BMC Infectious Diseases最新文献

Background: Catheter-associated urinary tract infections (CAUTIs) are a major healthcare-associated infection (HAI) in trauma care settings, contributing to morbidity, mortality and antimicrobial resistance. In this study we characterize the epidemiology, microbiological profile, antimicrobial resistance patterns, and clinical outcomes of CAUTIs and non-CAUTI urinary tract infections (UTIs) at a Level 1 Trauma Centre in India from 2017 to 2024, using a modified CDC-NHSN definition and digital surveillance.

Methods: A retrospective analysis of 723 UTI events was conducted using Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC-NHSN) definitions, modified to include Candida spp. at ≥ 10⁵ CFU/mL. Surveillance was performed by dedicated Hospital Infection Control Nurses (HICNs) using a digital system. Microbiological identification and antimicrobial susceptibility testing (AST) were conducted via the conventional manual methods and automated systems.

Results: of 723 UTI events, 608 (84.0%) were CAUTIs. The cohort had a median age of 34 years (IQR:22-45) and was 76% male. Pseudomonas aeruginosa (18%), Klebsiella pneumoniae (17.9%), and Escherichia coli (15%) were predominant pathogens. Antimicrobial resistance was high, with 100% resistance to ceftazidime in Acinetobacter baumannii and 93.6-94.1% resistance to ciprofloxacin in Klebsiella spp. and Enterococcus spp. Mortality was 25.5% (28.2% in CAUTI, 12.9% in non-CAUTI).

Conclusion: This large-scale, trauma specific study with modified fungal criteria and digital surveillance highlights the importance of CAUTI burden and the high resistance in pathogens causing this infection.

Clinical trial number: Not applicable.

Background: Tuberculosis (TB) has been recognized as one of the major public health problems in Ethiopia over the past 50 years. It is the leading cause of morbidity, the third leading cause of hospitalization, and the second leading cause of death. Successful treatment outcomes are crucial in order to improve the Tuberculosis management program. This study is aimed to assess treatment outcomes of TB and the factors that influence the observed treatment outcomes in TB patients of Nekemte public health facility.

Method: An institutional-based cross-sectional study design was conducted in Nekemte town public health care facilities from November 1 to November 30, 2021. The data were collected by using a checklist from TB registration logbook, patient medical cards, and laboratory requests. The data was entered into Epi data version 3.1 and analyzed using SPSS version 24. The variables associated with the treatment outcomes were selected using bivariable and multivariable logistic regression analysis. The level of significance was expressed by the adjusted odds ratio (AOR) with a 95% confidence interval (CI). A variable with a p-value less than 0.05 was considered statistically significant.

Result: Successful treatment outcomes of the TB patients were 77.3% (95%CI: 74.6, 79.8). Urban residency (AOR = 2.8, 95% CI: 1.8-4.34), absence previous treatment history (AOR = 3.5, 95% CI: 1.34-9.164), absence of history of comorbidity (AOR = 13.9, 95% CI:7.1-27.33), and patients who had DOTs supporter (AOR = 7.7, 95% CI: 3.9 -15.11) were significantly associated with successful TB treatment outcomes.

Conclusion and recommendation: The study found that TB treatment success rates were below national and global targets. Factors such as urban residency, absence of previous TB treatment, absence of comorbidity, DOTs supporter was found to be the significant predictors of TB treatment outcome. To improve success rates, it is recommended to expand access to trained DOTs supporters, particularly in rural areas, and prioritize monitoring of high-risk populations, including patients with a history of TB treatment, additionally, educate family members on supporting treatment adherence and addressing co-morbidities through integrated care models will contribute to improved treatment adherence and success.