scholarly journals Hospital-diagnosed infections with Escherichia coli clonal group ST131 are mostly acquired in the community

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Allison Muller ◽  
Houssein Gbaguidi-Haore ◽  
Pascal Cholley ◽  
Didier Hocquet ◽  
Marlène Sauget ◽  
...  
Keyword(s):  
Risk Factors ◽  
University Hospital ◽  
Clonal Group ◽  
E Coli ◽  
Factors Associated ◽  
Molecular Features ◽  
Two Factors ◽  
Genes Encoding ◽  
Common Risk Factors ◽  
M 14

AbstractThe worldwide spread of E. coli ST131 has significantly contributed to the dissemination of E. coli producing extended-spectrum β-lactamases (ESBL). In a French University hospital, we assessed the molecular features of ESBL-producing E. coli and identified risk factors in patients for colonization or infection with E. coli ST131. Over a 2-year period (2015–2017), each patient with at least one clinical isolate or one screening isolate positive with ESBL-producing E. coli were included (n = 491). The ST131 clonal group accounted for 17.5% (n = 86) of all ESBL-producing E. coli and represented 57.3% isolates of phylogroup B2. FimH-based sub-typing showed that 79.1% (68/86) of ST131 isolates were fimH30, among which 67.6% (n = 46), 20.6% (n = 14) and 11.8% (n = 8) isolates harbored genes encoding the ESBL CTX-M-15, CTX-M-27, and CTX-M-14, respectively. The multivariate analysis identified two factors independently associated with ST131 ESBL-producing E. coli isolates: infection (Odds ratio [OR] = 1.887, 95% confidence interval [CI]: 1.143–3.115; p = 0.013) and community acquisition (OR = 2.220, 95% CI: 1.335–3.693; p = 0.002). In conclusion, our study confirmed the predominance of ST131 clonal group among ESBL-producing E. coli and the difficulty to identify common risk factors associated with carriage of this pandemic clonal group.

scholarly journals Burnout Syndrome during Residency Training in Jordan: Prevalence, Risk Factors, and Implications

2021 ◽  
Vol 18 (4) ◽  
pp. 1557
Author(s):  
Abdullah Nimer ◽  
Suzan Naser ◽  
Nesrin Sultan ◽  
Rawand Said Alasad ◽  
Alexander Rabadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Working Hours ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Burnout Syndrome ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Factors Associated ◽  
Resident Physicians ◽  
Healthcare Professions

Burnout syndrome is common among healthcare professions, including resident physicians. We aimed to assess the prevalence of burnout among resident physicians in Jordan, and a secondary aim was to evaluate the risk factors associated with the development of burnout syndrome in those residents, including gender, working hours, psychological distress, training sector, and specialty. In this cross-sectional study, 481 residents were recruited utilizing multistage stratified sampling to represent the four major health sectors in Jordan. Data were collected using an online questionnaire, where the Copenhagen Burnout Inventory (CBI) was used to assess the prevalence of burnout. The prevalence, group differences, and predictors of burnout were statistically analyzed using STATA 15. Overall, 373 (77.5%) residents were found to have burnout. Factors associated with higher levels of burnout were psychological stress (β = 2.34, CI = [1.88–2.81]), longer working hours (β = 4.07, CI = [0.52–7.62], for 51–75 h a week, β = 7.27, CI = [2.86–11.69], for 76–100 h a week and β = 7.27, CI = [0.06–14.49], for >100 h a week), and obstetrics/gynecology residents (β = 9.66, CI = [3.59–15.73]). Conversely, medical sub-specialty residents, as well as private and university hospital residents, had lower burnout levels. We concluded that decreasing the workload on residents, offering psychological counseling, and promoting a safety culture for residents might help in mitigating burnout consequences.

Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

2021 ◽  
pp. 105477382110504
Author(s):  
Jeong Eun Yoon ◽  
Ok-Hee Cho
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Medical Records ◽  
Injury Severity ◽  
University Hospital ◽  
Factors Associated ◽  
Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

scholarly journals Recent Emergence of Clonal Group O25b:K1:H4-B2-ST131 ibeA Strains among Escherichia coli Poultry Isolates, Including CTX-M-9-Producing Strains, and Comparison with Clinical Human Isolates

2010 ◽  
Vol 76 (21) ◽  
pp. 6991-6997 ◽  
Author(s):  
Azucena Mora ◽  
Alexandra Herrera ◽  
Rosalia Mamani ◽  
Cecilia López ◽  
María Pilar Alonso ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Gene ◽  
Clonal Group ◽  
E Coli ◽  
Strain Collection ◽  
Zoonotic Risk ◽  
Recent Emergence ◽  
Avian Origin ◽  
K1 Capsule ◽  
M 14

ABSTRACT To discern the possible spread of the Escherichia coli O25b:H4-ST131 clonal group in poultry and the zoonotic potential of avian strains, we made a retrospective search of our strain collection and compared the findings for those strains with the findings for current strains. Thus, we have characterized a collection of 19 avian O25b:H4-ST131 E. coli strains isolated from 1995 to 2010 which, interestingly, harbored the ibeA gene. Using this virulence gene as a criterion for selection, we compared those 19 avian strains with 33 human O25b:H4-ST131 ibeA-positive E. coli strains obtained from patients with extraintestinal infections (1993 to 2009). All 52 O25b:H4-ST131 ibeA-positive E. coli strains shared the fimH, kpsMII, malX, and usp genes but showed statistically significant differences in nine virulence factors, namely, papGIII, cdtB, sat, and kpsMII K5, which were associated with human strains, and iroN, kpsMII K1, cvaC, iss, and tsh, which were associated with strains of avian origin. The XbaI macrorestriction profiles of the 52 E. coli O25b:H4-ST131 ibeA-positive strains revealed 11 clusters (clusters I to XI) of >85% similarity, with four clusters including strains of human and avian origin. Cluster VII (90.9% similarity) grouped 10 strains (7 avian and 3 human strains) that mostly produced CTX-M-9 and that also shared the same virulence profile. Finally, we compared the macrorestriction profiles of the 12 CTX-M-9-producing O25b:H4-ST131 ibeA strains (7 avian and 5 human strains) identified among the 52 strains with those of 15 human O25b:H4-ST131 CTX-M-14-, CTX-M-15-, and CTX-M-32-producing strains that proved to be negative for ibeA and showed that they clearly differed in the level of similarity from the CTX-M-9-producing strains. In conclusion, E. coli clonal group O25b:H4-ST131 ibeA has recently emerged among avian isolates with the new acquisition of the K1 capsule antigen and includes CTX-M-9-producing strains. This clonal group represents a real zoonotic risk that has crossed the barrier between human and avian hosts.

Presence of retained calcified fibrin sheath after central venous catheter removal: A systematic literature review

2020 ◽  
pp. 112972982096932
Author(s):  
Patrycja S Matusik ◽  
Piotr Łoboda ◽  
Katarzyna Krzanowska ◽  
Tadeusz J Popiela ◽  
Grzegorz Heba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Dwell Time ◽  
Case Reports ◽  
Central Venous ◽  
Factors Associated ◽  
Fibrin Sheath ◽  
Common Risk Factors

Central venous catheters (CVC) are used in many clinical settings for a variety of indications. We performed a systematic literature review concerning case reports of retained calcified fibrin sheaths after dialysis CVC removal. The aim of our study was to systematize the knowledge regarding clinical management of this phenomenon, placing special emphasis on diagnostic radiological features in different imaging modalities, including chest radiography, echocardiography, computed tomography, and magnetic resonance imaging. We discuss the most common risk factors associated with this CVC complication. In our review, we found eight cases of hemodialysis patients. The most common risk factors associated with calcified fibrin sheath formation in the analyzed cases were pro-thrombotic and pro-calcification factors related to patient comorbidities, and prolonged catheter dwell time. Differentiating between a calcified fibrin sheath (present in about 6% of patients with long-term indwelling CVC as diagnosed by computed tomography) and a retained catheter tip can be challenging. The initial diagnosis based on imaging methods was incorrect in most of the analyzed cases. This suggests that some cases of retained fibrin sheaths may remain undetected or misinterpreted. This is important in patients with known pro-thrombotic and pro-calcification risk factors and prolonged catheter dwell time. Therefore, implementation of preventive strategies, familiarity with radiological findings of this phenomenon, comparison with previous imaging studies, and an overall comprehensive assessment with clinical data is imperative.

scholarly journals Prevalence and risk factors associated with low back pain among hospital staff in a university hospital in Lebanon

2016 ◽  
Vol 59 ◽  
pp. e146 ◽  
Author(s):  
Khalil Ghoussoub ◽  
Alain El Asmar ◽  
Gaby Kreichati ◽  
Sawma Wakim ◽  
Mayla Bakhache ◽  
...  
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Hospital Staff ◽  
University Hospital ◽  
Low Back ◽  
Factors Associated

Microbiology and Risk Factors for Catheter Exit-Site and -Hub Colonization in Neonatal Intensive Care Unit Patients

2001 ◽  
Vol 22 (6) ◽  
pp. 357-362 ◽  
Author(s):  
Ludo M. Mahieu ◽  
Jozef J. De Dooy ◽  
Aimé O. De Muynck ◽  
Guillaume Van Melckebeke ◽  
Margareta M. Ieven ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Strong Association ◽  
University Hospital ◽  
Exit Site ◽  
Coagulase Negative Staphylococci ◽  
Factors Associated

AbstractObjective:To identify risk factors and describe the microbiology of catheter exit-site and hub colonization in neonates.Design:During a period of 2 years, we prospectively investigated 14 risk factors for catheter exit-site and hub colonization in 862 central venous catheters in a cohort of 441 neonates. Cultures of the catheter exit-site and hub were obtained using semiquantitative techniques at time of catheter removal.Setting:A neonatal intensive care unit at a university hospital.Results:Catheter exit-site colonization was found in 7.2% and hub colonization in 5.3%. Coagulase-negative staphylococci were predominant at both sites. Pathogenic flora were found more frequently at the catheter hub (36% vs 14%;P<.05). Through logistic regression, factors associated with exit-site colonization were identified as umbilical insertion (odds ratio [OR], 8.1; 95% confidence interval [CI95], 2.35-27.6;P<.001), subclavian insertion (OR, 54.6; CI95, 12.2-244;P<.001), and colonization of the catheter hub (OR, 8.9; CI95,3.5-22.8;P<.001). Catheter-hub colonization was associated with total parenteral nutrition ([TPN] OR for each day of TPN, 1.056; CI95,1.029-1.083;P<.001) and catheter exit-site colonization (OR, 6.11; CI95, 2.603-14.34;P<.001). No association was found between colonization at these sites and duration of catheterzation and venue of insertion, physician's experience, postnatal age and patient's weight, ventilation, steroids or antibiotics, and catheter repositioning.Conclusion:These data support that colonization of the catheter exit-site is associated with the site of insertion and colonization of the catheter hub with the use of TPN. There is a very strong association between colonization at both catheter sites.

scholarly journals Silver Resistance Genes Are Overrepresented among Escherichia coli Isolates with CTX-M Production

2014 ◽  
Vol 80 (22) ◽  
pp. 6863-6869 ◽  
Author(s):  
Susanne Sütterlin ◽  
Petra Edquist ◽  
Linus Sandegren ◽  
Marlen Adler ◽  
Thomas Tängdén ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Resistance Genes ◽  
Selective Pressure ◽  
Human Origin ◽  
Content Type ◽  
Beta Lactamases ◽  
E Coli ◽  
Genes Encoding ◽  
Extended Spectrum Beta Lactamases ◽  
M 14

ABSTRACTMembers of theEnterobacteriaceaewith extended-spectrum beta-lactamases (ESBLs) of the CTX-M type have disseminated rapidly in recent years and have become a threat to public health. In parallel with the CTX-M type expansion, the consumption and widespread use of silver-containing products has increased. To determine the carriage rates of silver resistance genes in differentEscherichia colipopulations, the presence of three silver resistance genes (silE,silP, andsilS) and genes encoding CTX-M-, TEM-, and SHV-type enzymes were explored inE. coliisolates of human (n= 105) and avian (n= 111) origin. The antibiotic profiles were also determined. Isolates harboring CTX-M genes were further characterized, and phenotypic silver resistance was examined. ThesilEgene was present in 13 of the isolates. All of them were of human origin. Eleven of these isolates harbored ESBLs of the CTX-M type (P= 0.007), and eight of them were typed as CTX-M-15 and three as CTX-M-14. None of thesilE-positive isolates was related to the O25b-ST131 clone, but 10 out of 13 belonged to the ST10 or ST58 complexes. Phenotypic silver resistance (silver nitrate MIC > 512 mg/liter) was observed after silver exposure in 12 of them, and a concomitant reduced susceptibility to piperacillin-tazobactam developed in three. In conclusion, 12% of the humanE. coliisolates but none of the avian isolates harbored silver resistance genes. This indicates another route for or level of silver exposure for humans than that caused by common environmental contamination. SincesilE-positive isolates were significantly more often found in CTX-M-positive isolates, it is possible that silver may exert a selective pressure on CTX-M-producingE. coliisolates.

scholarly journals Risk factors in bacterial colonization of internal ureteral stent

Bionatura ◽  
2021 ◽  
Vol 3 (3) ◽  
pp. 2022-2026
Author(s):  
Ekremah K. Shaker ◽  
Fatima A. Chaloob
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Renal Failure ◽  
Bacterial Culture ◽  
Urine Culture ◽  
Bacterial Colonization ◽  
Ureteral Stent ◽  
E Coli ◽  
Factors Associated

A ureteral stent is most broadly used to manage upper urinary tract disorders such as obstruction and prevent post-endoscopic complications. However, the stent may become a niche for bacterial colonization. This study aimed to determine the rate of bacterial colonization and type of bacteria in internal ureteral stents and the risk factors associated with bacterial colonization. This prospective cross-sectional study included 100 consecutive adult patients who had temporary ureteral stenting as preparation for a secondary ureterorenoscopy at Al-Yarmook Hospital/ Baghdad. All included patients were negative for bacterial culture before stenting. Stent and urine culture were performed at the time of stent removal. The colonization rate and bacteriuria in patients with internal ureteral stent were 19% and 9%, respectively. The most common bacteria in-stent and urine were E. coli accounting for 31.58% and 33.33%. Pseudomonas aeruginosa was common in stent culture, representing 21.05%. Positive bacterial culture was confirmed in 19 stents and 9 urine samples. All cases with positive urine samples were also positive for culture. Thus, the sensitivity and specificity of urine culture for detection of stent colonization were 47.37% and 100%, respectively. Diabetes mellitus, chronic renal failure, and prolonged stenting were significantly associated with increased stent colonization. The ureteral stent could be a source of urinary tract infection. The most pathogenic bacteria associated with the ureter stent are E. coli and Pseudomonas aeruginosa. Risk factors associated with stent colonization are diabetes mellitus, chronic renal failure, and prolonged indwelling time.

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