The goal of this study was to attempt to determine the rate of contamination of health-care workers' (HCWs) hands and environmental surfaces in intensive care units (ICU) by the main bacteria associated with hospital acquired infections (HAIs) in Tehran, Iran. A total of 605 and 762 swab samples were obtained from six ICU environments and HCWs' hands. Identification of the bacterial isolates was performed according to standard biochemical methods, and their antimicrobial susceptibility was determined based on the guidelines recommended by clinical and laboratory standards institute (CLSI). The homology of the resistance patterns was assessed by the NTSYSsp software. The most frequent bacteria on the HCWs' hands and in the environmental samples were Acinetobacter baumannii (1.4% and 16.5%, respectively), Staphylococcus aureus (5.9% and 8.1%, respectively), S. epidermidis (20.9% and 18.7%, respectively), and Enterococcus spp. (1% and 1.3%, respectively). Patients' oxygen masks, ventilators, and bed linens were the most contaminated sites. Nurses' aides and housekeepers were the most contaminated staff. Imipenem resistant A. baumannii (94% and 54.5%), methicillin-resistant S. aureus (MRSAs, 59.6% and 67.3%), and vancomycin resistant Enterococci (VREs, 0% and 25%) were detected on the hands of ICU staff and the environmental samples, respectively. Different isolates of S. aureus and Enterococcus spp. showed significant homology in these samples. These results showed contamination of the ICU environments and HCWs with important bacterial pathogens that are the main risk factors for HAIs in the studied hospitals.
BackgroundVitamin D concentrations are linked to body composition indices, particularly body fat mass. Relationships between hypovitaminosis D and obesity, described by both BMI and waist circumference, have been mentioned. We have investigated the effect of a 12-week vitamin D3 supplementation on anthropometric indices in healthy overweight and obese women.MethodsIn a double-blind, randomized, placebo-controlled, parallel-group trial, seventy-seven participants (age 38±8.1 years, BMI 29.8±4.1 kg/m2) were randomly allocated into two groups: vitamin D (25 μg per day as cholecalciferol) and placebo (25 μg per day as lactose) for 12 weeks. Body weight, height, waist, hip, fat mass, 25(OH) D, iPTH, and dietary intakes were measured before and after the intervention.ResultsSerum 25(OH)D significantly increased in the vitamin D group compared to the placebo group (38.2±32.7 nmol/L vs. 4.6±14.8 nmol/L; P<0.001) and serum iPTH concentrations were decreased by vitamin D3 supplementation (-0.26±0.57 pmol/L vs. 0.27±0.56 pmol/L; P<0.001). Supplementation with vitamin D3 caused a statistically significant decrease in body fat mass in the vitamin D group compared to the placebo group (-2.7±2.1 kg vs. -0.47±2.1 kg; P<0.001). However, body weight and waist circumference did not change significantly in both groups. A significant reverse correlation between changes in serum 25(OH) D concentrations and body fat mass was observed (r = -0.319, P = 0.005).ConclusionAmong healthy overweight and obese women, increasing 25(OH) D concentrations by vitamin D3 supplementation led to body fat mass reduction.This trial is registered at clinicaltrials.gov as NCT01344161.
The results indicate that the vitamin D3 supplement of 25 μg/day had no beneficial effect on glycaemic indices in healthy overweight or obese women.
Background: Vitamin D concentrations are linked to body composition indices, particularly body fat mass. Relationships between hypovitaminosis D and obesity, described by both BMI and waist circumference, have been mentioned. We have investigated the effect of a 12-week vitamin D3 supplementation on anthropometric indices in healthy overweight and obese women.
Evidence indicates that vitamin D deficiency contributes to CVD. We investigated the effect of vitamin D 3 supplementation on cardiovascular risk factors in women. Healthy premenopausal overweight and obese women (n 77; mean age 38 (SD 8·1) years) were randomly allocated to the vitamin D (25 mg/d as cholecalciferol) or the placebo group in a double-blind manner for 12 weeks. Blood pressure, serum lipoproteins, apolipoproteins and anthropometric parameters were recorded. Dietary intake was recorded using 24 h food recall and FFQ. Physical activity was assessed by the International Physical Activity Questionnaire. Mean total cholesterol concentrations increased in the vitamin D group (0·08 (SD 0·56) mmol/l) but declined in the placebo group (0·47 (SD 0·58) mmol/l), and a significant effect was observed (P#0·001). In the vitamin D group, mean HDL-cholesterol concentration increased, whereas it decreased in the placebo group (0·07 (SD 0·2) v. 20·03 (SD 0·2) mmol/l; P¼ 0·037). Mean apoA-I concentration increased in the vitamin D group, although it decreased in the placebo group (0·04 (SD 0·39) v. 20·25 (SD 0·2) g/l; P# 0·001). Mean LDL-cholesterol:apoB-100 ratio augmented in the vitamin D group, while this ratio declined in the placebo group (0·11 (SD 0·6) v. 2 0·19 (SD 0·3); P¼0·014). Body fat mass was significantly decreased in the vitamin D group more than the placebo group (22·7 (SD 2) v. 20·4 (SD 2) kg; P# 0·001). The findings showed that supplementation with vitamin D 3 can significantly improve HDL-cholesterol, apoA-I concentrations and LDL-cholesterol:apoB-100 ratio, which remained significant in the multivariate model including anthropometric, dietary and physical activity measures. Key words: Vitamin D: CVD: ObesityVitamin D is recognised as the vitamin of sunshine (1) .A relationship between vitamin D and CVD has been proposed by observing more incidence of CVD in winter compared with summer in many countries (2,3) , which might be attributable to the protective effect of vitamin D on CVD (4) .Ecological studies have indicated the higher rate of CHD and high blood pressure increment with more distance from the equator, which is also related to low sun exposure and higher prevalence of vitamin D deficiency (5,6) . It has beenshown that a range of markers including geographic latitude, altitude and season affect vitamin D status which are negatively correlated with cardiovascular morbidity and mortality. Evidence suggests that low levels of vitamin D may contribute to the development of CVD (7) .On the other hand, a range of CVD risk factors including dyslipoproteinaemia, high blood pressure, reduced glucose tolerance, diabetes and increased inflammatory markers are related to obesity, which has been increasing dramatically during recent decades (8 -10) . Serum 25-hydroxyvitamin D (25(OH)D) levels negatively correlate with BMI (11) . It is likely that alteration in vitamin D homeostasis affects CVD development in obese individuals (12)
Device-associated health care-acquired infections (DA-HAIs) pose a threat to patient safety, particularly in the intensive care unit (ICU). However, few data regarding DA-HAI rates and their associated bacterial resistance in ICUs from Iran are available. A DA-HAI surveillance study was conducted in six adult and pediatric ICUs in academic teaching hospitals in Tehran using CDC/NHSN definitions. We collected prospective data regarding device use, DA-HAI rates, and lengths of stay from 2584 patients, 16,796 bed-days from one adult ICU, and bacterial profiles and bacterial resistance from six ICUs. Among the DA-HAIs, there were 5.84 central line-associated bloodstream infections (CLABs) per 1000 central line-days, 7.88 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator-days and 8.99 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. The device utilization ratios were 0.44 for central lines, 0.42 for mechanical ventilators and 1.0 for urinary catheters. The device utilization ratios of mechanical ventilators and urinary catheters were higher than those reported in the ICUs of the INICC and the CDC's NHSN reports, but central line use was lower. The DA-HAI rates in this study were higher than the CDC's NHSN report. However, compared with the INICC report, the VAP rate in our study was lower, while the CLAB rate was similar and the CAUTI rate was higher. Nearly 83% of the samples showed a mixed-type infection. The most frequent pathogens were Acinetobacter baumannii, Staphylococcus aureus and Pseudomonas aeruginosa, followed by Klebsiella pneumoniae and Enterococcus spp. In the S. aureus isolates, 100% were resistant to oxacillin. Overall resistances of A. baumannii and K. pneumonia to imipenem were 70.5% and 76.7%, respectively. A multiple drug resistance phenotype was detected in 68.15% of the isolates. The DA-HAI rates in Iran were shown to be higher than the CDC-NHSN rates and similar to the INICC rates. Resistance to oxacillin and imipenem was higher as well. Comparing device use, DA-HAI rates, and bacterial resistance for the primary isolated bacteria indicated a direct association between urinary catheter use and the rates of CAUTI.
Background Intrauterine exposure to maternal vitamin D status <50 nmol/L of serum 25-hydroxyvitamin D (25(OH)D) may adversely impact infant body composition. Whether postnatal interventions can reprogram for a leaner body phenotype is unknown. Objectives The primary objective was to test whether 1000 IU/d of supplemental vitamin D (vs. 400 IU/d) improves lean mass in infants born with serum 25(OH)D <50 nmol/L. Design Healthy term breastfed infants (Montréal, Canada, March 2016–2019) were assessed for serum 25(OH)D (immunoassay) 24-36 h postpartum. Infants with serum 25(OH)D <50 nmol/L at 24-36 h were eligible for the trial and randomized at baseline (1 month postpartum) to 400 (29 males, 20 females) or 1000 IU/d (29 males, 20 females) of vitamin D until 12 months. Infants (23 males, 18 females) with 25(OH)D ≥50 nmol/L (sufficient) formed a non-randomized reference group provided 400 IU/d. Anthropometry, body composition (dual-energy x-ray absorptiometry) and serum 25(OH)D concentrations were measured at 1, 3, 6 and 12 months. Results At baseline, mean serum 25(OH)D concentration in infants allocated to the 400 and 1000 IU/d vitamin D groups were 45.8 ± 14.1 and 47.6 ± 13.4, respectively, and the reference group 69.2 ± 16.4 nmol/L. Serum 25(OH)D concentration increased on average to ≥50 nmol/L in the trial groups at 3 to 12 months. Lean mass varied differently among groups over time; at 12 months it was higher in the 1000 IU/d vitamin D group compared to the 400 IU/d group (7013 ± 904.6 vs. 6690.4 ± 1121.7 g, P = 0.0428), but not the reference (6715 ± 784.6 g, P = 0.19). Whole body fat mass was not different among groups over time. Conclusions Vitamin D supplementation (400 or 1000 IU/d) during infancy readily corrects vitamin D status, whereas 1000 IU/d modestly increases lean mass by 12 months. The long-term implications require further research.
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