scholarly journals COVID-19 and the potential long-term impact on antimicrobial resistance

2020 ◽  
Vol 75 (7) ◽  
pp. 1681-1684 ◽  
Author(s):  
Timothy M Rawson ◽  
Luke S P Moore ◽  
Enrique Castro-Sanchez ◽  
Esmita Charani ◽  
Frances Davies ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Severe Acute Respiratory Syndrome ◽  
Hand Hygiene ◽  
Infection Control ◽  
Negative Impact ◽  
Unintended Consequences ◽  
Emerging Infections ◽  
Long Term Impact ◽  
Global Threat

Abstract The emergence of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has required an unprecedented response to control the spread of the infection and protect the most vulnerable within society. Whilst the pandemic has focused society on the threat of emerging infections and hand hygiene, certain infection control and antimicrobial stewardship policies may have to be relaxed. It is unclear whether the unintended consequences of these changes will have a net-positive or -negative impact on rates of antimicrobial resistance. Whilst the urgent focus must be on controlling this pandemic, sustained efforts to address the longer-term global threat of antimicrobial resistance should not be overlooked.

scholarly journals Phenotypical antimicrobial resistance data of clinical and non-clinical Escherichia coli from poultry in Germany between 2014 and 2017

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243772
Author(s):  
Octavio Mesa-Varona ◽  
Heike Kaspar ◽  
Mirjam Grobbel ◽  
Bernd-Alois Tenhagen
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Clinical Isolates ◽  
Long Term Effects ◽  
Time Intervals ◽  
Explanatory Factors ◽  
Global Threat ◽  
Changes Over Time ◽  
Resistance Data

Antimicrobial resistance (AMR) is a global threat in humans and animals, and antimicrobial usage (AMU) has been identified as a main trigger of AMR. The purpose of this work was to compare data on AMR in clinical and non-clinical isolates of Escherichia coli in German broilers and turkeys between 2014 and 2017. Furthermore, we investigated AMR changes over time and the association of changes in AMU with changes in AMR. Data on clinical and non-clinical isolates together with data on therapy frequency of broilers and turkeys were collected from German monitoring systems. Logistic regression analyses were performed to assess the association between the explanatory factors (AMU, year and isolate type) and the dependent variable (AMR). In broilers, the analysis showed lower resistance proportions of clinical isolates of E. coli to ampicillin and colistin (ampicillin: Odds ratio (OR) and 95% confidence interval (CI) = 0.44 (0.3–0.64), p<0.001; colistin: OR and 95% CI = 0.75 (0.73–0.76), p<0.001) but higher proportions for cefotaxime (OR and 95% CI = 4.58 (1.56–15.1), p = 0.007). Resistance to ampicillin, gentamicin and tetracycline was less frequent in clinical isolates in turkeys (ampicillin: OR and 95% CI = 0.4 (0.29–0.53), p<0.001; gentamicin: OR and 95% CI = 0.5 (0.26–0.94), p = 0.035; tetracycline: OR and 95% CI = 0.4 (0.29–0.55), p<0.001). The analysis found decreasing associations of AMU with resistance to tetracycline in turkeys and to colistin in broilers. Year was associated with a decrease in resistance to colistin in broilers and to tetracycline in turkeys. Differences in resistance found in this study between clinical and non-clinical isolates might play an important role in resistance prevalence. This study indicated that further data analyses over longer time intervals are required to clarify the differences found between clinical and non-clinical isolates and to assess the long-term effects of changes in AMU on the prevalence of AMR.

scholarly journals Impact of the COVID-19 pandemic on core surgical training

2020 ◽  
Vol 65 (4) ◽  
pp. 133-137 ◽  
Author(s):  
Khurram Shahzad Khan ◽  
Rona Keay ◽  
Morag McLellan ◽  
Sajid Mahmud
Keyword(s):  
Surgical Training ◽  
Teaching Hospital ◽  
General Surgery ◽  
Negative Impact ◽  
Outpatient Clinics ◽  
Box Trainer ◽  
Surgical Trainees ◽  
Long Term Impact ◽  
The Impact

Background and aims COVID-19 pandemic has caused significant disruption in training which is even more pronounced in the surgical specialties. We aim to assess the impact of COVID-19 pandemic on core surgical training. Methods All core surgical and improving surgical trainees in West of Scotland region were invited to participate in an online voluntary anonymous survey via SurveyMonkey. Results 28 of 44 (63.6%) trainees responded, 15 (53.6%) were CT1/ST1. 14 (50.0%) working in teaching hospital and 15 (53.6%) working in general surgery. 20 (71.4%) felt that due to the pandemic they have less opportunity to operate as the primary surgeon. 21 (75.0%) have not attended any outpatient clinics. 8 (28.6%) did not have any form of access to the laparoscopic box-trainer. 20 (71.4%) felt their level of confidence in preforming surgical skills has been negatively impacted. 18 (64.3%) found it difficult to demonstrate progress in portfolio. 21 (75.0%) trainees have not attended any teaching. 10 (35.7%) trainees have been off-sick. 8 (28.6%) trainees have felt slightly or significantly more stressed. Conclusion COVID-19 pandemic has an unprecedented negative impact on all aspects of core surgical training. The long term impact on the current cohort of trainees is yet to be seen.

scholarly journals Frequently Identified Infection Control Gaps Related to Hand Hygiene in Long-Term Care Facilities

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S407-S407
Author(s):  
Kate Tyner ◽  
Regina Nailon ◽  
Sue Beach ◽  
Margaret Drake ◽  
Teresa Fitzgerald ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Long Term Care ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Care Facilities ◽  
And Control

Abstract Background Little is known about hand hygiene (HH) policies and practices in long-term care facilities (LTCF). Hence, we decided to study the frequency of HH-related infection control (IC) gaps and the factors associated with it. Methods The Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) in collaboration with NE Department of Health and Human Services conducted in-person surveys and on-site observations to assess infection prevention and control programs (IPCP) in 30 LTCF from 11/2015 to 3/2017. The Centers for Disease Control and Prevention (CDC) Infection Prevention and Control Assessment tool for LTCF was used for on-site interviews and the Centers for Medicare and Medicaid (CMS) Hospital IC Worksheet was used for observations. Gap frequencies were calculated for questions (6 on CDC survey and 8 on CMS worksheet) representing best practice recommendations (BPR). The factors studied for the association with the gaps included LTCF bed size (BS), hospital affiliation (HA), having trained infection preventionists (IP), and weekly hours (WH)/ 100 bed spent by IP on IPCP. Fisher’s exact test and Mann Whitney test were used for statistical analyses. Results HH-related IC gap frequencies from on-site interviews are displayed in Figure 1. Only 6 (20%) LTCF reported having all 6 BPR in place and 10 (33%) having 5 BPR. LTCF with fewer gaps (5 to 6 BPR in place) appear more likely to have HA as compared with the LTCF with more gaps but the difference didn’t reach statistical significance (37.5% vs. 7.1%, P = 0.09). When analyzed separately for each gap, it was found that LTCF with HA are more likely to have a policy on preferential use of alcohol based hand rubs than the ones without HA. (85.7%, vs. 26.1% P = 0.008). Several IC gaps were also identified during observations (Figure 2) with one of them being overall HH compliance of &lt;80%. LTCF that have over 90% HH compliance are more likely to have higher median IP WH/100 beds dedicated towards IPCP as compared with the LTCFs with less than 90% compliance (16.4 vs. 4.4, P &lt; 0.05). Conclusion Many HH-related IC gaps still exist in LTCF and require mitigation. Mitigation strategies may include encouraging LTCF to collaborate with IP at local acute care hospitals for guidance on IC activities and to increase dedicated IP times towards IPCP in LTCF. Disclosures All authors: No reported disclosures.

scholarly journals Greater empathy in MDMA users

2019 ◽  
Vol 33 (3) ◽  
pp. 295-304 ◽  
Author(s):  
Molly Carlyle ◽  
Tobias Stevens ◽  
Leah Fawaz ◽  
Beth Marsh ◽  
Sophia Kosmider ◽  
...  
Keyword(s):  
Social Exclusion ◽  
Psychosocial Functioning ◽  
Drug Users ◽  
Negative Impact ◽  
Cognitive Empathy ◽  
Self Report ◽  
Social Pain ◽  
Emotional Empathy ◽  
Long Term Impact

Background: 3,4-Methylenedioxymethamphetamine (MDMA) is widely known for its positive acute effects on social behaviour, such as increasing empathy, whilst also attenuating the negative impact of social exclusion. However there is a scarcity of research that investigates the long-term impact of recreational MDMA use on these fundamental social processes. Method: Sixty-seven individuals were split into three groups based on their drug-use history: poly-drug MDMA users ( n = 25), poly-drug users who do not use MDMA ( n = 19), alcohol-only users ( n = 23), and were tested in an independent groups design. Participants completed both a self-report measure of emotional and cognitive empathy, along with the Multifaceted Empathy Task – a computerised assessment of empathy – and the Cyberball Game – a social exclusion paradigm. Results: MDMA users had significantly greater subjective emotional empathy, and greater cognitive empathy on the computer task compared with the poly-drug users who do not use MDMA. There were no significant differences in subjective responses to social exclusion between the groups. Indices of MDMA use did not correlate with empathy. Conclusions: Long-term MDMA users in this sample exhibited normal psychosocial functioning in regard to empathy and social pain and had higher subjective emotional empathy. This conflicts with previous suggestions that moderate, long-term MDMA use may cause heightened social distress, and is further evidence of the safety of the drug, which is relevant to considerations of its therapeutic use.

The Universal Museum

2020 ◽  
Vol 2020 (46) ◽  
pp. 72-82
Author(s):  
Fatima El-Tayeb
Keyword(s):  
Collective Memory ◽  
Negative Impact ◽  
Focal Point ◽  
Refugee Crisis ◽  
Global Context ◽  
Colonial Art ◽  
Internal Structures ◽  
Universal Museum ◽  
Long Term Impact

This article addresses the long-term impact of colonialism on Europe’s internal structures and on its self-positioning in a global context. Using the 2015 refugee crisis as a focal point and centering the German example, the author explores the complex relationship between memory discourses and visions of Germany’s and Europe’s postunification future. The author argues that the erasure of colonial violence from the continent’s collective memory has a direct, negative impact on its ability to let go of a racialized identity that is in increasing tension with Europe’s actual multiracial and multireligious composition. The article traces this dynamic around the example of the non-European collections in Berlin’s Museum Island and the future Humboldt Forum, conceptualized as the world’s largest “universal museum.” The narratives through which this art is integrated into Europe’s cultural heritage are in stark contrast to those that simultaneously defined the refugees, who arrived from the same region in which the art originated, as fundamentally different and threatening. The narratives intersect in the Multaqa initiative, which offers Arab language tours of Museum Island to refugees, and in the controversy around the site of the Humboldt Forum and the colonial art it is meant to house.

scholarly journals Negative impact of manganese on honeybee foraging

2015 ◽  
Vol 11 (3) ◽  
pp. 20140989 ◽  
Author(s):  
Eirik Søvik ◽  
Clint J. Perry ◽  
Angie LaMora ◽  
Andrew B. Barron ◽  
Yehuda Ben-Shahar
Keyword(s):  
Risk Factor ◽  
Foraging Behaviour ◽  
Negative Impact ◽  
Direct Impact ◽  
Manganese Exposure ◽  
Accumulation Of Metals ◽  
The Common ◽  
Health Risk Factor ◽  
Long Term Impact

Anthropogenic accumulation of metals such as manganese is a well-established health risk factor for vertebrates. By contrast, the long-term impact of these contaminants on invertebrates is mostly unknown. Here, we demonstrate that manganese ingestion alters brain biogenic amine levels in honeybees and fruit flies. Furthermore, we show that manganese exposure negatively affects foraging behaviour in the honeybee, an economically important pollinator. Our findings indicate that in addition to its direct impact on human health, the common industrial contaminant manganese might also have indirect environmental and economical impacts via the modulation of neuronal and behavioural functions in economically important insects.

Relationship of Antimicrobial Control Policies and Hospital and Infection Control Characteristics to Antimicrobial Resistance Rates

2007 ◽  
Vol 16 (2) ◽  
pp. 110-120 ◽  
Author(s):  
Elaine L. Larson ◽  
Dave Quiros ◽  
Tara Giblin ◽  
Susan Lin
Keyword(s):  
Logistic Regression ◽  
Antimicrobial Resistance ◽  
Hand Hygiene ◽  
Infection Control ◽  
Practice Guidelines ◽  
The United States ◽  
Staff Attitudes ◽  
Provider Attitudes ◽  
Control Policies ◽  
Resistance Rates

• Background Antibiotic misuse and noncompliance with infection control precautions have contributed to increasing levels of antimicrobial resistance in hospitals. • Objectives To assess the extent to which resistance is monitored in infection control programs and to correlate resistance rates with characteristics of antimicrobial control policies, provider attitudes and practices, and systems-level indicators of implementation of the hand hygiene guideline of the Centers for Disease Control and Prevention. • MethodsAn on-site survey of intensive care unit staff and infection control directors of 33 hospitals in the United States was conducted. The following data were collected: antimicrobial control policies; rates during the previous 12 months of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and ceftazidime-resistant Klebsiella pneumoniae; an implementation score of systems-level efforts to implement the guideline; staff attitudes toward practice guidelines; and observations of staff hand hygiene. Variables associated with resistance rates were examined for independent effects by using logistic regression. • ResultsResistance rates for S aureus, enterococci, and K pneumoniae were 52.5%, 18.2%, and 16.0%, respectively. Ten (30.3%) hospitals had an antibiotic control policy. No statistically significant correlation was observed between staff attitudes toward practice guidelines, observed hand hygiene behavior, or having an antibiotic use policy and resistance rates. In logistic regression analysis, higher scores on measures of systems-level efforts to implement the guideline were associated with lower rates of resistant S aureus and enterococci (P=.046). • Conclusions Organizational-level factors independent of the practices of individual clinicians may be associated with rates of antimicrobial resistance.

scholarly journals The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status

Respirology ◽  
2010 ◽  
Vol 15 (3) ◽  
pp. 543-550 ◽  
Author(s):  
Jenny C. NGAI ◽  
Fanny W. KO ◽  
Susanna S. NG ◽  
Kin-Wang TO ◽  
Mabel TONG ◽  
...  
Keyword(s):  
Health Status ◽  
Severe Acute Respiratory Syndrome ◽  
Pulmonary Function ◽  
Exercise Capacity ◽  
Long Term Impact

scholarly journals Getting the Most Out of the ICAR Visit by Using a Scoring Report to Provide Feedback

2020 ◽  
Vol 41 (S1) ◽  
pp. s65-s66
Author(s):  
Rehab Abdelfattah ◽  
Virgie Fields ◽  
Carol Jamerson ◽  
Sarah Lineberger
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Acute Care ◽  
Infection Prevention ◽  
Long Term Care ◽  
Quantitative Measure ◽  
Infection Prevention And Control ◽  
Term Care

Background: The Centers for Disease Control and Prevention developed the Infection Control Assessment and Response (ICAR) tools to assist health departments in assessing infection prevention practices and to guide quality improvement activities. ICAR tools are available for the following healthcare settings: acute care (including hospitals and long-term acute-care hospitals), outpatient, long-term care, and hemodialysis. The Virginia Healthcare-Associated Infections and Antimicrobial Resistance (HAI/AR) Program developed a scoring report that provides a quantitative measure for each infection control domain and summarizes strengths and opportunities for improvement. The scoring report aims to provide feedback to facility administration in a simple, user-friendly way to increase their engagement, prioritize follow-up actions for areas in need of improvement, and to analyze statewide data systematically to identify and address major defects. Methods: Scoring reports were developed for acute care, long-term care, and hemodialysis facilities. Each report includes 2 tables: infection control domains for gap assessment and direct observation of facility practices. The first table has rows for infection control assessment domains, and the second table summarizes direct observations conducted during the ICAR visit such as hand hygiene, point-of-care testing, and wound dressing change. Each row is stratified by the score, which is determined by responses to the ICAR tool, for each domain or observation, interpretation of the score, strengths, and opportunities for improvement. Stoplight colors with assigned percentages are used for score interpretation. ICAR visit results from 5 long-term care facilities (LTCFs) and 3 hemodialysis centers were entered into a REDCap database and analyzed. Results: Data from these visits elucidated consistent gaps in Infection Prevention and Control programs and defined what practices are most lacking. The low-performance areas in LTCFs included hand hygiene, personal protective equipment (PPE), environmental cleaning and disinfection, and antimicrobial stewardship. In hemodialysis centers, respiratory hygiene and cough etiquette, injection safety, and surveillance and disease reporting had the lowest scores. Positive feedback on the scoring report was received from facilities and other state HAI programs. Conclusion: The Virginia HAI/AR Program developed a scoring report that engaged healthcare facility administration, including corporate leadership, by providing a composite score with interpretation. The report prioritized areas for improvement and guided public health follow-up visits. Common gaps in infection prevention practices were identified across facilities, and this information has been used to determine statewide training needs by facility type. The scoring report is an effective method to help allocate state resources and improve communication and engagement of healthcare facilities. Reports can be adapted for use in other jurisdictions.Funding: NoneDisclosures: None

scholarly journals Antimicrobial Resistance Following Prolonged Use of Hand Hygiene Products: A Systematic Review

Pharmacy ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 9
Author(s):  
Gouri Rani Banik ◽  
Bandar Durayb ◽  
Catherine King ◽  
Harunor Rashid
Keyword(s):  
Systematic Review ◽  
Antimicrobial Resistance ◽  
Hand Hygiene ◽  
Bibliographic Databases ◽  
Health Care Settings ◽  
Country Study ◽  
Newcastle Ottawa Scale ◽  
Study Setting ◽  
Ottawa Scale

Background: This systematic review aimed to establish whether antimicrobial resistance (AMR) occurs following prolonged use of antimicrobial hand hygiene (HH) products, and, if so, in what magnitude. Methods: Key bibliographic databases were searched to locate items on HH use and AMR development from database inception to December 2020. Records were screened and full texts of all potentially eligible articles were retrieved and checked for inclusion. The following data from the included studies were abstracted: type of HH product used, including the name of antimicrobial agent, study setting, country, study year, duration of use and development of AMR including the organisms involved. Quality assessment was done using the Newcastle-Ottawa Scale (NOS). Results: Of 339 full-text articles assessed for eligibility, only four heterogeneous United States (US) studies conducted in the period between 1986 and 2015 were found eligible, and included. One hospital-based study showed evidence of AMR following long term use of HH products, two studies conducted in household settings showed no evidence of AMR, and another experimental study showed partial evidence of AMR. The overall certainty of the evidence was moderate. Conclusion: Prolonged use of HH products may cause AMR in health care settings, but perhaps not in other settings.

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