Role of noscomial infection informatics surveillance system in the prevention and control of multidrug-resistant organisms infections

OBJECTIVE: To analyze the role of nosocomial infection informatics surveillance system in the prevention and control of multidrug-resistant organisms(MDROs) infections. METHODS: The First Affiliated Hospital of Guangdong Pharmaceutical University was selected as the study subjects, which had adopted the nosocomial infection informatics surveillance system since Jan.2020. The period of Jan.to Dec.2020 were regarded as the study period, and Jan.to Dec.2019 were regarded as the control period. The situation of nosocomial infection and MDROs infections in the two periods were retrospectively analyzed. RESULTS: The incidence of nosocomial infections and underreporting of nosocomial infection cases in this hospital during the study period were 2.52%(1 325/52 624) and 1.74%(23/1 325), respectively, and the incidences of ventilator associated pneumonia(VAP), catheter related bloodstream infection(CRBSI), catheter related urinary tract infection(CAUTI)were 4.10(31/7 568), 2.11(14/6 634), and 2.50(25/9 993) respectively, which were lower than those during the control period(P< 0.05). The positive rate of pathogenic examination in the hospital during the study period was 77.95%(1 269/1 628), which was higher than that during the control period(P<0.05), the overall detection rate of MDROs was 15.77%(206/1 306), the detection rates of MDROs in Escherichia coli, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus epidermidis, Pseudomonas aeruginosa and Staphylococcus aureus were lower than those during the control period(P<0.05). CONCLUSION: The development and application of the informatics technology-based surveillance system of nosocomial infection could effectively reduce the incidence of nosocomial infections and device related infections, decrease the under-reporting of infection cases, and also reduce the detection rate of MDROs as well as the proportion of MDROs detected in common pathogenic species.

Silent superbug killers in a river near you how factory farms contaminate public water courses on three continents

Water downstream from factory farms harbours an invisible threat to people's health which could eclipse the COVID-19 crisis. The threat? Antibiotic Resistance Genes (ARGs) which are driving antimicrobial resistance the world's superbug crisis - projected to kill up to 10 million people annually by 2050. This publication reports the presence of ARGs in animal waste discharged from industrial farms into public waterways or onto soil (or crops) in four countries. Gauge community impact and sentiment regarding the issue was also highlighted. The water and sediment from public water courses connected to effluent discharges from 6-10 pig farms were tested in each of four countries (Canada, Spain, Thailand and the USA).

Infectious disease Roundup 2022

This paper describes the epidemiology, prevalence, transmission, prevention and control of some infectious diseases in companion animals, livestock, wild animals and humans in Ontario, Canada, in 2022, including SARS-CoV-2;Echinococcus multilocularis, Leishmania spp. and SARS-CoV-2;antimicrobial stewardship resources;2 cases of rabid dogs imported from Iran (July 2021 and January 2022);prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriacea, Dirofilaria immitis, Brucella canis, canine parainfluenza and adeno- and herpes viruses in dogs recently imported from Asia;Paragonimus kellicotti lung flukes and Streptococcus equi subsp. zooepidemicus in dogs;African swine fever in pet pigs, backyard pigs and wild pigs and blastomycosis in dogs and humans.

Unintended impact of COVID-19 pandemic on the rate of catheter related nosocomial infections and incidence of multiple drug resistance pathogens in three intensive care units not allocated to COVID-19 patients in a large teaching hospital.

BACKGROUND: The prevalence of resistant hospital infections in the intensive care unit (ICU) increases mortality and antibiotic resistance. COVID-19 pandemic may have unintended impact on nosocomial infections (NI) and the prevalence of resistant microorganism. METHODOLOGY: The present non-interventional study was performed by a pre and a post survey each lasting 8 months before (March-October 2019) and after (March-October 2020) the onset of COVID-19 pandemic in three ICU's, not allocated to COVID-19 patients, in Nemazee Hospital, Shiraz, Iran. The rates of the following nosocomial infections were compared at pre- and post-pandemic period: ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI), catheter-associated urinary tract infections (CAUTI) and incidence of multiple drug resistance (MDR) pathogens. RESULTS: Pre-pandemic and pandemic incidence of VAP was 23.5 and 17.2 cases per 1000 device-days, respectively; an absolute decrease of 27%. The main reason for the decrease in the rate of VAP during the pandemic was a significant decrease in the rate of VAP caused by Acinetobacter baumannii; from 39 to 17% in total VAP episodes. The rate of VAP associated with other microorganisms remained relatively unchanged from 14.2 cases in pre-pandemic period to 14.3 cases per 1000 MV-days during the pandemic (P = 0.801). Pre-pandemic incidence of CLABSI was 7.3 cases and, in pandemic period, was 6.5 cases per 1000 device-days (IRR = 0.88, 95% CI 0.43-1.73, P = 0.703). Pre-pandemic incidence of CAUTI was 2 and in pandemic period, was 1.4 cases per 1000 device-days (IRR = 0.70, 95% CI 0.22-1.98, P = 0.469). CONCLUSION: The results of the present study showed a decrease in the incidence of VAP in critically ill non-COVID-19 patients during the pandemic compared to before the pandemic, especially regarding Acinetobacter baumannii.

Genotyping, virulence genes and drug resistance of MRSA strains isolated from skin and soft tissue infection in Tianjin

OBJECTIVE: To investigate and analyze the genotyping, virulence genes and drug-resistant genes of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from skin and soft tissue infections in this area. METHODS: The skin secretions of 204 patients with skin and soft tissue infections in the Fifth Central Hospital of Tianjin between Jan. 2019 and Dec. 2020 were collected, and MRSA strains identified as non-repetitive strains were isolated. The Staphylococcal cassette chromosome mec (SCCmec) and Staphylococcal protein A gene (spa) genotyping and Panton-valentine leukocidin (PVL) gene carrying status were analyzed among the MRSA strains, and their relationship with drug resistance was analyzed. RESULTS: Totally 82 strains of S. aureus were isolated from the skin secretions of 204 patients with skin and soft tissue infections, including 44 strains of MRSA (53.66%). The most common SCCmec genotype was genotype III (accounting for 84.09%) and the most common spa genotype was genotype t030 (accounting for 84.09%). PVL genes encoding virulence factors were amplified in 5 strains (11.36%). The drug resistance rates of 44 MRSA strains to vancomycin and compound sulfamethoxazole were 0.00%, and all the strains were drug-resistant to penicillin. Different SCCmec and spa genotypes were highly resistant to erythromycin, cefazolin, clindamycin and levofloxacin, but the differences in drug resistance rates of different SCCmec genotypes to clindamycin and levofloxacin were significant (P < 0.05). The resistance rates of strains with PVL positive genes to chloramphenicol, gentamicin and tetracycline were significantly higher than those with PVL negative genes (P < 0.05). CONCLUSION: Strains carrying SCCmec III and spa t030 genotypes may be the dominant strains of MRSA in skin and soft tissue infections in this area. Spa genotypes and PVL gene have certain impact on drug resistance of MRSA, and the isolated MRSA strains are all sensitive to vancomycin and compound sulfamethoxazole, which can provide a reference for anti-MRSA treatment in this area.

Pathogenic microorganism monitoring and traceability exploration of medical waste disposal routes in children's hospital

OBJECTIVE: Due to the lack of effective monitoring of microbial spectrum of medical waste collection, transport, storage and transfer path, as well as the evaluation of disinfection effects in medical institutions, this study aimed to explore the microenvironment, prevention and control difficulties and management opinions of medical waste disposal path through the microbial analysis of the medical waste disposal path in model departments. METHODS According to the standard process, the environmental samples at different time periods before and after the disinfection of the medical waste disposal path in the model department were collected and analyzed. The drug resistance and molecular typing traceability of important pathogens were analyzed. And the dynamic effect of the whole path application of the disinfection scheme for medical waste disposal in the model department were evaluated. Efficient frequency and application effect of disinfection of and hygiene of relevant places and gloves were evaluated through environmental monitoring before and after disinfection. RESULTS Most of the isolated strains were environmental microorganisms, Acinetobacter baumannii, Pseudomonas aeruginosa, Streptococcus pneumoniae, Enterococcus faecalis and Enterococcus faecium were also isolated, and a multidrug-resistant A. baumannii strain was identified. Through typing and tracing the source, the multiple strains of A. Baumannii were found to be of different genetic origins and the two strains were from the same clonal line. Using original detection technology, no contamination of Salmonella and Shigella was found in the path. The new coronavirus and norovirus were not detected. However, the environmental pollution of rotavirus was obvious. CONCLUSION The risk of random transmission of rotavirus cannot completely solved by existing hand-sterilized regents. Timely or even frequent replacement of gloves is a simple solution in the workflow. The sterilized medical waste transfer vehicles are likely to become the pollution source of rotavirus after passing through a certain medical waste path. The medical waste disposal personnel should replace the rotating vehicle in time before entering other wards. In addition, due to the weak professional ability of cleaners, simple and easy process guidelines is the most effective solution at present.

News from the 22nd National Days of Infectious Diseases (JNI) Montpellier, August 30 and 31, 2021

This proceedings contains s on the proper use of antibiotics, multidrug-resistant infections and new molecules;influenza and COVID-19;osteoarticular infections;and pneumocystis and CMV in the immunocompromised (excluding HIV).

Clinical characteristics and factors influencing development of a pulmonary fungal infection in patients with severe respiratory diseases

Objectives: To examine the clinical characteristics, drug resistance, and factors influencing development of a pulmonary fungal infection in patients with severe respiratory diseases in order to provide a reference for clinical treatment.

Analysis of pathogenic bacteria, their drug resistance, and cytokines in 60 patients with a puerperal infection after a Cesarian section

Objectives: To investigate pathogenic bacteria, their drug resistance, and changes in levels of cytokines in patients with a puerperal infection after a Cesarean section.

The impact of the COVID-19 pandemic on the resistance level of Mycobacterium tuberculosis in suspected tuberculosis patients at the Surakarta Central General Hospital

Background:Analysis of the impact of the Covid-19 pandemic on the resistance level of Mycobacterium tuberculosis (MTb) isolates to Anti Tuberculosis Drugs (ATD) needs to be carried out considering the level of MTB resistance is an important factor in the occurrence of Multidrug-Resistant TB (MDR-TB) in Indonesia. The purpose of the study was to analyze the impact of the Covid-19 pandemic on the level of resistance of MTb isolates of patients with suspected TB in Surakarta. Subjects and Method: This research is a quantitative descriptive study with a retrospective Cohort based on the medical record data of suspected TB patients at Surakarta Central General Hospital in 2020 - 2021. The sampling technique was random sampling with a total of 200 samples each year. Data analysis used the SPSS 21 program.

Acinetobacter baumannii strains grown in endotracheal aspirate culture in Samsun Bafra State Hospital intensive care units and the effect of COVID-19 on Acinetobacter baumannii strains (2019-2020)

INTRODUCTION: Acinetobacter baumannii is an important causative agent of ventilation-associated pneumonia capable of long-term survival in the hospital setting. Increasing resistance to antibiotics effective against this pathogen is of concern. In this study, the antibiotic resistance profiles of A. baumannii strains grown in endotracheal aspirate (ETA) cultures in intensive care units and the effect of the COVID-19 pandemic on the resistance profiles in our province where the highest number of cases were observed in our country for a long time were investigated. METHODS: Our study included 74 A. baumannii isolates isolated from ETA samples that was sent to our laboratory from the intensive care units of Bafra State Hospital between January 2019 and December 2020. Bacteria were identified using conventional methods and a semi automatic bacterial identification system Vitek-2 (bioMerieux, France). The antibiotic susceptibility tests of the isolated strains were studied in accordance with the European Committee for Antimicrobial Susceptibility Testing (EUCAST) standards. Antibiotic susceptibility of A. baumannii strains was tested with Vitek-2 system. RESULTS: The mean age and standard deviations of 18 patients before the COVID-19 pandemic and 56 patients after the pandemic were found to be 83.0 +or- 8.3 and 70.5 +or- 14.9 (p < 0.001), respectively. A statistically significant difference was found between the distributions of gender by years (p=0.025). While 55.6% of the patients were female in 2019, 73.2% of the patients in 2020 were male. There was no difference between the two periods in terms of death rates (p=0.628) and respiratory support needs (p=0.191). It was determined that the pandemic increased the number of isolated A. baumannii by 311%. For the two periods, resistance was greatest for piperacillin/tazobactam, ceftazidime, ciprofloxacin and against imipenem. Examinig the two periods, amikacin resistance was seen to a lesser extent in 2020. A statistically significant difference was found between tigecycline resistance rates according to years (p < 0.001). While the tigecycline susceptibility of strains was 88.9% in 2019, it was found to be 26.8% in 2020.11.1% of the strains in 2019 and 64.3% in 2020 were found to be moderately susceptible. In this study, colistin resistance was observed in one (1.4%) of all isolates, while tigecycline resistance was detected in five isolates (6.8%). One isolate (1.4%) was susceptible to all antibiotics except ceftazidime. When the multi-antibiotic resistance of 73 A. baumannii isolates was examined, multidrug resistant (MDR) was 22.9% (n: 17), extensive drug resistance (XDR) was 74.3% (n: 55), pandrug resistance (PDR) was 1.4% (n: 1). Although there was a statistical difference in amikacin, meropenem and tigecycline resistances before and after the pandemic, no difference was found between the resistance patterns (p=0.281). DISCUSSION AND CONCLUSION: It has been observed that the most effective antibiotics against A. baumannii are colistin and tigecycline. It was determined that the COVID-19 pandemic did not change the resistance pattern rates. It is thought that success in fighting this infection will increase when each hospital determines its own resistance patterns, updates empirical treatment protocols based on their results, and clinicians use appropriate antibiotics early.

MDR-TB in Pakistan: Challenges, efforts, and recommendations.

Tuberculosis (TB), a global health concern is also a leading cause of mortality and morbidity across Pakistan affecting a major proportion of the population. The absence of an integrated system to control the spread of TB has led to a rise in multidrug resistant strains of TB (MDR-Tb) which do not exhibit any sensitivity towards the first line therapy for TB. Such adverse circumstances call for effective planning strategies to mitigate the health hazards of MDR-TB. This article briefly highlights the challenges encountered by the already burdened healthcare system and suggests relatively inexpensive approaches to tackle the ongoing crisis associated with MDR-TB on a national scale.

2020 Congress of the Korean Society for Antimicrobial Therapy & The Society of Infectious Diseases

This proceedings contains the s submitted by the participants of the meeting, which summarize clinical research data diagnosis, prevention and treatment of pediatric infectious diseases;controversies in antibacterial therapy;multidrug resistance;progress towards better antimicrobial stewardship and policy;and COVID-19.

Special Issue: Infection prevention and control in healthcare, part II: management of infections. (Special Issue: Infection prevention and control in healthcare, part II: management of infections.)

This special issue (as well as the prior issue, Infection Prevention and Control in Health Care, Part I) serves as an inclusive, relatively concise, and focused primer on infection control. This issue containing 10 articles focuses on the epidemiology and prevention of different types of infections in the health care setting, which is one of the overarching and critical functions of the infection prevention department in a hospital. While the most recent 2019 Centers for Disease Control and Prevention progress report indicates reductions for several types of HAIs, recent publications indicate that there has been a relative increase in some HAIs during the COVID-19 pandemic. Multiple factors may be associated with these increases (shortages of personal protective equipment, disinfectants and medical equipment, staff, and host factors associated with increased infections), highlighting the need for continued vigilance in prevention practices. Various topics are covered, including prevention of device-associated infections, surgical site infection, infections due to multidrug-resistant pathogens, and prevention of other types of HAIs. This issue is intended to serve as a useful reference and primer for infection prevention and control, particularly with regards to key components and strategies to prevent infection acquisition in the hospital.

Amorphophallus paeoniifolius (Araceae): a nutraceutical for food disorders, novel bacterial & viral infections

Amorphophallus paeoniifolius is a very common tuber plant having diverse secondary metabolites and palatability levels. Keeping the problems of food shortage & novel infectious diseases throughout the world, an attempt has been made through fieldworks during 2009 to 2020 to gather the information on its ethnobotany, bioactive compounds from lab work and pharmacological properties from secondary sources to make it future nutraceutical against food disorders & novel microbial diseases. The tuber is used as food and medicines, it is rich with primary & secondary metabolites and its extracts are used to treat various infectious diseases. The compounds present in the species have potential to make novel drugs against present health problems throughout the world. The present study highlights the importance of wild tuberous plants in mitigation of food shortage, food disorders, anti-microbial resistance, novel bacterial & viral diseases like MDR-TB and COVID-19.

COVID-19 and Candida auris co-infection: an increasing threat

Candida auris has emerged in recent years as an important cause of hospital infection outbreaks around the world. C. auris is an intensive care unit (ICU) environmental colonizer and many hospital environments may harbor C. auris transmission. In addition, in 2020, other countries: Guatemala, Mexico, Peru, Panama, Colombia and the United States - documented cases of C. auris infection, mostly in patients with a history of COVID-19 infection, highlighting that in the first three countries no isolates were reported prior to this period. Therefore, it is noteworthy that both COVID-19 and C. auris share at least six characteristics that should be highlighted: (a) both pathogens may remain on surfaces, including hospital floors, beds, bedrails, poles, air conditioners and windows;(b) both may present high mortality rates;(c) both pathogens require standard laboratory methods for diagnosis;(d) both present treatment difficulties due to multidrug resistance (C. auris) or no effective medical therapy (SARS-Cov-2);(e) both are globally distributed causing outbreaks in healthcare facilities;(f) both present risk factors, including in cases of mechanical ventilation, diabetes mellitus, protracted ventilator-assisted management, immunosuppression, chronic kidney disease, etc. There is much to be learned about these infectious diseases, particularly in countries with poor hygiene, high population density and intense migratory flows, not to mention international travel contributing substantially to both pandemics. Vigilance practices by hospital committees for infection control and routine diagnostic processes for determining C. auris fungal infection in COVID-19 patients should be implemented. Modern diagnostic tests must be made available worldwide, as well as access to adequate antifungal therapy to manage C. auris infection. All of the aspects mentioned will effectively contribute to reducing mortality by COVID-19 and enable monitoring the emergence of C. auris.

Special Issue: Therapeutic innovations in infectious diseases. (Special Issue: Therapeutic innovations in infectious diseases.)

This special issue, consisting of 31 reviews and research articles, features the "complex roadmap" of the current state of anti-infectives to combat a range of pathogens from antivirals (e.g., severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), HIV, hepatitis B virus) to antibacterials (e.g., multidrug-resistant organisms and tuberculosis) to antifungals and antimalarials. This issue has articles covering topics that touch on leveraging real-world evidence for assessing pharmaceutical treatments in the context of COVID-19, tutorial on vaccines, and the US Food and Drug Administration (FDA) perspective on streamlined regulatory pathways providing knowledge and insights that can be leverage by those working outside the realm of infectious diseases. Several articles in this issue describe how the clinical pharmacology community have used its collective knowledge and expertise to address the ongoing global crisis. In contrast to the novelty of SARS-CoV-2, this issue also features clinical pharmacology approaches to a virus we have been fighting for over 40 years.