Active surveillance of carbapenem-resistant Gram-negative healthcare-associated infections in a low-middle-income country city

Dias, Viviane Maria de Carvalho Hessel; Silva, Daniela Maria Waszak da; Burger, Marion; Oliveira, Alcides Augusto Souto de; Capelo, Patrícia de Jesus; Specian, Fabio Augusto da Rocha; Figueiredo, Marianna Cavina de; Tuon, Felipe Francisco; Baena, Cristina Pellegrino

doi:10.1016/j.bjid.2021.101540

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…Patients infected with these bacteria are difficult to treat and have a high mortality rate (17)(18). Some scholars have pointed out in their studies that the reasons for the retrograde translocation of GI fixed bacteria are the impairment of the systemic defense mechanism of carbapenem-resistant gram-negative bacteria pneumonia, combined with the use of acid-suppressive drugs after the occurrence of stress ulcer or the disease itself (18)(19). In recent years some scholars pointed out that in the study of elderly patients with gram-negative bacteria pneumonia is increasing, and the prevalence is high, the structure of the medical special environment for patients of pathogenic bacteria screening, vulnerable to infection in patients with drug-resistant bacteria, therefore in the treatment of anti-infection, shall promptly carry out bacterial culture and drug susceptibility test, in order to achieve good treatment effect and reduce the generation of drug-resistant strains (20)(21).To strengthen the management of nosocomial infection, firstly strengthen the nutrition of patients, secondly improve the patients' immunity, reduce the invasive examination, and protect the patients' inherent natural immunity guarantee (22)(23).In this study, recent surgery, respiratory failure, shock, indwelling catheterization, and disturbance of consciousness were found to be risk factors for carbapenem-resistant gram-negative bacteria pneumonia, which was similar to the above results.In addition, recent surgery, respiratory failure, shock, indwelling catheterization, and disturbance of consciousness were also found to be closely related to the occurrence of carbapenem-resistant Gram-negative bacteria pneumonia in this study, which is expected to be the relevant indicators of carbapenem-resistant Gram-negative bacteria pneumonia in the future.…”

Section: Discussionmentioning

confidence: 99%

retrospecRisk factors of carbapenem-resistant Gram-negative bacteria pneumonia and mortality

Shen¹,

Xiquan²,

Lin³

2022

Cell Mol Biol (Noisy-le-grand)

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Section: Discussionmentioning

confidence: 99%

retrospecRisk factors of carbapenem-resistant Gram-negative bacteria pneumonia and mortality

Shen¹,

Xiquan²,

Lin³

2022

Cell Mol Biol (Noisy-le-grand)

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Development and Assessment of a Novel Predictive Nomogram to Predict the Risk of Secondary CR-GNB Bloodstream Infections among CR-GNB Carriers in the Gastroenterology Department: A Retrospective Case–Control Study

Zhang

et al. 2023

JCM

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Background: With the number of critically ill patients increasing in gastroenterology departments (GEDs), infections associated with Carbapenem-resistant Gram-negative bacteria (CR-GNB) are of great concern in GED. However, no CR-GNB bloodstream infection (BSI) risk prediction model has been established for GED patients. Almost universally, CR-GNB colonization precedes or occurs concurrently with CR-GNB BSI. The objective of this study was to develop a nomogram that could predict the risk of acquiring secondary CR-GNB BSI in GED patients who are carriers of CR-GNB. Methods: We conducted a single-center retrospective case–control study from January 2020 to March 2022. Univariate and multivariable logistic regression analysis was used to identify independent risk factors of secondary CR-GNB bloodstream infections among CR-GNB carriers in the gastroenterology department. A nomogram was constructed according to a multivariable regression model. Various aspects of the established predicting nomogram were evaluated, including discrimination, calibration, and clinical utility. We assessed internal validation using bootstrapping. Results: The prediction nomogram includes the following predictors: high ECOG PS, severe acute pancreatitis, diabetes mellitus, neutropenia, a long stay in hospital, and parenteral nutrition. The model demonstrated good discrimination and good calibration. Conclusions: With an estimate of individual risk using the nomogram developed in this study, clinicians and nurses can identify patients with a high risk of secondary CR-GNB BSI early.

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Growth of Gram-Negative Bacteria in Antiseptics, Disinfectants and Hand Hygiene Products in Two Tertiary Care Hospitals in West Africa—A Cross-Sectional Survey

et al. 2023

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Antiseptics, disinfectants, and hand hygiene products can act as reservoirs of Gram-negative bacteria causing healthcare-associated infections. This problem is rarely documented in low- and middle-income countries, particularly in sub-Saharan Africa. In a cross-sectional survey, we assessed the bacterial contamination of antiseptics, disinfectants, and hand hygiene products in two university hospitals in Burkina Faso and Benin. During ward visits and staff interviews, in-use products were cultured for the presence of Gram-negative bacteria. The growth of Gram-negative bacteria was absent or rare in alcohol-based products, povidone iodine, and Dakin solution. Contamination was highest (73.9% (51/69)) for liquid soap products (versus antiseptic/disinfectants (4.5%, 7/157) (p < 0.0001)), mostly used in high-risk areas and associated with high total bacterial counts (>10000 colony-forming units/mL). Contaminating flora (105 isolates) included Enterobacterales and the Vibrio non-cholerae/Aeromonas group (17.1%) and non-fermentative Gram-negative rods (82.8%). Multidrug resistance was present among 9/16 Enterobacterales (Klebsiella and Enterobacter spp.) and 3/12 Acinetobacter spp., including carbapenem resistance (Acinetobacter baumannii: NDM, Pseudomonas stutzeri: VIM). The risk factors for contamination included the type of product (cleaning grade and in-house prepared liquid soap), use of recycled disposable containers and soft drink bottles, absence of labeling, topping-up of containers, dilution with tap water (pharmacy and ward), and poor-quality management (procurement, stock management, expiry dates, and period after opening).

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Active surveillance of carbapenem-resistant Gram-negative healthcare-associated infections in a low-middle-income country city

Cited by 3 publications

References 21 publications

retrospecRisk factors of carbapenem-resistant Gram-negative bacteria pneumonia and mortality

retrospecRisk factors of carbapenem-resistant Gram-negative bacteria pneumonia and mortality

Development and Assessment of a Novel Predictive Nomogram to Predict the Risk of Secondary CR-GNB Bloodstream Infections among CR-GNB Carriers in the Gastroenterology Department: A Retrospective Case–Control Study

Growth of Gram-Negative Bacteria in Antiseptics, Disinfectants and Hand Hygiene Products in Two Tertiary Care Hospitals in West Africa—A Cross-Sectional Survey

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