ObjectiveOur study aims to understand the psychological impact of the COVID-19 pandemic among healthcare workers (HCWs) at acute hospital settings in the South-East of Ireland, as a crucial step in guiding policies and interventions to maintain their psychological well-being.DesignObservational cohort study.Participants and setting472 HCWs participated from two distinct acute hospital settings, A and B, in the South-East of Ireland.Primary and secondary outcome measuresMeasures of psychological distress—depression, anxiety, acute and post-traumatic stress disorder (PTSD)—as dictated by the Depression, Anxiety and Stress Scale (DASS-21) and Impact of Event Scale-Revised (IES-R). An independent sample t-test and a Mann-Whitney U test was used to determine significance of difference in continuous variables between groups. Categorical variables were assessed for significance with a χ2 test for independence.ResultsThe DASS-21 provided independent measures of depression (mean 4.57, IQR 2–7), anxiety (mean 3.87, IQR 1–6) and stress (mean 7.41, IQR 4–10). Positive scores were reflected in 201 workers (42.6%) for depression and 213 (45.1%) for both anxiety and stress. The IES-R measured subjective distress on three subscales: intrusion (mean 1.085, IQR 0.375–1.72), avoidance (mean 1.008, IQR 0.375–1.5) and hyperarousal (mean 1.084, IQR 0.5–1.667). Overall, 195 cases (41.3%) were concerning for PTSD. Site B scored significantly higher across all parameters of depression (5.24 vs 4.08, p<0.01), anxiety (4.66 vs 3.3, p<0.01), stress (8.91 vs 6.33, p<0.01) and PTSD (0.058 vs 0.043, p<0.01). Worse outcomes were also noted in HCWs with underlying medical ailments.ConclusionPsychological distress is prevalent among HCWs during the COVID-19 pandemic; screening for adverse mental and emotional outcomes and developing timely tailored preventative measures with effective feedback are vital to protect their psychological well-being, both in the immediate and long-term.
Background:
Nakaseomyces glabrata, formerly Candida glabrata, is an opportunistic yeast and an emerging cause of human infections. The use of broth microdilution (BMD) methodologies for caspofungin (CSP) antifungal susceptibility testing (AFST) against N. glabrata is reported to be prone to high inter-laboratory variation. We aimed to compare CSP minimum inhibitory concentrations (MICs) of N. glabrata isolates from our institution with those obtained by the Reference Laboratory for the same isolates.
Methods:
All clinically significant N. glabrata isolates from 2019-2021 inclusive were reviewed. AFST was performed locally using the VITEK2 system with the AST-YS08 card while E-tests were performed at Mycology Reference Laboratory (MRL), and agreement between these two methods was evaluated – categorical and essential.
Results:
41 isolates were reviewed during the study period – 30 from blood cultures, seven from intra-operative theatre specimens and four from sterile site drain fluids. Despite an essential agreement of 100% within ±2 log2 dilution, marked discrepancies were noted in interpretative breakpoints between assays with 17 Minor and 16 Major category errors. Categorical agreement was 19.5%, with the VITEK2 over-estimating resistance. A Mann-Whitney U Test assessed the relationship of MICs across the AFST modalities, and a statistically significant difference was noted, p<0.01, with a higher mean rank for VITKEK2 outputs.
Conclusion:
While the VITEK2 system is highly applicable, its performance for CSP AFST is unreliable and potentially results in the mis-classification of susceptible isolates as highlighted in our study. The use of VITEK2 AST-YS08 micafungin as a sentinel echinocandin should be explored and/or the evaluation of CSP-specific E-tests as utilised by the MRL. These methods appear more consistent and less prone to the variation seen with BMD for CSP.
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