Nosocomial Infections

Liu, Jia-Yia; Dickter, Jana

doi:10.1016/j.giec.2020.06.001

Cited by 62 publications

(48 citation statements)

References 67 publications

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“…These resistant infectious agents frequently cause infections in community and hospital settings. They can be involved in any type of infection, including respiratory, urinary tract, bloodstream (sepsis), post-surgical (wound) and pneumonia infections 5 – 7 . Several studies in many African countries including Ghana have revealed high rates of multidrug resistant pathogens in hospital settings 8 – 15 .…”

Section: Introductionmentioning

confidence: 99%

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Gnimatin

Weyori²,

Agossou

et al. 2022

Sci Rep

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Bacterial infections caused by multidrug resistant organisms are a major global threat. There is still a knowledge gap on this situation in the Northern Region of Ghana. This study determined the prevalence and resistance profile of bacterial infections. It also identified factors associated with multidrug resistance in the study area. This was a retrospective cross-sectional design and it analyzed data from the samples received at the Tamale Zonal Public Health Reference Laboratory from June 2018 to May 2022. The data were analyzed using the R software version 4.2.0. Univariate and multivariable binary logistic regression analyses were used to determine the factors associated with multidrug resistance. The samples included all specimen types possible. The specimens were collected for the purpose of clinical bacteriology diagnostics. Overall a total of 1222 isolates were obtained. The three (3) main bacteria responsible for infections were: Klebsiella spp. (27%), Moraxella spp. (22%), Escherichia spp. (16%). High resistance levels were found against the tested antibiotics and about 41.60% of the bacterial strains isolated were multidrug resistant. Hospitalization was associated with multidrug resistance in univariate (COR 1.96; 95% CI 1.43–2.71; P-value < 0.001) and multivariable analyses (AOR 1.78; 95% CI 1.28–2.49; P-value < 0.001). There is the need for further research on the molecular epidemiology of antibiotic resistance genes in the study area to effectively control the spread of multidrug resistant pathogens. In addition, efforts to build the capacity of health professionals on infection prevention and control as well as diagnostic and antimicrobial stewardship needs urgent attention.

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Section: Introductionmentioning

confidence: 99%

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Gnimatin

Weyori²,

Agossou

et al. 2022

Sci Rep

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“…ICU patients not affected by sepsis are at risk of undergoing sepsis because ICU non-septic patients often progress into sepsis or septic shock. Prophylactic treatment could be useful in the prevention of the adverse effects of nosocomial infections, such as catheter-induced urinary tract infections, intra-hospital acquired pneumonia, skin infections (mainly in burn patients), bloodstream infections, and surgery-induced infections [ 100 , 101 ]. Enteral nutrition can prevent catabolic states observed in critical illness as well as in intestinal villi atrophy, apoptosis of enterocytes, dysbiosis, and alterations of immune function in the gut [ 102 , 103 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Dietary Supplements with ω-3 Fatty Acids, Ascorbic Acid, and Polyphenolic Antioxidant Flavonoid on Gene Expression, Organ Failure, and Mortality in Endotoxemia-Induced Septic Rats

et al. 2023

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Sepsis syndrome develops through enhanced secretion of pro-inflammatory cytokines and the generation of reactive oxygen species (ROS). Sepsis syndrome is characterized by vascular hyperpermeability, hypotension, multiple organ dysfunction syndrome (MODS), and increased mortality, among others. Endotoxemia-derived sepsis is an important cause of sepsis syndrome. During endotoxemia, circulating endotoxin interacts with endothelial cells (ECs), inducing detrimental effects on endothelium function. The endotoxin induces the conversion of ECs into fibroblasts, which are characterized by a massive change in the endothelial gene-expression pattern. This downregulates the endothelial markers and upregulates fibrotic proteins, mesenchymal transcription factors, and extracellular matrix proteins, producing endothelial fibrosis. Sepsis progression is modulated by the consumption of specific nutrients, including ω-3 fatty acids, ascorbic acid, and polyphenolic antioxidant flavonoids. However, the underlying mechanism is poorly described. The notion that gene expression is modulated during inflammatory conditions by nutrient consumption has been reported. However, it is not known whether nutrient consumption modulates the fibrotic endothelial gene-expression pattern during sepsis as a mechanism to decrease vascular hyperpermeability, hypotension, MODS, and mortality. Therefore, the aim of this study was to investigate the impact of the consumption of dietary ω-3 fatty acids, ascorbic acid, and polyphenolic antioxidant flavonoid supplements on the modulation of fibrotic endothelial gene-expression patterns during sepsis and to determine the effects on sepsis outcomes. Our results indicate that the consumption of supplements based on ω-3 fatty acids and polyphenolic antioxidant flavonoids was effective for improving endotoxemia outcomes through prophylactic ingestion and therapeutic usage. Thus, our findings indicated that specific nutrient consumption improves sepsis outcomes and should be considered in treatment.

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“…This number increased to 18,866 in 2019. Isolates of resistant Staphylococcus aureus were the second most represented species, with 8,581 isolates in 2018 and 9,939 in 2019, followed by K. pneumoniae with 5,913 isolates in 2018 and 7,782 isolates in 2019 [6].…”

Section: Introductionmentioning

confidence: 99%

“…Catheter-associated urinary tract infections (CAUTIs) are prevalent worldwide (900,000 cases/year in the United States), whereas hospital-acquired pneumonia and blood stream infections (BSIs) are deadly and account for 67% of US annual deaths associated with HAIs. Surgical site infections are the most common and costly HAIs for surgical patients [6].…”

Section: Introductionmentioning

confidence: 99%

A novel, integrated approach for understanding and investigating Healthcare Associated Infections: A risk factors constellation analysis

et al. 2023

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Introduction Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) are major public health threats in upper- and lower-middle-income countries. Electronic health records (EHRs) are an invaluable source of data for achieving different goals, including the early detection of HAIs and AMR clusters within healthcare settings; evaluation of attributable incidence, mortality, and disability-adjusted life years (DALYs); and implementation of governance policies. In Italy, the burden of HAIs is estimated to be 702.53 DALYs per 100,000 population, which has the same magnitude as the burden of ischemic heart disease. However, data in EHRs are usually not homogeneous, not properly linked and engineered, or not easily compared with other data. Moreover, without a proper epidemiological approach, the relevant information may not be detected. In this retrospective observational study, we established and engineered a new management system on the basis of the integration of microbiology laboratory data from the university hospital “Policlinico Tor Vergata” (PTV) in Italy with hospital discharge forms (HDFs) and clinical record data. All data are currently available in separate EHRs. We propose an original approach for monitoring alert microorganisms and for consequently estimating HAIs for the entire period of 2018. Methods Data extraction was performed by analyzing HDFs in the databases of the Hospital Information System. Data were compiled using the AREAS-ADT information system and ICD-9-CM codes. Quantitative and qualitative variables and diagnostic-related groups were produced by processing the resulting integrated databases. The results of research requests for HAI microorganisms and AMR profiles sent by the departments of PTV from 01/01/2018 to 31/12/2018 and the date of collection were extracted from the database of the Complex Operational Unit of Microbiology and then integrated. Results We were able to provide a complete and richly detailed profile of the estimated HAIs and to correlate them with the information contained in the HDFs and those available from the microbiology laboratory. We also identified the infection profile of the investigated hospital and estimated the distribution of coinfections by two or more microorganisms of concern. Our data were consistent with those in the literature, particularly the increase in mortality, length of stay, and risk of death associated with infections with Staphylococcus spp, Pseudomonas aeruginosa, Klebsiella pneumoniae, Clostridioides difficile, Candida spp., and Acinetobacter baumannii. Even though less than 10% of the detected HAIs showed at least one infection caused by an antimicrobial resistant bacterium, the contribution of AMR to the overall risk of increased mortality was extremely high. Conclusions The increasing availability of health data stored in EHRs represents a unique opportunity for the accurate identification of any factor that contributes to the diffusion of HAIs and AMR and for the prompt implementation of effective corrective measures. That said, artificial intelligence might be the future of health data analysis because it may allow for the early identification of patients who are more exposed to the risk of HAIs and for a more efficient monitoring of HAI sources and outbreaks. However, challenges concerning codification, integration, and standardization of health data recording and analysis still need to be addressed.

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Nosocomial Infections

Cited by 62 publications

References 67 publications

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Bacterial infections epidemiology and factors associated with multidrug resistance in the northern region of Ghana

Effect of Dietary Supplements with ω-3 Fatty Acids, Ascorbic Acid, and Polyphenolic Antioxidant Flavonoid on Gene Expression, Organ Failure, and Mortality in Endotoxemia-Induced Septic Rats

A novel, integrated approach for understanding and investigating Healthcare Associated Infections: A risk factors constellation analysis

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