Morbidity, mortality, and emerging drug resistance in Device-associated infections (DAIs) in intensive care patients at a 1000-bedded tertiary care teaching hospital

Khan, Inam Danish; Gonimadatala, Geetanjali; Narayanan, Sandhya; Kapoor, Umesh; Kaur, Harleen; Makkar, Anuradha; Gupta, Rajeev

doi:10.1016/j.mjafi.2021.06.031

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…A 1990 study conducted in a pediatric surgical service, which overlaps the first period of our study, showed that the largest group of wound infections in children followed operations on the gastrointestinal tract; Staphylococcus aureus , Escherichia coli , and Alpha hemolytic Streptococcus were the most common wound pathogens [ 14 ]. Approximately 50% of NIs in the ICU are caused by aerobic Gram-negative bacilli like Pseudomonas aeruginosa , Enterobacter species, or Serratia marcescens ; 35% are caused by Gram-positive cocci, coagulase-negative staphylococci or Staphylococcus aureus and resistant enterococci; and almost 15% are caused by Candida species [ 21 , 24 ]. Overall rates of infections are two to three times higher for patients in a NICU than in other hospital units, and rates of ventilator-associated pneumonia and primary bacteremia—most cases of which originate from intravascular devices—are 10 times higher [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Nosocomial Infections Affecting Newborns with Abdominal Wall Defects

et al. 2023

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Abdominal wall defects are serious birth defects, with long periods of hospitalization and significant costs to the medical system. Nosocomial infection (NI) may be an additional risk factor that aggravates the evolution of newborns with such malformations. Methods: in order to analyze the factors that may lead to the occurrence of NI, we performed a retrospective study over a period of thirty-two years (1990–2021), in a tertiary children’s hospital; 302 neonates with omphalocele and gastroschisis were eligible for the study. Results: a total of 33.7 % patients were infected with one or more of species of bacteria or fungi. These species were Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp., Staphylococcus spp., Enterococcus spp. or Candida spp., but the rate of NI showed a significant decrease between the 1990–2010 and 2011–2021 period (p = 0.04). The increase in the number of surgeries was associated with the increase in the number of NI both for omphalocele and gastroschisis; in the case of gastroschisis, the age of over 6 h at the time of surgery increased the risk of infection (p = 0.052, marginal statistical significance). Additionally, for gastroschisis, the risk of NI was 4.56 times higher in the presence of anemia (p < 0.01) and 2.17 times higher for the patients developing acute renal failure (p = 0.02), and a hospitalization period longer than 14 days was found to increase the risk of NI 3.46-fold (p < 0.01); more than 4 days of TPN was found to increase the NI risk 2.37-fold (p = 0.015). Using a logistic regression model for patients with omphalocele, we found an increased risk of NI for those in blood group 0 (OR = 3.8, p = 0.02), in patients with a length of hospitalization (LH) of ≥14 days (OR = 6.7, p < 0.01) and in the presence of anemia (OR = 2.5, p = 0.04); all three independent variables in our model contributed 38.7% to the risk of NI. Conclusion: although in the past 32 years we have seen transformational improvements in the outcome of abdominal wall defects, there are still many factors that require special attention for corrections.

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Section: Discussionmentioning

confidence: 99%

Nosocomial Infections Affecting Newborns with Abdominal Wall Defects

et al. 2023

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“…But once a catheter infection occurs, it is necessary to remove the catheter, conduct catheter end and blood culture to determine the source of infection and bacterial species, use effective antibiotics, and reinsert the catheter in another location. Most of the bacteria associated with catheter infections are super bacteria that are resistant to most antibiotics (10), causing great harm to critically ill patients, exacerbating their condition, increasing treatment costs, and increasing the risk of other complications (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Study on PTFE Superhydrophobic Coating Modified by IC@dMSNs and its Enhanced Antibacterial Effect

Zhang¹,

Zhu

et al. 2023

Preprint

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Objective: Vascular catheter-related infections and thrombosis are common and may lead to serious complications after catheterization. Reducing the incidence of such infections has become a significant challenge. This study aims to develop a super hydrophobic nanocomposite drug-loaded vascular catheter that can effectively resist bacterial infections and blood coagulation. Methods: In this study, a SiO2 nanocoated PTFE (Polytetrafluoroethylene) catheter (PTFE-SiO2) was prepared and further optimized to prepare a SiO2 nanocoated PTFE catheter loaded with imipenem/cilastatin sodium (PTFE-IC@dMSNs). The catheters were characterized for performance, cell compatibility, anticoagulant performance, in vitro and in vivo antibacterial effect and biological safety. Result: PTFE-IC@dMSNs catheter has efficient drug loading performance and drug release rate and has good cell compatibility and anticoagulant effect in vitro. Compared with the PTFE-SiO2 catheter, the inhibition ring of the PTFE-IC@dMSNs catheter against Escherichia coli increased from 3.985 mm2 to 4.561 mm2, and the antibacterial rate increased from about 50.8% to 56.9%, with significant difference (p<0.05). The antibacterial zone against Staphylococcus aureus increased from 8.633 mm2 to 11.735 mm2, and the antibacterial rate increased from approximately 83.5% to 89.3%, showing a significant difference (p<0.05). PTFE-IC@dMSNs catheter also has good biocompatibility in vivo. Conclusion: Compared with PTFE, PTFE-SiO2 and PTFE-IC@dMSNs catheters have good characterization performance, cell compatibility, and anticoagulant properties. PTFE SiO2 and PTFE-IC@dMSNs catheters have good antibacterial performance and tissue safety against E. coli and S. aureus. Relatively, PTFE-SiO2 and PTFE-IC@dMSNs catheter has better antibacterial properties and histocompatibility and has potential application prospects in anti-bacterial catheter development and anticoagulation.

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