scholarly journals Comparison of the Value of SOFA and Pitt Bacteremia Scores in the Prognostic Evaluation of Patients With Hospital-acquired Klebsiella Pneumoniae Bloodstream Infection

2021 ◽  
Author(s):  
Jun Guo ◽  
Shuaihua Fan ◽  
Jinlan Lin ◽  
Sheng Wu
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Sofa Score ◽  
Tertiary Hospital ◽  
Klebsiella Pneumonia ◽  
Survival Group ◽  
Hospital Acquired Infection ◽  
Prognostic Evaluation ◽  
The Difference ◽  
Hospital Acquired

Abstract This clinical research studied the value of SOFA score and Pitt bacteremia score in the prognosis assessment of patients with hospital-acquired Klebsiella pneumonia bloodstream infection. We conducted a retrospective analysis of 40 patients with hospital-acquired Klebsiella pneumoniae bloodstream infection in a tertiary hospital from January 2016 to December 2020. For these patients, the SOFA score and Pitt bacteremia score were used to evaluate the prognosis. Logistic regression was performed with the known prognosis results to obtain the best cut-off value, sensitivity, and specificity. Pitt bacteremia score [3 (3-4) points to 6 (5.5-7) points] and SOFA score [7 (6-10) points to 17 (13-17.5) points] in the survival group were lower than those in the death group (P<0.05). The SOFA score predicts the death of hospital-acquired Klebsiella pneumoniae bloodstream infection patients with a sensitivity of 80%, a specificity of 84%, and the area under curve(AUC) of SOFA score is 0.8960 (95% CI 0.7951-0.9969); Pitt bacteremia score predicts the hospital-acquired Klebsiella pneumoniae blood infection with a sensitivity of 86.67%, a specificity of 80%, and AUC of Pitt bacteremia score is 0.9413 (95% CI 0.8700- 1.000). Both the SOFA score and the Pitt bacteremia score have predictive value for the prognosis of patients with HAI (hospital acquired infection) Klebsiella pneumonia blood infection. However, the difference shows that the SOFA score has obvious accuracy and specificity in the prognosis of patients with HAI Klebsiella pneumoniae bloodstream infection, it is better than the Pitt bacteremia score and has greater application prospects in prognostic evaluation.

scholarly journals Protection and Response of a Tertiary Hospital in Shenzhen, China to the COVID-19 Outbreak—the Practice of the Comprehensive Response Mode

2021 ◽  
pp. 1-17
Author(s):  
Benling Hu ◽  
Le Yang ◽  
Chan Wei ◽  
Min Luo
Keyword(s):  
Prevention And Control ◽  
Tertiary Hospital ◽  
Control Model ◽  
Normal Operation ◽  
Process Reengineering ◽  
Equipment Management ◽  
Hospital Acquired Infection ◽  
Public Health Emergencies ◽  
Hospital Acquired ◽  
And Control

ABSTRACT Objective: To evaluate the management mode for the prevention and control of coronavirus 2019 (COVID-19) transmission utilized at a general hospital in Shenzhen, China, with the aim to maintain the normal operation of the hospital. Methods: From January 2, 2020 to April 23, 2020, Hong Kong–Shenzhen Hospital, a tertiary hospital in Shenzhen, has operated a special response protocol named comprehensive pandemic prevention and control model, which mainly includes six aspects: 1) human resource management; 2) equipment management; 3) logistics management; 4) cleaning, disinfection and process reengineering; 5) environment layout; 6) and training and assessment. The detail of every aspect was described and its efficiency was evaluated. Results: A total of 198,802 patients were received. Of those, 10,821 were hospitalized; 26,767 were received by the emergency department and fever clinics; 288 patients were admitted for observation with fever; and 324 were admitted as suspected cases for isolation. Under the protocol of comprehensive pandemic prevention and control model, no case of hospital-acquired infection with COVID-19 occurred among the inpatients or staff. Conclusion: The present comprehensive response model may be useful in large public health emergencies to ensure appropriate management and protect the health and life of individuals.

scholarly journals Epidemiology, resistant pathogens and main causes of early death of bloodstream infection in patients with hematological malignancies from 2012 to 2019 in a Chinese tertiary hospital

2020 ◽  
Author(s):  
Meng Li ◽  
Mingmei Du ◽  
Honghua Li ◽  
Yunxi Liu ◽  
Daihong Liu
Keyword(s):  
Bloodstream Infection ◽  
Hematological Malignancies ◽  
Early Death ◽  
Tertiary Hospital ◽  
Klebsiella Pneumonia ◽  
Gram Negative Bacteria ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Negative ◽  
Resistance Rates

Abstract Background: To investigate epidemiology, antibiotic-susceptibility of pathogens, and risk factors for mortality of bloodstream infection (BSI) in patients with hematological malignancies (HMs).Methods: Single-centre retrospective analysis of BSI episodes in patients with HMs in a Chinese tertiary hospital from 2012 to 2019.Results: Among 17,796 analyzed admissions, 508 BSI episodes (2.85%) were identified. Of the 522 isolates, 326 (62.45%) were Gram-negative bacteria, 173 (33.14%) were Gram-positive bacteria, and 23 (4.41%) were fungi. The incidence of BSI differed significantly among the patients with different HMs (P = 0.000): severe aplastic anemia (6.67%), acute leukemia (6.15%), myelodysplastic syndrome(3.22%), multiple myeloma (1.29%), and lymphoma (1.02%). Escherichia coli (30.65%, 160/522) was the most common pathogens, followed by Coagulase-negative staphylococci (CoNS) (19.35%, 101/522) and Klebsiella pneumonia（9.96%, 52/522). The resistance rates of E. coli, K. pneumonia, P. aeruginosa, and A. baumannii to carbapenems were 6.42%, 15.00%, 27.78%, and 78.95%, respectively. All the Gram-positive pathogens were susceptible to linezolid, and 3 vancomycin-resistant Enterococcus were isolated. The overall 14-day mortality was 9.84%. The mortality of BSI caused by A. baumannii was 73.86%, while caused by other pathogens was 7.36% (p=0.000). A multivariate analysis showed that age >65 years, A. baumannii and non-remission of the malignancy were independent predictors of 14-day mortality.Conclusion: Gram-negative bacteria continued to be the most common pathogens causing BSIs in HM patients. An extensive multi-drug resistant baumanni with high mortality rate in HM patients made empirical antimicrobial choice a highly challenging issue.

scholarly journals Co-occurrence of blaNDM–1 and mcr-9 in a Conjugative IncHI2/HI2A Plasmid From a Bloodstream Infection-Causing Carbapenem-Resistant Klebsiella pneumoniae

2021 ◽  
Vol 12 ◽  
Author(s):  
Zhou Liu ◽  
Xiubin Hang ◽  
Xiao Xiao ◽  
Wenwen Chu ◽  
Xin Li ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Galleria Mellonella ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Colistin Resistance ◽  
Structural Variations ◽  
Single Chromosome ◽  
Antimicrobial Resistance Genes

Spread of the carbapenemase-encoding and mobilized colistin resistance (mcr) genes among Enterobacteriales poses a great threat to global public health, especially when the both genes are transferred by a single plasmid. Here, we identified a blaNDM–1- and mcr-9-co-encoding plasmid harbored by a clinical isolate of Klebsiella pneumoniae (KPN710429). KPN710429 was recovered from a blood sample from an inpatient in a tertiary hospital in China, and antimicrobial susceptibility testing showed that it was multidrug-resistant and only susceptible to aztreonam, colistin, and tigecycline. KPN710429 belongs to sequence type (ST) 1308 and capsular serotype KL144. The string test of KPN710429 was negative, and this strain didn’t exhibit a hypervirulent phenotype according to serum-killing and Galleria mellonella lethality assessments. Whole-genome sequencing revealed the KPN710429 genome comprises a single chromosome and three plasmids. All virulence associated genes were harbored by chromosome. Most of its antimicrobial resistance genes, including blaNDM–1 and mcr-9 were carried by plasmid pK701429_2, belonging to the incompatibility (Inc) HI2/HI2A group and ST1. Comparative genomics assays indicates that pK710429_2 could be a hybrid plasmid, formed by a Tn6696-like blaNDM–1 region inserting into a mcr-9-positive-IncHI2/HI2A plasmid. pK710429_2 contained the conjugative transfer gene regions, Tra1 and Tra2, with some structural variations, and conjugation assays revealed that pK710429_2 was transferable. Although pK710429_2 lacked the qseB-qseC regulatory genes, mcr-9 expression was upregulated after pretreatment with colistin for 6 h, leading to colistin resistance in KPN710429. To our knowledge, this is the first report of a blaNDM–1- and mcr-9-co-encoding transferable plasmid harbored by a bloodstream-infection-causing K. pneumoniae strain in China. Effective surveillance should be implemented to assess the prevalence of the plasmid co-harboring carbapenemase-encoding gene and mcr-9.

scholarly journals “Invasive Klebsiella Pneumoniae Syndrome in Qatar”

2021 ◽  
Author(s):  
Muhammad Jamshaid ◽  
Aamir Shahzad ◽  
Huma Munir ◽  
Muhammad Tayyab ◽  
Abdul Aziz Zafar. ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Morbidity And Mortality ◽  
Metastatic Spread ◽  
Hospital Acquired Infection ◽  
High Risk Patients ◽  
Risk Patients ◽  
Hospital Acquired

Klebsiella pneumoniae can cause community-acquired and hospital-acquired infection. It increases morbidity and mortality in high-risk patients. We present a case of invasive Klebsiella pneumoniae in poorly controlled diabetes mellitus, who ended up having a metastatic spread of Klebsiella pneumoniae involving the liver, lungs, kidneys, brain, and muscle.

scholarly journals Pola bakteri aerob yang berpotensi menyebabkan infeksi nosokomial di Instalasi Gawat Darurayt RSAD Robert Wolter Mongisidi Manado

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Sitti N. Gobel ◽  
Fredine E.S. Rares ◽  
Heriyannis Homenta
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Emergency Room ◽  
Medical Equipment ◽  
Ambient Air ◽  
Aerobic Bacteria ◽  
Bacillus Sp ◽  
Enterobacter Agglomerans ◽  
Hospital Acquired Infection ◽  
Hospital Acquired

Abstract: Nosocomial infection or Hospital Acquired infection (HAI) is caused by bacteria, parasites or viruses in hospitals and occurs after ≥48 hours of hospital admission. Emergency room is te starting place procedures and or medical measures so that the room IGD became one of the places that produces a lot of waste of medical procedures performed and as one of the places most likely to transmit the infection. This study was aimed to determine the sources and patterns of aerobic bacteria that could potentially cause nosocomial infections: in the walls, floors, medical equipment, and ambient air of Emergency Room Robert Wolter Mongisidi Hospital, Manado. This was a descriptive prospective study with a cross sectional design. Samples were bacteria in the walls, floors, medical equipment, and the ambient air of the room IGD in the emergency room, Robert Wolter Mongisidi Hospital, Manado. The results showed that of the 29 samples taken, one sample did not contain any bacteria. There were eight types of bacteria found: Bacillus sp (33%), Staphylococcus sp (27%) Enterobacter agglomerans (13%), Escherichia coli (10%), Streptococcus sp (10%), Serratia marcescens (3%), Neisseria sp (2%) and Klebsiella pneumoniae (2%). Conclusion: The most common bacteria was Bacillus sp.Keywords: IGD, nosocomial infections, patterns of aerobic bacteria Abstrak: Infeksi nosokomial atau Hospital Acquired infection (HAI) merupakan infeksi yang disebabkan oleh bakteri, parasit atau virus di rumah sakit, terjadi ≥ 48 jam sejak masuk rumah sakit. Ruangan IGD merupakan tempat awal pasien mendapatkan prosedur dan atau tindakan medis sehingga ruangan IGD menjadi salah satu tempat yang banyak menghasilkan limbah hasil prosedur dan tindakan medis yang dilakukan serta salah satu tempat yang paling mungkin menularkan infeksi. Penelitian ini bertujuan untuk mengetahui sumber dan pola bakteri aerob yang berpotensi menyebabkan infeksi nosokomial: di dinding, lantai, peralatan medis, dan udara di ruang IGD pada ruang gawat darurat medik RSAD Robert Wolter Mongisidi Manado. Jenis penelitian ialah deskriptif prospektif dengan desain otong lintang. Sampel penelitian ialah bakteri pada dinding, lantai, peralatan medis, dan udara di ruang gawat darura tmedik RSAD Robert Wolter Mongisidi Manado. Hasil penelitian memperlihatkan dari 29 sampel yang diambil 1 sampel tidak terdapat bakteri. Terdapat 8 jenis bakteri yang ditemukan yaitu: Bacillus sp (33%), Staphylococcus sp (27%), Enterobacter agglomerans (13%), Escherichia coli (10%), Streptococcus sp (10%), Serratia marcescens (3%), Neisseria sp (2%) dan Klebsiella Pneumoniae (2%). Simpulan: Bakteri yang paling banyak ditemukan ialah Bacillus sp. Kata kunci: IGD, infeksi nosokomial, pola bakteri aerob

Sign in / Sign up

Export Citation Format

Share Document