Incidence and clinical implication of nosocomial infections associated with implantable biomaterials – catheters, ventilator-associated pneumonia, urinary tract infections

Guggenbichler, J. P.; Assadian, Ojan; Boeswald, Michael; Krämer, Axel

doi:10.3205/dgkh000175

Cited by 56 publications

(19 citation statements)

References 162 publications

(165 reference statements)

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“…The primary endpoint was incidence of secondary infections in patients within 1 to 5 days after RSI. Secondary infections were categorized as bacteremia, sepsis, hospital-acquired pneumonia (HAP), ventilator-acquired pneumonia (VAP), urinary tract infection (UTI), and clostridium difficile infections that were not present prior to intubation [9][10][11][12][13][14][15] (Table 1). Secondary endpoints included type of secondary infection, number of mechanical ventilation free days out of 28 days, length of hospital stay, length of ICU stay, and 30-day mortality.…”

Section: Methodsmentioning

confidence: 99%

Etomidate Use for Rapid Sequence Intubation Is Not Associated With Nosocomial Infection

Hidalgo

Amin

Hukku

et al. 2020

Journal of Pharmacy Practice

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Introduction: Etomidate is commonly used for induction of anesthesia for rapid sequence intubation (RSI). It has little impact on hemodynamic status, making it a widely used agent. Due to the inhibition of cortisol production, etomidate causes adrenal suppression. The purpose of this study is to determine whether there is a correlation with etomidate use and the incidence of secondary infections. Methods: This was a retrospective cohort of hospitalized patients who received either etomidate or control (ketamine, propofol, or no agent) for RSI. The primary endpoint was the incidence of secondary infections. Secondary outcomes included number of mechanical ventilator-free days within 28 days, 30-day mortality, length of hospital stay, and length of intensive care unit stay. Results: A total of 434 patients were reviewed, of which 129 (29.7%) met the study criteria (n = 94 etomidate; n = 35 control). The incidence of secondary infection was numerically higher in the etomidate group compared with the control group, though this was not statistically significant (38.7% vs. 28.6%, p = 0.447). Also, though the secondary outcomes showed no statistically significant difference between the groups, the patients in the control group had a longer hospital stay (14.0 vs. 18.1, p = 0.20) and a longer ICU stay (11.0 vs. 14.1, p = 030). Furthermore, the etomidate group had a non-statistically significant higher incidence of bacteremia (8 vs. 0, p = 0.17) Conclusion: The use of etomidate was not associated with increased incidence of secondary infection. To fully understand the effects of etomidate use and its subsequent adrenal suppression, larger studies are needed.

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Section: Methodsmentioning

confidence: 99%

Etomidate Use for Rapid Sequence Intubation Is Not Associated With Nosocomial Infection

Hidalgo

Amin

Hukku

et al. 2020

Journal of Pharmacy Practice

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“…In addition, it will be a foreign material in the body of the recipients, increasing the risk of bacterial infections. Similarly, the use of urinary catheter during hospital stay is an independent risk factor for nosocomial infections including SSI ( Guggenbichler et al., 2011 ). The risk for SSI increases with the category of the wound ( Cheng et al., 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Variability in the serum and tissue concentrations of pre-incisional ceftriaxone for surgery in paediatric population and outcome of surgical-site infections; An open labelled, prospective, non-randomized, analytical study

Sheikh

Majoka

Tripathi

et al. 2022

Current Research in Pharmacology and Drug Discovery

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Studies have determined the serum concentration of ceftriaxone in the adult population, but there are only a few studies that measured the tissue concentrations. However, no studies have concurrently evaluated the serum and tissue concentrations of ceftrixaone in elective pediatric surgery patients. Therefore, our study was planned to evaluate the serum and tissue concentrations of single dose intravenous prophylactic ceftriaxone intra-operatively during an ongoing pediatric surgery and the outcome of surgical-site infections (SSIs). We did a correlation analysis to determine the relationship of various concentrations and surgery related risk factors with the outcome of SSIs. It was an open label prospective study in 50 patients who underwent elective pediatric surgery under prophylactic cover of ceftriaxone. Serum and tissue concentration were estimated by High Pressure Liquid Chromatography (HPLC). Subjects were observed for post operative complications including SSI. Serum and tissue concentrations of ceftriaxone were significant at test value of 4 mg/L. Tissue concentrations of ceftriaxone at incision (p = 0.02) and closure (p = 0.04) were significantly correlated with SSI but there was no significant association. The measured serum ceftriaxone concentrations were more than 20 times the susceptible minimum inhibitory concentration (MIC) at any given point of the surgery. On the other hand, this target level was achieved at the tissue levels in the majority of the patient. The factors associated with SSI were duration of surgery, wound category of contaminated clean type, the use of urinary catheter and implants in the surgery. An intra-operative re-dose, extension of dose or addition of another antibiotic may be considered for such patients.

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“…However, S. aureus has the ability to cause a broad spectrum of serious infections, starting from a comparatively mild involvement of the skin and soft tissue, to life-threatening systemic illnesses such as pneumonia, meningitis, bloodstream infections, and endocarditis, as well as toxin-mediated syndromes such as toxic shock, scalded skin syndrome, and food poisoning, are associated with significant morbidity and mortality [ 4 , 5 ]. It is also a predominant cause for nosocomial-acquired infections such as intravenous catheter-associated infections, ventilator-associated pneumonia, postsurgical wound infections, invasive infections in neutropenic patients, and patients undergoing solid organ or hematopoietic cell transplantations [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Clindamycin Resistance Profile of Staphylococcus aureus and Associated Factors among Patients Attending the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia

Ambachew

Gebrecherkos

Ayalew

2022

Interdisciplinary Perspectives on Infectious Diseases

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Clindamycin can serve as an alternative treatment for staphylococcal infections. Routine susceptibility tests may fail to determine inducible type clindamycin resistance and can be a source of failure in clinical therapeutics. Therefore, this study aimed to determine Staphylococcus aureus (S. aureus) prevalence, inducible clindamycin resistance pattern, and associated factors among patients attending the University of Gondar Comprehensive Specialized Hospital, Gondar, northwest Ethiopia. Methods. A cross-sectional study was conducted from January to April 2018. Clinical samples were inoculated on appropriate culture media. Standard bacteriological tests, including Gram stain, catalase, and coagulase tests, identified the presence of S. aureus. The antimicrobial susceptibility tests and the D-test were performed by using the Kirby–Bauer disk diffusion technique on the Mueller–Hinton agar. The D-test was performed using clindamycin (CLI) 2 ug and erythromycin (ERY) 15 ug disks located approximately 15 mm apart, and the cefoxitin susceptibility test was used to characterize methicillin-resistant S. aureus (MRSA). The association between S. aureus infection and different variables was assessed using bivariate and multivariate analysis. A P value <0.05 was considered statistically significant. Result. Of 388 study participants, the overall prevalence of S. aureus was 17% (66/388). Of these, the inducible type of clindamycin resistance was 25.8% (17/66) and 21.2% (14/66) were MRSA. All isolates were susceptible to chloramphenicol and resistant to tetracycline. A family size of 4–6 (AOR = 2.627, 95% CI (1.030–6.702)) and >7 (AOR = 3.892, 95% CI (1.169–12.959)), inpatient study participants (AOR = 3.198, 95% CI (1.197–8.070)), illness in the previous 4 weeks (AOR = 2.116, 95% CI (1.080–4.145)), and a history of chronic disease (AOR = 0.265, 95% CI (0.094–0.750)) were likely to have S. aureus infection. Conclusion. This study shows a considerable high magnitude of MRSA and inducible clindamycin resistance S. aureus isolates. To rule out clindamycin susceptibility testing, the D-test should be routinely performed.

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Incidence and clinical implication of nosocomial infections associated with implantable biomaterials – catheters, ventilator-associated pneumonia, urinary tract infections

Cited by 56 publications

References 162 publications

Etomidate Use for Rapid Sequence Intubation Is Not Associated With Nosocomial Infection

Etomidate Use for Rapid Sequence Intubation Is Not Associated With Nosocomial Infection

Variability in the serum and tissue concentrations of pre-incisional ceftriaxone for surgery in paediatric population and outcome of surgical-site infections; An open labelled, prospective, non-randomized, analytical study

Prevalence and Clindamycin Resistance Profile of Staphylococcus aureus and Associated Factors among Patients Attending the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia

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