scholarly journals Antimicrobial resistance profiles of microorganisms isolated from hospitalized patients in Dominican Republic

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
David de Luna ◽  
José Javier Sánchez ◽  
Miguel Peguero ◽  
Wilmary García ◽  
Sylmari Liciaga ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Dominican Republic ◽  
Methicillin Resistance ◽  
Carbapenem Resistance ◽  
Generation Cephalosporin ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional ◽  
Acinetobacter Spp

Objective. To define the antimicrobial resistance profiles of the microorganisms most commonly isolated from hospitalized adult patients in Dominican Republic (DR). Methods. A retrospective, cross-sectional study of phenotypic antimicrobial susceptibility patterns was conducted using data from 3 802 clinical microbiology reports specifying positive bacterial cultures in samples collected from patients admitted to the clinical, surgery, and intensive care units (ICU) at three tertiary-level care hospitals in the city of Santiago de los Caballeros from 1 January 2016 – 31 December 2017. Descriptive statistics and chi-square test (P ≤ 0.05) were used to analyze the qualitative variables. Results. At the three hospitals, there were 932, 1 090, and 1 780 microbiology reports analyzed. Of the total, 1274 were from the ICU, 1 042 from the surgery unit, and 1 486 from the clinical unit. Methicillin resistance was found in 57.3% of the Staphylococcus aureus isolates and 75.3% of the coagulase-negative staphylococci. Third-generation cephalosporin resistance was detected in 54.4% of isolates identified as members of the Enterobacteriaceae family, 67.3% of the Acinetobacter spp., and 91.7% of the Pseudomonas, while carbapenem resistance was shown by 8.0%, 23.8%, and 51.0% of these, respectively. Most of the resistant Acinetobacter spp. isolates were found in just one hospital and the prevalence of Enterobacteriaceae resistant to carbapenems was highest in the ICU. Conclusion. Antimicrobial resistance levels are high among hospitalized patients in Dominican Republic and may cause enhanced risk factors that impact clinical outcomes. Urgent measures are needed to address antimicrobial resistance in DR.

scholarly journals HOSPITALIZED PATIENTS

2016 ◽  
Vol 23 (07) ◽  
pp. 795-801
Author(s):  
Muhammad Saeed ◽  
Farhan Rasheed ◽  
Shahida Hussain ◽  
Maqsood Ahmad ◽  
Mizna Arif ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clinical Laboratory ◽  
Methicillin Resistance ◽  
Nasal Carriage ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Coagulase Negative Staphylococcus ◽  
Biochemical Tests ◽  
Carriage Rate ◽  
Cross Sectional

Objectives: An alarming rise in Methicillin resistant Staphylococcus aureus(MRSA) associated hospital based infections has been reported in recent decades.Prolongedhospital stay, unhygienic health services are confined to this challenging serious problem.Anterior nares of humans are a natural reservoir for Staphylococcus aureus with asymptomaticcolonization. This study was designed to determine the prevalence of nasal carriage rate ofMRSA among hospitalized patients. Study Design: Cross sectional study. Setting: PunjabInstitute of Cardiology, Lahore, Pakistan. Period: January 2013- 2014. Materials & Methods:Nasal swabs were collected from hospitalized patients. Total 2,440 patients were screened forthe nasal carriage of MRSA. Microbiologically, identification of S. aureus was done on the basisof colony morphology, Gram staining and biochemical tests. Identified isolates of S. aureus werefurther tested for cefoxitin susceptibility testing, following the technique of modified Kirby Bauer discdiffusion using Mueller-Hinton agar as per Clinical Laboratory Standards Institute (CLSI) guidelines2013. Results: Out of total 2,440 nasal swabs, 60.45% (1475/2440) were Staphylococcusspecies. Among Staphylococcus group, 86.10% (1270/1475) were Staphylococcus aureus.The frequency of MRSA and MSSA (Methicillin sensitive Staphylococcus aureus) was 5.20%(66/1270) and 94.8% (1204/1270) respectively. Overall nasal carriage of MRSA is 2.70%(66/2440). The coagulase negative Staphylococcus were found in 205 (13.90%) cases whileMRSE (Methicillin resistance Staphylococcus epidermdis) were found in only 7 (3.41%) cases.Conclusion: Overall nasal carriage rate of MRSA was 2.70%.

scholarly journals The Prevalence of antimicrobial resistance in Staphylococcus aureus and coagulase-negative Staphylococci strains isolated from inpatients

2020 ◽  
Author(s):  
Parva Farmehr ◽  
Javad fathi ◽  
Mahtab Hadadi ◽  
mohammad motamedifar
Keyword(s):  
Staphylococcus Aureus ◽  
Antimicrobial Susceptibility ◽  
Antibacterial Agents ◽  
Methicillin Resistance ◽  
Cross Sectional Study ◽  
Clinical Samples ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional ◽  
Antibiotic Policy ◽  
Southwest Of Iran

Abstract Objectives Globally nosocomial infection is a significant problem. Methicillin resistance Staphylococcus aureus (MRSA) and Methicillin resistance coagulase negative staphylococci (MRCoNS) are major causes of nosocomial infections. Aim of this study was to determine the prevalence and antimicrobial susceptibility of MRSA and MRCoNS in the southwest of Iran. This cross-sectional study was conducted on 221 non-duplicated staphylococci isolates collected from teaching hospital in Shiraz. The prevalence of MRSA and MRCoNS in clinical samples was identified with conventional microbiological tests. After identification, all of the isolates were subjected to antimicrobial susceptibility test and PCR to identify the presence of femA, mecA and pvl genes.Result 168 (76%) S. aureus and 53 (24%) CoNS were detected. 70 (41.7%) MRSA among 168 S. aureus, and 26 (15.48%) MRCoNS among 53 CoNS were examined. Chloramphenicol (65%) and Gentamicin (23%) were the most active antibacterial agents against MRSA and MRCoNS, whereas these isolates were susceptible to SXT (100%). The frequency of pvl gene among S. aureus strains was 3.57%. There is need for developing the antibiotic policy and limiting the use of powerful antibiotics.

Etiologies, Clinical Manifestations, and Factors Associated with Severe Symptomatic Hyponatremia among Hospitalized Hyponatremia Patients

2020 ◽  
Vol 103 (5) ◽  
pp. 465-471
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Sectional Study ◽  
Close Attention ◽  
Cross Sectional ◽  
Factors Associated ◽  
Present Cross Sectional Study ◽  
Important Health ◽  
Baseline Characteristics

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia

scholarly journals Trends in social inequalities in breastfeeding and infant formulas in Latin American countries between the 1990 and 2010 decades

2021 ◽  
pp. 1-10
Author(s):  
Camila S Ferreira ◽  
Catarina M Azeredo ◽  
Ana Elisa M Rinaldi
Keyword(s):  
Dominican Republic ◽  
Social Inequality ◽  
Latin American ◽  
Low Income ◽  
Social Inequalities ◽  
Weighted Least Squares ◽  
Cross Sectional Study ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Simultaneous Decrease

Abstract Objective: To analyse trends of social inequality in breastfeeding and infant formula (IF) use in Latin America between 1990 and 2010 decades. Design: Time-series cross-sectional study with data from Demographic and Health Surveys. We described the prevalence of exclusive breastfeeding (EBF), breastfeeding between 6 and 12 months (BF6-12) and IF for infants under 6 months (IF < 6) and between 6 and 12 months (IF6-12). Social inequalities were assessed using the slope index of inequality (SII) and concentration index (CIX). Trends in the prevalence of breastfeeding, IF and index of social inequality were analysed by a linear regression model with weighted least squares variance. Setting: Bolivia, Colombia, Dominican Republic, Guatemala, Haiti and Peru. Participants: 51·358 alive infants younger than 12 months. Results: Five countries showed an increasing trend for EBF and BF6-12, four increased for IF < 6 and six for IF6-12. Simultaneous decrease in IF < 6 (Colombia: −0·3/year; Haiti: −0·02/year) and increase in EBF (Colombia: +2·0/year; Haiti: +1·9/year) were observed only in two countries. EBF prevalence was high in the lowest income quintiles in five countries, and IF prevalence was high in the highest income quintiles in all countries and over the decades. For BF6-12, a decrease in inequality (prevalence increased in the highest quintile) was observed in Guatemala (SII1995 = −0·42; SII2015 = −0·28) and the Dominican Republic (SII1996 = −0·54; SII2013 = −0·26). Guatemala was the only country showing a decrease in inequality for BF (SII = −0·005; CIX = −0·0035) and an increase for IF (SII = 0·022; CIX = 0·01). Conclusions: The inequality in BF and IF remained over time. However, inequality in IF < 6 has decreased because low-income infants have increased use and high-income infants have decreased.

scholarly journals Risk Factors for Undernutrition at Admission Among Adult Hospitalized Patients at a Referral Hospital in Indonesia

SAGE Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 215824402098331
Author(s):  
Nur Chandra Bunawan ◽  
Dwi Suseno ◽  
Drupadi H. S. Dillon ◽  
Ikhwan Rinaldi ◽  
Dyah Purnamasari
Keyword(s):  
Associated Factors ◽  
Multivariate Analyses ◽  
Gastrointestinal Disease ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Initial Hospital ◽  
Comorbidity Index

Patients with undernutrition at admission have higher risks to worsen their nutritional status, which is linked to an increase in morbidity and mortality. This study investigated the prevalence of undernutrition at admission and its associated factors. A cross-sectional study was conducted on patients aged 18 to 59 years old in Internal Medicine ward at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, between July and September 2019. Factors that might be associated with undernutrition at admission, such as age, sex, marital status, Charlson Comorbidity Index (CCI) and type of comorbidity, depression, and neutrophil–lymphocyte ratio (NLR), were assessed. Bivariate and multivariate analyses were used to determine the associated factors. Sixty hospitalized patients with median age of 42 years and 76.7% with married status joined the study. The most common reason for hospitalization was acute gastrointestinal disease with gallstones as the most common comorbidity. Undernutrition exists in 26.7% of subjects. High CCI score was observed among 11.7% subjects and half of subjects had NLR category ≥5. Bivariate analysis revealed that unmarried status, age ≥40 years, and malignancy were associated with undernutrition at admission. Logistic regression analysis showed malignancy as an independent predictor of undernutrition during the initial hospital admission (odds ratio [OR] = 11.8; 95% confidence interval [CI]: [1.1, 125.7]). The prevalence of undernutrition at admission was 26.7%. Factors associated with an increased prevalence of undernutrition at admission were age <40 years, unmarried status, and malignancy. Malignancy was an independent factor of the prevalence of undernutrition at admission.

scholarly journals Assessing Knowledge and Perception Regarding Antimicrobial Stewardship and Antimicrobial Resistance in University Students of Pakistan: Findings and Implications

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 866
Author(s):  
Iltaf Hussain ◽  
Nisa Yousaf ◽  
Sana Haider ◽  
Pervisha Jalil ◽  
Muhammad Usman Saleem ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
University Students ◽  
Antimicrobial Stewardship ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Dosing Regimen ◽  
Student Knowledge ◽  
Chi Square ◽  
Cross Sectional ◽  
Self Administered Questionnaire

The irrational use of antimicrobials has enormously contributed to antimicrobial resistance (AMR) globally and especially in the developing world. To assess the knowledge and perception regarding AMR and antimicrobial stewardship (AMS), a descriptive cross-sectional study was carried out in university students enrolled in pharmacy, veterinary, and biology programs by using an online self-administered questionnaire. The Chi-square and Fisher exact tests (where applicable) were performed to assess the association of the demographics with the students’ knowledge and perception regarding AMR and AMS. A total of 496 students completed the questionnaire, among which, 85.7% of the participants were familiar with the term AMR and 79.4% of the participants correctly identified a poorly designed dosing regimen as a contributing factor towards AMR. The majority of participants (57.9%) were familiar with the term AMS and 86.5% were aware of the aim of AMS. The participants showed good knowledge regarding AMR and AMS, but to further improve student knowledge and perception of AMS and AMR, it is suggested that dedicated modules on antibiotic use and AMS should be incorporated into the curricula of these undergraduate and postgraduate programs.

scholarly journals Perspectives of Healthcare Professionals Regarding Factors Associated with Antimicrobial Resistance (AMR) and Their Consequences: A Cross Sectional Study in Eastern Province of Saudi Arabia

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 878
Author(s):  
Mohamed A. Baraka ◽  
Amany Alboghdadly ◽  
Samar Alshawwa ◽  
Asim Ahmed Elnour ◽  
Hassan Alsultan ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Inappropriate Prescribing ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Key Factors ◽  
Eastern Province ◽  
Cross Sectional ◽  
Factors Associated ◽  
Factors Influencing

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians’ decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients’ clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber’s choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians’ choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician’s prescription (i.e., self-medication) represent key factors which contribute to AMR from participants’ perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.

scholarly journals Dietary Factors of blaNDM Carriage in Health Community Population: A Cross-Sectional Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5959
Author(s):  
Shuangfang Hu ◽  
Ziquan Lv ◽  
Qiumei Xiang ◽  
Yang Wang ◽  
Jianzhong Shen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antimicrobial Resistance ◽  
Cross Sectional Study ◽  
Dietary Factors ◽  
Coarse Grain ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Community ◽  
Health Communities ◽  
Tuber Crops

Aim: There is an ongoing debate as to what extent antimicrobial resistance (AMR) can be transmitted from dietary to humans via the consumption of food products. We investigated this association between dietary and global spreading carbapenem-resistant gene blaNDM Methods: We did a cross-sectional study to assess the risk factors for carrier of blaNDM in health community. Healthy adults were recruited from the residents attending Community Healthcare Service in Shenzhen City (Guangdong Province, China), through 1February 2018 to 31December 2019, and 718 pre-participants were included in this study. Questionnaire were obtained and the qualitative food frequency questionnaire (Q-FFQ) were used to assess dietary intake. qPCR was applied to confirm the carrier of blaNDM in participants’fecal samples. Multivariable logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each outcome according to each dietary factor before and after prosperity score matching (PSM). Results: we showed that a high intake of coarse grain (OR 1.003; 95% CI 1.001–1.005, p < 0.01) and root and tuber crops (OR 1.003; 95% CI 1.001–1.004, p < 0.05) were independent risk factor for blaNDM carrier in health communities, suggesting a possible transfer of AMRbetweendietary andhumans. Surprisingly, we also showed an association between a higher intake of poultry as a protective, which may be explained by the beneficial effects on the gut microbiota. Conclusion: Dietary factors such as intake of coarse grain, root and tuber crops and poultry were associated with blaNDM carrier in health communities. The influence of dietary factorson blaNDM carrier in the present study provides insights for the tangible dietary advice with guidelines to the routine of people with the risk of blaNDM carrier. This demonstrates the role of dietary intake in the prevention of blaNDM carrier, since prevention is the best way to control modifiable risk factors. A lower carrier rate of blaNDM is helpful to reduce the possibility of transmission and pathogenicity. Further studies on food, microbiota and antimicrobial resistance are necessary to confirm this possible association and unravel underlying mechanisms.

scholarly journals The importance of dysphagia screening and nutritional assessment in hospitalized patients

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Patrícia Amaro Andrade ◽  
Carolina Araújo dos Santos ◽  
Heloísa Helena Firmino ◽  
Carla de Oliveira Barbosa Rosa
Keyword(s):  
Nutritional Status ◽  
Global Assessment ◽  
Assessment Tool ◽  
Nutritional Assessment ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
The Body ◽  
Subjective Global Assessment ◽  
Cross Sectional ◽  
Knee Height

ABSTRACT Objective: To determine frequency of dysphagia risk and associated factors in hospitalized patients as well as to evaluate nutritional status by using different methods and correlate the status with scores of the Eating Assessment Tool (EAT-10). Methods: This was a cross-sectional study including 909 inpatients of a philanthropic hospital. For the diagnosis of dysphagia we used an adapted and validated Brazilian version of the Eating Assessment Tool (EAT-10). The nutritional status was evaluated through the subjective global assessment, and anthropometric measurements included weight, calf and arm circumference, and knee height. The Mann-Whitney test, associations using the Pearson’s χ2 and Spearman’s correlation were used to verify differences between the groups. Results: The prevalence of dysphagia risk was 10.5%, and aging was the associated factor with this condition. Patients at risk presented lower values of arm and calf circumference, variables that correlated inversely with the Eating Assessment Tool (EAT-10) score. Malnutrition was observed in 13.2% of patients based on the subjective global assessment and in 15.2% based on the Body Mass Index. Conclusion: Screening for dysphagia and malnutrition should be introduced in hospitals routine to avoid or minimize damages caused by dysphagia or malnutrition, especially among older people.

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