scholarly journals Epidemiological and clinical features of the course of postoperative sternomediastinitis (clinical case)

2021 ◽  
Vol 16 (1) ◽  
pp. 56-73
Author(s):  
Olga Mironenko ◽  
◽  
Lidiia Soprun ◽  
Anna Tovanova ◽  
Denis Obuchov ◽  
...  
Keyword(s):  
Antibacterial Therapy ◽  
Staphylococcus Epidermidis ◽  
Clinical Case ◽  
Severe Disease ◽  
Hospital Environment ◽  
Period Increase ◽  
Relevant Today ◽  
Epidemiological Monitoring ◽  
Bed Days ◽  
Hospital Acquired

Health-care-related infections are becoming more relevant today. The difficulty and largely of diagnosis increased impact of adverse effects (postoperative period, increase of bed-days, use of irrational antibacterial therapy, use of excessive methods of disinfection) factors of the hospital environment on the human body, contributing to the development of severe postoperative complications, among them, sternomediastinitis occupies a special place in cardiac surgery. The clinical case we represent clearly demonstrates the atypical flow of sternominetite caused by the hypervirulent strain Klebsiella pneumoniae blaNDM-Type. Generally, sternomediastinitis causes Staphylococcus epidermidis, Staphylococcus haemolyticus. Every week the patient stays in the cardiothoracic ward of the hospital is associated with a 15 % increase in the risk of mediastinitis development. The data indicate the need for continuous epidemiological monitoring of the relevant microorganisms that are potential agents of nosocomial infections. Thus, adequate diagnosis, choice of rational treatment tactics and effective antibacterial therapy significantly improve the prognosis of the current of a given severe disease. Early epidemiological diagnosis will help to reduce the risk of the development and spread of hospital-acquired infections in the post-operative period.

scholarly journals Molecular characterization of Staphylococcus epidermidis strains isolated from a teaching hospital in Shanghai, China

2009 ◽  
Vol 58 (4) ◽  
pp. 456-461 ◽  
Author(s):  
Min Li ◽  
Xing Wang ◽  
Qian Gao ◽  
Yuan Lu
Keyword(s):  
Medical Devices ◽  
Staphylococcus Epidermidis ◽  
Hospital Setting ◽  
Clonal Analysis ◽  
Hospital Environment ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
Sequence Types ◽  
Seriously Ill

Staphylococcus epidermidis is a leading cause of hospital-acquired infections, mostly associated with the use of medical devices in seriously ill or immunocompromised patients. Currently, the clonal characteristics of S. epidermidis in the hospital environment in China are unknown; neither is it known why these sequence types are easily disseminated in the hospital setting. In this study, multilocus sequence typing (MLST) was employed for the clonal analysis of 80 S. epidermidis isolates collected from patients with S. epidermidis infections. MLST revealed a total of 16 different sequence types among these isolates. ST2, which contained exclusively ica-positive, IS256-positive and biofilm-forming isolates, represented the majority of clinical strains tested. Of the S. epidermidis strains circulating in the hospital environment in China, as many as 96.25 % are resistant to meticillin. Four staphylococcal chromosomal cassette mec (SCCmec) types were identified among the total 80 S. epidermidis isolates, none of the strains carried an SCCmec I cassette. All of the ST2 isolates carried the SCCmec type III cassette. Taken together, the combination of biofilm-forming ability and antibiotic resistance helps ST2 become successfully established within nosocomial environments, and promotes the device-related infection and bacteraemia.

scholarly journals 491. Aerosol-Generating Medical Procedures: Transmission of SARS-CoV-2 and Emerging Viruses

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S312-S312
Author(s):  
Seth D Judson ◽  
Vincent J Munster
Keyword(s):  
High Risk ◽  
Severe Disease ◽  
Experimental Studies ◽  
Virus Transmission ◽  
Nosocomial Transmission ◽  
Medical Procedures ◽  
Emerging Viruses ◽  
Zoonotic Viruses ◽  
Increased Risk ◽  
Hospital Acquired

Abstract Background During the pandemic of coronavirus disease 2019 (COVID-19), many questions arose regarding risks for hospital-acquired or nosocomial transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Aerosol generating medical procedures (AGMPs), techniques that can generate infectious, virus-laden aerosols, could potentially amplify transmission among healthcare workers (HCWs). Thus, it was widely recommended that HCWs use airborne precautions when performing AGMPs. However, in clinical settings it is often unclear what procedures constitute AGMPs and how the risk varies by procedure or pathogen. We set out to further define AGMPs and assess the risk for nosocomial transmission of SARS-CoV-2 and other high-risk viruses via AGMPs. Methods We identified potential AGMPs and emerging viruses that were high-risk for nosocomial transmission through reviewing experimental and clinical data. Potential AGMPs were those associated with previous virus transmission or mechanically capable of transmission. High-risk viruses were defined as those that cause severe disease in humans for which limited therapies or interventions exist, are infectious via aerosols in humans or non-human primates (NHPs), found in the respiratory tract of infected humans or NHPs, and had previous evidence of nosocomial transmission. Results We identified multiple potential AGMPs, which could be divided into those that generate aerosols or induce a patient to form aerosols, as well as eight families of high-risk viruses. All of the viruses were emerging zoonotic RNA viruses. In the family Coronaviridae, we identified potential evidence for SARS-CoV-1, MERS-CoV, and SARS-CoV-2 transmission via AGMPs. SARS-CoV-1 and SARS-CoV-2 were also found to be similarly stable when aerosolized. Conclusion Multiple emerging zoonotic viruses pose a high risk for nosocomial transmission through a variety of AGMPs. Given the similar stability of SARS-CoV-2 with SARS-CoV-1 when aerosolized and prior nosocomial transmission of SARS-CoV-1 via AGMPs, we suspect that certain AGMPs pose an increased risk for SARS-CoV-2 transmission. Additional experimental studies and on-site clinical sampling during AGMPs are necessary to further risk stratify AGMPs. Disclosures All Authors: No reported disclosures

scholarly journals Thromboembolism after COVID-19 vaccine in patients with preexisting thrombocytopenia

2021 ◽  
Vol 12 (8) ◽  
Author(s):  
Alessandro Mauriello ◽  
Manuel Scimeca ◽  
Ivano Amelio ◽  
Renato Massoud ◽  
Antonio Novelli ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Exome Sequencing ◽  
Clinical Case ◽  
Severe Disease ◽  
Low Frequency ◽  
Postmortem Examination ◽  
Capillary Leak ◽  
Platelet Factor ◽  
Whole Exome

AbstractWhile vaccination is the single most effective intervention to drastically reduce severe disease and death following SARS-CoV-2 infection, as shown in UK and Israel, some serious concerns have been raised for an unusual adverse drug reaction (ADR), including vaccine-induced immune thrombotic thrombocytopenia (VITT) with concurrent low platelets as well as capillary leak syndrome. In fact, the overall safety of the vaccine is highlighted by the low frequency of ADR considering that in UK, by the early June, 40 million first doses and 29 million second doses have been injected; nonetheless, 390 thrombotic events, including 71 fatal events have been reported. Interestingly, the cases reported low platelet counts with the presence of anti-platelet factor-4 (PF4) antibodies, indicating an abnormal clotting reaction. Here, out of three referred cases, we report a post-vaccine clinical case of fatal thrombosis with postmortem examination and whole exome sequencing (WES) analysis, whose pathogenesis appeared associated to a preexisting condition of thrombocytopenia due to myelodysplasia.

scholarly journals EMERGENCE AND ANTIBIOTIC SENSITIVITY PATTERN OF ACINETOBACTER BAUMANNII IN HOSPITAL FACILITY

2017 ◽  
Vol 10 (3) ◽  
pp. 77
Author(s):  
Anania Arjuna ◽  
Dinobandhu Nandi
Keyword(s):  
Acinetobacter Baumannii ◽  
Nosocomial Infections ◽  
Antibiotic Sensitivity ◽  
Hospital Environment ◽  
Sensitivity Testing ◽  
Hospital Acquired Infection ◽  
Clinical Specimens ◽  
Sensitivity Pattern ◽  
Tract Infections ◽  
Hospital Acquired

ABSTRACTObjective: Nosocomial infections or Hospital acquired infection (HAI) are one of the major threats to hospitalized patients as well as for the hospitalassociated personnel. In last few years there is a gross change in causative agents, new organisms have come out with great threat to hospitals as theypossess antibiotic resistance property e.g. production of biofilm, production of enzymes such as β- lactamases. Among many organisms, Acinetobacterbaumannii has emerged as a potent nosocomial pathogen. Our objective of this study was to find the burden of Acinetobacter baumannii infectionswhich are associated as nosocomial infections and to determine the drug of choice for an effective treatment.Methods: Clinical specimens were collected from patients of different unit of the hospital by maintaining universal precautions and standardmicrobiological protocols. All the respective specimens were cultured in respective culture medium i.e. MacConkey agar, blood agar, chocolate agar,cysteine lactose electrolyte deficient (CLED) agar and, fluid thioglycolate (TG) medium at 37˚C for 24-48 hours. After incubation of 24-48 hours cultureplates were examined for bacterial growth and identification and antibiotic sensitivity test was made by Vitek2 compact.Result: The study was conducted at the department of microbiology from January 2016 to April 2016. A total of 2582 specimens were collected andprocessed for identification and sensitivity testing. Specimens of all age group (2 days- 93 years) and both sexes were processed for identificationof A. baumannii and antibiotic sensitivity testing. A total of 119 isolates (4.60%) of A. baumannii were obtained from 2582 clinical specimens. Themost common infection A. baumannii was found as lower respiratory tract infection (89.07%) followed by abscess (6.72%), septicaemia (2.52%),urinary tract infections (0.84%), and soft tissue infections (0.84%). The maximum sensitivity of A. baumannii isolates were seen to Colistin (CL) (119,100%), followed by Tigecycline (TGC) (63, 52.94%) and Minocycline (MIN) (27, 22.69%). The maximum resistant was observed for Imipenem (IMI),Aztreonam (AZT) and Ticarcillin- clavulanic acid (TIC) (119, 100%).Conclusion: The Gram- negative coccobacillus, Acinetobacter baumannii poses a formidable threat to patients. It has emerged as a superbug inhospital environment particularly in ICU units. The chances of A. baumannii infections increase in the presence of iatrogenic factors like inadequatelong- term antibiotic therapy and new interventions in a medical facility. To control the burden of Acinetobacter infections new therapies suchas combine therapy must be obtained and followed with proper dose as recommend by physicians; along with awareness of the importance ofthis infection should be implicated. Proper sanitation, good housekeeping, sterilization of equipment, hand hygiene, water purification, isolationprocedures and maintaining of the hospital environment, use of infection control practices are some of the measures to control the transmission ofAcinetobacter spp. among hospital personnel.Keywords: Acinetobacter baumannii, Biofilm, β-lactamases, Hospital acquired infection.

scholarly journals Evolution of Acinetobacter baumannii infections and antimicrobial resistance. A review

2019 ◽  
Vol 2 (1) ◽  
pp. 28-36
Author(s):  
Sonia Elena Popovici ◽  
Ovidiu Horea Bedreag ◽  
Dorel Sandesc
Keyword(s):  
Antimicrobial Agents ◽  
Resistance Mechanisms ◽  
Hospital Environment ◽  
Medical Community ◽  
Molecular Testing ◽  
Medical Systems ◽  
Antimicrobial Drugs ◽  
Hospital Acquired Infections ◽  
Acinetobacter Spp ◽  
Hospital Acquired

AbstractThe emergence of multi-drug resistantAcinetobacter sppinvolved in hospital-acquired infections, once considered an easily treatable pathogen, is troublesome and an immense burden for the modern medical systems worldwide. In the last 20 years the medical community recorded an increase in the incidence and severity of these infections as therapeutic means tend to be less and less effective on these strains. The ability of these bacteria to rapidly develop resistance to antimicrobial agents by continuously changing and adapting their mechanisms, their ability to survive for long periods of time in the hospital environment and the multitude of transmission possibilities raises serious issues regarding the management of these complex infections. The future lies in developing new and targeted methods for the early diagnosis ofA. baumannii, as well as in the judicious use of antimicrobial drugs. This review details the evolution of the pathogenicity of this microorganism, together with the changes that appeared in resistance mechanisms and the advancements in molecular testing for the early detection of infection.

scholarly journals Prognosis of COVID-19 Pneumonia Can Be Early Predicted Combining Age-Adjusted Charlson Comorbidity Index, CRB Score and Baseline Oxygen Saturation.

2021 ◽  
Author(s):  
Pilar Nuevo-Ortega ◽  
Carmen Reina-Artacho ◽  
Francisco Dominguez-Moreno ◽  
Victor Manuel Becerra-Muñoz ◽  
Luis Ruiz-Del-Fresno ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Charlson Comorbidity Index ◽  
Severe Disease ◽  
Hospital Environment ◽  
Severe Illness ◽  
Comorbidity Index ◽  
Clinical Tools ◽  
Discharge From Hospital ◽  
Statistical Criteria

Abstract Background: In potentially severe diseases in general and COVID-19 in particular, it is vital to early identify those patients who are going to develop complications. The last update of a recent living systematic review dedicated to predictive models in COVID-19,[1] critically appraises 145 models, 8 of them focused on prediction of severe disease and 23 on mortality. Unfortunately, in all 145 models, they found a risk of bias significant enough to finally "not recommend any for clinical use". Authors suggest concentrating on avoiding biases in sampling and prioritising the study of already identified predictive factors, rather than the identification of new ones that are often dependent on the database. Our objective is to develop a model to predict which patients with COVID-19 pneumonia are at high risk of developing severe illness or dying, using basic and validated clinical tools.Methods: prospective cohort of consecutive patients admitted in a teaching hospital during the “first wave” of the COVID-19 pandemic. Follow-up to discharge from hospital. Multiple logistic regression selecting variables according to clinical and statistical criteria. Results: 404 consecutive patients were evaluated, 392 (97%) completed follow-up. Mean age was 61 years; 59% were men. The median burden of comorbidity was 2 points in the Age-adjusted Charlson Comorbidity Index, CRB was abnormal in 18% of patients and basal oxygen saturation on admission lower than 90% in 18%. A model composed of Age-adjusted Charlson Comorbidity Index, CRB score and basal oxygen saturation can predict unfavorable evolution or death with an area under the ROC curve of 0.85 (95% CI: 0.80-0.89), and 0.90 (95% CI: 0.86 to 0.94), respectively.Conclusion: prognosis of COVID-19 pneumonia can be predicted in the out-of-hospital environment using two classic prognostic scales and a pocket pulse oximeter.

scholarly journals Tinjauan Literatur Malnutrisi Didapat di Rumah Sakit: Karakteristik Anak dan Alat Skrining yang Digunakan

2020 ◽  
Vol 11 ◽  
pp. 41
Author(s):  
Yuni Maria Olviani Ndede ◽  
Dessie Wanda
Keyword(s):  
Screening Tool ◽  
Screening Tools ◽  
Hospital Environment ◽  
Online Database ◽  
Review Articles ◽  
Keywords Child ◽  
Hospital Acquired ◽  
Hospital Acquire

This article aimed of child’s characteristic of hospital acquired malnutrition (HAMs) that need to used screening tool to early detect of that risk. This review articles sourced from online database with the keywords child, pediatric, malnutrition, malnourished, hospital or hospital acquire and screening tool were taken from 2014 to 2019.This review discussed 3 subtopics were: (1) Hospital acquired malnutrition, (2) The characteristics of child with hospital acquired malnutrition, and (3) Instrument of malnutrition assessment in hospitals. Based on 3 subtopics, several factors are found that can make increased of hospital acquired malnutrition in child and a few screening tools that used. Screening tools that are appropriate to the hospital environment and the characteristics of children to be able to assess the nutritional malnutrition properly. Keywords: hospital acquired malnutrition; hospitalization; child; screening tool ABSTRAK Artikel ini membahas tentang karakteristik anak terhadap malnutrisi didapat di rumah sakit (MddRS) yang perlu menggunakan alat skrining baku untuk deteksi awal risiko tersebut. Telaah artikel ini berdasarkan sumber dari online database dengan menggunakan kata kunci digunakan child, pediatric, malnutrition, malnourished, hospital or hospital acquire dan screening tool yang diterbitkan tahun 2014 hingga 2019. Dari hasil telaah artikel, didapatkan subtopik pembahasan diantaranya: 1) Malnutrisi didapat di rumah sakit, 2) Karakteristik malnutrisi didapat di rumah sakit, dan 3) Instrumen penilaian malnutrisi di rumah sakit. Simpulan: Berdasarkan tiga subtopik yang menjelaskan tentang malnutrisi didapat di rumah sakit, didapat beberapa faktor penyebab yang mendasari peningkatan kejadian MddRS dan beberapa alat skrining yang digunakan. Perlu alat yang sesuai dengan lingkungan rumah sakit dan karakteristik pasien untuk dapat menilai kejadian malnutrisi dengan baik dan tepat. Kata kunci: malnutrisi didapat di rumah sakit; hospitalisasi; anak; alat skrining

Plasmids and Bacterial Strains Mediating Multidrug-Resistant Hospital-Acquired Infections Are Coresidents of the Hospital Environment

2013 ◽  
Vol 19 (2) ◽  
pp. 104-109 ◽  
Author(s):  
Thu Betteridge ◽  
John Merlino ◽  
Jonathon Natoli ◽  
Elaine Y.-L. Cheong ◽  
Thomas Gottlieb ◽  
...  
Keyword(s):  
Multidrug Resistant ◽  
Hospital Environment ◽  
Bacterial Strains ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

scholarly journals Bacteriological Monitoring of Inanimate Surfaces and Equipment in Some Referral Hospitals in Assiut City, Egypt

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Entsar H. Ahmed ◽  
Hebat-Allah M. Hassan ◽  
Nahla M. El-Sherbiny ◽  
Asmaa M. A. Soliman
Keyword(s):  
Essential Element ◽  
Public Health Problem ◽  
Hospital Environment ◽  
Coagulase Negative Staphylococcus ◽  
Biochemical Tests ◽  
Nosocomial Pathogens ◽  
Environmental Surfaces ◽  
Significant Difference ◽  
Referral Hospitals ◽  
Hospital Acquired

Hospital-acquired infections represent a serious public health problem in all countries. It is clear that monitoring of the hospital environment is an essential element in the control and a part of the policy for preventing nosocomial infections. It allows a better understanding of the microbial ecology for the purpose of conducting preventive and corrective actions. The aims of this work were to determine the percentage of bacterial contamination of environmental samples and to identify potential nosocomial pathogens isolated from environments of seven referral hospitals from 2009 to 2015. By using the swab technique, 12863 samples were collected. Qualitative and quantitative cultures were performed. The organisms were primarily identified by colony morphology, microscopy of Gram stain, and standard biochemical tests. 25.6% of total samples showed contamination (93% was monomicrobial and 7.0% was polymicrobial). The predominant species was coagulase-negative staphylococcus (CNS) (32%), followed by methicillin-resistant S. aureus (MRSA) (26%) and then K. pneumonia (10.6%). The percentage of contamination varied among the covered hospitals and according to the year of monitoring with highly statistically significant difference (p value<0.001). Direct contact with environmental surfaces or equipment transmits the majority of nosocomial infection. Major nosocomial pathogens have been identified. Hospital managers and healthcare bodies must be aware of the reality of the concept of environmental bacterial tanks and the need for respect of biocleaning procedures and choice of biocleaning tools.

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