Interdisciplinary Perspectives on Infectious Diseases最新文献

{"title":"Clinical Characteristics and Predictors of Mortality in Elderly Patients Hospitalized with COVID-19 in Bangladesh: A Multicenter, Retrospective Study","authors":"M. Asaduzzaman, Z. N. Nazmul Alam, Mohammad Zabed Jillul Bari, M. Jahangir Alam, Shishir Ranjan Chakraborty, Tasnima Ferdousi","doi":"10.1155/2022/5904332","DOIUrl":"https://doi.org/10.1155/2022/5904332","url":null,"abstract":"Purpose Elderly patients are at high risk of fatality from COVID-19. The present work aims to describe the clinical characteristics of elderly inpatients with COVID-19 and identify the predictors of in-hospital mortality at admission. Materials and Methods In this retrospective, multicenter cohort study, we included elderly COVID-19 inpatients (n = 245) from four hospitals in Sylhet, Bangladesh, who had been discharged between October 2020 and February 2021. Demographic, clinical, and laboratory data were extracted from hospital records and compared between survivors and nonsurvivors. We used univariable and multivariable logistic regression analysis to explore the risk factors associated with in-hospital death. Principal Results. Of the included patients, 202 (82.44%) were discharged and 43 (17.55%) died in hospital. Except hypertension, other comorbidities like diabetes, chronic kidney disease, ischemic heart disease, and chronic obstructive pulmonary disease were more prevalent in nonsurvivors. Nonsurvivors had a higher prevalence of leukocytosis (51.2 versus 30.7; p=0.01), lymphopenia (72.1 versus 55; p=0.05), and thrombocytopenia (20.9 versus 9.9; p=0.07). Multivariable regression analysis showed an increasing odds ratio of in-hospital death associated with older age (odds ratio 1.05, 95% CI 1.01–1.10, per year increase; p=0.009), thrombocytopenia (OR = 3.56; 95% CI 1.22–10.33, p=0.019), and admission SpO2 (OR 0.91, 95% CI 0.88–0.95; p=0.001). Conclusions Higher age, thrombocytopenia, and lower initial level of SpO2 at admission are predictors of in-hospital mortality in elderly patients with COVID-19.","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48326096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes of Patients Hospitalized with COVID-19 at Case Hospital, Uganda.","authors":"Mirriam Apiyo, Ronald Olum, Amina Kabuye, Betty Khainza, Anne M Amate, Vittal Byabashaija, Derrick Nomujuni, Kato Sebbaale, Peter Senfuka, Simon Kazibwe, Gurav Sharma, Lindsay Davidson, Felix Bongomin","doi":"10.1155/2022/5477790","DOIUrl":"10.1155/2022/5477790","url":null,"abstract":"<p><p>Data on clinical outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) in private health facilities in Uganda is scarce. We conducted a retrospective cohort study of patients hospitalized with COVID-19 at Case Hospital, Kampala, Uganda, between June 2020 and September 2021. Data of 160 participants (median age 45 years (interquartile range [IQR]: 37-57) and 63.5% male) was analyzed. Seventy-seven (48.1%) participants had non-severe, 18 (11.3%) severe, and 83 (51.9%) critical COVID-19 illness. In 62 participants with chest computed tomography findings, 54 (87%) had bilateral disease, with 22 (35%) having ground-glass opacities. The median duration of hospitalization was 5 days (IQR: 3-9 days). Overall, 18 (11.3%) participants died. Survival at 14 and 28 days was 89% and 72%, respectively. Factors strongly associated with all-cause mortality were as follows: age >50 years (odds ratio [OR]: 8.6, 95% confidence interval [CI]: 1.1-69.2, and <i>p</i>=0.042), having at least 1 comorbidity (OR: 3.2, 95% CI: 1.1-8.9, and <i>p</i>=0.029), hypertension (OR: 3.2, 95% CI: 1.2-8.6, and <i>p</i>=0.024), diabetes mellitus (OR: 2.9, 95% CI: 1.0-8.5, and<i>p</i>=0.056), and oxygen saturation <92% (OR: 5.1, 95% CI: 1.8-14.4, and <i>p</i>=0.002). In this private health facility, mortality was about 1 in 10 patients, and more people presented with critical illness in the second wave of the pandemic, and most deaths occurred after 2 weeks of hospitalization.</p>","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":" ","pages":"5477790"},"PeriodicalIF":0.0,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9188300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48660919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pathogenic Aspects of Human Parvovirus B19 NS1 Protein in Chronic and Inflammatory Diseases.","authors":"Sedigheh Jalali, Ali Farhadi, Gholamreza Rafiei Dehbidi, Shirin Farjadian, Sedigheh Sharifzadeh, Reza Ranjbaran, Noorossadat Seyyedi, Sepide Namdari, Abbas Behzad-Behbahani","doi":"10.1155/2022/1639990","DOIUrl":"10.1155/2022/1639990","url":null,"abstract":"<p><strong>Background: </strong>The nonstructural protein (NS1) of human parvovirus B19 (hPVB19) is considered to be a double-edged sword in its pathogenesis. NS1 protein promotes cell death by apoptosis in erythroid-lineage cells and is also implicated in triggering and the progression of various inflammation and autoimmune disorders.</p><p><strong>Objectives: </strong>We investigated the possible role of hPVB19 NS1 in the modulation of proinflammatory cytokines in nonpermissive HEK-293T cells.</p><p><strong>Methods: </strong>A plasmid containing the fully sequenced NS1 gene (pCMV6-AC-GFP-NS1) was transfected into HEK-293T cells. Transfection efficiency was assessed by fluorescent microscopy over time. Mock (pCMV6-AC-GFP) transfected cells were used as controls. The percentage of apoptotic cells was measured by flow cytometry at 24, 48, and 72 h posttransfection. Interleukin 6 (IL-6) mRNA, as a pleiotropic cytokine, was measured by real-time PCR. Furthermore, cellular supernatants were collected to determine the type and quantity of cytokines produced by mock- and NS1-transfected cells using flow cytometry.</p><p><strong>Results: </strong>Fold change in the expression level of IL-6 mRNA in transfected cells after 72 hr of incubation was found to be 3.01 when compared with mock-transfected cells; however, cell apoptosis did not happen over time. Also, the concentration of cytokines such as IL-2, IL-6, IL-9, IL-17A, IL-21, IL-22, interferon (IFN)-<i>γ</i>, and tumor necrosis factor <i>α</i> (TNF-<i>α</i>) increased in NS1-transfected cells.</p><p><strong>Conclusions: </strong>Overall, our results indicated that proinflammatory cytokine levels had increased following the expression of hPVB19 NS1 in HEK-293T cells, consistent with a role for NS1 expression facilitating the upregulation of inflammatory reactions. Therefore, hPVB19 NS1 function may play a role in the progression of some chronic and inflammatory diseases.</p>","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":" ","pages":"1639990"},"PeriodicalIF":0.0,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47350983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Preexisting Asthma on the Risk of ICU Admission, Intubation, and Death from COVID-19: A Systematic Review and Meta-Analysis","authors":"Abhinav Bhattarai, Garima Dhakal, Sangam Shah, Aastha Subedi, S. Sah, S. K. Mishra","doi":"10.1155/2022/8508489","DOIUrl":"https://doi.org/10.1155/2022/8508489","url":null,"abstract":"Background The Centers for Disease Control and Prevention (CDC) identifies asthma as a comorbidity in COVID-19 that increases the risk of severity and death. However, research has shown that asthma is not associated with increased severity and death, thus making the consequences of asthma in COVID-19 unclear. Methods We searched the electronic databases PubMed, WHO COVID-19 database, and Taylor and Francis Online for studies that compared the medical outcomes of COVID-19 between patients with and without asthma, from the emergence of SARS-CoV-2 in December 2019 to the 3rd of September 2021, excluded duplicates, reviews, editorials, and case reports, and screened the titles, abstracts, and full texts. The quality of the included studies was assessed using the Newcastle–Ottawa Scale (NOS) for nonrandomized studies. Rates of intensive care unit (ICU) admission, intubation, and death among patients with and without asthma were compiled and meta-analysis was conducted using a random-effects model. Results Nineteen studies with a total of 289,449 participants met the inclusion criteria. COVID-19 patients with asthma had no significant association with increased risk of ICU admission, intubation, and death as compared with those without asthma ((odds ratio (OR) = 1.25, confidence interval (CI) = 0.90–1.74, I2 = 82%, X2 = 55.13, p < 0.01), (OR = 0.89, CI = 0.59–1.34, I2 = 91%, X2 = 110.82, p < 0.01), and (OR = 0.90, 95% CI = 0.63–1.27, I2 = 88%, X2 = 146.96, p < 0.01)), respectively. Conclusion Preexisting asthma did not significantly increase the risk of poorer prognosis and death from COVID-19.","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41955927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2: Molecular Structure, Pathogenesis, Potential Therapeutic Targets, and Immune Response of the Infected Subject.","authors":"R Wumba,&nbsp;M Mandina,&nbsp;Y Nlandu,&nbsp;J R Makulo,&nbsp;A Tshimpi,&nbsp;P Mbala,&nbsp;A Mbangama,&nbsp;P Kabututu,&nbsp;J M Kayembe","doi":"10.1155/2022/7856659","DOIUrl":"10.1155/2022/7856659","url":null,"abstract":"<p><strong>Background: </strong>The pathogenic mechanisms and immune response of COVID-19 are far from clear. Through a documentary review of literature, the authors describe virological and molecular aspects of SARS-CoV-2, the intimate mechanisms of cell infection, and potential therapeutic targets. They also analyze the characteristics of immune response of the infected subject.</p><p><strong>Objectives: </strong>Objectives of this study are to describe the state of knowledge on virological data, molecular and physiopathogenic mechanisms of SARS-CoV-2, with a view to a better understanding of the therapeutic targets, as well as the immune response of the infected subject. <i>Methodology</i>. This documentary review is a compilation of several meta-analyses, consistent with the methodology described in the PRISMA statement on literature data on SARS-CoV-2, published between March 22 and August 14, 2020 (Moher et al.). The search engines used for the selection of articles were as follows: PubMed, Google Scholar, Global Health, and WHO reports. Papers of interest were those addressing virological and molecular data on SARS-CoV-2, therapeutic aspects of COVID-19, and immunity of the infected subject. Of the 617 eligible papers, 417 could be retained after removing the duplicates. Ultimately, only 50 articles were retained for final evaluation. The data collected allowed the development of a two-armed model around the physiopathological aspects and potential therapeutic targets, as well as aspects of host immunity, respectively. The model was then compared to data from the HIV literature.</p><p><strong>Conclusion: </strong>Reported data could contribute to a better understanding of molecular mechanisms of cellular infection by SARS-CoV-2 as well as to a more easy explanation of the action of pharmacological agents used for the treatment, while elucidating intimate mechanisms of the immunity of infected subject.</p>","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":"2022 ","pages":"7856659"},"PeriodicalIF":0.0,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9184234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9179662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Sepsis in a Resource-Limited Setting: Causative Microorganisms and Antimicrobial Susceptibility Profile","authors":"Edna Nai Acheampong, Joseph Adjei Tsiase, D. Afriyie, S. Amponsah","doi":"10.1155/2022/7905727","DOIUrl":"https://doi.org/10.1155/2022/7905727","url":null,"abstract":"Background Empiric treatment of suspected neonatal sepsis must be based on data on setting-specific causative pathogens and their respective susceptibilities to antimicrobials, as well as universal treatment guidelines. This approach will ensure better therapeutic outcomes and reduce mortality. Objectives The objectives of this study were to determine the bacteriological profile and antibiotic susceptibility pattern of isolated microorganisms responsible for neonatal sepsis in a regional hospital in Ghana. Methods This was a retrospective study that assessed causative microorganisms and antimicrobial susceptibility profiles of neonates suspected of sepsis at the Greater Accra Regional Hospital from January 2018 to December 2019. Blood culture was done using a fully automated BACTEC 9240 blood culture system. Bacteria isolates were identified by Gram staining and conventional biochemical methods. Antimicrobial susceptibility testing was done by Kirby–Bauer's disc diffusion method, and interpretations were carried out according to clinical and laboratory standards. Culture and antibiotic sensitivity reports were obtained and the data subsequently analyzed. Results Of 2514 blood samples collected from neonates suspected of neonatal sepsis, 528 (21.0%) of the samples were found to be culture-positive. The majority of these positive cultures were from male neonates (68.9%). A total of 11 different pathogens were isolated, of which Gram-positive organisms had a preponderance of 72.0% over Gram-negative organisms (28.0%). Staphylococcus epidermidis was the most common pathogen identified, accounting for 60.0% of isolates. The most prevalent Gram-negative bacteria were Klebsiella spp. (13.6%). Most Gram-positive microorganisms showed sensitivity to amikacin, meropenem, vancomycin, and piperacillin/tazobactam. Gram-positive isolates were found to be resistant to ampicillin and penicillin, but moderately susceptible to flucloxacillin. Most Gram-negative isolates were sensitive to meropenem. Conclusion The prevalence of culture-proven sepsis was 21.0%. The most prevalent Gram-negative bacteria were Klebsiella spp. As there is some level of antibiotic resistance observed in the current study, it is necessary for routine microbial analysis of samples and their antibiogram.","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44655801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Evidence of Emerged Pulmonary Lophomoniasis due to Lophomonas blattarum among Hospitalized Patients in Southwestern Iran: A National Registry-Based Study","authors":"K. Mokhtarian, S. Taghipour, M. Nakhaei, A. Taheri, A. Sharifpour, M. Fakhar, Hajar Ziaei Hezarjaribi","doi":"10.1155/2022/6292823","DOIUrl":"https://doi.org/10.1155/2022/6292823","url":null,"abstract":"Objectives Lophomonas protozoan is an emerging pathogen transmitted through arthropods such as cockroaches. Lophomoniasis is still a mysterious disease with many unknown epidemiological aspects. The current study aimed to determine the prevalence of lophomoniasis among patients who were hospitalized in Hajar Hospital, Shahrekord, southwestern Iran, using a conventional PCR technique. Methods In this retrospective study, 132 frozen bronchoalveolar lavage fluid (BALF) specimens from patients with respiratory disorders hospitalized in Hajar Hospital, Shahrekord district, southwestern Iran, were analyzed during 2020-2021. Samples are referred to the Iranian National Registry Center for Lophomoniasis (INRCL), Mazandaran Province, Northern Iran, for detecting Lophomonas spp. infection by a conventionally small subunit ribosomal RNA (SSU rRNA) PCR test. Results A total of 132 frozen BALF specimens were examined, 36 (27.3%) tested Lophomonas spp. positive using the conventional PCR technique. Also, based on sequencing data and blast analysis, the presence of L. blattarum species was confirmed. The average age of Lophomonas spp.‐ positive patients was 67.02 ± 15.14 years. Out of the 36 positive subjects, 63.9% were male and 36.1% female. Male and Lophomonas infection had a significant correlation (p=0.001). Our findings revealed that L. blattarum infected nonsmokers more than smokers (p=0.001). The most common underlying disease was also bronchitis Conclusion Our results showed, for the first time, that pulmonary lophomoniasis caused by L. blattarum is a common and emerging disease in the study area, southwestern Iran. Furthermore, our findings support the use of the PCR test to detect Lophomonas infection in archived frozen clinical samples.","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":"11 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41260656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of COVID-19 Pandemic in Bangladesh: Dual Application of Susceptible-Infective-Recovered (SIR) and Machine Learning Approach.","authors":"Iqramul Haq, Md Ismail Hossain, Ahmed Abdus Saleh Saleheen, Md Iqbal Hossain Nayan, Mafruha Sultana Mila","doi":"10.1155/2022/8570089","DOIUrl":"10.1155/2022/8570089","url":null,"abstract":"<p><p>The outbreak of COVID-19 is a global problem today, and, to reduce infectious cases and increase recovered cases, it is relevant to estimate the future movement and pattern of the disease. To identify the hotspot for COVID-19 in Bangladesh, we performed a cluster analysis based on the hierarchical k-means approach. A well-known epidemiological model named \"susceptible-infectious-recovered (SIR)\" and an additive regression model named \"Facebook PROPHET Procedure\" were used to predict the future direction of COVID-19 using data from IEDCR. Here we compare the results of the optimized SIR model and a well-known machine learning algorithm (PROPHET algorithm) for the forecasting trend of the COVID-19 pandemic. The result of the cluster analysis demonstrates that Dhaka city is now a hotspot for the COVID-19 pandemic. The basic reproduction ratio value was 2.1, which indicates that the infection rate would be greater than the recovery rate. In terms of the SIR model, the result showed that the virus might be slightly under control only after August 2022. Furthermore, the PROPHET algorithm observed an altered result from SIR, implying that all confirmed, death, and recovered cases in Bangladesh are increasing on a daily basis. As a result, it appears that the PROPHET algorithm is appropriate for pandemic data with a growing trend. Based on the findings, the study recommended that the pandemic is not under control and ensured that if Bangladesh continues the current pattern of infectious rate, the spread of the pandemic in Bangladesh next year will increase.</p>","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":"2022 ","pages":"8570089"},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9041159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9546163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring the Possibility of Middle Ear Discharge for COVID-19 Test Material","authors":"H. Kadriyan, Lalu Hizrian Rizkika Abtartu, E. H. Wardoyo, F. R. Andiwijaya","doi":"10.1155/2022/7207846","DOIUrl":"https://doi.org/10.1155/2022/7207846","url":null,"abstract":"The COVID-19 pandemic is still ongoing, and new variants continue to emerge. Various examination methods and sampling specimens are continuously being developed and published. The standard for sampling is in the nasopharynx. However, in children, this is often uncomfortable and at risk of eliciting complications. Therefore, it is necessary to look for other alternative sampling sites such as fluid from the middle ear. Scientific evidence shows that the middle ear can be a place for the attachment and growth of the SARS-CoV-2 virus. Currently, to the best of the author's knowledge, there have been no publications on middle ear discharge as a sample for the determination of the diagnosis of COVID-19. Based on this, the authors would like to explore the possibility of middle ear discharge for COVID-19 test material. A narrative review on the use of middle ear discharge as a potential diagnostic specimen for COVID-19 was conducted. The searches were conducted in the PubMed and ProQuest databases.","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42337265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Antimicrobial Stewardship Program in Long-Term Care: A Five-Year Prospective Single-Center Study","authors":"M. Alawi, W. Tashkandi, Mohamed A Basheikh, Faten M Warshan, Hazem Ahmed Ghobara, Rosemarie B. Ramos, Mary Leilani Guiriba, Omar Ayob, Safiah Saad Janah, A. Sindi, Suheib Ali Abdulhamid Ahmed, Salah Dammnan, E. Azhar, A. Rabaan, Salma Alnahdi, Maged Mohammed Bamahakesh","doi":"10.1155/2022/8140429","DOIUrl":"https://doi.org/10.1155/2022/8140429","url":null,"abstract":"Objective To report the effectiveness of the antimicrobial stewardship program (ASP) in a long-term care (LTC) facility, by analyzing the change in antimicrobial consumption and cost and multidrug resistance (MDR) rates over a 5-year period. Method A prospective interventional study was conducted at a 106-bed facility (nursing home: 100 beds and an intensive care unit (ICU): 6 beds). The ASP was designed and led by a multidisciplinary team including an infectious disease consultant, two clinical pharmacists, a clinical microbiologist, and an infection control preventionist. Five key performance indicators were monitored: (1) intravenous (IV)-to-oral switch rate, (2) consumption of restricted IV antimicrobials (raw consumption and defined daily doses (DDD) index), (3) cost of restricted IV antimicrobials, (4) antimicrobial sensitivity profiles, and (5) MDR rate among hospital-acquired infections (MDR-HAI). Result A ∼5.5-fold enhancement of the IV-to-oral switch and a 40% reduction in the overall consumption of restricted IV antimicrobials were observed. Regarding the cost, the cumulative cost saving was estimated as 5.64 million SAR (US$1.50 million). Microbiologically, no significant change in antimicrobial sensitivity profiles was observed; however, a large-size reduction in the MDR-HAI rate was observed, notably in ICU where it declined from 3.22 per 1,000 patient days, in 2015, to 1.14 per 1,000 patient days in 2020. Interestingly, the yearly overall MDR rate was strongly correlated with the level of antimicrobial consumption. Conclusion The implementation of a multidisciplinary ASP in LTC facilities should be further encouraged, with emphasis on physicians' education and active involvement to enhance the success of the strategy.","PeriodicalId":39128,"journal":{"name":"Interdisciplinary Perspectives on Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46813285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}