scholarly journals The Spread of Plasmidic AmpC in a General Lebanese Hospital Over Nine Consecutive Years and the Relationship With Restricted Isolation Protocols

2021 ◽  
Vol 8 ◽  
Author(s):  
Mohamad Fleifel ◽  
Ahmad Machmouchi ◽  
Omar Alameddine ◽  
Kim Hoyek ◽  
Dimitri Melki ◽  
...  
Keyword(s):  
Infection Control ◽  
Medical Center ◽  
Multidrug Resistant ◽  
Healthcare Personnel ◽  
The Public ◽  
Centre Hospitalier ◽  
Extended Spectrum ◽  
Matched Data ◽  
Hospital Wards ◽  
The Relationship

Background: The dreaded bacterial infection by extended-spectrum β-lactamases (ESBL)-producers has always troubled the medical field whether on the public, scientific, or clinical levels. One of the lesser known β-lactamases, which is capable of hydrolyzing broad and extended-spectrum cephalosporins—i.e., cephamycins plus oxyimino-β-lactams—are the AmpC β-lactamases. This group, which has also been termed occasionally—and incorrectly—as ESBL Class C, confers resistance to β-lactamase inhibitors. The prevalence of plasmidic AmpC (pAmpC) strains is possibly still a matter of debate considering the unevenly matched data between phenotypically-detected and molecularly-detected pAmpC.Aim: In the absence of any study in Lebanon addressing the AmpC, our intention was to determine the numbers and percentages of AmpC Enterobacteriaceae isolates, notably plasmid-mediated ones, across different wards at the Centre Hospitalier du Nord (CHN), Lebanon, and highlight the importance of infection control protocols.Materials and Methods: Carriage and infection with pAmpC Enterobacteriaceae were retrospectively investigated between 2011 and 2015 and prospectively between 2016 and 2019 at the Centre Hospitalier du Nord Hospital, North Lebanon. The rise or decline in the numbers of such strains, in concordance with the allegedly intensive isolation of the patients, were analyzed.Results: Intensive care unit (ICU) data shows an initial rise in infection isolates from 2012 to 2014 and in the carriage isolates from 2012 to 2013 with later notable overall decrease in the both isolates' numbers with the application of the isolation protocols at CHN from 2014 onwards. Floors 2, 3, and 4 seemed to house the bulk of the isolates as well.Conclusion: Preventive measures, such as on-going surveillance of the hospital wards by specialized healthcare personnel and strict implementation of infection control practices, should be a top priority in any medical center in order to isolate such strains and try to put a limit for the development and the dissemination of any possible multidrug resistant strains.

Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility—A qualitative analysis

2021 ◽  
pp. 1-7
Author(s):  
Katharina R. Rynkiewich ◽  
Jinal Makhija ◽  
Mary Carl M. Froilan ◽  
Ellen C. Benson ◽  
Alice Han ◽  
...  
Keyword(s):  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Healthcare Personnel ◽  
Skilled Nursing ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Resident Care ◽  
Semistructured Interviews ◽  
Self Protection

Abstract Objective: Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. Design: A qualitative study involving semistructured interviews. Setting: One vSNF in the Chicago, Illinois, metropolitan region. Participants: The study included 17 healthcare personnel representing management, nursing, and nursing assistants. Methods: We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. Results: Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were ‘invisible’ and potentially ‘threatening.’ Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. Conclusions: Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.

Use of Longitudinal Surveillance Data to Assess the Effectiveness of Infection Control in Critical Care

2009 ◽  
Vol 30 (11) ◽  
pp. 1109-1112 ◽  
Author(s):  
John W. Ahern ◽  
W. Kemper Alston
Keyword(s):  
Infection Control ◽  
Medical Center ◽  
Academic Medical Center ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Surveillance Data ◽  
Simple Method ◽  
Academic Medical ◽  
Multidrug Resistant Organisms ◽  
The Impact

A simple method for quantifying nosocomial infection and colonization with multidrug-resistant organisms is described. This method is applied to the intensive care unit of an academic medical center where longitudinal surveillance data have been used to assess the impact of infection control interventions and antibiotic use.

scholarly journals Outbreak of Extended Spectrum Beta Lactamase Producing Klebsiella Species Causing Neonatal Sepsis at Patan Hospital in Nepal

2015 ◽  
Vol 1 (1) ◽  
pp. 20-25
Author(s):  
Puja Amatya ◽  
Suchita Joshi ◽  
Shrijana Shrestha
Keyword(s):  
Infection Control ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Beta Lactamase ◽  
Plain Language ◽  
Klebsiella Species ◽  
Extended Spectrum Beta Lactamase ◽  
Infection Control Measures ◽  
Extended Spectrum

Introductions: Klebsiella sepsis is the most important nosocomial infection in neonates. The objectives of this study were to review an outbreak in a neonatal unit caused by Klebsiella species, to identify the source of the infections, and to identify infection control measures for eradication and prevention of these infections. Methods: The case notes and investigation reports of all sepsis cases admitted in neonatal units of Patan hospital from July to December 2011 caused by Klebsiella species were retrospectively reviewed. The demographic profile, risk factors along with clinical features and management of sepsis were reviewed. Results: Twenty three out of 37 neonatal blood cultures grew Klebsiella species. Thirty one were K. pneumoniae and six K. oxytoca. Seventeen of the 31 (55%) K. pneumoniae isolates were multidrug resistant and extended spectrum beta lactamase producers. Eighteen of 23 (78%) neonates with Klebsiella sepsis died. After extensive cleaning methods and identifying an intermittently leaking roof in one of the nurseries below a vescicovaginal fistula room of gynecological ward above, the infection outbreak was finally controlled. Conclusions: Infections with extended spectrum beta lactamase producing Klebsiella spp. are a threat in neonatal units because of limited treatment options for these multidrug resistant organisms. Identification of the source and control of the outbreak can be a challenge. Plain Language Summary: The study was done to review an outbreak caused by Klebsiella species, to identify the source of the infections along with infection control measures for eradication and prevention of these infections in neonate unit. Identification of the source and eradication of the outbreak of Klebsiella species can be a challenge. Hand washing remains one of the most important methods to prevent cross infections and nosocomial infections. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13011 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):20-25 

scholarly journals Orthopedic Implant-Associated Infection by Multidrug Resistant Enterobacteriaceae

2019 ◽  
Vol 8 (2) ◽  
pp. 220 ◽  
Author(s):  
Bernadette G. Pfang ◽  
Joaquín García-Cañete ◽  
Julia García-Lasheras ◽  
Antonio Blanco ◽  
Álvaro Auñón ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Implant Removal ◽  
Beta Lactamase ◽  
Orthopedic Implant ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Implant Retention ◽  
Clinical Records

Introduction: Orthopedic implant-associated infections caused by multidrug-resistant Enterobacteriaceae are a growing challenge for healthcare providers due to their increasing incidence and the difficulties of medical and surgical treatment. Material and Methods: A retrospective observational study of all cases of multidrug resistant Enterobacteriaceae orthopedic implant-associated infection diagnosed in a tertiary European hospital from December 2011 to November 2017 was carried out. Clinical records were reviewed using a previously designed protocol. Data analysis was performed with IBM® SPSS®, version 22. Results: 25 patients met inclusion criteria. The infected implants included 10 prosthetic joints, seven osteosyntheses, six combinations of prosthetic joint and osteosynthesis material, and two spacers. Of the multidrug resistant Enterobacteriaceae obtained on culture, 12 were extended-spectrum beta-lactamase-producing Escherichia coli, three OXA-48-producing Klebsiella pneumoniae, nine extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, and one extended-spectrum beta-lactamase-producing Proteus mirabilis. Combination antimicrobial therapy was employed in all cases but two. Overall, 16 (64%) patients underwent implant removal. The rate of infection control in the overall implant removal group was 100% compared to 33% in the implant retention group. A strong relationship between implant removal and infection control was observed (p = 0.001). Discussion: Implant removal is strongly associated with infection control. However, in some cases, patient age and comorbidity contraindicate hardware extraction. Potential objectives for future studies should be geared towards targeting the population in which debridement, antibiotic therapy, and implant retention can be used as a first-line therapeutic strategy with a reasonable probability of achieving infection control.

Incidence of Completed and Attempted Suicide in Trabzon, Turkey

Crisis ◽  
2002 ◽  
Vol 23 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Mustafa Bilici ◽  
Mehmet Bekaroğlu ◽  
Çiçek Hocaoğlu ◽  
Serhat Gürpınar ◽  
Cengiz Soylu ◽  
...  
Keyword(s):  
Suicide Risk ◽  
Attempted Suicide ◽  
Medical Center ◽  
Study Data ◽  
Public Prosecutor ◽  
Suicide Method ◽  
Hospital Data ◽  
State Institute ◽  
The Public ◽  
Completed Suicide

Summary: Objective: Studies of completed and attempted suicide in Turkey are based on data of State Institute of Statistics (SIS) and emergency clinics of the large hospitals. This study seeks (1) to find, independent of the SIS and hospital data, the annual incidences of completed and attempted suicide in Trabzon, Turkey; (2) to examine the associated factors between the incidence of completed and attempted suicide. Method: The data are derived by using a method specially designed for this study. Data sources include emergency clinics in all hospitals, village clinics, the Forensic Medical Center of Trabzon, the Governorship of Trabzon, “mukhtars” (local village representatives) of neighborhoods, the Office of the Public Prosecutor of Trabzon, the Police Headquarters and Gendarmerie, and the local press organs. Results: The incidences of completed and attempted suicide per 100,000 inhabitants turned out to be 2.60 and 31.5, respectively, whereas the SIS reported the incidence of completed suicide to be 1.11 per 100,000 inhabitants in Trabzon in 1995. Conclusion: Our results demonstrate that SIS data are inadequate for suicide research in Turkey. Our findings show that the risk of completed and attempted suicide is high in young, unmarried, and unemployed persons, and that these groups must be carefully evaluated for suicide risk. The study highlights the need for culture-specific research on suicidal behavior in Turkey.

The Dynamics of Egypt’s “Semi-opposition,” 2004–11

2019 ◽  
Vol 12 (4) ◽  
pp. 83-103
Author(s):  
Mai Mogib Mosad
Keyword(s):  
Public Sphere ◽  
Political System ◽  
Muslim Brotherhood ◽  
The Public ◽  
The Muslim Brotherhood ◽  
The Public Sphere ◽  
The Relationship

This paper maps the basic opposition groups that influenced the Egyptian political system in the last years of Hosni Mubarak’s rule. It approaches the nature of the relationship between the system and the opposition through use of the concept of “semi-opposition.” An examination and evaluation of the opposition groups shows the extent to which the regime—in order to appear that it was opening the public sphere to the opposition—had channels of communication with the Muslim Brotherhood. The paper also shows the system’s relations with other groups, such as “Kifaya” and “April 6”; it then explains the reasons behind the success of the Muslim Brotherhood at seizing power after the ousting of President Mubarak.

Tanggung Jawab Hukum Penilai Publik terhadap Laporan Penilaian Kegiatan Pengadaan Tanah bagi Pembangunan untuk Kepentingan Umum (Studi Atas Kantor Jasa Penilai Publik Toto Suharto)

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Gagah Yaumiyya Riyoprakoso ◽  
AM Hasan Ali ◽  
Fitriyani Zein
Keyword(s):  
Future Development ◽  
Public Interest ◽  
Legal Responsibility ◽  
Legal Research ◽  
The Public ◽  
The Government ◽  
Conducting Research ◽  
The Right ◽  
The Relationship ◽  
Systematic Explanation

This study is based on the legal responsibility of the assessment of public appraisal reports they make in land procurement activities for development in the public interest. Public assessment is obliged to always be accountable for their assessment. The type of research found in this thesis is a type of normative legal research with the right-hand of the statue approach and case approach. Normative legal research is a study that provides systematic explanation of rules governing a certain legal category, analyzing the relationship between regulations explaining areas of difficulty and possibly predicting future development. . After conducting research, researchers found that one of the causes that made the dispute was a lack of communication conducted between the Government and the landlord. In deliberation which should be the place where the parties find the meeting point between the parties on the magnitude of the damages that will be given, in the field is often used only for the delivery of the assessment of the compensation that has been done.

“Our Dead are the Ultimate Teachers of Life”. The Corpse as an Inter-mediator of Transcendence

2013 ◽  
Vol 8 (2) ◽  
pp. 223-240
Author(s):  
Antje Kahl
Keyword(s):  
Death And Dying ◽  
Modern Society ◽  
Religious Institutions ◽  
Spiritual Experiences ◽  
Dead Body ◽  
Funeral Directors ◽  
The Public ◽  
Funeral Director ◽  
The Dead ◽  
The Relationship

Today in Germany, religion and the churches forfeit their sovereignty of interpretation and ritual concerning death and dying. The funeral director is the first point of contact when death occurs. Therefore he or she is able to influence the relationship between the living and the dead. In the course of this development, the dead body, often referred to as dirty and dangerous, is being sanitized by funeral directors. Funeral directors credit the dead body with a certain quality; they claim that facing the dead may lead to religious or spiritual experiences, and therefore they encourage the public viewing of the dead – a practice which was, and still is not very common in Germany. The new connotation of the dead body is an example for the dislimitation of religion in modern society. The religious framing of death-related practises no longer exclusively belongs to traditional religious institutions and actors, but can take place in commercial business companies as well.

PERSOALAN KEHIDUPAN KONTEMPORER: MENGGAGAS KAJIAN SACHEDINA TENTANG THEOLOGI PLURALISME

EMPIRISMA ◽  
2017 ◽  
Vol 26 (1) ◽  
Author(s):  
Limas Dodi
Keyword(s):  
Religious Pluralism ◽  
Main Argument ◽  
Religious Groups ◽  
Common View ◽  
The Public ◽  
The People ◽  
Muslim Majority ◽  
The Common ◽  
The Relationship ◽  
Religious Differences

According to Abdulaziz Sachedina, the main argument of religious pluralism in the Qur’an based on the relationship between private belief (personal) and public projection of Islam in society. By regarding to private faith, the Qur’an being noninterventionist (for example, all forms of human authority should not be disturb the inner beliefs of individuals). While the public projection of faith, the Qur’an attitude based on the principle of coexistence. There is the willingness of the dominant race provide the freedom for people of other faiths with their own rules. Rules could shape how to run their affairs and to live side by side with the Muslims. Thus, based on the principle that the people of Indonesia are Muslim majority, it should be a mirror of a societie’s recognizion, respects and execution of religious pluralism. Abdul Aziz Sachedina called for Muslims to rediscover the moral concerns of public Islam in peace. The call for peace seemed to indicate that the existence of increasingly weakened in the religious sense of the Muslims and hence need to be reaffi rmed. Sachedina also like to emphasize that the position of peace in Islam is parallel with a variety of other doctrines, such as: prayer, fasting, pilgrimage and so on. Sachedina also tried to show the argument that the common view among religious groups is only one religion and traditions of other false and worthless. “Antipluralist” argument comes amid the reality of human religious differences. Keywords: Theology, Pluralism, Abdulaziz Sachedina

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