 pandemic. Overall, RSV, mycoplasma pneumoniae (MP), H. influenzae, and IFV were the major pathogens causing LRTIs in hospitalized children before and during the COVID-19 pandemic. Conclusion Public health interventions for COVID-19 prevention are beneficial to reduce the incidence of LRTIs in children by limiting the prevalence of ADV, MP, BP, and M. catarrhalis, but which have limited restrictive effects on other common LRTIs-associated pathogens. Collectively, the data in this study comprehensively investigated the effects of COVID-19 pandemic on the epidemiological characteristics of respiratory pathogens, which will be beneficial for improving early preventive measures.
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Affiliation(s)
- Yuan Feng
- Department of Pediatrics, Xiangtan Central Hospital, Xiangtan, China
| | - Huaixiao Zhang
- Department of Pediatrics, Xiangtan Central Hospital, Xiangtan, China
| | - Bo Zhang
- Department of Pediatrics, Xiangtan Central Hospital, Xiangtan, China
| | - Yinfei Zhou
- Department of Pediatrics, Xiangtan Central Hospital, Xiangtan, China
| | - Haibin Yuan
- Department of Pediatrics, Xiangtan Central Hospital, Xiangtan, China
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8
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Wang X, Li S, Huo D, Wang S, Wang W, He H, Zhang Q, Li J, Wang X. Healthcare associated infection management in 62 intensive care units for patients with congenital heart disease in China, a survey study. Int J Surg 2024; 110:01279778-990000000-01027. [PMID: 38320095 PMCID: PMC11020057 DOI: 10.1097/js9.0000000000001138] [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: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVES All patients with congenital heart disease (CHD) receive postoperative management in ICUs. Infection prevention and control (IPC) has a significant impact on prognosis. This study provides a preliminary understanding of the fundamental aspects of IPC in ICUs following CHD surgery in China. METHODS From September to October 2023, we initiated a survey on HAI management in hospitals that perform CHD surgeries independently. The questionnaires were jointly completed by the ICU physicians and IPC personnel. Duplicate or unqualified questionnaires were excluded from the study. The contents of our questionnaires covered hospital and ICU capacity, performance of the infection control department, HAI surveillance, implementation of IPC measures, and antimicrobial stewardship (AMS). Qualified questionnaires were compared according to the volume of annual CHD surgeries performed in different ICUs. Group 1 was defined as volume > 300 cases and group 2 was defined as volume ≤300 cases. RESULTS 62 of the 118 questionnaires were completed, with a response rate of 53%. The CHD surgical volume in 2022 of the 62 hospitals was 36342, accounting for 52% of the annual CHD surgical volume (69672) across the country. The postoperative infection rates obtained from the 15 ICUs varied from 1.3% to 15%, with a median rate of 4.5%. A total of 16 ICUs provided data on drug-resistant bacteria, Klebsiella pneumoniae exhibiting the highest frequency. More than 95% of ICUs have established complete HAI management systems. Information-based HAI surveillance was conducted in 89% of ICUs. Approximately 67% of ICUs stopped prophylactic antibiotics within 48 hours after surgery. In complex cases, carbapenems were administered empirically in 89% of ICUs. Group 1 had an advantage over group 2 in preventing multidrug-resistant organisms (all instruments should be used alone 100% vs. 86%, P=0.047; cleaning and disinfection of environmental surfaces, 100% vs. 81%, P=0.035; antibiotic consumption control 85% vs. 61%, P=0.044) and in preventing surgical site infections (perioperative blood glucose monitoring, 88% vs. 67%, P=0.048). However, Group 1 did not perform well in preventing catheter-related bloodstream infection (delayed catheter removal due to convenience of laboratory tests, 31% vs. 6%, P=0.021) and catheter-associated urinary tract infection (delayed catheter removal due to muscle relaxant administration, 88% vs. 58%, P=0.022). CONCLUSIONS A relatively complete HAI management system has been established throughout the country in ICUs for CHD patients. Information-based surveillance of HAI needs to be promoted, and actions should be taken to facilitate the implementation of IPC measures and AMS bundles. Training and feedback are critical for implementing IPC measures.
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Affiliation(s)
- Xiaofeng Wang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
| | - Shuo Li
- Department of Infection Control, Peking University First Hospital
| | - Da Huo
- Institute for Infectious Disease and Endemic Disease Control, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Shilin Wang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
| | - Wenlong Wang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
| | - Hongxia He
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
| | - Qian Zhang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
| | - Jiantao Li
- Department of Infection Control, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
| | - Xu Wang
- Department of Pediatric Intensive Care Unit, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College
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Ismaeil R, Nahas ARF, Kamarudin NB, Abubakar U, Mat-Nor MB, Mohamed MHN. Evaluation of the impact of COVID-19 pandemic on hospital-acquired infections in a tertiary hospital in Malaysia. BMC Infect Dis 2023; 23:779. [PMID: 37946158 PMCID: PMC10636815 DOI: 10.1186/s12879-023-08770-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital. METHOD This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients' electronic medical records. RESULTS There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19. CONCLUSION Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices.
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Affiliation(s)
- Rehab Ismaeil
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Abdul Rahman Fata Nahas
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia
| | - Norhidayah Binti Kamarudin
- Department of Medical Microbiology, Kulliyyah of Medicine, International Islamic University Malaysia, 25200, Kuantan, Malaysia
| | - Usman Abubakar
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, 2713, Doha, Qatar.
| | - Mohamad Basri Mat-Nor
- Department of Intensive Care, Kulliyyah of Medicine, International Islamic University Malaysia, 25200, Kuantan, Malaysia
| | - Mohamad Haniki Nik Mohamed
- Department of Pharmacy Practice, Kulliyah of Pharmacy, International Islamic University Malaysia (IIUM), Jalan Sultan Ahmad Shah, 25200, Kuantan, Pahang, Malaysia.
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10
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Wang M, Dehghan M, Li C, Amedei A, Rodriguez-Morales AJ. Editorial: Impact of coronavirus disease 2019 (COVID-19) pandemic on nosocomial infection. Front Med (Lausanne) 2023; 10:1298645. [PMID: 37908852 PMCID: PMC10614156 DOI: 10.3389/fmed.2023.1298645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Mingke Wang
- Naval Medical Center of PLA, Naval Medical University, Shanghai, China
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Chunhui Li
- Department of Infection Control Center, Xiangya Hospital, Central South University, Changsha, China
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alfonso J. Rodriguez-Morales
- Faculty of Health Sciences, Universidad Científica del Sur, Lima, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
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11
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Alsaffar MJ, Alsheddi FM, Humayun T, Aldalbehi FZ, Alshammari WHS, Aldecoa YS, Burhan NM, El-Saed A, Tawfeeq S, Alanazi KH. Impact of COVID-19 pandemic on the rates of central line...associated bloodstream infection and catheter-associated urinary tract infection in an.ßintensive care setting:.ßNational experience. Am J Infect Control 2023; 51:1108-1113. [PMID: 37024013 PMCID: PMC10072974 DOI: 10.1016/j.ajic.2023.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND COVID-19 is believed to increase the risk of secondary health care...associated infections. The objective was to estimate the impact of COVID-l9 pandemic on the rates of central line...associated bloodstream infection (CLABSI) and catheter-associated urinary tract infections (CAUTIs) in the.ßMinistry of Health hospitals across Saudi Arabia. METHODS A retrospective analysis of prospectively collected CLABSI and CAUTI data over a period of 3 years (2019-2021) was done. The data were obtained from the Saudi Health Electronic Surveillance Network. All adult intensive care units in 78 Ministry of Health hospitals that contributed CLABSI or CAUTI data before (2019) and during (2020-2021).ßthe pandemic were included. RESULTS During the study, 1440 CLABSI events and 1119 CAUTI events were identified. CLABSI rates significantly increased in 2020-2021 compared with 2019 (2.50 versus 2.16 per 1000 central line days, P.ß=.ß.010). CAUTI rates significantly decreased in 2020-2021 compared with 2019 (0.96 versus 1.54 per 1000 urinary catheter days, P.ß<.ß.001). CONCLUSIONS COVID-19 pandemic is.ßassociated with increased CLABSI rates and reduced CAUTI rates. It.ßis believed to have negative impacts on several infection control practices and surveillance accuracy. The opposite impacts of COVID-19 on CLABSI and CAUTI probably reflect.ßthe nature of their case definitions.
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Affiliation(s)
- Manar Jaffer Alsaffar
- Surveillance Department, General Directorate of Ministry of Health Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Faisal Mohammed Alsheddi
- Surveillance Department, General Directorate of Ministry of Health Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Tabish Humayun
- Surveillance Department, General Directorate of Ministry of Health Riyadh, Riyadh, Kingdom of Saudi Arabia.
| | - Fayez Zabar Aldalbehi
- Surveillance Department, General Directorate of Ministry of Health Riyadh, Riyadh, Kingdom of Saudi Arabia
| | | | - Yvonne Suzette Aldecoa
- Surveillance Department, General Directorate of Ministry of Health Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Nadeen Mahmoud Burhan
- Monitoring and Evaluation Department, General Directorate of Ministry of Health Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Aiman El-Saed
- King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Sameh Tawfeeq
- Surveillance Department, General Directorate of Ministry of Health Riyadh, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Hamdan Alanazi
- Infection Prevention and Control Department, General Directorate of Infection Prevention and Control, Riyadh, Kingdom of Saudi Arabia
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12
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Oy S, Saing CH, Ung M, Zahari M, Nouhak I, Kim S, Nagashima-Hayashi M, Khuon D, Koy V, Mam S, Sayasone S, Saphonn V, Yi S. Developing an infection prevention and control intervention to reduce hospital-acquired infections in Cambodia and Lao People's Democratic Republic: the HAI-PC study protocol. Front Public Health 2023; 11:1239228. [PMID: 37799162 PMCID: PMC10548876 DOI: 10.3389/fpubh.2023.1239228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/30/2023] [Indexed: 10/07/2023] Open
Abstract
Background Hospital-acquired infections (HAIs) are significant public health issues, especially in low-and middle-income countries (LMICs). Hand hygiene and low-level disinfection of equipment practices among healthcare workers are some of the essential measures to reduce HAIs. Various infection prevention and control (IPC) interventions to reduce HAI incidence have been developed. However, effective interventions have not been well developed in the LMICs context. Therefore, this protocol aims to develop, pilot, and assess the feasibility and acceptability of an IPC intervention in Cambodia and the Lao People's Democratic Republic. Methods This study will consist of four phases guided by the Medical Research Council (MRC) Framework. Three hospitals will be purposely selected - each from the district, provincial, and national levels - in each country. The gap analysis will be conducted in Phase 1 to explore IPC practices among healthcare workers at each hospital through desk reviews, direct observation of hand hygiene and low-level disinfection of equipment practices, in-depth interviews with healthcare workers, and key informant interviews with stakeholders. In Phase 2, an IPC intervention will be developed based on the results of Phase 1 and interventions selected from a systematic literature review of IPC interventions in LMICs. In Phase 3, the developed intervention will be piloted in the hospitals chosen in Phase 1. In Phase 4, the feasibility and acceptability of the developed intervention will be assessed among healthcare workers and representatives at the selected hospitals. National consultative workshops in both countries will be conducted to validate the developed intervention with the national technical working groups. Discussion The MRC Framework will be employed to develop and evaluate an intervention to reduce HAIs in two LMICs. This theoretical framework will be used to explore the factors influencing hand hygiene compliance among healthcare workers. The gap analysis results will allow us to develop a comprehensive IPC intervention to reduce HAI incidence in Cambodia and Lao People's Democratic Republic. Findings from this protocol will feed into promising IPC interventions to reduce HAI incidence in other resource-limited settings. Clinical trial registration ClinicalTrial.Gov, identifier NCT05547373.
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Affiliation(s)
- Sreymom Oy
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Chan Hang Saing
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mengieng Ung
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Marina Zahari
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Inthavong Nouhak
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | - Sothea Kim
- University of Health Sciences, Phnom Penh, Cambodia
| | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Dyna Khuon
- University of Health Sciences, Phnom Penh, Cambodia
| | - Virya Koy
- Department of Hospital Services, Ministry of Health, Phnom Penh, Cambodia
| | - Sovatha Mam
- University of Health Sciences, Phnom Penh, Cambodia
| | - Somphou Sayasone
- Department of International Program for Health in the Tropics, Lao Tropical and Public Health Institute, Vientiane, Lao People’s Democratic Republic
| | | | - Siyan Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Public Health Program, College of Education and Health Sciences, Touro University California, Vallejo, CA, United States
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13
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Porcel JM, Bielsa S, Civit C, Aujayeb A, Janssen J, Bodtger U, Fjaellegaard K, Petersen JK, Welch H, Symonds J, Mitchell MA, Grabczak EM, Ellayeh M, Addala D, Wrightson JM, Rahman NM, Munavvar M, Koegelenberg CF, Labarca G, Mei F, Maskell N, Bhatnagar R. Clinical characteristics of chylothorax: results from the International Collaborative Effusion database. ERJ Open Res 2023; 9:00091-2023. [PMID: 37850216 PMCID: PMC10577597 DOI: 10.1183/23120541.00091-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 08/14/2023] [Indexed: 10/19/2023] Open
Abstract
Background Chylothorax is an uncommon medical condition for which limited data are available regarding the contemporary aetiology, management and outcomes. The goal of this study was to better define these poorly characterised features. Methods The medical records of adult patients diagnosed with chylothorax at 12 centres across Europe, America and South Africa from 2009-2021 were retrospectively reviewed. Descriptive and inferential statistics were performed. Results 77 patients (median age 69 years, male to female ratio 1.5) were included. Subacute dyspnoea was the most typical presenting symptom (66%). The commonest cause of chylothorax was malignancy (68.8%), with lymphoma accounting for 62% of these cases. Other aetiologies were trauma (13%), inflammatory/miscellaneous conditions (11.7%) and idiopathic cases (6.5%). At the initial thoracentesis, the pleural fluid appeared milky in 73%, was exudative in 89% and exhibited triglyceride concentrations >100 mg·dL-1 in 88%. Lymphangiography/lymphoscintigraphy were rarely ordered (3%), and demonstration of chylomicrons in pleural fluid was never ascertained. 67% of patients required interventional pleural procedures. Dietary measures were infrequently followed (36%). No patient underwent thoracic duct ligation or embolisation. Morbidity included infections (18%), and thrombosis in malignant aetiologies (16%). The 1-year mortality was 47%. Pleural fluid protein >3.5 mg·dL-1 (sub-distribution hazard ratio (SHR) 4.346) or lactate dehydrogenase <500 U·L-1 (SHR 10.21) increased the likelihood of effusion resolution. Pleural fluid protein ≤3.5 mg·dL-1 (HR 4.047), bilateral effusions (HR 2.749) and a history of respiratory disease (HR 2.428) negatively influenced survival. Conclusion Chylothoraces have a poor prognosis and most require pleural interventions. Despite the standard recommendations, lymphatic imaging is seldom used, nor are dietary restrictions followed.
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Affiliation(s)
- José M. Porcel
- Pleural Medicine Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRBLleida, University of Lleida, Lleida, Spain
| | - Silvia Bielsa
- Pleural Medicine Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRBLleida, University of Lleida, Lleida, Spain
| | - Carmen Civit
- Pleural Medicine Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRBLleida, University of Lleida, Lleida, Spain
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare Foundation Trust, Cramlington, UK
| | - Julius Janssen
- Respiratory Department, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands
| | - Uffe Bodtger
- Respiratory Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
| | - Katrine Fjaellegaard
- Respiratory Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
| | - Jesper Koefod Petersen
- Respiratory Research Unit PLUZ, Department of Respiratory Medicine, Zealand University Hospital, Naestved, Denmark
| | - Hugh Welch
- Academic Respiratory Unit, University of Bristol, Bristol, UK
- Respiratory Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Jenny Symonds
- Respiratory Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Michael A. Mitchell
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | | | - Mohamed Ellayeh
- Department of Chest Medicine, Mansoura University, Mansoura, Egypt
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Dinesh Addala
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - John M. Wrightson
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Najib M. Rahman
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Oxford NIHR Biomedical Research Centre, Oxford, UK
| | - Mohammed Munavvar
- Respiratory Department, Lancashire Teaching Hospitals NHS Trust, Preston, UK
- University of Central Lancashire, Preston, UK
| | - Coenraad F.N. Koegelenberg
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Gonzalo Labarca
- Division of Internal Medicine, Complejo Asistencial Dr Víctor Ríos Ruiz, Los Angeles, Chile
- Molecular and Translational Immunology Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepcion, Concepcion, Chile
| | - Federico Mei
- Respiratory Disease Unit, Department of Internal Medicine, University Hospital, Ancona, Italy
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Nick Maskell
- Academic Respiratory Unit, University of Bristol, Bristol, UK
- Respiratory Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Rahul Bhatnagar
- Academic Respiratory Unit, University of Bristol, Bristol, UK
- Respiratory Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
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14
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Ahadi M, Shams AH, Yadollahi M. Effect of COVID-19 pneumonia infection control protocols on nosocomial infection incidence in trauma patients. Chin J Traumatol 2023; 26:284-289. [PMID: 37268479 PMCID: PMC10174345 DOI: 10.1016/j.cjtee.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/12/2023] [Accepted: 05/04/2023] [Indexed: 06/04/2023] Open
Abstract
PURPOSE Nosocomial infection is a major threat to the health care system and patient welfare. After the pandemic, new protocols were established in hospitals and communities to protect against the transmission of COVID-19, which may have changed the incidence of nosocomial transmission. This study was conducted to compare the incidence of nosocomial infection before and after the COVID-19 pandemic. METHODS This was a retrospective cohort study performed on trauma patients who were admitted, from May 22, 2018 to November 22, 2021, to the largest level-1 trauma center in Shiraz, Iran (Shahid Rajaei Trauma Hospital). All the trauma patients over 15 years old admitted during the study time were included in this study. Individuals who were declared dead upon arrival were excluded. Patients were evaluated in 2 periods: before the pandemic (May 22, 2018 - February 19, 2020) and after the pandemic (February 19, 2020 - November 22, 2021). Patients were assessed based on demographic information (age, gender, length of hospital stay, and patient outcome), the occurrence of hospital infection, and the type of infection. The analysis was done using SPSS version 25. RESULTS Overall, 60,561 patients were admitted, with a mean age of 40 years. Nosocomial infection was diagnosed in 4.00% (n = 2423) of all admitted patients. The incidence rate of post-COVID-19 hospital-acquired infections decreased by 16.28% (p < 0.001) when compared to before the pandemic; in contrast, surgical site infection (p < 0.001) and urinary tract infection (p = 0.043) were responsible for this change, while hospital-acquired pneumonia (p = 0.568) and bloodstream infection (p = 0.156) were not significantly different. Overall mortality was 1.79%, while 28.52% of all patients with nosocomial infections died. During the pandemic, there was a 25.78% increase (p < 0.001) in the overall incidence rate of mortality, which was also observed among patients with nosocomial infections (17.84%). CONCLUSION The incidence of nosocomial infection has decreased during the pandemic, possibly due to the use of more personal protective equipment and modified protocols after the outbreak. This also explains the difference in the change in incidence rates of nosocomial infection subtypes.
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Affiliation(s)
- Mahsa Ahadi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Hossein Shams
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Yadollahi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
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15
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Athan E, Watters DA. Hand hygiene: a call to 'all hands on deck'. ANZ J Surg 2023; 93:2067-2069. [PMID: 37587660 DOI: 10.1111/ans.18657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Eugene Athan
- School of Medicine and Health Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Geelong, Victoria, Australia
| | - David Allan Watters
- School of Medicine and Health Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
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16
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Mitchell BG, Stewardson AJ, Kerr L, Ferguson JK, Curtis S, Busija L, Lydeamore MJ, Graham K, Russo PL. The incidence of nosocomial bloodstream infection and urinary tract infection in Australian hospitals before and during the COVID-19 pandemic: an interrupted time series study. Antimicrob Resist Infect Control 2023; 12:61. [PMID: 37400858 PMCID: PMC10318831 DOI: 10.1186/s13756-023-01268-2] [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: 03/15/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a significant impact on healthcare including increased awareness of infection prevention and control (IPC). The aim of this study was to explore if the heightened awareness of IPC measures implemented in response to the pandemic influenced the rates of healthcare associated infections (HAI) using positive bloodstream and urine cultures as a proxy measure. METHODS A 3 year retrospective review of laboratory data from 5 hospitals (4 acute public, 1 private) from two states in Australia was undertaken. Monthly positive bloodstream culture data and urinary culture data were collected from January 2017 to March 2021. Occupied bed days (OBDs) were used to generate monthly HAI incidence per 10,000 OBDs. An interrupted time series analysis was undertaken to compare incidence pre and post February 2020 (the pre COVID-19 cohort and the COVID-19 cohort respectively). A HAI was assumed if positive cultures were obtained 48 h after admission and met other criteria. RESULTS A total of 1,988 bloodstream and 7,697 urine positive cultures were identified. The unadjusted incident rate was 25.5 /10,000 OBDs in the pre-COVID-19 cohort, and 25.1/10,000 OBDs in the COVID-19 cohort. The overall rate of HAI aggregated for all sites did not differ significantly between the two periods. The two hospitals in one state which experienced an earlier and larger outbreak demonstrated a significant downward trend in the COVID-19 cohort (p = 0.011). CONCLUSION These mixed findings reflect the uncertainty of the effect the pandemic has had on HAI's. Factors to consider in this analysis include local epidemiology, differences between public and private sector facilities, changes in patient populations and profiles between hospitals, and timing of enhanced IPC interventions. Future studies which factor in these differences may provide further insight on the effect of COVID-19 on HAIs.
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Affiliation(s)
- Brett G Mitchell
- School of Nursing, Avondale University, Cooranbong, NSW, 2265, Australia
- Nursing and Midwifery, Monash University, Frankston, VIC, 3199, Australia
- Gosford Hospital, Central Coast Local Health District, NSW, 2250, Australia
| | - Andrew J Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia
| | - Lucille Kerr
- Nursing and Midwifery, Monash University, Frankston, VIC, 3199, Australia
- Department of Nursing Research, Cabrini Institute, Malvern, VIC, 3144, Australia
- School of Nursing and Midwifery, Deakin University, Burwood, Australia
| | - John K Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle Regional Mail Centre, 2310, NSW, Australia
- University of Newcastle, Callaghan, NSW, 2308, Australia
- Infection Prevention Service, Hunter New England Health, John Hunter Hospital, NSW, 2310, Australia
| | - Stephanie Curtis
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia
| | - Ljoudmila Busija
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Michael J Lydeamore
- Department of Econometrics and Business Statistics, Monash University, Melbourne, 3800, Australia
| | - Kirsty Graham
- Infection Prevention and Control, Central Coast Local Health District, Gosford, NSW, 2250, Australia
| | - Philip L Russo
- School of Nursing, Avondale University, Cooranbong, NSW, 2265, Australia.
- Nursing and Midwifery, Monash University, Frankston, VIC, 3199, Australia.
- Department of Nursing Research, Cabrini Institute, Malvern, VIC, 3144, Australia.
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Mukomena PN, Munsaka S, Simunza M, Kwenda G, Yamba K, Kabwe J, Mukubesa A, Bumbangi FN, Ndebe J, Libonda L, Mutemba C, Fwoloshi S, Kayembe JM, Muma JB. Nosocomial infections and associated risk factors at two tertiary healthcare facilities in Lusaka and Copperbelt Provinces, Zambia. SCIENTIFIC AFRICAN 2023. [DOI: 10.1016/j.sciaf.2023.e01644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
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18
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Dai R, Wu H, Liu G, Shen L, Geng Y, Zhang S, Zhou H, Jiang C, Gong J, Fan X, Ji C. Investigation of bacterial and fungal population structure on environmental surfaces of three medical institutions during the COVID-19 pandemic. Front Microbiol 2023; 14:1089474. [PMID: 36970696 PMCID: PMC10033641 DOI: 10.3389/fmicb.2023.1089474] [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: 11/04/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
Objectives To evaluate the population structure of environmental bacteria and fungi in three different types of medical institutions and the potential risks due to antibiotic resistance during the coronavirus disease 2019 (COVID-19) pandemic. Methods One hundred twenty-six environmental surface samples were collected from three medical institutions during the COVID-19 pandemic. A total of 6,093 and 13,514 representative sequences of 16S and ITS ribosomal RNA (rRNA) were obtained by amplicon sequencing analysis. The functional prediction was performed using the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States tool based on the Greengenes database and the FAPROTAX database. Results On environmental surfaces in three medical institutions during the COVID-19 pandemic, Firmicutes (51.6%) and Bacteroidetes (25%) were the dominant bacteria, while Ascomycota (39.4%) and Basidiomycota (14.2%) were the dominant fungi. A number of potential bacterial and fungal pathogens were successfully identified by the metagenomic approach. Furthermore, compared with the bacterial results, the fungi showed a generally closer Bray Curtis distance between samples. The overall ratio of Gram-negative bacteria to Gram-positive bacteria was about 3:7. The proportion of stress-tolerant bacteria in medical institutions A, B and C reached 88.9, 93.0 and 93.8%, respectively. Anaerobic bacteria accounted for 39.6% in outdoor environments, 77.7% in public areas, 87.9% in inpatient areas and 79.6% in restricted areas. Finally, the β-Lactam resistance pathway and polymyxin resistance pathway were revealed through functional prediction. Conclusion We described the microbial population structure changes in three different types of medical institutions using the metagenomic approach during the COVID-19 pandemic. We found that the disinfection measures performed by three healthcare facilities may be effective on the "ESKAPE" pathogens, but less effective on fungal pathogens. Moreover, emphasis should be given to the prevention and control of β-lactam and polymyxin antibiotics resistance bacteria during the COVID-19 pandemic.
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Affiliation(s)
- Rongchen Dai
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hanting Wu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Guiming Liu
- Beijing Agro-Biotechnology Research Center, Beijing Academy of Agriculture and Forestry Sciences, Beijing, China
| | - Linlai Shen
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanyuan Geng
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shu Zhang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Haijian Zhou
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Canran Jiang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jie Gong
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xin Fan
- Department of Infectious Diseases and Clinical Microbiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Conghua Ji
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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19
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Antimicrobial resistance patterns in paediatric infections at Damascus Hospital, Syria: a retrospective cohort study. Ann Med Surg (Lond) 2023; 85:418-423. [PMID: 36923771 PMCID: PMC10010845 DOI: 10.1097/ms9.0000000000000267] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/26/2023] [Indexed: 03/18/2023] Open
Abstract
Antimicrobial resistance is the third top-ranking global causative of death. Ninety per cent of babies with sepsis who were admitted to the ICU in the Middle East had antibiotic-resistant bacteria. We aim to describe the epidemiology, culture findings, bacterial antibiotic resistance, as well as the outcomes of children who present with nosocomial or community-acquired infections. Methods A retrospective observational cohort study was conducted to analyze children with positive culture results presenting with nosocomial or community-acquired infections in Damascus Hospital, Damascus, Syria, which is considered one of the biggest hospitals in Syria. Results In all, 116 patients with 177 positive culture results were included in the study. However, 54 (47%) were males, and 62 (53%) were females. Ages ranged between 3 h and 13 years. Cases of positive culture results peaked at the age or period of 0-11 months, that is 59(50%). The most prevalent bacteria were Staphylococcus aureus (33%), Enterobacter (21%), Pseudomonas aeruginosa (15%) and Escherichia coli (12%). The most used antibiotics were ceftriaxone (70%), vancomycin (60%) and amikacin (25%). The highest bacterial antibiotic resistance occurred with third-generation cephalosporins, and the most antibiotic-resistant bacterium was P. aeruginosa. Nosocomial infections occurred in 51% of the patients. Death was the outcome of 16% of the patients. Conclusion The situation regarding bacterial resistance to antibiotics is critical, with the most notable examples of these resisted antibiotics being ceftriaxone, cefepime, cefotaxime, trimethoprim, gentamycin, levofloxacin and piperacillin with tazobactam, and there is no doubt that this is a major contributing factor to the high prevalence of nosocomial infections and death rates found in this study.
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Zand F, Vakili H, Asmarian N, Masjedi M, Sabetian G, Nikandish R, Shafiee E, Tabatabaei Esfehani A, Azadi F, Sanaei Dashti A. Unintended impact of COVID-19 pandemic on the rate of catheter related nosocomial infections and incidence of multiple drug resistance pathogens in three intensive care units not allocated to COVID-19 patients in a large teaching hospital. BMC Infect Dis 2023; 23:11. [PMID: 36609225 PMCID: PMC9821351 DOI: 10.1186/s12879-022-07962-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 12/21/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. COVID-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism. METHODOLOGY The present non-interventional study was performed by a pre and a post survey each lasting 8 months before (March-October 2019) and after (March-October 2020) the onset of COVID-19 pandemic in three ICU's, not allocated to COVID-19 patients, in Nemazee Hospital, Shiraz, Iran. The rates of the following nosocomial infections were compared at pre- and post-pandemic period: ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI), catheter-associated urinary tract infections (CAUTI) and incidence of multiple drug resistance (MDR) pathogens. RESULTS Pre-pandemic and pandemic incidence of VAP was 23.5 and 17.2 cases per 1000 device-days, respectively; an absolute decrease of 27%. The main reason for the decrease in the rate of VAP during the pandemic was a significant decrease in the rate of VAP caused by Acinetobacter baumannii; from 39 to 17% in total VAP episodes. The rate of VAP associated with other microorganisms remained relatively unchanged from 14.2 cases in pre-pandemic period to 14.3 cases per 1000 MV-days during the pandemic (P = 0.801). Pre-pandemic incidence of CLABSI was 7.3 cases and, in pandemic period, was 6.5 cases per 1000 device-days (IRR = 0.88, 95% CI 0.43-1.73, P = 0.703). Pre-pandemic incidence of CAUTI was 2 and in pandemic period, was 1.4 cases per 1000 device-days (IRR = 0.70, 95% CI 0.22-1.98, P = 0.469). CONCLUSION The results of the present study showed a decrease in the incidence of VAP in critically ill non-COVID-19 patients during the pandemic compared to before the pandemic, especially regarding Acinetobacter baumannii.
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Affiliation(s)
- Farid Zand
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hedayatollah Vakili
- grid.412571.40000 0000 8819 4698Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mansoor Masjedi
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- grid.412571.40000 0000 8819 4698Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Nikandish
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Shafiee
- grid.412571.40000 0000 8819 4698Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Tabatabaei Esfehani
- grid.412571.40000 0000 8819 4698Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Azadi
- grid.412571.40000 0000 8819 4698Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Sanaei Dashti
- grid.412571.40000 0000 8819 4698Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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21
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Wang Z, Tang Y, Cui Y, Guan H, Cui X, Liu Y, Liu Y, Kang Z, Wu Q, Hao Y, Liu C. Delay in seeking health care from community residents during a time with low prevalence of COVID-19: A cross-sectional national survey in China. Front Public Health 2023; 11:1100715. [PMID: 36895687 PMCID: PMC9989024 DOI: 10.3389/fpubh.2023.1100715] [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: 11/17/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
Background The pandemic of COVID-19 has significant implications on health resources allocation and health care delivery. Patients with non-COVID illness may have to change their care seeking behaviors to mitigate the risk of infections. The research aimed to investigate potential delay of community residents in seeking health care at a time with an overall low prevalence of COVID-19 in China. Methods An online survey was conducted in March 2021 on a random sample drawn from the registered survey participants of the survey platform Wenjuanxing. The respondents who reported a need for health care over the past month (n = 1,317) were asked to report their health care experiences and concerns. Logistic regression models were established to identify predictors of the delay in seeking health care. The selection of independent variables was guided by the Andersen's service utilization model. All data analyses were performed using SPSS 23.0. A two-sided p value of <0.05 was considered as statistically significant. Key results About 31.4% of respondents reported delay in seeking health care, with fear of infection (53.5%) as a top reason. Middle (31-59 years) age (AOR = 1.535; 95% CI, 1.132 to 2.246), lower levels of perceived controllability of COVID-19 (AOR = 1.591; 95% CI 1.187 to 2.131), living with chronic conditions (AOR = 2.008; 95% CI 1.544 to 2.611), pregnancy or co-habiting with a pregnant woman (AOR = 2.115; 95% CI 1.154 to 3.874), access to Internet-based medical care (AOR = 2.529; 95% CI 1.960 to 3.265), and higher risk level of the region (AOR = 1.736; 95% CI 1.307 to 2.334) were significant predictors of the delay in seeking health care after adjustment for variations of other variables. Medical consultations (38.7%), emergency treatment (18.2%), and obtainment of medicines (16.5%) were the top three types of delayed care, while eye, nose, and throat diseases (23.2%) and cardiovascular and cerebrovascular diseases (20.8%) were the top two conditions relating to the delayed care. Self-treatment at home was the most likely coping strategy (34.9%), followed by Internet-based medical care (29.2%) and family/friend help (24.0%). Conclusions Delay in seeking health care remained at a relatively high level when the number of new COVID-19 cases was low, which may present a serious health risk to the patients, in particular those living with chronic conditions who need continuous medical care. Fear of infection is the top reason for the delay. The delay is also associated with access to Internet-based medical care, living in a high risk region, and perceived low controllability of COVID-19.
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Affiliation(s)
- Ziyu Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yurong Tang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yu Cui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hanwen Guan
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xiaoqian Cui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yuan Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yanni Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- School of Health Management, Harbin Medical University, Harbin, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Trześniewska-Ofiara Z, Mendrycka M, Cudo A, Szmulik M, Woźniak-Kosek A. Hospital Urinary Tract Infections in Healthcare Units on the Example of Mazovian Specialist Hospital Ltd. Front Cell Infect Microbiol 2022; 12:891796. [PMID: 35899043 PMCID: PMC9309389 DOI: 10.3389/fcimb.2022.891796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022] Open
Abstract
Microbiological diagnostics is of great importance in limiting the spread of nosocomial infections. The information on etiological agents of infections and their susceptibility to antibiotics enables a quick response in the case of a suspected epidemic outbreak. The aim of this study is to analyze the incidence of nosocomial urinary tract infections among patients hospitalized in hospital wards over a period of 2 years and to determine the predominant etiological agent depending on the method of clinical specimen collection. Data from the Mazovian Specialist Hospital (MSH) in Radom constitute the material for the preparation of this study. Urine was collected using two methods. The first one was the method of collecting urine from the central stream, while the second method was urine collected from patients with a urinary catheter in place. The statistical calculations were conducted using the statistical software. Based on hospital data, it was shown that 5,870 urine tests were performed during the period under review, of which 2,070 were positive. The number of positive results in 2021 decreased by 2.84% compared to that in 2020. On the basis of the statistical analysis, differences in the occurrence of multiple strains were observed between catheter-based and midstream urine collection. Differences were observed especially for Acinetobacter baumannii, Candida albicans, Escherichia coli, and Pseudomonas aeruginosa. A. baumannii, C. albicans, and P. aeruginosa were significantly more frequently found in urine samples collected through the catheter than from the midstream. Furthermore, E. coli (51.56%) and Enterococcus species (25.46%) were more frequent when collected from the middle stream than when urine was collected through a catheter. However, for the strain K. pneumoniae, the results were comparable when urine was collected from catheterized patients (13.83%) and from midstream (13.35%). Urinary tract infection among hospitalized patients of the Mazovian Specialist Hospital in Radom was diagnosed quite frequently. In 2021, 32 more urine cultures were performed than in 2020. In the analyzed period, among all ordered urine cultures, 35.27% of samples were positive.
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Affiliation(s)
- Zuzanna Trześniewska-Ofiara
- Department of Laboratory Diagnostics, Mazovian Specialist Hospital Ltd, Radom, Poland
- *Correspondence: Zuzanna Trześniewska-Ofiara, ; Mariola Mendrycka,
| | - Mariola Mendrycka
- Department of Nursing, Faculty of Medical Sciences and Health Sciences, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
- *Correspondence: Zuzanna Trześniewska-Ofiara, ; Mariola Mendrycka,
| | - Andrzej Cudo
- Department of Experimental Psychology, Institute of Psychology, The John Paul II Catholic University of Lublin, Lublin, Poland
| | - Magdalena Szmulik
- Sysmex Poland Ltd, scientific aspect prepared in cooperation with Department of Laboratory Diagnostics, Military Institute of Medicine, Warsaw, Poland
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Comparing the Occurrence of Healthcare-Associated Infections in Patients with and without COVID-19 Hospitalized during the Pandemic: A 16-Month Retrospective Cohort Study in a Hospital Intensive Care Unit. J Clin Med 2022; 11:jcm11051446. [PMID: 35268538 PMCID: PMC8910983 DOI: 10.3390/jcm11051446] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has increased the healthcare-associated infection (HAI) risk in intensive care unit (ICU) patients. However, a comparison between patients with and without COVID-19 in terms of HAI incidence has been rarely explored. In this study, we characterized the occurrence of HAI among patients with and without COVID-19 admitted to the ICU of the Umberto I hospital of Rome during the first 16 months of the pandemic and also identified risk factors for HAI acquisition. Patients were divided into four groups according to their ICU admission date. A multivariable conditional risk set regression model for multiple events was constructed for each admission period. Adjusted hazard ratios and 95% confidence intervals were calculated. Overall, 352 COVID-19 and 130 non-COVID-19 patients were included, and a total of 361 HAIs were recorded. We found small differences between patients with and without COVID-19 in the occurrence and type of HAI, but the infections in the two cohorts mostly involved different microorganisms. The results indicate that patient management was likely an important factor influencing the HAI occurrence during the pandemic. Effective prevention and control strategies to reduce HAI rates should be implemented.
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24
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Wu AW. The masks are off–maintaining gains in patient safety post COVID-19. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2021. [DOI: 10.1177/25160435211039057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Albert W Wu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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