RESUMO
Background: Percutaneous endoscopic gastrostomy [PEG] is the preferred route of feeding and nutritional support in patients with a functional gastrointestinal system who require long-term enteral nutrition. The objective of this descriptive study was to detect the commonest multidrug resistant bacteria and its antibiotic sensitivity at PEG tube site of elderly residents at long term care facility [LTCF]. Forty two long term care facility elderly residents bedridden were having multi drug resistant organisms at percutaneous endoscopic gastrostomy tube site. Informed consent taken from each patient or from his/her guardian, also Ethical committee approval was obtained. Demographic data were collected and comorbidities were established. Culture and sensitivity was done for pus samples from PEG tube site [stoma] and documented multidrug resistant organisms with antibiotic susceptibility to a range of different antibiotic groups. All samples were processed as per standard techniques and bacteria identified by standard biochemical tests. IBM SPSS statistics [version 24, IBM corp., USA, 2016] was used for data analysis. The age ranges from 60 to 79 years with mean 69.19 +/- 7.01 years. 47.6 % of residents in the age group 60-66 y while 52.4% of residents are in the age group 67-80 y. Males were 57.1% while females were 42.9 %, The predominant resistant detected organism in this sample was Klebsiella [57.1%] while E coli accounts for 28.6% and Proteus is 14.3%. The study revealed that klebsiella was highly statistically significant sensitive to Cefepime [CPM], Imipenam [IMP], Ciprofloxacin [CP], and Colistin [CT] and statistically significant resistant to Trimethoprim/Sulfamethoxazole [TS], and tobramycin [tobra.] Whereas Proteus was highly statistically significant resistant to Cefepime [CPM], Colistin [CT], Imipenam [IMP] and highly statistically significant sensitive to Ciprofloxacin [CP], Trimethoprim/Sulfamethoxazole [TS], tobramycin [tobra.]. E Coli was found to be highly statistically significant intermediately sensitive to Cefepime [CPM], Colistin [CT], and Tobramycin and highly statistically significant resistant to Ciprofloxacin [CP], Trimethoprim/Sulfamethoxazole [TS]. Further studies are recommended on larger numbers of elderly patients to confirm significant findings in this study, try to explain these findings, and make use of them in clinical practice
RESUMO
To describe and analyze an outbreak of novel 2009 influenza A [H1N1] among patients of a long term care facility [LTCF] in Prince Mansour Military Hospital [PMMH], Taif -Kingdom of Saudi Arabia. Those patients were admitted to the LTCF months or years before the outbreak due to several reasons [e.g. cerebral palsy, neurological deficits due to road traffic accidents with handicapping, chronic diseases associates with old age]. An observational study was done to demonstrate and analyze the epidemiological characteristics [demographic factors, risk factors, and outcomes] associated the outbreak, to elucidate prevention and control measures taken, and recommendations concluded. During the period from October 28-November 11, 2010, twenty-one LTCF residents suspected clinically to be involved [fever > 38°C with influenza like illness], their age ranged from 9-91 years [mean age = 46 +/- 24.13], 62% were males. Among them, 12 [57%] proved by RT-PCR to be influenza A [H1N1] positive. Mortality involved 2 [17%] of the A [H1N1] -lab- confirmed individuals. Implementation of the recommended infection control measures mitigated the transmission of infection to new individuals. The fulfillment of strict infection control measures could limit H1N1 infection among LTCF-PMMH patients. Routine influenza, including specific H1N1 immunization of all LTCF residents together with their healthcare staff should be mandatory in those settings serving immunocompromised patients