scholarly journals Emergence of Glutaraldehyde-Resistant Pseudomonas aeruginosa

2011 ◽  
Vol 32 (12) ◽  
pp. 1173-1178 ◽  
Author(s):  
Sarah Tschudin-Sutter ◽  
Reno Frei ◽  
Günter Kampf ◽  
Michael Tamm ◽  
Eric Pflimlin ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Chart Review ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Incidence Rates ◽  
Medical Chart ◽  
University Hospital ◽  
Clinical Samples ◽  
Medical Chart Review

Objective.In November 2009, routine sampling of endoscopes performed to monitor the effectiveness of the endoscope-cleaning procedure at our hospital detected Pseudomonas aeruginosa. Herein we report the results of the subsequent investigation.Design and Methods.The investigation included environmental cultures for source investigation, molecular analysis by pulsed-field gel electrophoresis (PFGE) to reveal the identity of the strains, and determination of the bactericidal activity of the glutaraldehyde-based disinfectant used for automated endoscope reprocessing. In addition, patient outcome was analyzed by medical chart review, and incidence rates of clinical samples with P. aeruginosa were compared.Setting.The University Hospital of Basel is an 855-bed tertiary care center in Basel, Switzerland. Approximately 1,700 flexible bronchoscopic, 2,500 gastroscopic, 1,400 colonoscopic, 140 endoscopic retrograde cholangiopancreatographic, and 140 endosonographic procedures are performed annually.Results.P. aeruginosa was detected in samples obtained from endoscopes in November 2009 for the first time since the initiation of surveillance in 2006. It was found in the rinsing water and in the drain of 1 of the 2 automated endoscope reprocessors. PFGE revealed 2 distinct P. aeruginosa strains, one in each reprocessor. The glutaraldehyde-based disinfectant showed no activity against the 2 pseudo-outbreak strains when used in the recommended concentration under standard conditions. After medical chart review, 6 patients with lower respiratory tract and bloodstream infections were identified as having a possible epidemiological link to the pseudo-outbreak strain.Conclusions.This is the first description of a pseudo-outbreak caused by P. aeruginosa with reduced susceptibility to an aldehyde-based disinfectant routinely used in the automated processing of endoscopes.

scholarly journals Experience With Ceftolozane-Tazobactam for the Treatment of Serious Pseudomonas aeruginosa Infections in Saudi Tertiary Care Center

2020 ◽  
Vol 13 ◽  
pp. 117863372090597 ◽  
Author(s):  
M Bosaeed ◽  
A Ahmad ◽  
A Alali ◽  
E Mahmoud ◽  
L Alswidan ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Clinical Success ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Signs And Symptoms ◽  
Central Line ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Duration Of Treatment

Introduction: Multidrug-resistant Pseudomonas aeruginosa isolates have multiple resistance mechanisms, and there are insufficient therapeutic options to target them. Ceftolozane-tazobactam is a novel antipseudomonal agent that contains a combination of an oxyimino-aminothiazolyl cephalosporin (ceftolozane) and a β-lactamase inhibitor (tazobactam). Methods: A single-center retrospective observational study between January 2017 and December 2018 for patients who had been diagnosed with carbapenem-resistant P aeruginosa infections and treated with ceftolozane-tazobactam for more than 72 hours. We assessed clinical success based on microbiological clearance as well as the clinical resolution of signs and symptoms of infection. Results: A total of 19 patients fit the inclusion criteria, with a median age was 57 years, and 53% were female. The types of infections were nosocomial pneumonia, acute bacterial skin, and skin structure infections; complicated intra-abdominal infections; and central line–associated bloodstream infections. All of the isolates were resistant to both meropenem and imipenem. The duration of therapy was variable (average of 14 days). At day 14 of starting ceftolozane-tazobactam, 18 of 19 patients had a resolution of signs and symptoms of the infection. Only 14 of 19 patients (74%) had proven microbiological eradication observed at the end of therapy. During therapy, there was no adverse event secondary to ceftolozane-tazobactam, and no Clostridium difficile infection was identified. The 30-day mortality rate was 21% (4/19). Conclusions: Multidrug-resistant P aeruginosa infection is associated with high mortality, which would potentially be improved using a new antibiotic such as ceftolozane-tazobactam. Studies are required to explain the role of combination therapy, define adequate dosing, and identify the proper duration of treatment.

Development of a Novel Electronic Surveillance System for Monitoring of Bloodstream Infections

2010 ◽  
Vol 31 (7) ◽  
pp. 740-747 ◽  
Author(s):  
Jenine Leal ◽  
Daniel B. Gregson ◽  
Terry Ross ◽  
Ward W. Flemons ◽  
Deirdre L. Church ◽  
...  
Keyword(s):  
Nosocomial Infections ◽  
Chart Review ◽  
Bloodstream Infections ◽  
Medical Chart ◽  
Administrative Databases ◽  
Electronic Surveillance ◽  
Medical Chart Review ◽  
Comparative Review ◽  
Healthcare Associated ◽  
Community Onset

Background.Electronic surveillance systems (ESSs) that utilize existing information in databases are more efficient than conventional infection surveillance methods.Objective.To develop an ESS for monitoring bloodstream infections (BSIs) and assess whether data obtained from the ESS were in agreement with data obtained by traditional manual medical-record review.Methods.An ESS was developed by linking data from regional laboratory and hospital administrative databases. Definitions for excluding BSI episodes representing contamination and duplicate episodes were developed and applied. Infections were classified as nosocomial infections, healthcare-associated community-onset infections, or community-acquired infections. For a random sample of episodes, data in the ESS were compared with data obtained by independent medical chart review.Results.From the records of the 306 patients whose infections were selected for comparative review, the ESS identified 323 episodes of BSI, of which 107 (33%) were classified as healthcare-associated community-onset infections, 108 (33%) were classified as community-acquired infections, 107 (33%) were classified as nosocomial infections, and 1 (0.3%) could not be classified. In comparison, 310 episodes were identified by use of medical chart review, of which 116 (37%) were classified as healthcare-associated community-onset infections, 95 (31%) as community-acquired infections, and 99 (32%) as nosocomial infections. For 302 episodes of BSI, there was concordance between the findings of the ESS and those of traditional manual chart review. Of the additional 21 discordant episodes that were identified by use of the ESS, 17 (81%) were classified as representing isolation of skin contaminants, by use of chart review. Of the additional 8 discordant episodes further identified by use of chart review, most were classified as repeat or polymicrobial episodes of disease. There was an overall 85% agreement between the findings of the ESS and those of chart review (K = 0.78; standard error, K = 0.04) for classification according to location of acquisition.Conclusion.Our novel ESS allows episodes of BSI to be identified and classified with a high degree of accuracy. This system requires validation in other cohorts and settings.

Strict Infection Control Leads to Low Incidence of Methicillin-ResistantStaphylococcus aureusBloodstream Infection over 20 Years

2015 ◽  
Vol 36 (6) ◽  
pp. 702-709 ◽  
Author(s):  
Andreas F. Widmer ◽  
Botond Lakatos ◽  
Reno Frei
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
University Hospital ◽  
Multiple Infection ◽  
Case Report Form ◽  
Contact Precautions

OBJECTIVEMethicillin-resistantStaphylococcus aureus(MRSA) is a worldwide issue associated with significant morbidity and mortality. Multiple infection control (IC) approaches have been tested to control its spread; however, the success of the majority of trials has been short-lived and many efforts have failed. We report the long-term success of MRSA control from a prospective observational study over 20 years.SETTINGUniversity Hospital Basel is a large tertiary care center with a median bed capacity of 855 and 5 intensive care units (ICUs); currently, the facility has >32,000 admissions per year.METHODSThe IC program at the University Hospital Basel was created in 1993, after 2 MRSA outbreaks. The program has included strict contact precautions with single rooms for MRSA-colonized or -infected patients, targeted admission screening of high-risk patients and healthcare workers at risk for carriage, molecular typing of all MRSA strains and routine decolonization of MRSA carriers including healthcare workers. We used the incidence of MRSA bloodstream infections (BSIs) to assess the effectiveness of this program. All MRSA cases were prospectively classified using a standardized case report form in nosocomial and nonnosocomial cases, based on CDC definitions.RESULTSBetween 1993 and 2012, 540,669 blood samples were cultured. The number of blood cultures increased from 865 per 10,000 patient days in 1993 to 1,568 per 10,000 patient days in 2012 (P<.001). We identified 1,268 episodes ofS. aureusBSI from 1,204 patients. MRSA accounted for 34 episodes (2.7%) and 24 of these (1.9%) were nosocomial. MRSA BSI incidence varied between 0 and 0.27 per 10,000 patient days and remained stable with no significant variation throughout the study period (P=.882).CONCLUSIONSLong-term control of MRSA is feasible when a bundle of IC precautions is strictly enforced over time.Infect Control Hosp Epidemiol2015;00(0): 1–8

Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection

2021 ◽  
pp. 019459982110089
Author(s):  
Quinn Dunlap ◽  
James Reed Gardner ◽  
Amanda Ederle ◽  
Deanne King ◽  
Maya Merriweather ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Surgical Complications ◽  
Chart Review ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Continuous Variables ◽  
Significant Difference ◽  
History Of

Objective Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND). Study Design Retrospective chart review. Setting Academic tertiary care center. Methods Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05. Results Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P < .001) and endocrine pathology (34% vs 2.6%, P < .001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis. Conclusion While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.

scholarly journals Clinical and laboratory follow-up after hospitalization for COVID-19 at an Italian tertiary care center

2021 ◽  
Author(s):  
Michele Spinicci ◽  
Iacopo Vellere ◽  
Lucia Graziani ◽  
Marta Tilli ◽  
Beatrice Borchi ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
Tertiary Care Center ◽  
Persistent Symptom ◽  
Post Discharge

Abstract We evaluated 100 post-acute COVID-19 patients, a median of 60 days (IQR 48-67) after discharge from the Careggi University Hospital, Italy. Eighty-four (84%) had at least one persistent symptom, irrespective of COVID-19 severity. A considerable number of hospital re-admission (10%) and/or infectious diseases (14%) during the post-discharge period was reported.

Histopathological Study of Cystoscopic Bladder Biopsies in a Tertiary Care Center

2021 ◽  
Vol 6 (1) ◽  
pp. 1310-1314
Author(s):  
Rachana Dhakal ◽  
Hem Nath Joshi ◽  
Ramesh Makaju ◽  
Shailendra Sigdel
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Pathological Condition ◽  
Care Center ◽  
Tertiary Care ◽  
University Hospital ◽  
World Health ◽  
Histopathological Study ◽  
Neoplastic Lesion ◽  
Neoplastic Lesions

Introduction: Non-neoplastic urinary bladder lesions are not life threatening, but are an important source to cause clinical symptoms and signs. However, neoplasms of the bladder are a source of morbidity, mortality, and exhibit more clinical challenges. Cystoscopy provides overall information about an anatomical/pathological condition of the urinary bladder which will be helpful for patients' management. A cystoscopic biopsy is a primary diagnostic tool for diagnosing urinary bladder cancer. Objectives: The objective of the study was to find the frequency and histomorphological characteristics of urinary bladder lesions in Dhulikhel Hospital, to find the clinical presentation of urinary bladder lesions and to grade the urothelial tumors based on the World Health Organization (WHO)/ International Society of Urological Pathology (ISUP) classification 2004. Methodology: This was a retrospective, cross-sectional, observational study carried out in the Department of Pathology, Dhulikhel Hospital-Kathmandu University Hospital. Convenient sampling was done. All cystoscopy biopsies received from January 2014 to December 2018 were studied. All tissue blocks were retrieved, cut, and stained with Hematoxylin and Eosin. The stained slides were examined under a light microscope by the primary investigator. Result: A total of 70 cystoscopic biopsies were analyzed. The majority of patients 20 (28.6%) were in the age group between 60 and 69 years and males were predominant 43 (61.4%). The neoplastic lesions constituted 40 (57.1%) of all bladder lesions, among them urothelial carcinoma accounted for 38 (54.2%). Similarly, chronic cystitis 27(38.6%) was the most common non-neoplastic lesion. Conclusion: The study found that the neoplastic lesions were commonly encountered in urinary bladder lesions. Among them, lowgrade urothelial carcinoma was the most common bladder tumor. However, most of the non-neoplastic lesions were inflammatory in origin. Cystoscopy combined with histomorphological examination helps in the early detection of bladder lesions. 

PATTERNS OF ANTIMICROBIAL RESISTANCE AMONG MAJOR BACTERIAL PATHOGENS ISOLATED FROM CLINICAL SAMPLES IN TWO TERTIARY’S HOSPITALS, IN SANA'A, YEMEN

2021 ◽  
Author(s):  
Huda Zaid Al-Shami ◽  
Muhamed Ahmed Al-Haimi ◽  
Omar Ahmed Esma’il Al-dossary ◽  
Abeer Abdulmahmood Mohamed Nasher ◽  
Mohammed Mohammed Ali Al-Najhi ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Peer Review ◽  
Bacterial Pathogens ◽  
University Hospital ◽  
Clinical Samples ◽  
Isolation And Identification ◽  
Hemolytic Streptococcus ◽  
Study Results

Background and objectives: At the present time, antimicrobial resistance (AMR) is a major public health hazard, with antimicrobial resistance bacteria increasing exponentially. This study estimates the epidemiological profiles and antimicrobial resistance of Gram-positive bacteria (GPB) and Gram-negative bacteria (GNB)  isolated from clinical samples among patients admitted to two University hospitals in Sana'a city for one year (2019). Methods: This was a retrospective study of clinical samples of patients collected from January 1, 2019 to December 30, 2019. All samples were appraised to determine presence of infectious agents using standard methods for isolation and identification of bacteria and yeasts from clinical samples of patients admitted to Al-Gumhouri University Hospital and Al-Kuwait University Hospital in Sana'a city. Antibiotic resistance was done using Kirby-Bauer disc diffusion methods. Results:  2,931 different pathogenic bacteria were detected from 24,690 different clinical specimens. The samples had an overall detection rate of 11.9% (2931/24,690). Among the bacterial pathogens isolated from clinical samples, 52.4% (n=1536) had GPB and 41.2% (n=1207) had GNB. The predominant GNB isolates were E.coli (22.04%), Klebsiella spp (6.03%), Pseudomonas aeruginosa (7.1%), Acinetobacter baumannii (1.46%), Enterobacter spp. (1.09%), Citrobacter spp. (1.16%), respectively. Among the GPB, S.aureus was the most common (26.3%), Coagulase-negative Staphylococcus (8.1%), Non-hemolytic Streptococcus (9.1%), Other alpha-hemolytic Streptococcus (3.9%), Streptococcus pyogenes (1.9%), and Streptococcus pneumoniae (0.5% ). A high rate of antibiotic resistance was recorded for sulfamethoxazole/trimethoprim (85.5%), ceftazidime (81.07%), ampicillin (70.4%), cefuroxime (66.4%). Conclusions:  The current study results revealed that the rate of resistance between GNB and GPB is associated with the incidence of different infections in patients attending two major tertiary hospitals in Sana'a city is very high. These results indicate ongoing screening and follow-up programs to detect antibiotic resistance, and also suggest the development of antimicrobial stewardship programs in Sana'a, Yemen.                     Peer Review History: Received: 9 September 2021; Revised: 11 October; Accepted: 23 October, Available online: 15 November 2021 Academic Editor:  Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Rima Benatoui, Laboratory of Applied Neuroendocrinology, Department of Biology, Faculty of Science, Badji Mokhtar University Annaba, BP12 E L Hadjar–Algeria, [email protected] Dr. Wadhah Hassan Ali Edrees, Hajja University, Yemen, [email protected] Rola Jadallah, Arab American University, Palestine, [email protected] Similar Articles: PREVALENCE OF PSEUDOMONAS AERUGINOSA (P. AERUGINOSA) AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AT A PRIVATE HOSPITAL IN SANA'A, YEMEN EVALUATION OF ANTIBACTERIAL RESISTANCE OF BIOFILM FORMS OF AVIAN SALMONELLA GALLINARUM TO FLUOROQUINOLONES

Sign in / Sign up

Export Citation Format

Share Document