Infection, disease & health最新文献

Arterial catheter outcomes in intensive care: An analysis of 1117 patients. 重症监护中动脉导管的效果：对 1117 名患者的分析。

Infection, disease & health Pub Date : 2024-08-22 DOI: 10.1016/j.idh.2024.07.006

Samantha Keogh, Emily Larsen, Amanda Corley, Mari Takashima, Nicole Marsh, Melannie Edwards, Heather Reynolds, Jayesh Dhanani, Fiona Coyer, Kevin B Laupland, Claire M Rickard

{"title":"Arterial catheter outcomes in intensive care: An analysis of 1117 patients.","authors":"Samantha Keogh, Emily Larsen, Amanda Corley, Mari Takashima, Nicole Marsh, Melannie Edwards, Heather Reynolds, Jayesh Dhanani, Fiona Coyer, Kevin B Laupland, Claire M Rickard","doi":"10.1016/j.idh.2024.07.006","DOIUrl":"https://doi.org/10.1016/j.idh.2024.07.006","url":null,"abstract":"Background: Access to arterial circulation through arterial catheters (ACs) is crucial for monitoring and decision-making in intensive care units (ICU) but carries the risk of complications including bloodstream infection (BSI).Methods: We conducted a secondary analysis of data from four randomised controlled trials in Australian ICUs, investigating the efficacy of different AC interventions. De-identified data were combined into a single dataset, and per-patient outcomes analysed. The primary outcome was AC-BSI, defined as laboratory confirmed bloodstream infection (LCBI) type 1 or 2, with a concurrent local infection. All-cause AC failure was defined as any unplanned removal. AC infection and failure were reported as rates per 1000 catheter days and hours.Results: Data from 1117 adult patients were analysed. Mean age was 58.8 years (±16.6); and 41% (n = 462) were male. Median AC dwell time was 110 h (IQR 28.3-168.0). There was one case (<0.1%; 0.18/1000 catheter days [95% CI 0.03-1.29]) of AC-BSI, and 14 cases of LCBI (1%; 13 LCBI-1 and 1 LCBI-2; 2.54/1000 catheter days [95% CI 1.51-4.30]). LCBI were most commonly Enterococcus faecalis; Escherichia coli and Klebsiella pneumoniae. There were four cases of local infection (<1%; 0.73/1000 catheter days [95% CI 0.27-1.94]). Overall AC failure rate was 13% (n = 146) or 26.53/1000 catheter days (95% CI 22.56-31.20).Conclusion: This study identified a relatively low incidence of complications. This is likely reflective of poor monitoring of ACs in intensive care. Better surveillance and a rigorous prospective evaluation of AC outcomes is required to understand the true risk ACs pose to critically ill patients.","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047702","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}

引用次数: 0

Ventilator-associated pneumonia risk factors in patients with severe COVID-19 in southern Brazil: A retrospective observational study. 巴西南部重症 COVID-19 患者的呼吸机相关肺炎风险因素：一项回顾性观察研究。

Infection, disease & health Pub Date : 2024-08-20 DOI: 10.1016/j.idh.2024.07.004

Gabriela De Souza Dos Santos, Viviane Alves de Carvalho França de Macedo, Samantha Oliniski Reikdal, Maria Esther Graf, Beatris Mario Martin, Marineli Joaquim Meier

{"title":"Ventilator-associated pneumonia risk factors in patients with severe COVID-19 in southern Brazil: A retrospective observational study.","authors":"Gabriela De Souza Dos Santos, Viviane Alves de Carvalho França de Macedo, Samantha Oliniski Reikdal, Maria Esther Graf, Beatris Mario Martin, Marineli Joaquim Meier","doi":"10.1016/j.idh.2024.07.004","DOIUrl":"https://doi.org/10.1016/j.idh.2024.07.004","url":null,"abstract":"Backgound: During the SARS-CoV-2 pandemic, a significant number of critical patients required ventilatory assistance in health institutions. In this context, Ventilator-Associated Pneumonia (VAP) was the most prevalent nosocomial infection among critically ill patients. We aimed to analyze the occurrence of VAP in critically ill patients with SARS-CoV-2 and the risk factors associated with the outcome.Method: This is a multicenter, retrospective cohort study which included patients ≥18 years old, diagnosed with COVID-19, admitted to intensive care units (ICU) and who received invasive mechanical ventilation (MV) for >2 consecutive days. The associations between the variables were initially tested, and those that showed potential associations (p<0.05) were included in the multivariate logistic regression model.Results: One third of patients had an episode of VAP, with an incidence density of 34.97 cases per 1000 MV days. In addition, 42.37% (50) of the microorganisms causing VAP were multidrug-resistant, predominantly gram-negative bacteria (61.32%). More than 50% of participants developed healthcare-associated infections and 243 (73.64%) died. The factors associated with greater chances of VAP were: prone position (OR= 3.77), BMI 25-29.9 kg/m2 (OR= 4.76), pressure injury (OR= 4.41), length of stay in the ICU (OR= 1.06), positive tracheal aspirate before VAP (OR= 5.41) and dyspnea (OR= 3.80).Conclusions: Patients with COVID-19 are at high risk of VAP, which leads to an increased risk of death (OR = 2.18). Multiple factors increase the chances of VAP in this population, namely: work overload in health institutions, prone position, prolonged ICU time, infusion of multiple drugs, invasive devices, and in particular, immobility in bed.","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019992","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}

引用次数: 0

Prediction of multidrug-resistant bacteria (MDR) hospital-acquired infection (HAI) and colonisation: A systematic review. 耐多药细菌（MDR）医院获得性感染（HAI）和定植的预测：系统综述。

Infection, disease & health Pub Date : 2024-08-18 DOI: 10.1016/j.idh.2024.07.003

Leila Figueiredo Dantas, Igor Tona Peres, Bianca Brandão de Paula Antunes, Leonardo S L Bastos, Silvio Hamacher, Pedro Kurtz, Ignacio Martin-Loeches, Fernando Augusto Bozza

{"title":"Prediction of multidrug-resistant bacteria (MDR) hospital-acquired infection (HAI) and colonisation: A systematic review.","authors":"Leila Figueiredo Dantas, Igor Tona Peres, Bianca Brandão de Paula Antunes, Leonardo S L Bastos, Silvio Hamacher, Pedro Kurtz, Ignacio Martin-Loeches, Fernando Augusto Bozza","doi":"10.1016/j.idh.2024.07.003","DOIUrl":"https://doi.org/10.1016/j.idh.2024.07.003","url":null,"abstract":"Background: Hospital-Acquired Infections (HAI) represent a public health priority in most countries worldwide. Our main objective was to systematically review the quality of the predictive modeling literature regarding multidrug-resistant gram-negative bacteria in Intensive Care Units (ICUs).Methods: We conducted and reported a Systematic Literature Review according to the recommendations of the PRISMA statement. We analysed the quality of the articles in terms of adherence to the TRIPOD checklist.Results: The initial search identified 1935 papers and 15 final articles were included in the review. Most studies analysed used traditional prediction models (logistic regression), and only three developed machine-learning techniques. We noted poor adherence to the main methodological issues recommended in the TRIPOD checklist to develop prediction models, such as handling missing data (20% adherence), model-building procedures (20% adherence), assessing model performance (47% adherence), and reporting performance measures (33% adherence).Conclusions: Our review found few studies that use efficient alternatives to predict the acquisition of multidrug-resistant gram-negative bacteria in ICUs. Furthermore, we noted a lack of strategies for dealing with missing data, feature selection, and imbalanced datasets, a common problem in HAI studies.","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006188","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}

引用次数: 0

Sustainability and novel technologies to improve environmental cleaning in healthcare - Implications and considerations. 改善医疗环境清洁的可持续性和新技术--影响和考虑因素。

Infection, disease & health Pub Date : 2024-08-14 DOI: 10.1016/j.idh.2024.07.002

S Jain, K Dempsey, K Clezy, B G Mitchell, M A Kiernan

引用次数: 0

Assessment of peripheral venous catheters microbiota and its association with phlebitis. 评估外周静脉导管微生物群及其与静脉炎的关系。

Infection, disease & health Pub Date : 2024-08-05 DOI: 10.1016/j.idh.2024.07.005

Gustavo Francisco Lopes, Viviane de Cássia Oliveira, Rachel Maciel Monteiro, Pedro Castania Amadio Domingues, Felipe Lazarini Bim, Lucas Lazarini Bim, Gabriela Bassi Ferreira da Silva, André Pereira Dos Santos, Cássio do Nascimento, Denise de Andrade, Evandro Watanabe

{"title":"Assessment of peripheral venous catheters microbiota and its association with phlebitis.","authors":"Gustavo Francisco Lopes, Viviane de Cássia Oliveira, Rachel Maciel Monteiro, Pedro Castania Amadio Domingues, Felipe Lazarini Bim, Lucas Lazarini Bim, Gabriela Bassi Ferreira da Silva, André Pereira Dos Santos, Cássio do Nascimento, Denise de Andrade, Evandro Watanabe","doi":"10.1016/j.idh.2024.07.005","DOIUrl":"https://doi.org/10.1016/j.idh.2024.07.005","url":null,"abstract":"Background: Peripheral venous catheters (PVCs) remain the primary mode of short-term venous access for managing intravenous fluid, obtaining blood samples, and peripheral parenteral nutrition. They may get contaminated and require regular monitoring to prevent complications. This study evaluated the occurrence of phlebitis and its associated-clinical and microbiological indicators.Methods: The frequency of phlebitis was evaluated in hospitalized patients of both medical and surgical fields. Subsequently, the dichotomous association between the presence of phlebitis and the clinical aspects was investigated. In parallel, the bacterial contamination of PVCs was assessed through culture-based methods, microscopy observation, and 16S rRNA gene sequencing.Results: Approximately one in four patients presented phlebitis (28.4%). The most frequent symptom was erythema at access site, with or without pain, corresponding to Score 1 on the phlebitis scale (17.9%). Colonization of both lumen and external surface of PVC was observed in 31.3% of the samples. Staphylococcus and Pseudomonas were the most isolated bacterial genera on the PVC surface. No significant association was observed between the presence of phlebitis and the clinical aspects, as well as the presence of microorganisms.Conclusion: Microorganism were present on both internal and external PVC surface, without being associated to phlebitis.","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899239","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}

引用次数: 0