The impact of coronavirus disease 2019 (COVID-19) response on central-line-associated bloodstream infections and blood culture contamination rates at a tertiary-care center in the Greater Detroit area.
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ABSTRACT:
SUBMITTER: LeRose J
PROVIDER: S-EPMC8185425 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:We observed a higher rate of blood-culture contamination during the COVID-19 pandemic at our institution compared to a prepandemic period. Given the potential implications of blood contamination in antibiotic and diagnostic test utilization as well as added cost, it is imperative to continue efforts to minimize these episodes during the pandemic.
| S-EPMC8280393 | biostudies-literature
Project description:PurposeIn the management of COVID-19, knowledge is lacking on the frequency of secondary bacterial infections and on how empirical antibiotic therapy should be used. In the present study, we aimed to compare blood culture (BC) results of a COVID-19 patient cohort with two cohorts of patients without detected COVID-19.MethodsUsing a retrospective cohort study design of patients subjected to BC in six tertiary care hospitals, SARS-CoV-2 positive patients from March 1 to April 30 in 2020 (COVID-19 group) were compared to patients without confirmed SARS-CoV-2 during the same period (control group-2020) and with patients sampled March 1 to April 30 in 2019 (control group-2019). The outcomes studied were proportion of BC positivity, clinically relevant growth, and contaminant growth.ResultsIn total 15,103 patients and 17,865 BC episodes were studied. Clinically relevant growth was detected in 197/3,027 (6.5%) BC episodes in the COVID-19 group compared to 717/6,663 (10.8%) in control group-2020 (p<0.0001) and 850/8,175 (10.4%) in control group-2019 (p<0.0001). Contamination was present in 255/3,027 (8.4%) BC episodes in the COVID-19 group compared to 330/6,663 (5.0%) in control group-2020 (p<0.0001) and 354/8,175 (4.3%) in control group-2019 (p<0.0001).ConclusionIn COVID-19 patients, the prevalence of bloodstream bacterial infection is low and the contamination rate of BC is high. This knowledge should influence guidelines regarding blood culture sampling and empirical antibiotic therapy in COVID-19 patients.
| S-EPMC7682817 | biostudies-literature
Project description: Not available
| S-EPMC8353185 | biostudies-literature
Project description:AbstractProminent ears are considered the most common congenital external ear deformity among Caucasians. Affecting approximately 5% of the population, it runs in families and exhibits equal sex incidence. This study aimed to determine the complication rate from otoplasty in a tertiary facial plastic surgery center. This retrospective cross-sectional study included all patients with prominent ears deformities who underwent otoplasty at King Abdul-Aziz University Hospital between January 2019 and June 2021. The records of 116 patients who underwent otoplasty during the study period were examined and only 44 matched the inclusion and exclusion criteria. The total of 85 operated ears from 44 patients were included. Of these, 17 were pediatric patients and 25 were male patients. Forty-one patients underwent bilateral otoplasty and 3 underwent unilateral otoplasty. Complications occurred in 17/85 (20%) patients and the complications included recurrence 4 (4.70%), hypertrophic scar 3 (3.52%), keloid 2 (2.35), granuloma 2 (2.35%), infection 2 (2.35%), discomfort 1 (1.17%), wound dehiscence 1 (1.17%), hematoma 1 (1.17%), and retracted ear 1 (1.17%). The overall patient satisfaction was 38/44 (86.36%). Our study is first study conducted in middle east about otoplasty complications. It showed that the complications from otoplasty surgery varied from severe to mild, with acceptable overall satisfactory results. The most common complication was recurrence. Fortunately, serious complications, such as wound dehiscence and hematoma, were rare. However, our study's small sample size remains a major limitation.
| S-EPMC9432815 | biostudies-literature
Project description:BackgroundRecent epidemiological studies on bloodstream infection (BSI) that include the proportion, species distribution and dynamic changes are scarce in China. This study was performed to understand these epidemiological data of BSI over the past 10 years in China.MethodsUsing a prospective nosocomial infection surveillance system, this study was retrospectively performed in one of the largest hospitals in China. The time trend was tested using the Cochran-Armitage trend test in R Programming Language.ResultsFrom 2010 to 2019, there were totally 9381 episodes of BSI cases out of 1,437,927 adult-hospitalized patients in the hospital, the total proportion of BSI cases was 6.50‰ (6.50 episodes per 1000 adult-hospitalized patients) and the proportion had significantly decreased (8.24-6.07‰, time trend P < 0.001). Among the 9381 episodes of BSI, 93.1% were bacteremia and others were fungemia (6.9%). As the most common species, the composition ratios of coagulase-negative staphylococcus (25.6-32.5%), Escherichia coli (9.8-13.6%) and Klebsiella pneumoniae (5.3-10.4%) had been dynamically increased (all time trends P < 0.05) and the proportion of Pseudomonas aeruginosa had decreased (4.0-2.4%, time trend P = 0.032). However, Staphylococcus aureus (3.3-3.1%) and Acinetobacter baumannii (4.4-4.2%) had not changed significantly (P > 0.05). These common species were consistent with China Antimicrobial Surveillance Network reported in 2018 (2018 CHINET report), but their composition ratios were different. In addition, among bacteremia, the proportion of multidrug-resistant bacteria gradually increased from 52.9 to 68.4% (time trend P < 0.001).ConclusionThe proportion and species distribution of BSI were dynamically changing along certain trends. These trends deserved more attention from clinicians and researchers.
| S-EPMC8803777 | biostudies-literature
Project description:How extraintestinal pathogenic Escherichia coli (ExPEC) and antimicrobial-resistant E. coli disseminate through the population is undefined. We studied public restrooms for contamination with E. coli and ExPEC in relation to source and extensively characterized the E. coli isolates. For this, we cultured 1,120 environmental samples from 56 public restrooms in 33 establishments (obtained from 10 cities in the greater Minneapolis-St. Paul, MN, metropolitan area in 2003) for E. coli and compared ecological data with culture results. Isolates underwent virulence genotyping, phylotyping, clonal typing, pulsed-field gel electrophoresis (PFGE), and disk diffusion antimicrobial susceptibility testing. Overall, 168 samples (15% from 89% of restrooms) fluoresced, indicating presumptive E. coli: 25 samples (2.2% from 32% of restrooms) yielded E. coli isolates, and 10 samples (0.9% from 16% of restrooms) contained ExPEC. Restroom category and cleanliness level significantly predicted only fluorescence, gender predicted fluorescence and E. coli, and feces-like material and toilet-associated sites predicted all three endpoints. Of the 25 E. coli isolates, 7 (28%) were from phylogenetic group B2(virulence-associated), and 8 (32%) were ExPEC. ExPEC isolates more commonly represented group B2 (50% versus 18%) and had significantly higher virulence gene scores than non-ExPEC isolates. Six isolates (24%) exhibited ?3-class antibiotic resistance, 10 (40%) represented classic human-associated sequence types, and one closely resembled reference human clinical isolates by pulsed-field gel electrophoresis. Thus, E. coli, ExPEC, and antimicrobial-resistant E. coli sporadically contaminate public restrooms, in ways corresponding with restroom characteristics and within-restroom sites. Such restroom-source E. coli strains likely reflect human fecal contamination, may pose a health threat, and may contribute to population-wide dissemination of such strains.
| S-EPMC4475876 | biostudies-literature
Project description:Data specific to the epidemiology and burden of sepsis in low- and middle-income countries are limited. This study aimed to determine the epidemiology and burden of adult patients with sepsis at Siriraj Hospital during 2019. Randomly selected adult patients who had blood cultures performed at our center during January-December 2019 were enrolled. A Quick Sepsis-related Organ Failure Assessment (qSOFA) score was used to determine the presence of sepsis. Demographic data and clinical outcome data were collected, and the annual incidence of sepsis or septic shock and death was estimated. Of the 987 subjects who had blood cultures performed, 798 had infections, 341 had sepsis, and 104 had septic shock. The prevalence of sepsis or septic shock was 34.9% among blood cultured patients, and 42.7% among those with infections. The prevalence of septic shock was 30.5% among subjects with sepsis. Approximately 63% of sepsis subjects were hospital-acquired infections. The factors independently associated with 28-day mortality in sepsis were receiving an immunosuppressive agent (adjusted odds ratio [aOR]: 2.37, 95% confidence interval [CI]: 1.27-4.45; p = 0.007), septic shock (aOR: 2.88, 95% CI: 1.71-4.87; p < 0.001), and proven infection (aOR: 2.88, 95% CI: 1.55-5.36; p = 0.001). Receiving appropriate, definitive antibiotic therapy (ABT) was independently associated with lower mortality in sepsis (aOR: 0.50, 95% CI: 0.27-0.93; p = 0.028) and septic shock subjects (aOR: 0.21, 95% CI: 0.06-0.72; p = 0.013). Achievement of mean arterial pressure (MAP) ≥ 65 mmHg (aOR: 0.09, 95% CI: 0.01-0.77; p = 0.028) and urine output ≥ 0.5 mL/kg/h (aOR: 0.15, 95% CI: 0.04-0.51; p = 0.006) were independently associated with lower mortality in septic shock patients. The incidence and mortality of sepsis remains high. Appropriate choice of definitive ABT and achievement of MAP and urine output goals may lower mortality in patients with sepsis or septic shock.
| S-EPMC9312064 | biostudies-literature
Project description:The true clinical significance of Lodderomyces elongisporus remains underestimated as a result of problems associated with its identification by the VITEK 2 yeast identification system. Here we describe a case of L. elongisporus primary progressive fungaemia in a woman with no known risk factors for invasive fungal infections. The isolate was identified by PCR sequencing of the internally transcribed spacer region of ribosomal DNA. Despite treatment with caspofungin, the patient died within 3 days of onset of fungaemia. Our literature review highlights this organism's emerging role as a bloodstream pathogen. A need for application of molecular methods for its accurate identification is emphasized.
| S-EPMC6141678 | biostudies-literature
Project description:Of 1,118 patients with COVID-19 at a university hospital in Switzerland during October 2020-June 2021, we found 83 (7.4%) had probable or definite healthcare-associated COVID-19. After in-hospital exposure, we estimated secondary attack rate at 23.3%. Transmission was associated with longer contact times and with lower cycle threshold values among index patients.
| S-EPMC9514341 | biostudies-literature
Project description:BackgroundUnique blood culture (UBC) has been proposed to limit the number of venipuncture and to decrease the risk of BC contaminations (BCC) without affecting their yield. We hypothesized that a multi-faceted program based on UBC in the ICU may reduce the rate of contaminants with a similar performance for bloodstream infections (BSI) identification.MethodsIn a before and after design, we compared the proportion of BSI and BCC. A first 3-year period with multi-sampling (MS) strategy followed by a 4-month washout period, where staff received education and training for using UBC, and a 32-month period, where UBC was routinely used, while education and feedback were maintained. During the UBC period, a large volume of blood (40 mL) was sampled through a unique venipuncture with additional BC collections discouraged for 48 h.ResultsOf the 4,491 patients included (35% female patients, mean age 62 years) 17,466 BC were collected. The mean volume of blood per bottle collected increased from 2.8 ± 1.8 mL to 8.2 ± 3.9 mL between the MS and UBC periods, P < 0.01. A 59.6% reduction (95% CI 56.7-62.3; P < 0.001) of BC bottles collected per week was observed between the MS and UBC periods. The rate of BCC per patient decreased between the two periods from 11.2% to 3.8% (73.4% reduction; P < 0.001) for the MS and UBC periods, P < 0.001. Meanwhile, the rate of BSI per patient remained stable at 13.2% and 13.2% for the MS and UBC periods, P = 0.98.ConclusionsIn ICU patients, a strategy based on UBC reduces the contamination rate of cultures without affecting their yield.
| S-EPMC9984630 | biostudies-literature