ABSTRACT
BACKGROUND: Comamonas testosteroni is a gram-negative bacillus, known before 1987 as Pseudomonas testosteroni. Although considered as a rare pathogen, its frequency has been increasing. Data regarding its antibiotic susceptibility are insufficient. To date, forty-four cases have been reported in the literature. In this study, we identified the C. testosteroni infections observed in our hospital and evaluated their antimicrobial agent susceptibility patterns compared with cases reported in the literature. METHODS: For the purposes of the present study, patients admitted to hospital between November 2019 and December 2020 were screened. Those with clinical and laboratory signs of infection with positive C. testosteroni growth in culture were enrolled. Clinical isolates obtained from the samples processed in accordance with standard microbiological examination procedures in our laboratory were defined by MALDI-TOF mass spectrometry with 99.9% probability as C. testosteroni. RESULTS: C testosteroni infection was detected between November 2019 and December 2020 in eight patients in our hospital. Six of them had a bloodstream infection (BSI), one had pneumonia, and one had urinary tract infection due to C. testosteroni. Coexistence of COVID-19 was detected in four patients. Six out of the eight cases with BSI had hospital-acquired infection and all of the infections were healthcare-associated. When antimicrobial agent susceptibility results reported in the literature were evaluated in combination with the current results, ceftazidime and meropenem were found to be the most susceptible agents (96.1% and 80%, respectively). CONCLUSIONS: The frequency of nosocomial C. testosteroni infections and resistance to antimicrobial agents are gradually increasing. While resistance to carbapenems is on the upswing, third-generation cephalosporins are still seen as suitable treatment options.
ABSTRACT
Objective: Iatrogenic anemia is an overlooked entity in daily practice. It is known that iatrogenic anemia is associated with increased morbidity and mortality, especially in intensive care unit patients. COVID-19 caused excessive intensive care hospitalizations due to acute respiratory failure. We sought to investigate iatrogenic anemia and its results in COVID-19 patients followed in intensive care unit. Materials and Methods: We retrospectively reviewed the adult patients who were hospitalized in ICU for COVID-19 longer than 14 days. Individuals younger than 18 or who had major bleeding, or postoperative patients were excluded. The remaining 112 patients took part in study. We collected the demographic data, comorbidities, laboratory results, and total amount of blood samples taken in intensive care follow-up in mililiters (mL). Results: The mean age of participants was 71.3 (min: 23, max: 100). Male/ female ratio was 1.8. The most common comorbidity was hypertension (60), coronary heart disease (29), and diabetes mellitus (26), The median length of ICU stay is 19 days (min: 14, max: 58). 66 (58.6%) patients have died. Mean Hb was decreased from 13.9 (±SD: 1.67) to 9.74 (±SD: 1.98) g/dL. In the end, 65 (90.2%) of males and 38 (95.0%) of females were anemic. On a total of 2545 hospitalization days, an average of 27.6 mL of blood was drawn in 7.4 sampling tubes per patient day. Biochemistry tests were the most common reason. We observed that more blood was drawn from intubated patients than non-intubated patients, resulting in a greater reduction in hemoglobin levels (463 mL, 2 g/dL, 677 mL, 3.9 g/ dL, respectively) (p<0.001). Conclusion: Excessive blood sampling is still a significant problem in ICUs associated with poor outcomes. Considering that most COVID-19 patients are admitted to ICU due to acute respiratory failure, it is vital to keep hemoglobin levels as high as possible to maintain oxygenation. [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Objective: Since the COVID-19 pandemic caused respiratory failure in many patients, oxygen delivery methods had to be diversified, and their numbers increased. High flow nasal cannula (HFNC), which has been shown beneficial in acute respiratory failure previously, also came to the fore. We aimed to investigate the efficacy of HFNC on patients hospitalized in intensive care units due to COVID-19. Materials and Methods: We retrospectively screened the patients followed in the intensive care unit due to COVID-19. Patients treated with HFNC performed the study group. We analyzed the relationship between demographics, laboratory results, treatment modalities, complications, and outcomes. Results: Among the 330 patients included mean ventilation duration with HFNC was 7.84 days. 170 (51.5%) patients intubated during HFNC treatment. Only 5 of them were extubated. Intubated patients had higher mean HFNC duration (9.74 days - min: 2, max: 49) compared to nonintubated patients (6.05 days - min: 1, max: 30). There was a significant relationship between mortality and age (OR: 1.04), APACHE II score (OR: 1.35), having cancer (OR: 3.89), receiving NIV (OR: 5.94), and presence of secondary bacterial infection (OR: 44.6). Conclusion: HFNC, whose benefit in acute respiratory failure has been proven, is also widely and successfully used in COVID-19 patients. Comprehensive randomized studies are needed to demonstrate the effect of HFNC use on intubation requirement and mortality. [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)