The gram-negative bacterium Helicobacter pylori(H.pylori)causes chronic gastritis,gastric and duodenal ulcers,gastric cancer and mucosa-associated lymphoid tissue lymphoma.Treatment is recommended in all symptomatic p...The gram-negative bacterium Helicobacter pylori(H.pylori)causes chronic gastritis,gastric and duodenal ulcers,gastric cancer and mucosa-associated lymphoid tissue lymphoma.Treatment is recommended in all symptomatic patients.The current treatment options for H.pylori infection are outlined in this review in light of the recent challenges in eradication success,largely due to the rapid emergence of antibiotic resistant strains of H.pylori.Antibiotic resistance is a constantly evolving process and numerous studies have shown that the prevalence of H.pylori antibiotic resistance varies significantly from country to country,and even between regions within the same country.In addition,recent data has shown that previous antibiotic use is associated with harbouring antibiotic resistant H.pylori.Local surveillance of antibiotic resistance is warranted to guide clinicians in their choice of therapy.Antimicrobial resistance is assessed by H.pylori culture and antimicrobial susceptibility testing.Recently developed molecular tests offer an attractive alternative to culture and allow for the rapid molecular genetic identification of H.pylori and resistance-associated mutations directly from biopsy samples or bacterial culture material.Accumulating evidence indicates that surveillance of antimicrobial resistance by susceptibility testing is feasible and necessary to inform clinicians in their choice of therapy for management of H.pylori infection.展开更多
The Coronavirus disease 2019(COVID-19)pandemic increased the burden of critically ill patients who required hospitalization in the intensive care unit(ICU).Bacterial and fungal co-infections,including bloodstream infe...The Coronavirus disease 2019(COVID-19)pandemic increased the burden of critically ill patients who required hospitalization in the intensive care unit(ICU).Bacterial and fungal co-infections,including bloodstream infections(BSIs),increased significantly in ICU patients with COVID-19;this had a significant negative impact on patient outcomes.Reported data pertaining to BSI episodes from the ICU setting during the COVID-19 pandemic were collected and analyzed for this narrative review.We searched the PubMed database for articles published between March 2020 and October 2023;the terms“COVID-19”AND“bloodstream infections”AND“ICU”were used for the search.A total of 778 articles were retrieved;however,only 27 were exclusively related to BSIs in ICU patients with COVID-19.Data pertaining to the epidemiological characteristics,risk factors,characteristics of bacterial and fungal BSIs,patterns of antimicrobial resistance,and comparisons between ICU and non-ICU patients during and before the COVID-19 pandemic were obtained.Data on antimicrobial stewardship and infection-control policies were also included.The rates of BSI were found to have increased among ICU patients with COVID-19 than in non-COVID-19 patients and those admitted during the pre-pandemic period.Male gender,60–70 years of age,increased body mass index,high Sequential Organ Failure Assessment scores at admission,prolonged hospital and ICU stay,use of central lines,invasive ventilation,and receipt of extracorporeal membrane oxygenation were all defined as risk factors for BSI.The use of immune modulators for COVID-19 appeared to increase the risk of BSI;however,the available data are conflicting.Overall,Enterococci,Acinetobacter baumannii,and Candida spp.emerged as prominent infecting organisms during the pandemic;along with Enterobacterales and Pseudomonas aeruginosa they had a significant impact on mortality.Multidrug-resistant organisms prevailed in the ICU,especially if antimicrobial resistance was established before the COVID-19 pandemic an展开更多
文摘The gram-negative bacterium Helicobacter pylori(H.pylori)causes chronic gastritis,gastric and duodenal ulcers,gastric cancer and mucosa-associated lymphoid tissue lymphoma.Treatment is recommended in all symptomatic patients.The current treatment options for H.pylori infection are outlined in this review in light of the recent challenges in eradication success,largely due to the rapid emergence of antibiotic resistant strains of H.pylori.Antibiotic resistance is a constantly evolving process and numerous studies have shown that the prevalence of H.pylori antibiotic resistance varies significantly from country to country,and even between regions within the same country.In addition,recent data has shown that previous antibiotic use is associated with harbouring antibiotic resistant H.pylori.Local surveillance of antibiotic resistance is warranted to guide clinicians in their choice of therapy.Antimicrobial resistance is assessed by H.pylori culture and antimicrobial susceptibility testing.Recently developed molecular tests offer an attractive alternative to culture and allow for the rapid molecular genetic identification of H.pylori and resistance-associated mutations directly from biopsy samples or bacterial culture material.Accumulating evidence indicates that surveillance of antimicrobial resistance by susceptibility testing is feasible and necessary to inform clinicians in their choice of therapy for management of H.pylori infection.
文摘The Coronavirus disease 2019(COVID-19)pandemic increased the burden of critically ill patients who required hospitalization in the intensive care unit(ICU).Bacterial and fungal co-infections,including bloodstream infections(BSIs),increased significantly in ICU patients with COVID-19;this had a significant negative impact on patient outcomes.Reported data pertaining to BSI episodes from the ICU setting during the COVID-19 pandemic were collected and analyzed for this narrative review.We searched the PubMed database for articles published between March 2020 and October 2023;the terms“COVID-19”AND“bloodstream infections”AND“ICU”were used for the search.A total of 778 articles were retrieved;however,only 27 were exclusively related to BSIs in ICU patients with COVID-19.Data pertaining to the epidemiological characteristics,risk factors,characteristics of bacterial and fungal BSIs,patterns of antimicrobial resistance,and comparisons between ICU and non-ICU patients during and before the COVID-19 pandemic were obtained.Data on antimicrobial stewardship and infection-control policies were also included.The rates of BSI were found to have increased among ICU patients with COVID-19 than in non-COVID-19 patients and those admitted during the pre-pandemic period.Male gender,60–70 years of age,increased body mass index,high Sequential Organ Failure Assessment scores at admission,prolonged hospital and ICU stay,use of central lines,invasive ventilation,and receipt of extracorporeal membrane oxygenation were all defined as risk factors for BSI.The use of immune modulators for COVID-19 appeared to increase the risk of BSI;however,the available data are conflicting.Overall,Enterococci,Acinetobacter baumannii,and Candida spp.emerged as prominent infecting organisms during the pandemic;along with Enterobacterales and Pseudomonas aeruginosa they had a significant impact on mortality.Multidrug-resistant organisms prevailed in the ICU,especially if antimicrobial resistance was established before the COVID-19 pandemic an
