scholarly journals Assessment of Respiratory Bacterial Coinfections Among Severe Acute Respiratory Syndrome Coronavirus 2-Positive Patients Hospitalized in Intensive Care Units Using Conventional Culture and BioFire, FilmArray Pneumonia Panel Plus Assay

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Camille Kolenda ◽  
Anne-Gaëlle Ranc ◽  
Sandrine Boisset ◽  
Yvan Caspar ◽  
Anne Carricajo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Bacterial Infections ◽  
Early Stage ◽  
Bacterial Load ◽  
Empiric Antibiotic Therapy ◽  
Molecular Diagnostic ◽  
Oral Flora ◽  
Conventional Culture

Abstract Background Approximately 15% of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present with severe forms of the disease and require hospitalization in intensive care units, which has been associated with high mortality rates. The prevalence of bacterial infections in these patients is not well established, and more data are needed to guide empiric antibiotic therapy and improve patient outcomes. Methods In this prospective multicenter study, we assessed bacterial coinfections identified in culture from 99 French patients infected by SARS-Cov-2 and hospitalized in intensive care units. We concomitantly evaluated an innovative molecular diagnostic technology technique, the BioFire, FilmArray Pneumonia Panel plus (FA-pneumo) assay, to identify these coinfections at an early stage, and its concordance with conventional culture. Results We showed that a bacterial coinfection was detected in 15% of patients based on conventional culture. Staphylococcus aureus and Haemophilus influenzae were the most prevalent pathogens. The sensitivity of FA-pneumo compared with culture was 100%. In contrast, the specificity varied between 88.4% and 100% according to the pathogen, and our results highlighted that 60.5% of bacterial targets reported using this assay were not recovered by culture; 76.9% of discordant results corresponded to bacteria belonging to commensal oral flora and/or reported with ≤105 copies/mL bacterial nucleic acids. Conclusions Based on its excellent sensitivity, the FA-pneumo assay is useful to rule out bacterial coinfections in the context of severe SARS-CoV-2 infection and avoid the inappropriate prescription of antibiotics. However, positive tests should be interpreted carefully, taking into consideration deoxyribonucleic acid bacterial load and all clinical and biological signs.

scholarly journals SARS-CoV-2 aerosol generation during respiratory equipment reprocessing

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Camila Quartim de Moraes Bruna ◽  
Caroline Lopes Ciofi-Silva ◽  
Anderson Vicente de Paula ◽  
Lucy Santos Villas Boas ◽  
Noely Evangelista Ferreira ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Medical Devices ◽  
Aerosol Generation ◽  
Surface Samples ◽  
Tertiary Hospitals ◽  
Air Sample ◽  
Sterile Processing

AbstractAerosolization may occur during reprocessing of medical devices. With the current coronavirus disease 2019 pandemic, it is important to understand the necessity of using respirators in the cleaning area of the sterile processing department. To evaluate the presence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) in the air of the sterile processing department during the reprocessing of contaminated medical devices. Air and surface samples were collected from the sterile processing department of two teaching tertiary hospitals during the reprocessing of respiratory equipment used in patients diagnosed with coronavirus disease 2019 and from intensive care units during treatment of these patients. SARS-CoV-2 was detected only in 1 air sample before the beginning of decontamination process. Viable severe acute respiratory syndrome coronavirus 2 RNA was not detected in any sample collected from around symptomatic patients or in sterile processing department samples. The cleaning of respiratory equipment does not cause aerosolization of SARS-CoV-2. We believe that the use of medical masks is sufficient while reprocessing medical devices during the coronavirus disease 2019 pandemic.

scholarly journals Otolaryngology activity in two hospitals in northern and central Italy differently affected by COVID-19 pandemic

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042199848
Author(s):  
Antonio Minni ◽  
Francesco Pilolli ◽  
Massimo Ralli ◽  
Niccolò Mevio ◽  
Luca Roncoroni ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Healthcare System ◽  
Central Italy ◽  
Northern Italy ◽  
Public Hospitals ◽  
Geographical Differences ◽  
Italian Regions

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic had a significant impact on the Italian healthcare system, although geographical differences were present; regions in northern Italy have been the most severely affected while regions in the south of the country were relatively spared. Otolaryngologists were actively involved in the management of the pandemic. In this work, we analyzed and compared the otolaryngology surgical activity performed during the pandemic in two large public hospitals located in different Italian regions. In northern Italy, otolaryngologists were mainly involved in performing surgical tracheotomies in COVID-19 positive patients and contributed to the management of these patients in intensive care units. In central Italy, where the burden of the infection was significantly lower, otolaryngologists focused on diagnosis and treatment of emergency and oncology patients. This analysis confirms the important role of the otolaryngology specialists during the pandemic, but also highlights specific differences between two large hospitals in different Italian regions.

scholarly journals EARLY STAGE RESPONSES OF INTENSIVE CARE UNITS DURING MAJOR DISASTERS: FROM THE EXPERIENCES OF THE GREAT EAST JAPAN EARTHQUAKE

2015 ◽  
Vol 61 (1) ◽  
pp. 32-37
Author(s):  
JIRO SHIMADA ◽  
CHOICHIRO TASE ◽  
YASUHIKO TSUKADA ◽  
ARIFUMI HASEGAWA ◽  
HIROSHI IIDA
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Early Stage ◽  
Great East Japan Earthquake

scholarly journals Basic Principles of Antibiotics Dosing in Patients with Sepsis and Acute Kidney Damage Treated with Continuous Venovenous Hemodiafiltration

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Aleksandra Nikolić ◽  
Sasa Jaćović ◽  
Željko Mijailović ◽  
Dejan Petrović
Keyword(s):  
Intensive Care ◽  
Renal Clearance ◽  
Intensive Care Units ◽  
Flow Rate ◽  
Early Stage ◽  
Target Therapy ◽  
Kidney Damage ◽  
Dialysis Dose ◽  
Continuous Venovenous Hemodiafiltration ◽  
The Impact

Abstract Sepsis is the leading cause of acute kidney damage in patients in intensive care units. Pathophysiological mechanisms of the development of acute kidney damage in patients with sepsis may be hemodynamic and non-hemodynamic. Patients with severe sepsis, septic shock and acute kidney damage are treated with continuous venovenous hemodiafiltration. Sepsis, acute kidney damage, and continuous venovenous hemodiafiltration have a significant effect on the pharmacokinetics and pharmacodynamics of antibiotics. The impact dose of antibiotics is increased due to the increased volume of distribution (increased administration of crystalloids, hypoalbuminemia, increased capillary permeability syndrome toproteins). The dose of antibiotic maintenance depends on renal, non-renal and extracorporeal clearance. In the early stage of sepsis, there is an increased renal clearance of antibiotics, caused by glomerular hyperfiltration, while in the late stage of sepsis, as the consequence of the development of acute renal damage, renal clearance of antibiotics is reduced. The extracorporeal clearance of antibiotics depends on the hydrosolubility and pharmacokinetic characteristics of the antibiotic, but also on the type of continuous dialysis modality, dialysis dose, membrane type, blood flow rate, dialysis flow rate, net filtration rate, and effluent flow rate. Early detection of sepsis and acute kidney damage, early target therapy, early administration of antibiotics at an appropriate dose, and early extracorporeal therapy for kidney replacement and removal of the inflammatory mediators can improve the outcome of patients with sepsis in intensive care units.

scholarly journals Bacterial but no SARS-CoV-2 contamination after terminal disinfection of tertiary care intensive care units treating COVID-19 patients

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Daniel A. Hofmaenner ◽  
◽  
Pedro David Wendel Garcia ◽  
Branko Duvnjak ◽  
Bhavya Chakrakodi ◽  
...  
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Ribonucleic Acid ◽  
Bacterial Contamination ◽  
Tertiary Care ◽  
Invasive Ventilation ◽  
Gram Negative ◽  
Skin Flora

Abstract Background In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission. Methods Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients. Results A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards. Conclusions After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.

scholarly journals A high frequency of Candida auris blood stream infections in COVID-19 patients admitted to intensive care units, North-western India: A case control study

2021 ◽  
Author(s):  
Ekadashi Rajni ◽  
Ashutosh Singh ◽  
Bansidhar Tarai ◽  
Kusum Jain ◽  
Ravi Shankar ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Bacterial Infections ◽  
Ferritin Level ◽  
Case Control ◽  
Nosocomial Transmission ◽  
Western India ◽  
Candida Auris ◽  
Icu Stay ◽  
Hospitalised Patients

Abstract Background The ongoing pandemic of COVID-19 has overwhelmed healthcare facilities raising an important novel concern of nosocomial transmission of Candida species in the intensive care units. Methods We evaluated the incidence and risk factors for development of candidemia in 2384 COVID-19 patients admitted during August 2020-January 2021 in ICUs of two hospitals (Delhi and Jaipur), India. A 1:2 case control matching was used to identify COVID-19 patients who did not develop candidemia as controls. Result A total of 33 patients developed candidemia accounting for an overall incidence of 1.4% over a median ICU stay of 24 days. A two-fold increase in the incidence of candidemia in COVID-19 versus non–COVID-19 patients was observed with an incidence rate of 14 and 15/1000 admissions in two ICUs. Candida auris was the predominant species (42%) followed by Candida tropicalis. Multivariable regression analysis revealed the use of tocilizumab, duration of ICU stay (24 vs. 14 days) and raised ferritin level as an independent predictor for the development of candidemia. Azole resistance was observed in C. auris and C. tropicalis harbouring mutations in the azole target ERG11 gene. MLST identified identical genotypes of C. tropicalis in COVID-19 patients raising concern of nosocomial transmission of resistant strains. Conclusion Secondary bacterial infections has been a concern with the use of tocilizumab. In this cohort of critically ill COVID-19 patients tocilizumab was associated with development of candidemia. Surveillance of antifungal resistance is warranted to prevent transmission of MDR strains of nosocomial yeasts in COVID-19 hospitalised patients.

scholarly journals Two original observations concerning bacterial infections in COVID-19 patients hospitalized in intensive care units during the first wave of the epidemic in France

2021 ◽  
Author(s):  
Camille d’Humières ◽  
Juliette Patrier ◽  
Brice Lortat-Jacob ◽  
Alexy Tran-dinh ◽  
Lotfi Chemali ◽  
...  
Keyword(s):  
Intensive Care ◽  
Bacterial Infection ◽  
Digestive Tract ◽  
Intensive Care Units ◽  
Bacterial Infections ◽  
Bloodstream Infections ◽  
Bacterial Persistence ◽  
Adequate Therapy

AbstractAmong 197 COVID-19 patients hospitalized in ICU, 88 (44.7%) experienced at least one bacterial infection, with pneumonia (39.1%) and bloodstream infections (15,7%) being the most frequent. Unusual findings include frequent suspicion of bacterial translocations originating from the digestive tract as well as bacterial persistence in the lungs despite adequate therapy.

Sign in / Sign up

Export Citation Format

Share Document