scholarly journals Trichosporon species isolated from scald burn wound in an immunocompetent adult: a case report from Southern Assam

2021 ◽  
Vol 9 (12) ◽  
pp. 3700
Author(s):  
Barnamoy Bhattacharjee ◽  
Debadatta D. Chanda ◽  
Atanu Chakravarty
Keyword(s):  
Fungal Infection ◽  
Bacterial Infections ◽  
Case Reports ◽  
Tertiary Care ◽  
Fungal Colonization ◽  
Trauma Patients ◽  
Sensitivity Testing ◽  
Industrial Worker ◽  
Burn Wounds ◽  
Trichosporon Species

There are quite a good number of case reports on fungal infection in burn wounds in addition to the conventionally notorious bacterial infections in immune-compromised burn trauma patients leading to protracted course of morbidity and higher chances of mortality due to delay in diagnosis. The incidence of fungal infection in burn patients has been increasing with paradigm shift of causal fungus over last 2 decades from Candida albicans and molds to non-albicans Candida, Trichosporon species and other yeast like fungus. But there are rarely few cases of invasive Trichosporon infection in scald burn wounds in immunocompetent individuals. We therefore report a case of Trichosporon species isolation from a scald burn ulcer of an immunocompetent young male industrial worker in 2nd week of its clinical course which responded to oral fluconazole followed by skin grafting since this case scenario in itself is an uncommonly presented and reported event coupled with finding of first ever case with such presentation in this tertiary care institute of Southern Assam. This case is also reported with intention of raising awareness in surgeons for keeping vigil on non-healing burn wounds with empirical antibiotics and about the need of timely pus culture and sensitivity testing to rule out fungal colonization and prevent mortality due to disseminated fungal infection.

scholarly journals Fungal infection profile in burn patients at a tertiary care centre of India

2018 ◽  
Vol 6 (8) ◽  
pp. 2633
Author(s):  
Imran Ahmad ◽  
Mohammed Fahud Khurram ◽  
Sudheer Kumar Maurya ◽  
Rajesh Kumar Maurya ◽  
Mohd. Tafazul Sheikh
Keyword(s):  
Candida Albicans ◽  
Fungal Infection ◽  
Bacterial Infections ◽  
Late Onset ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Fungal Culture ◽  
Burn Patients ◽  
Burn Wound ◽  
Culture Positive

Background: Burn patients are at high risk of infections and burn wound infection is one of the most important factor responsible for their morbidity and mortality. Burn patients have increased incidence of fungal infection in comparison to others. Fungal infection is difficult to diagnose because it has similar symptoms like bacterial infections. Common fungal organism causing burn wounds infections are Candida sp., Aspergillus sp., non albicans Candida, Zygomycetes etc.Methods: This prospective study was carried out in Department of Burn, Plastic and Reconstructive Surgery, J.N.M.C.H., Aligarh Muslim University, India from December 2015 to June 2017. Patients having 20 to 60% body surface area involvement with more than 5 years of age with no comorbidity were included in this study.Results: In our study, total 126 patients were included, 9 male patients (18.37%) were found fungal culture positive whereas 14 females (18.18%) were culture positive. 12 patients (9.52%) were found to be positive for Candida albicans, 6 patients (4.76%) were Aspergillus flavus positive, 3 patients (2.38%) were positive for Non Candida albicans and 2 patients (1.59%) were positive for Aspergillus niger.Conclusions: Fungal burn wound infections are one of the most common cause of late onset morbidity and mortality in burn patients. So, high level of suspicion and tissue culture are essential in making early diagnosis and treatment. Judicious use of antibiotics are also necessary for decreasing its incidence.

scholarly journals P050: The Northern Amazing and Awesome Model: Using positive deviance to impact patient care

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S82-S82
Author(s):  
R. Ohle ◽  
S. McIsaac
Keyword(s):  
Professional Training ◽  
Allied Health ◽  
Case Reports ◽  
Tertiary Care ◽  
Lessons Learned ◽  
Positive Deviance ◽  
Trauma Patients ◽  
Administrative Staff ◽  
Post Intervention ◽  
Allied Health Professionals

Introduction: Positive deviance recognizes that there are individuals and teams within our community of practice that succeed in spite of system constraints. Amazing and awesome rounds has been proposed as a forum to identify behaviours and processes that lead to exceptional results. The objective of this study was to determine the feasibility and acceptability of a structured amazing and awesome rounds model through an innovative educational intervention. Methods: The authors engaged a broad range of professional designations(physicians, surgeons, nurses, respiratory therapists, administrative staff) at a tertiary care institution. A&A rounds were open to all allied health professionals and administrative staff. The Northern A&A rounds model was developed, implemented, and then evaluated as a four-part intervention. This consisted of: 1) Allied health professional training on case selection and analysis, 2) Engaging inter professional members, 3) disseminating lessons learned, and 4) creating an administrative pathway for acting on issues identified through the A&A rounds. The measures of intervention feasibility included the proportion of sessions adherent to the new model and A&A rounds attendance. Post intervention surveys of presenters and attendees were used to determine intervention acceptability. A&A presentation content was reviewed to determine the most frequently adopted components of the model. Results: Nine out of 9(100%) of presented cases were adherent to the three components of the Northern A&A Model. A&A rounds were highest attended of all hospital wide grand rounds(N = 75 SD 2.4 P < 0.001). Nine case presentations were analyzed and 7 action items were identified for amplification across the hospital. Including 3 case reports published of a novel approach to a patient case,a rapid referral for trauma patients at risk for PTSD, AED placement in all community clinics and routine debrief after resuscitations. Presenters included a broad representation of hospital staff including surgeons, emergency physicians, radiologists, nurses, and administrators. Conclusion: The Northern A&A Model was a feasible intervention that was perceived to be effective by both presenters and attendees. The authors believe that this could be readily applied to any hospital seeking to enhance quality of care and patient safety.

Homelessness among an inpatient HIV-positive cohort at a tertiary care hospital in central London

2020 ◽  
Vol 31 (7) ◽  
pp. 705-707
Author(s):  
Venkateshwaran Sivaraj ◽  
Rudiger Pittrof ◽  
Olubanke Davies ◽  
Ranjababu Kulasegaram
Keyword(s):  
Bacterial Infections ◽  
Substance Misuse ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Hiv Viral Load ◽  
Cd4 Cell Count ◽  
Cell Counts ◽  
Cd4 Cell

A cohort review was conducted at a central London tertiary care hospital trust on the prevalence of homelessness among human immunodeficiency virus (HIV)-positive inpatients over a year. Data were collected on the duration of inpatient stay, co-morbidities including acquired immune deficiency syndrome (AIDS)-defining illnesses, co-infections, initiation of antiretroviral therapy, CD4 cell count, HIV viral load and substance misuse. Homeless people were found to be at high risk for hepatitis C, mental health illness, substance misuse including injecting drug use, recurrent bacterial infections, AIDS-associated illnesses, lower CD4 cell counts and HIV viremia. They also had more missed HIV outpatient appointments. It was highlighted that a multidisciplinary approach in their care was necessary to address their needs and reduce the morbidity burden in this cohort.

scholarly journals A Japanese traditional medicine Hochuekkito promotes negative conversion of vancomycin-resistant Enterococci

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Junko Kohno ◽  
Tsuyoshi Kawamura ◽  
Akiko Kikuchi ◽  
Tetsuya Akaishi ◽  
Shin Takayama ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Tertiary Care ◽  
Albumin Level ◽  
Kampo Medicine ◽  
Care Hospital ◽  
Intestinal Immunity ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Japanese Traditional Medicine ◽  
Negative Conversion

AbstractVancomycin-resistant enterococci (VRE) are prominent causes of nosocomial infections. Japanese traditional (Kampo) medicine promotes intestinal immunity and protects against bacterial infections. We assessed potential differences in the clinical course of VRE-positive patients, based on their characteristics and treatment with Kampo medicines. This retrospective observational study collected data from VRE-positive patients from August 2018 to July 2019 at a tertiary-care hospital in Japan. The data of 122 consecutive VRE-positive inpatients were analyzed. Sixty-nine patients were treated with probiotics, among whom, 18 were further treated with Kampo medicines. Twenty-six of the 122 patients subsequently died. In univariate analyses, subsequent VRE negative conversion significantly reduced the mortality of VRE-detected patients (p = .0003). Administration of probiotics (p = .0065) and Kampo medicines with probiotics (p = .0002), especially of the Kampo medicine hochuekkito (p = .0014), and a higher serum albumin level positively contributed to the subsequent VRE negative conversion. Multivariate analyses demonstrated that Kampo medicines and body mass index contributed to VRE negative conversion. Hochuekkito shortened the time needed for VRE negative conversion (p = 0.0485). Administration of Kampo medicines, especially of hochuekkito, in addition to probiotics in VRE patients may promote VRE negative conversion.

scholarly journals Bacterial and fungal colonization of burn wounds

2005 ◽  
Vol 100 (5) ◽  
pp. 535-539 ◽  
Author(s):  
Jefferson Lessa Soares de Macedo ◽  
João Barberino Santos
Keyword(s):  
Fungal Colonization ◽  
Burn Wounds

scholarly journals Surgical Site Infections at a Level I Trauma Center in India: Data From an Indigenously Developed, e-SSI Surveillance System

2020 ◽  
Vol 41 (S1) ◽  
pp. s397-s398
Author(s):  
Ayush Lohiya ◽  
Samarth Mittal ◽  
Vivek Trikha ◽  
Surbhi Khurana ◽  
Sonal Katyal ◽  
...  
Keyword(s):  
Surveillance System ◽  
Trauma Center ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Trauma Patients ◽  
Care Hospital ◽  
Middle Income ◽  
Predominant Pathogen ◽  
Level I

Background: Globally, surgical site infections (SSIs) not only complicate the surgeries but also lead to $5–10 billion excess health expenditures, along with the increased length of hospital stay. SSI rates have become a universal measure of quality in hospital-based surgical practice because they are probably the most preventable of all healthcare-associated infections. Although, many national regulatory bodies have made it mandatory to report SSI rates, the burden of SSI is still likely to be significant underestimated due to truncated SSI surveillance as well as underestimated postdischarge SSIs. A WHO survey found that in low- to middle-income countries, the incidence of SSIs ranged from 1.2 to 23.6 per 100 surgical procedures. This contrasted with rates between 1.2% and 5.2% in high-income countries. Objectives: We aimed to leverage the existing surveillance capacities at our tertiary-care hospital to estimate the incidence of SSIs in a cohort of trauma patients and to develop and validate an indigenously developed, electronic SSI surveillance system. Methods: A prospective cohort study was conducted at a 248-bed apex trauma center for 18 months. This project was a part of an ongoing multicenter study. The demographic details were recorded, and all the patients who underwent surgery (n = 770) were followed up until 90 days after discharge. The associations of occurrence of SSI and various clinico-microbiological variables were studied. Results: In total, 32 (4.2%) patients developed SSI. S. aureus (28.6%) were the predominant pathogen causing SSI, followed by E. coli (14.3%) and K. pneumoniae (14.3%). Among the patients who had SSI, higher SSI rates were associated in patients who were referred from other facilities (P = .03), had wound class-CC (P < .001), were on HBOT (P = .001), were not administered surgical antibiotics (P = .04), were not given antimicrobial coated sutures (P = .03) or advanced dressings (P = .02), had a resurgery (P < .001), had a higher duration of stay in hospital from admission to discharge (P = .002), as well as from procedure to discharge (P = .002). SSI was cured in only 16 patients (50%) by 90 days. SSI data collection, validation, and analyses are essential in developing countries like India. Thus, it is very crucial to implement a surveillance system and a system for reporting SSI rates to surgeons and conduct a robust postdischarge surveillance using trained and committed personnel to generate, apply, and report accurate SSI data.Funding: NoneDisclosures: None

scholarly journals Invasive fungal infection in immunocompetent trauma patients – A case series

2018 ◽  
Vol 9 ◽  
pp. S10-S14 ◽  
Author(s):  
Senthil Loganathan ◽  
Gowtham.A.E Ajay ◽  
U. Thyagarajan ◽  
Raj.D Gokul
Keyword(s):  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Case Series ◽  
Trauma Patients

scholarly journals Investigation of the antimicrobial activity of danofoloxacin against bacteria pathogens in goats

2020 ◽  
Vol 22 (97) ◽  
pp. 74-78
Author(s):  
T. I. Stetsko ◽  
Ya. M. Liubenko ◽  
V. N. Padovskyi ◽  
L. L. Ostrovska ◽  
O. Yo. Kalinina ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Antimicrobial Activity ◽  
Bacterial Infections ◽  
Chemotherapeutic Agents ◽  
Diffusion Method ◽  
Bacteriostatic Activity ◽  
Intestinal Infection ◽  
Sensitivity Testing ◽  
First Choice

Fluoroquinolones are critical antimicrobials for both human and veterinary medicine. Due to their unique mechanism of antimicrobial action and good pharmacokinetic properties, they are often the first choice drugs in the treatment of bacterial infections in animals. The purpose of the investigation was to study the antimicrobial activity of a third-generation fluoroquinolone antibiotic of danofloxacin against bacteria, pathogens of respiratory and intestinal infection in goats. The samples of the nasal outflows (respiratory infection) and fecal masses (intestinal infection) were collected from clinically ill goats for microbiological studies. The sensitivity test of the microflora of the biomaterial, carried out by the disco-diffusion method, showed that the microorganisms of all the samples were sensitive to danofloxacin. Bacteria Streptococcus pneumonia (n = 10), Staphylococcus aureus (n = 4) and Escherichia coli (n = 2) were isolated and identified from nasal exudate samples (n = 10). Pathogenic strains of Escherichia coli were isolated from all faecal samples (n = 12). The degree of bacteriostatic activity of danofloxacin was determined by establishing its minimum inhibitory concentration (MIC) for bacterial isolates by sequential dilutions in a liquid nutrient medium. The average MIC of danofloxacin for Streptococcus pneumoniae isolates was 0.26 ± 0.13 μg/ml and for Staphylococcus aureus isolates – 0.25 ± 0.075 μg/ml. For Escherichia coli strains isolated from faeces of goats suffering from coli infection, the average MIC of danofloxacin was 0.38 ± 0.12 μg/ml (range 0.2 to 0.8 μg/ml). Antimicrobial sensitivity testing have shown a high level of bacteriostatic activity of danofloxacin against bacteria, pathogens of respiratory and intestinal infections in goats. This may be the argument for the use of danofloxacin-based chemotherapeutic agents in the treatment of bacterial infections in goats, especially for the empirical approach to therapy.

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