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Incidence and Predictors of Severe Adverse Drug Reactions among Patients on Antiretroviral Drugs in Harari Regional State, Eastern Ethiopia 埃塞俄比亚东部哈拉里地区使用抗逆转录病毒药物的患者中严重药物不良反应的发生率和预测因素
Pub Date : 2024-01-19 DOI: 10.1155/2024/5580728
Obsa Anbessa, Behailu Hawulte, Tariku Dingeta, Abdi Birhanu
Background. The introduction of combination antiretroviral therapy improves the quality and longevity of people living with HIV/AIDS. However, adverse drug reactions associated with antiretroviral therapy compromise the resulting benefits and have been reported differently worldwide, including Ethiopia. Severe adverse drug reactions are one of the major public health concerns for the reason that they can potentially impede the benefit of antiretroviral therapy and put the patient’s survival at risk. Despite many successes achieved with the introduction of the combined antiretroviral therapy, the majority of the patients on antiretroviral therapy experience adverse drug reactions associated with the drugs. Consequently, little is known about the problem in the current study area. This is, therefore, to study incidence and predictors of severe adverse drug reactions among patients on antiretroviral drugs in the Harari region, Eastern Ethiopia. The aim of this study was to assess the incidence and predictors of severe adverse drug reactions among patients on antiretroviral therapy from February 25, 2022, to March 25, 2022, in the Harari region, Eastern Ethiopia. Methods. A hospital-based retrospective cohort study was conducted among 449 randomly selected medical records of people living with HIV on first-line antiretroviral therapy. Collected data were entered into EpiData version 3.1 and exported to STATA version 15 for analysis. Kaplan–Meier survival curve with log-rank test was used to compare survival curves for categorical independent variables. A value ≤0.05 was declared as significant, and an adjusted hazard ratio was used to report the effect size using the multivariate Cox proportional hazard model. Result. The overall incidence density of the severe adverse reactions was 7.22 per 1000 months (95% CI: 5.5, 9.6). After adjusting for all potential confounders using multivariable Cox proportional hazard ratio, advanced clinical diseases (AHR = 3.44; 95% CI: 1.54, 7.65), HIV/tuberculosis confections (AHR = 2.38; 95% CI: 1.23, 4.62), and being female (AHR = 3.12; 95% CI: 1.57, 6.18) were significantly associated with the experience of severe adverse drug reactions. Conclusion. In this study, the incidence of severe adverse reactions was consistent with the previous studies, and advanced World Health Organization (WHO) clinical stage, HIV/TB confection, and being female were the independent predictors of the severe adverse drug reactions.
背景。抗逆转录病毒联合疗法的引入提高了艾滋病毒/艾滋病感染者的质量和寿命。然而,与抗逆转录病毒疗法相关的药物不良反应损害了由此带来的益处,在包括埃塞俄比亚在内的世界各地都有不同的报告。严重的药物不良反应是主要的公共卫生问题之一,因为它们有可能阻碍抗逆转录病毒疗法带来的益处,并危及患者的生存。尽管采用抗逆转录病毒联合疗法取得了许多成功,但大多数接受抗逆转录病毒疗法的患者都会出现与药物相关的药物不良反应。因此,本研究领域对这一问题知之甚少。因此,本研究旨在研究埃塞俄比亚东部哈拉里地区服用抗逆转录病毒药物的患者中严重药物不良反应的发生率和预测因素。本研究旨在评估埃塞俄比亚东部哈拉里地区 2022 年 2 月 25 日至 2022 年 3 月 25 日期间接受抗逆转录病毒治疗的患者中严重不良药物反应的发生率和预测因素。研究方法在随机抽取的 449 份接受一线抗逆转录病毒治疗的艾滋病病毒感染者的病历中开展了一项基于医院的回顾性队列研究。收集的数据输入 EpiData 3.1 版,并导出到 STATA 15 版进行分析。卡普兰-梅耶生存曲线与对数秩检验用于比较分类自变量的生存曲线。数值≤0.05为显著性,使用多变量考克斯比例危险模型,用调整后的危险比来报告效应大小。结果严重不良反应的总体发生率为每1000个月7.22例(95% CI:5.5-9.6)。使用多变量 Cox 比例危险比对所有潜在混杂因素进行调整后,晚期临床疾病(AHR = 3.44;95% CI:1.54,7.65)、HIV/结核感染(AHR = 2.38;95% CI:1.23,4.62)和女性(AHR = 3.12;95% CI:1.57,6.18)与严重药物不良反应的发生显著相关。结论本研究中,严重不良反应的发生率与之前的研究一致,世界卫生组织(WHO)临床分期晚期、HIV/TB感染和女性是严重药物不良反应的独立预测因素。
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引用次数: 0
What Makes the Gut-Lung Axis Working? From the Perspective of Microbiota and Traditional Chinese Medicine 是什么让 "肠肺轴 "发挥作用?从微生物群和中医的角度看肠肺轴的作用
Pub Date : 2024-01-18 DOI: 10.1155/2024/8640014
Hui Wang, Ying Wang
Background. An increasing number of studies have proved that gut microbiota is involved in the occurrence and development of various lung diseases and can interact with the diseased lung. The concept of the gut-lung axis (GLA) provides a new idea for the subsequent clinical treatment of lung diseases through human microbiota. This review aims to summarize the microbiota in the lung and gut and the interaction between them from the perspectives of traditional Chinese medicine and modern medicine. Method. We conducted a literature search by using the search terms “GLA,” “gut microbiota,” “spleen,” and “Chinese medicine” in the databases PubMed, Web of Science, and CNKI. We then explored the mechanism of action of the gut-lung axis from traditional Chinese medicine and modern medicine. Results. The lung and gut microbiota enable the GLA to function through immune regulation, while metabolites of the gut microbiota also play an important role. The spleen can improve the gut microbiota to achieve the regulation of the GLA. Conclusion. Improving the gut microbiota through qi supplementation and spleen fortification provides a new approach to the clinical treatment of lung diseases by regulating the GLA. Currently, our understanding of the GLA is limited, and more research is needed to explain its working principle.
背景。越来越多的研究证明,肠道微生物群与各种肺部疾病的发生和发展有关,并能与患病肺部相互作用。肠道-肺轴(GLA)的概念为随后通过人体微生物群临床治疗肺部疾病提供了新思路。本综述旨在从中医和现代医学的角度总结肺和肠道中的微生物群及其相互作用。研究方法我们在 PubMed、Web of Science 和 CNKI 数据库中使用 "GLA"、"肠道微生物群"、"脾 "和 "中医 "等检索词进行文献检索。然后,我们从传统中医和现代医学的角度探讨了肠肺轴的作用机制。研究结果肺和肠道微生物群通过免疫调节使 GLA 发挥作用,而肠道微生物群的代谢产物也发挥着重要作用。脾能改善肠道微生物群,实现对 GLA 的调节。结论通过补气健脾改善肠道微生物群,为临床治疗肺部疾病提供了一种调节 GLA 的新方法。目前,我们对 GLA 的了解还很有限,需要更多的研究来解释其工作原理。
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引用次数: 0
Phylogenetic Aspects of Antibiotic Resistance and Biofilm Formation of P. aeruginosa Isolated from Clinical Samples 从临床样本中分离出的铜绿微囊桿菌的抗生素耐药性和生物膜形成的系统发育特征
Pub Date : 2024-01-13 DOI: 10.1155/2024/6213873
Maryam Motevasel, Masoud Haghkhah, Negar Azimzadeh
Introduction. Biofilm production and drug resistance phenomenon play a critical role in P. aeruginosa infections. Several genes, including psl, pel, brlR, and mex, are involved in the phenomenon. The aim of this study was to find the relationship between the mentioned genes and the sources of P. aeruginosa infections. Materials and Methods. Fifty-nine P. aeruginosa isolates detected from clinical specimens were used to determine antibiotic susceptibility patterns, prevalence of the genes using PCR, biofilm formation, biofilm eradication concentration assay (MBEC), and epidemiological characteristics using pulsed-field gel electrophoresis (PFGE). Results. The results showed that 35.6% and 16.94% of all the samples were isolated from urine and wounds, 81.33% of the isolates were biofilm producers, 27.11% were multidrug-resistant (MDR), and 100% of the main biofilm former genes belonged to pslA. 94.91% of the isolates possessed brlR and mexA, and 91.5% of them expressed pslA. It was also indicated that neither ciprofloxacin nor imipenem could eradicate the formed biofilms. Moreover, we could identify 81.4% distinctive restriction profiles among the isolates, using an 80% similarity cutoff point; brlR and pel genes were significantly (;
导言。生物膜的产生和耐药性现象在铜绿假单胞菌感染中起着至关重要的作用。包括 psl、pel、brlR 和 mex 在内的多个基因参与了这一现象。本研究旨在找出上述基因与铜绿假单胞菌感染源之间的关系。材料与方法。对从临床标本中检测到的 59 株铜绿假单胞菌进行抗生素敏感性模式测定、利用 PCR 测定基因的流行率、生物膜形成、生物膜根除浓度测定(MBEC)以及利用脉冲场凝胶电泳(PFGE)测定流行病学特征。结果显示结果显示,35.6%和 16.94%的样本分别从尿液和伤口中分离出来,81.33%的分离株是生物膜生产者,27.11%的分离株具有多重耐药性(MDR),100%的主要生物膜形成基因属于 pslA。94.91% 的分离物拥有 brlR 和 mexA,91.5% 的分离物表达 pslA。研究还表明,环丙沙星和亚胺培南都无法根除已形成的生物膜。此外,以 80% 的相似度为临界点,我们可以在分离株中识别出 81.4% 的独特限制性图谱;brlR 和 pel 基因与系统发育脉型有显著(;)关系。对分离物的树枝图进行比较后发现,从尿液中检测到的分离物存在于 12 个不同的脉型中。结论研究发现,分离物中的 MDR、生物膜生成、brlR 和 pel 基因之间存在关系。尿液中检测到的分离株之间存在相似的基因模式,因此可以得出结论,尿道在维持和转移铜绿假单胞菌生物膜耐药基因方面在临床中起着关键作用。这项研究强调了尿液在临床生物膜形成和耐药铜绿假单胞菌分离物分布中的重要性。
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引用次数: 0
Prevalence of blaCTX-M and blaTEM Genes in Cefotaxime-Resistant Escherichia coli Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study 尼泊尔中部三级医疗机构发现的耐头孢他啶大肠埃希菌中 blaCTX-M 和 blaTEM 基因的流行情况:描述性横断面研究
Pub Date : 2024-01-08 DOI: 10.1155/2024/5517662
Rani Kumari Sah, Pragyan Dahal, Ranjana Parajuli, Gorkha Raj Giri, Era Tuladhar
Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by Escherichia coli and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (blaCTX-M and blaTEM) in cephalosporin-resistant E. coli. Altogether, 1050 urine samples were processed to obtain 165 isolates of E. coli. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby–Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (blaCTX-M and blaTEM) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant E. coli. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as E. coli. The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the E. coli isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (blaCTX-M and blaTEM) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the blaCTX-M gene was 55.26%. The prevalence of MDR E. coli harboring the blaCTX-M and blaTEM genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.
尿路感染(UTI)在全球范围内发病率很高,人们使用各种抗生素对其进行治疗。然而,尿路感染病原体对这些抗生素产生耐药性,导致发病率和死亡率居高不下。本研究于2021年11月至2022年5月在格兰德国际医院微生物实验室进行,旨在评估由大肠埃希菌引起的UTI发病率及其对抗生素的敏感性模式,重点关注广谱β-内酰胺酶(ESBLs)以及耐头孢菌素大肠埃希菌中两种基因(blaCTX-M和blaTEM)的流行情况。研究人员共处理了 1050 份尿液样本,从中分离出 165 株大肠杆菌。根据菌落形态和生化特征对分离菌进行鉴定。抗菌药物敏感性试验(AST)采用柯比鲍尔盘扩散法(Kirby-Bauer disk diffusion method)测定,ESBL酶采用组合盘法(CDM)估算。通过聚合酶链反应(PCR)研究了耐头孢他啶大肠杆菌中的两种 ESBL 基因(blaCTX-M 和 blaTEM)。在处理的 1050 份尿液样本中,335 份(31.9%)培养呈阳性,其中 165 份(49.2%)被鉴定为大肠杆菌。年龄≥60 岁的人群(30.3%)更容易受到细菌感染。AST 显示,美罗培南非常有效(95.7% 的敏感性),而氨苄西林的敏感性最低(42.4%)。在分离出的大肠杆菌中,86 个具有多重耐药性(MDR),10 个具有广泛耐药性(XDR)。其中,46 个 MDR(96%)和 2 个 XDR(4%)产生 ESBL。ESBL基因(blaCTX-M和blaTEM)的流行率分别为49.3%和54.8%。与 PCR 相比,CDM 检测 blaCTX-M 基因的总体准确率为 55.26%。携带 blaCTX-M 和 blaTEM 基因的 MDR 大肠杆菌的流行强调了 ESBL 检测在准确鉴定 beta-内酰胺酶生产者和非生产者方面的重要作用。
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引用次数: 0
Insight into the Burden of Antimicrobial Resistance among Bacterial Pathogens Isolated from Patients Admitted in ICUs of a Tertiary Care Hospital in India 洞察印度一家三级医院重症监护室住院病人分离出的细菌病原体的抗菌药耐药性负担
Pub Date : 2024-01-06 DOI: 10.1155/2024/7403044
Garima Gautam, Shweta Satija, Ravinder Kaur, Anil Kumar, Divakar Sharma, Megh Singh Dhakad
Intensive care unit (ICU) patients are prone to develop infections by hospital prevalent organisms. The aim of the study was to determine the bacteriological profiles and their drug resistance pattern among different infections in ICU patients of a tertiary care hospital. The record-based retrospective data of culture reports of the patients admitted to all the ICUs of a tertiary care hospital during the period from January 2020 to May 2022 were analyzed. A total of 3,056 samples were obtained from 2308 patients. The infection rate among ICU patients was found to be 53.40%. Isolates belonged equally to males (50.86%) and females (49.14%). The most common culture-positive clinical specimen received was blood (39.08%) followed by respiratory samples (29.45%). Acinetobacter sp. (33.02%) was the most common organism isolated from various clinical specimens, followed by Klebsiella pneumoniae (20.89%), and Escherichia coli (13.8%). More than 80% of Acinetobacter species were found to be resistant to third-generation cephalosporins, aminoglycosides, and carbapenems, whereas minocycline (56.31% S) and colistin (100% S) were the most effective drugs. Klebsiella sp. was found to be more resistant than E.coli, and the least resistance was observed to be tetracycline (43.97%) and doxycycline (55.84%). Among Staphylococcus aureus, 82.78% of strains were methicillin-resistant (MRSA). Vancomycin-resistant Enterococci (VRE) sp. accounted for 16.67% of the isolates. Evidence-based knowledge regarding the local bacterial organisms and their antimicrobial resistance pattern is pivotal in deciding empirical drug therapy, ultimately leading to the management of antimicrobial resistance (AMR).
重症监护室(ICU)患者很容易受到医院流行病菌的感染。本研究旨在确定一家三级医院重症监护室患者不同感染的细菌学特征及其耐药性模式。研究分析了一家三甲医院所有重症监护室在 2020 年 1 月至 2022 年 5 月期间收治的患者的培养报告记录。共从 2308 名患者身上获得了 3056 份样本。结果发现,重症监护室患者的感染率为 53.40%。男性(50.86%)和女性(49.14%)所占比例相当。最常见的培养阳性临床样本是血液(39.08%),其次是呼吸道样本(29.45%)。从各种临床标本中分离出的最常见微生物是不动杆菌(33.02%),其次是肺炎克雷伯菌(20.89%)和大肠埃希菌(13.8%)。超过 80% 的醋氨曲霉菌对第三代头孢菌素、氨基糖苷类和碳青霉烯类产生耐药性,而米诺环素(56.31% S)和可乐定(100% S)则是最有效的药物。克雷伯氏菌的耐药性高于大肠杆菌,耐药性最低的是四环素(43.97%)和强力霉素(55.84%)。在金黄色葡萄球菌中,82.78%的菌株耐甲氧西林(MRSA)。耐万古霉素肠球菌(VRE)占分离菌株的 16.67%。有关本地细菌生物及其抗菌药耐药性模式的循证知识在决定经验性药物疗法方面至关重要,最终将导致抗菌药耐药性(AMR)的管理。
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引用次数: 0
Inpatient Q Fever Frequency Is on the Rise 住院病人 Q 热发病率呈上升趋势
Pub Date : 2023-12-31 DOI: 10.1155/2023/4243312
Mohamad Alhoda Mohamad Alahmad, Kassem A. Hammoud
Background. Q fever is a zoonotic bacterial infection caused by Coxiella burnetii that is reportable in the USA. This infection is often asymptomatic; acute infection usually manifests as a self-limited febrile illness, hepatitis, or pneumonia. Chronic infection (usually infective endocarditis) often affects patients with valvulopathy or immunosuppression. Herein, we study the inpatient frequency of Q fever in the United States. Methods. We used a nationwide inpatient sample (NIS) for our retrospective cohort study to include hospitalizations with a diagnosis of Q fever between 2010 and 2019. Survey procedures were applied to accommodate for complex sampling design of NIS. Chi-square and least-square means were used for categorical and continuous variables, respectively. Jonckheere–Terpstra test was used to study the trends over the years. SAS 9.4 was used for data mining and analysis. Results. A total of 2,685 hospitalizations with a diagnosis of Q fever were included, among which 451 (17%) cases had a concurrent diagnosis of infective endocarditis. The mean age of patients was 58 years, and less than a third was female. Our analysis demonstrated that infective endocarditis was the most common cardiac complication associated with Q fever and was associated with increased inpatient mortality ( value <0.001). There is a trend of an increase in cases of inpatient Q fever with or without endocarditis over the years ( value <0.05). Q fever cases were more common across the Pacific and the South Atlantic divisions. Conclusion. Physicians should be aware of an increasing trend of hospitalized patients with Q fever and the significant association with infective endocarditis. Further studies are needed.
背景。Q 热是一种由烧伤柯西氏菌引起的人畜共患细菌感染,在美国可报告。这种感染通常没有症状;急性感染通常表现为自限性发热、肝炎或肺炎。慢性感染(通常是感染性心内膜炎)通常会影响瓣膜病或免疫抑制患者。在此,我们对美国 Q 热的住院病人频率进行了研究。方法。我们在回顾性队列研究中使用了全国住院病人样本(NIS),包括 2010 年至 2019 年期间诊断为 Q 热的住院病人。我们采用了调查程序,以适应 NIS 复杂的抽样设计。对分类变量和连续变量分别采用了卡方和最小二乘法。Jonckheere-Terpstra 检验用于研究多年来的趋势。使用 SAS 9.4 进行数据挖掘和分析。结果共纳入 2,685 例诊断为 Q 热的住院病例,其中 451 例(17%)同时诊断为感染性心内膜炎。患者的平均年龄为 58 岁,女性患者不到三分之一。我们的分析表明,感染性心内膜炎是与 Q 热相关的最常见的心脏并发症,并且与住院患者死亡率的增加有关(值为 0.001)。多年来,伴有或不伴有心内膜炎的 Q 热住院病例呈上升趋势(数值为 0.05)。太平洋和南大西洋分区的 Q 热病例更为常见。结论。医生应该意识到,Q热住院病人呈上升趋势,且与感染性心内膜炎密切相关。还需要进一步研究。
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引用次数: 0
Association between Pneumonia Development and Virulence Gene Expression in Carbapenem-Resistant Acinetobacter baumannii Isolated from Clinical Specimens 从临床标本中分离出的耐碳青霉烯类鲍曼不动杆菌肺炎发展与病毒基因表达之间的关系
Pub Date : 2023-12-21 DOI: 10.1155/2023/8265683
Ji Yun Bae, Ina Yun, Kang Il Jun, Chung-Jong Kim, Miae Lee, Hee Jung Choi
We investigated the virulence gene expression of carbapenem-resistant Acinetobacter baumanii (CRAB) isolated from the respiratory samples of patients with CRAB pneumonia and those with CRAB colonization to identify the virulence genes contributing to CRAB pneumonia’s development and mortality. Patients with CRAB identified from respiratory specimens were screened at a tertiary university hospital between January 2018 and January 2019. Patients were classified into CRAB pneumonia or CRAB colonization groups according to predefined clinical criteria. A. baumannii isolated from respiratory specimens was examined for the expression levels of ompA, uspA, hfq, hisF, feoA, and bfnL by quantitative reverse-transcription polymerase chain reaction. Among 156 patients with CRAB from respiratory specimens, 17 and 24 met the criteria for inclusion in the pneumonia and colonization groups, respectively. The expression level of ompA was significantly higher in the pneumonia group than in the colonization group (1.45 vs. 0.63, ). The expression levels of ompA (1.97 vs. 0.86, ), hisF (1.06 vs. 0.10,
我们研究了从CRAB肺炎患者和CRAB定植患者的呼吸道样本中分离出的耐碳青霉烯类鲍曼不动杆菌(CRAB)的毒力基因表达,以确定导致CRAB肺炎发生和死亡的毒力基因。2018年1月至2019年1月期间,一家三级大学医院对从呼吸道标本中鉴定出的CRAB患者进行了筛查。根据预先确定的临床标准,患者被分为CRAB肺炎组和CRAB定植组。通过反转录聚合酶链反应定量检测从呼吸道标本中分离出的鲍曼不动杆菌的ombA、uspA、hfq、hisF、feoA和bfnL的表达水平。在呼吸道标本中发现的 156 例 CRAB 患者中,分别有 17 例和 24 例符合肺炎组和定植组的标准。肺炎组的 ompA 表达水平明显高于定植组(1.45 对 0.63)。30 天死亡患者的 ompA(1.97 vs. 0.86, )、hisF(1.06 vs. 0.10, )、uspA(1.62 vs. 1.01, )和 bfnL(3.14 vs. 2.14, )的表达水平明显高于存活患者。在调整年龄和夏尔森评分后,hisF(调整后的几率比=5.93,)和uspA(调整后的几率比=7.36,)的表达升高与30天死亡率相关。
{"title":"Association between Pneumonia Development and Virulence Gene Expression in Carbapenem-Resistant Acinetobacter baumannii Isolated from Clinical Specimens","authors":"Ji Yun Bae, Ina Yun, Kang Il Jun, Chung-Jong Kim, Miae Lee, Hee Jung Choi","doi":"10.1155/2023/8265683","DOIUrl":"https://doi.org/10.1155/2023/8265683","url":null,"abstract":"We investigated the virulence gene expression of carbapenem-resistant <i>Acinetobacter baumanii</i> (CRAB) isolated from the respiratory samples of patients with CRAB pneumonia and those with CRAB colonization to identify the virulence genes contributing to CRAB pneumonia’s development and mortality. Patients with CRAB identified from respiratory specimens were screened at a tertiary university hospital between January 2018 and January 2019. Patients were classified into CRAB pneumonia or CRAB colonization groups according to predefined clinical criteria. <i>A. baumannii</i> isolated from respiratory specimens was examined for the expression levels of <i>ompA</i>, <i>uspA</i>, <i>hfq</i>, <i>hisF</i>, <i>feoA</i>, and <i>bfnL</i> by quantitative reverse-transcription polymerase chain reaction. Among 156 patients with CRAB from respiratory specimens, 17 and 24 met the criteria for inclusion in the pneumonia and colonization groups, respectively. The expression level of <i>ompA</i> was significantly higher in the pneumonia group than in the colonization group (1.45 vs. 0.63, <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"></path></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 8.8423\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>).</span></span> The expression levels of <i>ompA</i> (1.97 vs. 0.86, <span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 19.289 8.8423\" width=\"19.289pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"><use xlink:href=\"#g113-81\"></use></g><g transform=\"matrix(.013,0,0,-0.013,11.658,0)\"><use xlink:href=\"#g117-34\"></use></g></svg><span></span><span><svg height=\"8.8423pt\" style=\"vertical-align:-0.2064009pt\" version=\"1.1\" viewbox=\"22.8711838 -8.6359 21.918 8.8423\" width=\"21.918pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.921,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,29.161,0)\"><use xlink:href=\"#g113-47\"></use></g><g transform=\"matrix(.013,0,0,-0.013,32.125,0)\"><use xlink:href=\"#g113-49\"></use></g><g transform=\"matrix(.013,0,0,-0.013,38.365,0)\"></path></g></svg>),</span></span> <i>hisF</i> (1.06 vs. 0.10, <span><svg height=\"9.27","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138826037","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
Radiology Department: A Potential Source of Multidrug-Resistant Microorganisms: A Cross-Sectional Study at Tertiary Hospital, Palestine 放射科:耐多药微生物的潜在来源:巴勒斯坦三级医院横断面研究
Pub Date : 2023-12-18 DOI: 10.1155/2023/4441338
Zena Odeh, Safaa Abatli, Mohammad Qadi
Introduction. Globally, healthcare facilities face a great challenge in the form of hospital-acquired infections (HAIs). Aside from the morbidity and mortality they cause, these illnesses are also extremely costly. Research on infection transmission in the medical field has been considerable, but not so much in the radiology department. Aim. This study aims to identify the presence of multidrug-resistant (MDR) microbes on surfaces that are frequently touched in computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), plain X-ray examination rooms, and portable radiography that are susceptible to contamination as well as to investigate the potential dangers of contracting MDR organisms to patients and healthcare providers. Materials and Method. In this study, 160 swab samples were collected from the radiology department during May and June 2022. Samples were obtained from 80 predefined surfaces twice within and outside of CT and MRI examination rooms as well as from US and plain X-ray machines and portable X-ray machines. Samples were taken at 7:00 a.m. using cotton swabs following the regular cleaning procedure. Bacterial colony-forming units (CFUs) per square centimeter were calculated after swabbing a 100 cm2 surface. Results. Nearly all of the surfaces tested had bacterial CFUs. The highest contamination rate was found on keyboards ranging from (1.2–8) CFU/cm2, the sides of patient tables (1.2–20) CFU/cm2, knee coil (2.4–3) CFU/cm2, and patient leg supports (1.2–8) CFU/cm2. A noticeable increase in the contamination was noticed in June compared to May, and this was consistent with the increase in the number of isolated patients in the hospital, the workload in the radiology department, and the number of patients referred to the hospital. In our study, none of the examined sites showed contamination with MDR Gram-negative bacteria such as extended-spectrum beta-lactamases producing Enterobacterales (ESPL) or Carbapenemase-producing Enterobacterales (CPE). On the other hand, methicillin-resistant Staphylococcus (MRS), vancomycin-resistant Staphylococcus (VRS), and vancomycin-resistant Enterococcus (VRE) were detected. Conclusion. All of the radiology department equipment and sites could be a source of bacterial infection including MDR, so the obligatory and committed disinfection protocol must be revised and implemented in the morning and between patients.
导言。在全球范围内,医疗机构都面临着医院感染(HAIs)的巨大挑战。这些疾病除了会导致发病率和死亡率外,还会造成巨大的经济损失。医学领域对感染传播的研究相当多,但放射科的研究却不多。研究目的本研究旨在确定计算机断层扫描(CT)、磁共振成像(MRI)、超声波(US)、普通 X 射线检查室和便携式射线照相术中经常接触的、易受污染的表面上是否存在耐多药(MDR)微生物,并调查患者和医护人员感染耐多药微生物的潜在危险。材料和方法。本研究在 2022 年 5 月和 6 月期间从放射科采集了 160 份拭子样本。样本从 CT 和 MRI 检查室内外的 80 个预定表面采集两次,也从 US 和普通 X 光机以及便携式 X 光机采集两次。样本于早上 7:00 按照常规清洁程序用棉签采集。用棉签拭擦 100 平方厘米的表面后,计算每平方厘米的细菌菌落形成单位 (CFU)。结果显示几乎所有被测表面都有细菌菌落形成单位。污染率最高的是键盘(1.2-8)CFU/cm2、病人桌边(1.2-20)CFU/cm2、膝关节圈(2.4-3)CFU/cm2 和病人腿部支撑(1.2-8)CFU/cm2。与 5 月份相比,6 月份的污染量明显增加,这与医院隔离病人数量、放射科工作量和转诊病人数量的增加是一致的。在我们的研究中,没有一个受检部位出现耐多药革兰氏阴性菌污染,如产广谱β-内酰胺酶肠杆菌(ESPL)或产碳青霉烯酶肠杆菌(CPE)。另一方面,还检测到耐甲氧西林葡萄球菌(MRS)、耐万古霉素葡萄球菌(VRS)和耐万古霉素肠球菌(VRE)。结论放射科的所有设备和部位都可能是细菌感染(包括 MDR)的源头,因此必须修订并在早上和病人之间执行强制性和承诺性消毒协议。
{"title":"Radiology Department: A Potential Source of Multidrug-Resistant Microorganisms: A Cross-Sectional Study at Tertiary Hospital, Palestine","authors":"Zena Odeh, Safaa Abatli, Mohammad Qadi","doi":"10.1155/2023/4441338","DOIUrl":"https://doi.org/10.1155/2023/4441338","url":null,"abstract":"<i>Introduction</i>. Globally, healthcare facilities face a great challenge in the form of hospital-acquired infections (HAIs). Aside from the morbidity and mortality they cause, these illnesses are also extremely costly. Research on infection transmission in the medical field has been considerable, but not so much in the radiology department. <i>Aim</i>. This study aims to identify the presence of multidrug-resistant (MDR) microbes on surfaces that are frequently touched in computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), plain X-ray examination rooms, and portable radiography that are susceptible to contamination as well as to investigate the potential dangers of contracting MDR organisms to patients and healthcare providers. <i>Materials and Method</i>. In this study, 160 swab samples were collected from the radiology department during May and June 2022. Samples were obtained from 80 predefined surfaces twice within and outside of CT and MRI examination rooms as well as from US and plain X-ray machines and portable X-ray machines. Samples were taken at 7:00 a.m. using cotton swabs following the regular cleaning procedure. Bacterial colony-forming units (CFUs) per square centimeter were calculated after swabbing a 100 cm<sup>2</sup> surface. <i>Results</i>. Nearly all of the surfaces tested had bacterial CFUs. The highest contamination rate was found on keyboards ranging from (1.2–8) CFU/cm<sup>2</sup>, the sides of patient tables (1.2–20) CFU/cm<sup>2</sup>, knee coil (2.4–3) CFU/cm<sup>2</sup>, and patient leg supports (1.2–8) CFU/cm<sup>2</sup>. A noticeable increase in the contamination was noticed in June compared to May, and this was consistent with the increase in the number of isolated patients in the hospital, the workload in the radiology department, and the number of patients referred to the hospital. In our study, none of the examined sites showed contamination with MDR Gram-negative bacteria such as extended-spectrum beta-lactamases producing <i>Enterobacterales</i> (ESPL) or Carbapenemase-producing <i>Enterobacterales</i> (CPE). On the other hand, methicillin-resistant <i>Staphylococcus</i> (MRS), vancomycin-resistant <i>Staphylococcus</i> (VRS), and vancomycin-resistant <i>Enterococcus</i> (VRE) were detected. <i>Conclusion</i>. All of the radiology department equipment and sites could be a source of bacterial infection including MDR, so the obligatory and committed disinfection protocol must be revised and implemented in the morning and between patients.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":"264 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138717165","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
Time Series Modeling of Tuberculosis Cases in India from 2017 to 2022 Based on the SARIMA-NNAR Hybrid Model 基于 SARIMA-NNAR 混合模型的 2017-2022 年印度肺结核病例时间序列模型
Pub Date : 2023-12-16 DOI: 10.1155/2023/5934552
Baikunth Kumar Yadav, Sunil Kumar Srivastava, Ponnusamy Thillai Arasu, Pranveer Singh
Tuberculosis (TB) is still one of the severe progressive threats in developing countries. There are some limitations to social and economic development among developing nations. The present study forecasts the notified prevalence of TB based on seasonality and trend by applying the SARIMA-NNAR hybrid model. The NIKSHAY database repository provides monthly informed TB cases (2017 to 2022) in India. A time series model was constructed based on the seasonal autoregressive integrated moving averages (SARIMA), neural network autoregressive (NNAR), and, SARIM-NNAR hybrid models. These models were estimated with the help of the Bayesian information criterion (BIC) and Akaike information criterion (AIC). These models were established to compare the estimation. A total of 12,576,746 notified TB cases were reported over the years whereas the average case was observed as 174,677.02. The evaluating parameters values of RMSE, MAE, and MAPE for the hybrid model were found to be (13738.97), (10369.48), and (06.68). SARIMA model was (19104.38), (14304.15), and (09.45) and the NNAR were (11566.83), (9049.27), and (05.37), respectively. Therefore, the NNAR model performs better with time series data for fitting and forecasting compared to other models such as SARIMA as well as the hybrid model. The NNAR model indicated a suitable model for notified TB incidence forecasting. This model can be a good tool for future prediction. This will assist in devising a policy and strategizing for better prevention and control.
结核病(TB)仍然是发展中国家面临的严重渐进威胁之一。发展中国家的社会和经济发展受到一些限制。本研究通过应用 SARIMA-NNAR 混合模型,根据季节性和趋势预测结核病的通报流行率。NIKSHAY 数据库存储库提供了印度每月通报的肺结核病例(2017 年至 2022 年)。基于季节自回归综合移动平均(SARIMA)、神经网络自回归(NNAR)和 SARIM-NNAR 混合模型构建了一个时间序列模型。在贝叶斯信息准则(BIC)和阿凯克信息准则(AIC)的帮助下对这些模型进行了估计。建立这些模型是为了比较估算结果。多年来共报告了 12,576,746 例肺结核病例,平均病例数为 174,677.02 例。混合模型的 RMSE、MAE 和 MAPE 的评估参数值分别为(13738.97)、(10369.48)和(06.68)。SARIMA 模型的 RMSE、MAE 和 MAPE 分别为(19104.38)、(14304.15)和(09.45),NNAR 模型的 RMSE、MAE 和 MAPE 分别为(11566.83)、(9049.27)和(05.37)。因此,与 SARIMA 和混合模型等其他模型相比,NNAR 模型在时间序列数据的拟合和预测方面表现更好。NNAR 模型是一个适用于结核病发病率预测的模型。该模型可作为未来预测的良好工具。这将有助于制定更好的预防和控制政策和战略。
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引用次数: 0
Which Groups of Children Are at More Risk of Fatality during COVID-19 Pandemic? A Case-Control Study in Yazd, Iran 哪些儿童群体在 COVID-19 大流行期间死亡风险更高?伊朗亚兹德的病例对照研究
Pub Date : 2023-12-14 DOI: 10.1155/2023/8838056
Behnam Shafaei, Zahra Nafei, Mehran Karimi, Nasrin Behniafard, Farimah Shamsi, Masoud Faisal, Amir Pasha Amel Shahbaz, Elahe Akbarian
Introduction. The study aims to investigate the characteristics, comorbidities, laboratory findings, and clinical manifestations of under 18-year-old patients who died with the diagnosis of COVID-19 and determination of the most prevalent risk factors. Method. This case-control study was performed at a referral hospital in Yazd from March 2020 to August 2021. All patients under 18 years who were diagnosed through real-time RT-PCR, chest computed tomography, and the World Health Organization definition were divided into deceased and survived groups. The characteristics (age and sex), disease severity, comorbidities, laboratory findings, and clinical manifestations of the two groups were compared and analyzed using SPSS, version 18 (SPSS Inc., Chicago, III., USA). Results. A total of 24 patients in the deceased group and 167 patients in the survived group were compared. The highest mortality rate was observed in the age group of 1 month to 5 years, although no statistically significant relationship was found between age groups and the risk of mortality. Disease severity, dyspnea, low oxygen saturation on admission, length of hospital stays, and hospitalization history before the last admission were significantly correlated with mortality ( < 0.05). Lymphopenia increased the probability of mortality by more than two times (OR: 2.568; 95% CI (0.962–6.852)), but this was not the case for D-dimer and C-reactive protein. Furthermore, 27.5% of survived patients had normal chest CT scans, which was a statistically significant difference compared to the deceased patients (: 0.031). Conclusion. Based on the findings of this study, dyspnea, low oxygen saturation, and lymphopenia are critical indicators for identifying high-risk children with COVID-19 and triaging them for better care and treatment.
介绍。本研究旨在调查18岁以下因COVID-19诊断死亡的患者的特征、合并症、实验室检查结果和临床表现,并确定最常见的危险因素。方法。这项病例对照研究于2020年3月至2021年8月在亚兹德的一家转诊医院进行。所有通过实时RT-PCR、胸部计算机断层扫描和世界卫生组织定义诊断的18岁以下患者分为死亡组和存活组。对两组患者的特征(年龄和性别)、疾病严重程度、合并症、实验室结果和临床表现进行比较和分析,使用SPSS, version 18 (SPSS Inc., Chicago, III.)。美国)。结果。死亡组24例,存活组167例。死亡率最高的年龄组为1个月至5岁,但没有发现年龄组与死亡风险之间有统计学意义的关系。疾病严重程度、入院时呼吸困难、低血氧饱和度、住院时间、上次入院前住院史与死亡率显著相关(< 0.05)。淋巴细胞减少使死亡率增加2倍以上(OR: 2.568;95% CI(0.962-6.852)),但d -二聚体和c反应蛋白的情况并非如此。此外,27.5%的存活患者胸部CT扫描正常,与死亡患者相比差异有统计学意义(0.031)。结论。根据这项研究的结果,呼吸困难、低氧饱和度和淋巴细胞减少是识别COVID-19高危儿童并对其进行分类以获得更好的护理和治疗的关键指标。
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Canadian Journal of Infectious Diseases and Medical Microbiology
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