To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with d...To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with different types of infectious agents, includ-ing CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature(via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manu-facturer and User Facility Device Experience database, or "MAUDE"; and the Internet(via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the sub-urbs of Chicago(IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Con-trol and Prevention(CDC), which published a report about this outbreak in Morbidity and Mortality WeeklyReport(MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's in-fection control practices following this CRE outbreak, were also reviewed. While this article focuses primar-ily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infec-tious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently as-sociated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, know展开更多
Background: Personal hygiene in non-self-sufficient patients is essential to prevent the proliferation and spread of bacteria from one patient to another, both through inanimate objects (fomites) and directly through ...Background: Personal hygiene in non-self-sufficient patients is essential to prevent the proliferation and spread of bacteria from one patient to another, both through inanimate objects (fomites) and directly through healthcare workers. The first 1000 bed hygiene treatments performed by the collaborative robot “COPERNICO Surveillance & Prevention” in 229 non-self-sufficient patients were analyzed. Materials and Methods: A total of 229 patients were included: 215 patients came from emergency contexts or home, and 14 from long-term care facilities;the presence of sepsis, venous or urinary catheters, non-invasive ventilation, bedsores, clinical condition at discharge, and treatment sessions performed were recorded. All patients were hospitalized in the Geriatrics, Medicine and Pneumology departments. The system is able to collect and process data in real time. Results: Seventy-one patients with community-acquired sepsis and fourteen with healthcare-associated infections were treated;sixty-two had pressure ulcers. The analysis of the first 1000 treatments shows the healing of almost all sepsis cases, positive evolution of pressure ulcers, and hospital stays comparable to those of the entire group of 1008 hospitalized in the same period. There was no onset of side effects or complications. Conclusions: Although the healthcare setting is not among those at greatest risk of infections, the clinical efficacy, along with excellent evaluations from patients, family members, and healthcare personnel and the absence of side effects and complications, makes the system exceptionally manageable and user-friendly for non-self-sufficient patients.展开更多
Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse env...Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse environmental conditions (low or high temperatures, high pH, and high salinity). The global Enterococcus faecalis-Enterococcus faecium ratio is currently shifting towards Enterococcus faecium. Enterococci present variable levels of resistance to certain families of antibiotics. This is the case for aminoglycosides, beta-lactams and cephalosporins. In 2017, WHO ranked Enterococci among priority pathogens for research and development of new antibiotics. The objective of our study was to determine the antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolates from urine and pleural fluid in two hospitals in Cameroon. This cross-sectional and analytic study was carried out between June to August 2023 on hospitalized and day patients in which a cytobacteriological test of urine and pleural fluid was done. The samples were inoculated on CLED Agar for urine and on Chocolate + polyvitex and blood agar (prepared from Columbia agar) for pleural fluid samples and incubated at 37℃ for 18 to 24 hours. Identification of isolates was carried out using the API 20 STREP micro gallery (Biomerieux, France) and tested for antimicrobial susceptibility. The data on socio-demographical and potential risk factors were recorded using self-administered questionnaires and data from laboratory analyses of the specimen were collected in a data capture sheet. Potential risk factors associated with the presence of Enterococci, were evaluated using the logistic regression in univariate and multivariate analysis. P value < 0.05 was considered as significant. A total of 511 patients were recruited who were predominantly females. Enterococcus spp were isolated in 27.79% of our samples with Enterococcus faecalis mostly encountered. Enterococcus spp showed a high level of resistance to penicilline (99.3% to展开更多
Introduction: Healthcare-associated infections are involved in hospital long-stay and in the increase in inherent costs to patients care. Objectives: Objective was to describe the characteristics of healthcare-associa...Introduction: Healthcare-associated infections are involved in hospital long-stay and in the increase in inherent costs to patients care. Objectives: Objective was to describe the characteristics of healthcare-associated bacteremia and urinary tract infections in medical wards of CNHU-HKM of Cotonou, describe the distribution of germs identified according to admission wards and identify factors associated with onset of healthcare-associated infections. Materials and Methods: It was a cohort study conducted from 4th April to 16th September 2016. The study population included patients admitted in wards A and B of CNHU-HKM Medicine department for at least the past 48 hours, or readmitted in one of the medical wards less than 14 days after their discharge from hospital. Results: The study included 825 patients in total. Prevalence of healthcare-associated infections was 9.8%. Bacteremia was the most represented group (65.4%). The most often identified germs regardless of the site were respectively: K. pneumonia (38.5%), S. aureus (23.1%) and E. coli (20.0%). HIV+ status, internal medicine department, nephrology and endocrinology, duration of admission and the use of urinary catheter represent factors statistically associated with the onset of healthcare-associated infections. Conclusion: Healthcare-associated infections are a real public health issue in CNHU-HKM Medicine Department. There is pressing need to conduct a study on clinical hygiene so as to assess healthcare staff in practice.展开更多
Introduction: Healthcare-associated infections (HAIs) are a worldwide concern because of their magnitude and their human and financial cost. While nurses’ non-compliance of hygiene and asepsis measures is questioned,...Introduction: Healthcare-associated infections (HAIs) are a worldwide concern because of their magnitude and their human and financial cost. While nurses’ non-compliance of hygiene and asepsis measures is questioned, the rationale behind it is not fully understood. We hypothesized that nurses’ experiences and perceptions are one of the reasons for their non-compliance with prevention recommendations. Also, nurses’ caring approach would play an important role in patient safety. The objective of this study was to describe nurses’ experiences and perceptions of HAIs in a district hospital in Burkina Faso with the aim of developing a culture of safety in health care practices. Methods: Qualitative data were collected through unstructured interviews with twenty nurses from the Ziniaré district hospital. Data analysis followed the qualitative phenomenological method according to Giorgi. Results: Phenomenological analysis yielded the following themes: “an ignored reality”;“a denied responsibility”;and “a vulnerable problem”. These results show that nurses’ perception of the extent and seriousness of HAIs is low, and that they deny responsibility for their occurrence. As a result, HAIs are not always perceived as a concern. However, nurses deplore the situation, but remain optimistic about resolving the problem. Conclusion: These nurses’ perceptions of HAIs could explain their non-compliance with prevention recommendations. Corrective action could be redirected by raising awareness, continuing training, improving working conditions and involving all players, including patients and their families, in the fight against HAIs. .展开更多
<strong>Background</strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Neonatal sepsis is a global health problem...<strong>Background</strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Neonatal sepsis is a global health problem that mainly affects low- and middle-income countries. We have previously shown that early neonatal mortality is high at the Ho Teaching Hospital (HTH) of Ghana. We sought to determine the prevalence of neonatal sepsis, sepsis-related mortality, and bacterial species patterns in neonatal and young infant sepsis in this hospital.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">A hospital-based study was conducted in the hospital’s neonatal intensive care unit (NICU) from March to June 2018. Blood samples from 96 babies clinically diagnosed with or at risk of sepsis were cultured using the BACTEC 9050<span style="white-space:nowrap;"><sup>®</sup> </span>machine. Clinical data including gravida, parity and antibiotic medication before delivery of mother and delivery type, gestation, birth weight and antibiotic medication status were collected for analysis. MALDI-TOF MS identified bacterial isolates, and their identities were confirmed via </span><i><span style="font-family:Verdana;">tuf</span></i><span style="font-family:Verdana;"> gene sequence typing. The data were analyzed using GraphPad Prism 8.0.2.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Blood cultures were positive in 28 of the babies, with 14 and 12 representing early-onset and late-onset neonatal sepsis, respectively, and two cases of unknown sepsis type. Of the bacterial species that caused sepsis in the babies, coagulase-negative staphylococcus (CoNS) was the most prevalent isolate in 22 cases, 展开更多
基金Supported by An educational grant provided by FUJIFILM Medical Systems,USA,Inc.,Endoscopy Division(Wayne,NJUnited States)
文摘To evaluate the risk of transmission of carbapenem-resistant Enterobacteriaceae(CRE) and their related superbugs during gastrointestinal(GI) endoscopy. Reports of outbreaks linked to GI endoscopes contami-nated with different types of infectious agents, includ-ing CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature(via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manu-facturer and User Facility Device Experience database, or "MAUDE"; and the Internet(via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the sub-urbs of Chicago(IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Con-trol and Prevention(CDC), which published a report about this outbreak in Morbidity and Mortality WeeklyReport(MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's in-fection control practices following this CRE outbreak, were also reviewed. While this article focuses primar-ily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infec-tious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently as-sociated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, know
文摘Background: Personal hygiene in non-self-sufficient patients is essential to prevent the proliferation and spread of bacteria from one patient to another, both through inanimate objects (fomites) and directly through healthcare workers. The first 1000 bed hygiene treatments performed by the collaborative robot “COPERNICO Surveillance & Prevention” in 229 non-self-sufficient patients were analyzed. Materials and Methods: A total of 229 patients were included: 215 patients came from emergency contexts or home, and 14 from long-term care facilities;the presence of sepsis, venous or urinary catheters, non-invasive ventilation, bedsores, clinical condition at discharge, and treatment sessions performed were recorded. All patients were hospitalized in the Geriatrics, Medicine and Pneumology departments. The system is able to collect and process data in real time. Results: Seventy-one patients with community-acquired sepsis and fourteen with healthcare-associated infections were treated;sixty-two had pressure ulcers. The analysis of the first 1000 treatments shows the healing of almost all sepsis cases, positive evolution of pressure ulcers, and hospital stays comparable to those of the entire group of 1008 hospitalized in the same period. There was no onset of side effects or complications. Conclusions: Although the healthcare setting is not among those at greatest risk of infections, the clinical efficacy, along with excellent evaluations from patients, family members, and healthcare personnel and the absence of side effects and complications, makes the system exceptionally manageable and user-friendly for non-self-sufficient patients.
文摘Enterococcus faecalis and Enterococcus faecium rank among the leading causes of nosocomial bacteremia and urinary tract infections. They often persist on hospital surfaces due to their ability to withstand adverse environmental conditions (low or high temperatures, high pH, and high salinity). The global Enterococcus faecalis-Enterococcus faecium ratio is currently shifting towards Enterococcus faecium. Enterococci present variable levels of resistance to certain families of antibiotics. This is the case for aminoglycosides, beta-lactams and cephalosporins. In 2017, WHO ranked Enterococci among priority pathogens for research and development of new antibiotics. The objective of our study was to determine the antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolates from urine and pleural fluid in two hospitals in Cameroon. This cross-sectional and analytic study was carried out between June to August 2023 on hospitalized and day patients in which a cytobacteriological test of urine and pleural fluid was done. The samples were inoculated on CLED Agar for urine and on Chocolate + polyvitex and blood agar (prepared from Columbia agar) for pleural fluid samples and incubated at 37℃ for 18 to 24 hours. Identification of isolates was carried out using the API 20 STREP micro gallery (Biomerieux, France) and tested for antimicrobial susceptibility. The data on socio-demographical and potential risk factors were recorded using self-administered questionnaires and data from laboratory analyses of the specimen were collected in a data capture sheet. Potential risk factors associated with the presence of Enterococci, were evaluated using the logistic regression in univariate and multivariate analysis. P value < 0.05 was considered as significant. A total of 511 patients were recruited who were predominantly females. Enterococcus spp were isolated in 27.79% of our samples with Enterococcus faecalis mostly encountered. Enterococcus spp showed a high level of resistance to penicilline (99.3% to
文摘Introduction: Healthcare-associated infections are involved in hospital long-stay and in the increase in inherent costs to patients care. Objectives: Objective was to describe the characteristics of healthcare-associated bacteremia and urinary tract infections in medical wards of CNHU-HKM of Cotonou, describe the distribution of germs identified according to admission wards and identify factors associated with onset of healthcare-associated infections. Materials and Methods: It was a cohort study conducted from 4th April to 16th September 2016. The study population included patients admitted in wards A and B of CNHU-HKM Medicine department for at least the past 48 hours, or readmitted in one of the medical wards less than 14 days after their discharge from hospital. Results: The study included 825 patients in total. Prevalence of healthcare-associated infections was 9.8%. Bacteremia was the most represented group (65.4%). The most often identified germs regardless of the site were respectively: K. pneumonia (38.5%), S. aureus (23.1%) and E. coli (20.0%). HIV+ status, internal medicine department, nephrology and endocrinology, duration of admission and the use of urinary catheter represent factors statistically associated with the onset of healthcare-associated infections. Conclusion: Healthcare-associated infections are a real public health issue in CNHU-HKM Medicine Department. There is pressing need to conduct a study on clinical hygiene so as to assess healthcare staff in practice.
文摘Introduction: Healthcare-associated infections (HAIs) are a worldwide concern because of their magnitude and their human and financial cost. While nurses’ non-compliance of hygiene and asepsis measures is questioned, the rationale behind it is not fully understood. We hypothesized that nurses’ experiences and perceptions are one of the reasons for their non-compliance with prevention recommendations. Also, nurses’ caring approach would play an important role in patient safety. The objective of this study was to describe nurses’ experiences and perceptions of HAIs in a district hospital in Burkina Faso with the aim of developing a culture of safety in health care practices. Methods: Qualitative data were collected through unstructured interviews with twenty nurses from the Ziniaré district hospital. Data analysis followed the qualitative phenomenological method according to Giorgi. Results: Phenomenological analysis yielded the following themes: “an ignored reality”;“a denied responsibility”;and “a vulnerable problem”. These results show that nurses’ perception of the extent and seriousness of HAIs is low, and that they deny responsibility for their occurrence. As a result, HAIs are not always perceived as a concern. However, nurses deplore the situation, but remain optimistic about resolving the problem. Conclusion: These nurses’ perceptions of HAIs could explain their non-compliance with prevention recommendations. Corrective action could be redirected by raising awareness, continuing training, improving working conditions and involving all players, including patients and their families, in the fight against HAIs. .
文摘<strong>Background</strong><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Neonatal sepsis is a global health problem that mainly affects low- and middle-income countries. We have previously shown that early neonatal mortality is high at the Ho Teaching Hospital (HTH) of Ghana. We sought to determine the prevalence of neonatal sepsis, sepsis-related mortality, and bacterial species patterns in neonatal and young infant sepsis in this hospital.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Methods</span></b><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:;" "=""> </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">A hospital-based study was conducted in the hospital’s neonatal intensive care unit (NICU) from March to June 2018. Blood samples from 96 babies clinically diagnosed with or at risk of sepsis were cultured using the BACTEC 9050<span style="white-space:nowrap;"><sup>®</sup> </span>machine. Clinical data including gravida, parity and antibiotic medication before delivery of mother and delivery type, gestation, birth weight and antibiotic medication status were collected for analysis. MALDI-TOF MS identified bacterial isolates, and their identities were confirmed via </span><i><span style="font-family:Verdana;">tuf</span></i><span style="font-family:Verdana;"> gene sequence typing. The data were analyzed using GraphPad Prism 8.0.2.</span></span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">Blood cultures were positive in 28 of the babies, with 14 and 12 representing early-onset and late-onset neonatal sepsis, respectively, and two cases of unknown sepsis type. Of the bacterial species that caused sepsis in the babies, coagulase-negative staphylococcus (CoNS) was the most prevalent isolate in 22 cases,
