Depression and anxiety in hospitalized patients on contact precautions for multidrug-resistant microorganisms

Abstract Background Contaminated environmental surfaces contribute to transmission of healthcare-associated pathogens such as multidrug-resistant gram-negative bacilli. We hypothesized that medical procedures and patient care activities facilitate environmental dissemination of multidrug-resistant gram-negative bacilli in hospitalized patients. Methods We conducted a cohort study of hospitalized patients in contact precautions for carriage of extended-spectrum β-lactamase (ESBL)-producing or carbapenem-resistant gram-negative bacilli (CR-GNB) to determine the frequency of environmental shedding during procedures and care activities. Perirectal, wound, and skin were cultured for the gram-negative bacilli of interest. Prior to each procedure or activity, surfaces in the room and portable equipment used for procedures were disinfected. After procedures, high-touch surfaces and portable equipment were cultured; negative control cultures were collected after 1 hour in the absence of a procedure. Results Of 60 participants, 38 (63%) were in contact precautions for ESBL-producing gram-negative bacilli and 22 (37%) for CR-GNB. Thirty-four (57%) participants had positive perirectal, wound, or skin cultures. Contamination of surfaces with the colonizing multidrug-resistant gram-negative bacilli occurred frequently during procedures and activities such as wound care, assistance with meals, and urinary catheter or colostomy care (11% to 29% of procedures/activities), whereas contamination was rare in the absence of a procedure (1%). Contamination was recovered from 6 of 56 (10%) portable devices used for procedures. Conclusion Environmental shedding of multidrug-resistant gram-negative bacilli occurs frequently during medical and non-medical procedures in hospitalized patients. Our results suggest that there is a need for effective strategies to disinfect surfaces and equipment after procedures. Disclosures All authors: No reported disclosures.

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Contact precautions for colonisation with multidrug-resistant organisms and haemodialysis patient quality of life and mood: a pilot case-control study

Renal Society of Australasia Journal ◽

10.33235/rsaj.15.1.19-25 ◽

2019 ◽

pp. 19-25 ◽

Cited By ~ 1

Author(s):

Rathika Krishnasamy

Keyword(s):

Quality Of Life ◽

Qualitative Interviews ◽

Social Function ◽

Multidrug Resistant ◽

Contact Precautions ◽

Dialysis Vintage ◽

Multidrug Resistant Organisms ◽

And Gender ◽

The Impact

Background: The rate of multidrug-resistant organisms (MDRO) colonisation in dialysis populations has increased over time. This study aimed to assess the effect of contact precautions and isolation on quality of life and mood for haemodialysis (HD) patients colonised with MDRO. Methods: Patients undergoing facility HD completed the Kidney Disease Quality of Life (KDQOL–SFTM), Beck Depression Inventory (BDI) and Personal Wellbeing-Index Adult (PWI-A). Patients colonised with MDRO were case-matched by age and gender with patients not colonised. Results: A total of 16 MDRO-colonised patients were matched with 16 controls. Groups were well matched for demographics and co-morbidities, other than a trend for older dialysis vintage in the MDRO group [7.2 years (interquartile range 4.6–10.0) compared to 3.2 (1.4–7.6) years, p=0.05]. Comparing MDRO-positive with negative patients, physical (30.5±10.7 vs. 34.6±7.3; p=0.2) and mental (46.5±11.2 vs. 48.5±12.5; p = 0.6) composite scores were not different between groups. The MDRO group reported poorer sleep quality (p=0.01) and sleep patterns (p=0.05), and lower social function (p=0.02). BDI scores were similar (MDRO-positive 10(3.5–21.0) vs. MDRO-negative 12(6.5–16.0), p=0.6). PWI-A scores were also similar in both groups; however, MDRO patients reported lower scores for “feeling safe”, p=0.03. Conclusion: While overall scores of quality of life and depression were similar between groups, the MDRO group reported poorer outcomes in sleep and social function. A larger cohort and qualitative interviews may give more detail of the impact of contact precautions and isolation on HD patients. The necessity for contact precautions for different MDRO needs consideration.

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Prevalence and predictors of posttraumatic stress disorder, depression and anxiety among hospitalized patients with coronavirus disease 2019 in China

BMC Psychiatry ◽

10.1186/s12888-021-03076-7 ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Yaru Chen ◽

Xin Huang ◽

Chengyuan Zhang ◽

Yuanyuan An ◽

Yiming Liang ◽

...

Keyword(s):

Mental Health ◽

Social Support ◽

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Perceived Social Support ◽

Trauma Exposure ◽

Hospitalized Patients ◽

Depression And Anxiety ◽

Negative News

Abstract Background Coronavirus disease 2019 (COVID-19) has affected more than 5 million people around the world and killed more than 300,000 people; thus, it has become a global public health emergency. Our objective was to investigate the mental health of hospitalized patients diagnosed with COVID-19. Methods The PTSD checklist for DSM-5 (PCL-5), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Trauma Exposure Scale, abbreviated version of the Connor–Davidson Resilience Scale (CD-RISC-10), Perceived Social Support Scale (PSSS) and Demographic Questionnaire were used to examine posttraumatic stress disorder (PTSD), depression, anxiety, trauma exposure, resilience and perceived social support among 898 patients who were hospitalized after being diagnosed with COVID-19 in China. The data were analyzed with t tests, one-way ANOVA and multivariable logistic regression analysis. Results The results showed that the prevalence of PTSD, depression and anxiety was 13.2, 21.0 and 16.4%, respectively. Hospitalized patients who were more impacted by negative news reports, had greater exposure to traumatic experiences, and had lower levels of perceived social support reported higher PTSD, depression and anxiety. Conclusions Effective professional mental health services should be designed to support the psychological wellbeing of hospitalized patients, especially those who have severe disease, are strongly affected by negative news and have high levels of exposure to trauma.

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Two Candida auris Cases in Germany with No Recent Contact to Foreign Healthcare—Epidemiological and Microbiological Investigations

Journal of Fungi ◽

10.3390/jof7050380 ◽

2021 ◽

Vol 7 (5) ◽

pp. 380

Author(s):

Joerg Steinmann ◽

Thomas Schrauzer ◽

Lisa Kirchhoff ◽

Jacques F. Meis ◽

Peter-Michael Rath

Keyword(s):

South Asian ◽

Multidrug Resistant ◽

Health Care Facilities ◽

Candida Auris ◽

Contact Precautions ◽

Asian Clade ◽

Care Facilities ◽

Long Time ◽

European Health ◽

Healthcare Associated

Candida auris has become a global fungal public health threat. This multidrug-resistant yeast is associated with nosocomial intra- and interhospital transmissions causing healthcare-associated infections. Here, we report on two C. auris cases from Germany. The two patients stayed in Germany for a long time before C. auris was detected during their hospitalization. The patients were isolated in single rooms with contact precautions. No nosocomial transmissions were detected within the hospital. Both C. auris isolates exhibited high minimum inhibitory concentrations (MICs) of fluconazole and one isolate additionally high MICs against the echinocandins. Microsatellite genotyping showed that both strains belong to the South Asian clade. These two cases are examples for appropriate in-hospital care and infection control without further nosocomial spread. Awareness for this emerging, multidrug-resistant pathogen is justified and systematic surveillance in European health care facilities should be performed.

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Transmission-based contact precautions for multidrug-resistant organisms in trauma patients

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0000000000000359 ◽

2014 ◽

Vol 77 (6) ◽

pp. 960-963 ◽

Cited By ~ 3

Author(s):

Lynda Watkins ◽

Sadia Ali ◽

Adam Clark ◽

Carlos V.R. Brown

Keyword(s):

Multidrug Resistant ◽

Trauma Patients ◽

Contact Precautions ◽

Multidrug Resistant Organisms

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Intravenous Fosfomycin: An Assessment of Its Potential for Use in the Treatment of Systemic Infections in Canada

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2018/8912039 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13 ◽

Cited By ~ 8

Author(s):

George G. Zhanel ◽

Michael A. Zhanel ◽

James A. Karlowsky

Keyword(s):

Antimicrobial Agents ◽

Multidrug Resistant ◽

Hospitalized Patients ◽

Second Line ◽

Pharmacological Interactions ◽

Term Administration ◽

Excellent Safety Profile ◽

Tract Infections ◽

Systemic Infections

Fosfomycin is a bactericidal agent that inhibits cell wall synthesis using a mechanism of action distinct from β-lactams or other antimicrobial agents. It is a broad-spectrum agent that is frequently active against antimicrobial-resistant bacterial pathogens including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), multidrug-resistant (MDR) Enterobacteriaceae, and some isolates of MDR Pseudomonas aeruginosa. Intravenous fosfomycin has been prescribed for a wide variety of infections in many countries for >40 years. It is most frequently used in combination with other antimicrobial agents (e.g., β-lactams, carbapenems, and aminoglycosides) and has an excellent safety profile, including in neonates and children, even with long-term administration (weeks). Fosfomycin achieves extensive tissue distribution including difficult to reach compartments such as aqueous humor, vitreous humor, abscess fluid, and CSF. Available data, to date, suggest no clinically relevant pharmacological interactions between fosfomycin and other agents, including drugs, stimulants, or food. Intravenous fosfomycin’s role in therapy in Canada is likely as an agent used alone or in combination for complicated urinary tract infections in hospitalized patients as well as hospitalized patients with MDR infections who have not responded to first-, and potentially, second-line antimicrobials or in patients who cannot tolerate (due to adverse effects) first- and second-line antimicrobials.

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