Predictor of Mortality COVID-19 in Two Referral Hospital in Surabaya, Indonesia

Introduction: Klebsiella pneumoniae is a common cause of nosocomial infections; however, there is limited information in Iran regarding nosocomial outbreaks due to extended-spectrum &#946;–lactamase (ESBL) producing K pneumoniae strains, particularly using molecular methods. The present study focused on the molecular mechanism of ESBL resistance and genetic relatedness in K. pneumoniae isolates causing nosocomial infections in an Iranian referral hospital. Material and Methods: This study evaluated the antimicrobial resistance and molecular epidemiology of K. pneumoniae causing nosocomial infections in children between October 2013 and March 2014. The ESBL detection was carried out for all the isolates by the CLSI method and PCR was carried out for the detection of the blaSHV, blaTEM, and blaCTX-M genes among ESBL-producing K. pneumonia. Molecular typing of the K. pneumoniae was performed using random amplification of polymorphic DNA-polymerase chain reaction (RAPD-PCR). Results: A total of 30 isolates of K. pneumoniae were used for epidemiological analysis. High rates of resistance to cefotaxime (n=29, 97%), cefazolin (n=29, 97%), cefepime (n=25, 83%) and gentamicin (n=23, 77%) were observed. A total of 29 strains (97%) produced ESBLs. The frequency of blaSHV, blaCTX-M and blaTEM genes among these isolates was 83% (n=25), 70% (n=21) and 57% (n=17), respectively. Surprisingly 11 isolated (37%) carried blaSHV, blaCTX-M and blaTEM genes simultaneously. Moreover, the concurrent presence of “blaSHV and blaCTX-M” and “blaSHV and blaTEM” was seen in 8 (27%) and 4 (13%) isolates, respectively. RAPDPCR analyses revealed that K. pneumoniae isolates belonged to 2 RAPD-PCR types among which one cluster counted for 28 isolates. Conclusion: To our knowledge, this is the first published report of a nosocomial outbreak of ESBL-producing K. pneumoniae in children in Iran. Although the epidemiology of nosocomial infections with ESBL-producing organisms has not yet been explored in depth in Iran, our findings suggest that ESBL-producing organisms are already an established public health threat in our country.

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Antimicrobial susceptibility of bacterial isolates from ambulatory practice and from a referral hospital

Journal of Veterinary Internal Medicine ◽

10.1111/jvim.15685 ◽

2019 ◽

Vol 34 (1) ◽

pp. 300-306 ◽

Cited By ~ 3

Author(s):

Julie F. N. Potier ◽

Andy E. Durham

Keyword(s):

Antimicrobial Susceptibility ◽

Referral Hospital ◽

Bacterial Isolates ◽

Ambulatory Practice

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Symptoms of acute transfusion reactions at a general referral hospital in Kinshasa, Democratic Republic of Congo: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-045081 ◽

2021 ◽

Vol 11 (7) ◽

pp. e045081

Author(s):

Patou Masika Musumari ◽

Samclide Mutindu Mbikayi ◽

Kriengkrai Srithanaviboonchai ◽

Teeranee Techasrivichien ◽

Arunrat Tangmunkongvorakul ◽

...

Keyword(s):

Blood Transfusion ◽

Respiratory Distress ◽

Democratic Republic ◽

Democratic Republic Of Congo ◽

Referral Hospital ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Data Set ◽

Republic Of Congo ◽

Transfusion Reactions

ObjectivesBlood transfusion is a life-saving procedure and is also associated with a range of risks including the occurrence of symptoms of acute transfusion reactions (ATRs). Very few studies in sub-Saharan Africa have reported on ATRs. The present study addresses this gap in the literature by documenting the prevalence of and factors associated with ATRs in the Democratic Republic of Congo (DRC).DesignThis is a cross-sectional descriptive and analytical study using blood bank data from a general referral hospital.SettingCentre Hospitalier Mère-Enfant (CHME) Monkole, a general referral hospital in Kinshasa, DRC.ParticipantsGeneral population who have received blood transfusion in CHME Monkole between 2014 and 2019.ResultsThe data set included a total of 7166 patients; 3153 (44%) men and 4013 (56%) women. The overall prevalence of symptoms of ATRs was 2.6%; the lowest prevalence was in 2017 (2.34%) and highest in 2018 (2.95%) and 2019 (2.94%). The documented symptoms included 74 (39.6%) cases of dyspnoea/respiratory distress, 60 (32.1%) cases of fever, 36 (19.2%) cases of pruritus/urticaria and 17 (9.1%) cases of vomiting. None of the studied factors was associated with symptoms of ATRs.ConclusionSymptoms of ATRs were not uncommon in the studied population. Dyspnoea and respiratory distress, fever and pruritus/urticaria were the most common symptoms of ATRs. This study highlights the need for a clinical and biological surveillance to detect, prevent and manage ATRs in the context of the DRC.

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