Risk Factors for Fluoroquinolone Resistance in Nosocomial Urinary Tract Infections caused by Gram-Negative Bacilli 3.5.10
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This study identified risk factors for fluoroquinolone resistance in nosocomial urinary tract infections caused by gram-negative bacilli. Recent exposure to fluoroquinolones, cotrimoxazole, and metronidazole were independent risk factors. Residence in a long-term care facility and prior hospitalization were also risk factors, suggesting resistance may spread across healthcare facilities. The study analyzed 251 cases of infections from two hospitals between 2003-2005.
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![Risk Factors for Fluoroquinolone Resistance in Nosocomial Urinary Tract Infections Caused by Gram-Negative Bacilli Pinyo Rattanaumpawan, MD; Pam Tolomeo, MPH; Warren B. Bilker, PhD; Ebbing Lautenbach, MD, MPH, MSCE; University of Pennsylvania School of Medicine Pinyo Rattanaumpawan, MD 108 Blockley Hall, 423 Guardian Drive Philadelphia, PA 19104-6021 USA (267)-746-9084; pinyo@mail.med.upenn.edu ,[object Object],[object Object],[object Object],[object Object],[object Object],BACKGROUND & OBJECTIVE Background: The prevalence of urinary tract infections (UTIs) caused by fluoroquinolone-resistant gram-negative bacilli (FQR-GNB) has increased in recent years. Although many studies have explored risk factors for FQ-resistance, the majority have focused only on UTIs caused by E. coli and/or failed to distinguish colonization and infection. Objectives: To identify risk factors FQ-resistance among nosocomial UTIs caused by GNB. Methods: We conducted a case-control study of hospitalized patients with nosocomial GNB UTIs at 2 medical centers within the University of Pennsylvania Health System. Of subjects in whom GNB were isolated on urine culture, only those who met CDC criteria for nosocomial UTI were eligible for the study. Of these eligible subjects, all patients with urinary pathogens demonstrating a levofloxacin-MIC of ≥ 8 ug/mL were selected as cases. Among all subjects with FQ-susceptible gram-negative bacilli (FQS-GNB), controls were frequency matched to cases by month of isolation and species of infecting organism. . Results: A total of 251 cases with FQR-GNB and 263 controls with FQS-GNB UTIs were included from January 1, 2003 – March 31, 2005. Among 251 cases, major causative pathogens were E. coli (51.0%),, P. aeruginosa (21.5%) , Klebsiella spp. (9.2%). Independent risk factors for FQ-resistance identified via multiple logistic regression analyses are noted in the table 2. Conclusion: Not only FQ use, but also cotrimoxazole and metronidazole use should be optimized in an effort to reduce the emergence of FQ resistance among GNB uropathogens. Residence in a long term care facility and prior hospitalization were also risk factors, suggesting FQ resistance may be spreading across healthcare facilities. ABSTRACT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],RESULTS ,[object Object],[object Object],ACKNOWLEDGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],METHODS ,[object Object],[object Object],CONCLUSIONS Table 2. Risk factors for FQ-resistance (Multivariable analysis) Risk factors Unadjusted OR [95% CI] Adjusted OR [95% CI] P-value Month of isolation * * 0.966 Species of infecting organism * * 0.738 LOS prior to UTI (days) 1.03 (1.01-1.04) 1.01 [0.99-1.02] 0.258 Male sex 1.86 (1.26-2.74) 2.03 [1.21-3.39 ] 0.007 African American 1.31 (0.91-1.91) 1.80 [1.10-2.94] 0.03 Having chronic respiratory diseases 3.32 (1.74-6.63) 22.58 [1.18-5.62] 0.01 Residence of a LTCF 4.09 (1.98-9.07) 4.41 [1.79-10.88 ] 0.002 Previous hospitalization within 2 wks 2.28 (1.55-3.38) 2.19 [1.31-3.64 ] 0.003 Medicine services 2.34 (1.62-3.40) 2.72 [1.63-4.54 ] <0.001 Recent antibiotic exposure Fluoroquinolones 26.98 (11.50-76.72) 15.73 [6.15-40.26] <0.001 Cotrimoxazole 3.23 (1.69-6.45) 2.49 [1.07-5.79] 0.008 Metronidazole 3.18 (2.02-5.06) 2.89 [1.48-5.65] 0.001 Cefazolin 0.31 (0.19-0.50) 0.53 [0.29-0.97] 0.03 ,[object Object],Table 1. Baseline characteristic and Recent antibiotic exposure of cases and controls Variables Cases (n=251) ( %) Controls (n=263) (%) P-value Median age (range), years 69 (21-95) 68 (23-91) 0.225 Median LOS prior UTI (range), days 8 (2-120) 5 (2-68) <0.001 Male sex 101 (40.2) 70 (26.6) 0.001 African American 106 (42.2) 94 (35.7) 0.131 Residence of a long term care facility (LTCF) 38 (15.1) 11 (4.2) <0.001 Previous hospitalization within 2 wks 110 (43.8) 67 (25.5) <0.001 Medicine services 141 (56.2) 93 (35.4) <0.001 Underlying diseases 194 (56.9) 147 (43.1) <0.001 ,[object Object],11 (4.4) 5 (1.9) 0.105 ,[object Object],88 (35.1) 59 (22.4) 0.002 ,[object Object],75 (29.9) 58 (22.1) 0.043 ,[object Object],42 (16.7) 15 (5.7) <0.001 ,[object Object],18 (7.2) 6 (2.3) 0.009 ,[object Object],23 (9.2) 18 (6.8) 0.332 ,[object Object],40 (15.9) 44 (16.7) 0.808 ,[object Object],11 (4.4) 3 (1.1) 0.024 ,[object Object],36 (14.3) 13 (4.9) <0.001 ,[object Object],9 (3.6) 3 (1.1) 0.067* ,[object Object],172 (68.5) 150 (57.0) 0.007 ,[object Object],9 (4.8) 2 (0.8) 0.031* Recent antibiotic exposure 188 (74.9) 142 (54.0) <0.001 ,[object Object],32 (12.7) 15 (5.7) 0.006 ,[object Object],6 (2.4) 3 (1.1) 0.280* ,[object Object],35 (13.9) 24 (9.1) 0.087 ,[object Object],60 (23.9) 95 (36.1) 0.003 ,[object Object],30 (12.0) 80 (30.4) <0.001 ,[object Object],32 (12.7) 23 (8.7) 0.142 ,[object Object],97 (38.6) 6 (2.3) <0.001 ,[object Object],11 (4.4) 2 (0.8) 0.009* ,[object Object],14 (5.6) 14 (5.3) 0.898 ,[object Object],[object Object],17 (6.8) 8 (3.0) 0.049 ,[object Object],41 (16.3) 15 (5.7) <0.001 ,[object Object],86 (34.3) 37 (14.1) <0.001 ,[object Object],79 (31.5) 37 (14.1) <0.001 Categorical variables were compared by using Chi-square test or fisher’s exact test* when appropriate. Continuous variables were compared by using Wilcoxon Rank Sum test.](https://image.slidesharecdn.com/lautenbachebbingriskfactorsforfluoroquinoloneresistanceinnosocomialurinary-3-5-10-100818154016-phpapp02/85/Risk-Factors-for-Fluoroquinolone-Resistance-in-Nosocomial-Urinary-Tract-Infections-caused-by-Gram-Negative-Bacilli-3-5-10-1-320.jpg)
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This document describes research conducted to identify the cause of a SARS outbreak in 2003. Researchers tested clinical samples from SARS patients for a variety of pathogens. They were able to isolate a novel coronavirus from patients meeting the SARS case definition. Electron microscopy revealed coronavirus-like particles. RT-PCR and sequencing confirmed it was a unique coronavirus strain. This provided evidence that a coronavirus was associated with the SARS outbreak. The researchers proposed naming the first isolate the "Urbani strain" after Dr. Carlo Urbani who died from SARS.
Directly acting antivirals and Visceral Leishmaniasis: A case report
This case report describes a 70-year-old man in Sicily, Italy who developed visceral leishmaniasis after receiving direct-acting antiviral treatment for hepatitis C virus infection. The man presented with fever and asthenia and was found to have pancytopenia, splenomegaly, and tested positive for Leishmania infantum. He was diagnosed with direct-acting antiviral-induced visceral leishmaniasis and treated with liposomal amphotericin B, which improved his symptoms and cleared the infection. The report discusses how direct-acting antivirals may suppress immune responses and allow reactivation of latent infections like leishmaniasis by downregulating type II and III
The relationship between the molecular epidemiology of hepatitis c and the be...
This study examined the molecular epidemiology and prevalence of hepatitis C virus (HCV) infection in Jordan. Researchers tested 1929 patients for HCV antibodies between 2010-2011. A total of 149 patients (9%) tested positive, with the infection being twice as common in males compared to females. The most common causes of infection were blood transfusion (68%), kidney dialysis (17%), addiction treatment centers (6%), and unknown causes (9%). HCV RNA detection and genotyping was performed on positive samples. The results suggest blood transfusion is a major route of HCV transmission in Jordan and screening of blood donors has helped reduce prevalence over time.
Investigating Foodborne Illness Outbreaks With Attorney William Marler
- An E. coli O157 outbreak in Minnesota in September 2005 was initially detected when 3 isolates with indistinguishable PFGE patterns were identified by the Minnesota Public Health Laboratory. This PFGE pattern was rare in the US.
- A case-control study found that cases were 9 times more likely to have eaten prepackaged lettuce salads and 10 times more likely to have eaten Dole prepackaged lettuce salads.
- The outbreak was linked to Dole Classic Romaine lettuce bags that shared a common production code and "Best if Used By" date from a single processing plant in California. Isolates from lettuce bags matched the PFGE patterns of cases.
Mechanisms and management of staphylococal toxic shock syndrome
This document summarizes staphylococcal toxic shock syndrome (TSS), caused by toxins produced by Staphylococcus aureus that act as superantigens. The superantigens activate large numbers of T cells, triggering a massive cytokine release and systemic inflammatory response. This can lead to fever, rash, shock, and multiple organ failure. While the precipitating infection may seem minor, TSS has a high mortality rate. The document reviews the pathophysiology, epidemiology, clinical presentation, diagnosis and management of this condition.
Causes of death among hiv infected adults 2005
1) The study examined causes of death among 964 HIV-infected adults in France in the year 2000, in the era of potent antiretroviral therapy (HAART).
2) The main underlying causes of death were AIDS-related (47%), viral hepatitis (11%), cancer not related to AIDS or hepatitis (11%), cardiovascular disease (7%), and bacterial infections (6%).
3) Among AIDS-related deaths, HIV infection had been diagnosed recently in 20%. Smoking was recorded in 72% of cancer deaths and alcohol consumption in 54% of hepatitis deaths.
Treatment of Legionnaires’ Disease
This document discusses treatment options for Legionnaires' disease, including macrolides versus fluoroquinolones. It summarizes several studies comparing these drug classes and finds azithromycin and levofloxacin to be equally effective with shorter treatment duration for fluoroquinolones. Severe Legionnaires' disease is associated with higher mortality, especially if initial appropriate treatment is delayed or inadequate. Prognostic factors for death include an APACHE score over 15, shock, immunosuppression, and acute renal failure.
Risk pathways and prevalence in slaughtered pig blood of Streptococcus suis i...
Poster by Sinh Dang-Xuan, Juliet E. Bryant, Fred Unger, Bao Ngo-Thanh, Bich Vu Thi Ngoc, Phuc Pham-Duc, Delia Grace and Hung Nguyen-Viet presented at the 9th European Congress on Tropical Medicine and International Health, Basel, Switzerland, 6-10 September 2015.
ANTIBIOTICS SUSCEPTIBILITY PATTERN OF COAGULASE NEGATIVE STAPHYLOCOCCI ISOLAT...
ANTIBIOTICS SUSCEPTIBILITY PATTERN OF COAGULASE NEGATIVE STAPHYLOCOCCI ISOLAT...International Educational Applied Scientific Research Journal (IEASRJ)
A total number of 74 coagulase negative Staphylococci were isolated from orthopaedic patients in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. They were further characterized into various Staphylococci species using API STAPH identification kit: Staph xylosus (31.1%), Staph lentus (10.8%), Staph hominis (10.8%), Staph cohnii cohnii (5.4%), Staph epidermidis (4.1%) others were Staph cohnii ureal., Staph hyicus, Staph lugdunensis (2.7% each) Staph caprae , Staph capitis, Staph haemolyticus, Staph scuiri, Staph chromogenes and Staph warneri (1.4% each). Microcossus spp was 8.2% while 13.5% isolates were undetermined. Kirby Baurer disk method was used for the antibiotics susceptibility test, the result showed gentamicin and ciprofloxacin to be most active (96.6%), followed by vancomycin (93.1) and pefloxacin (87.9). The isolates were resistant to ampicillin (96.6), amoxicillin clavulanic acid (65.5%), clindamycin 41.4%). The aim of this study is to classify the coagulase negative Staphylococci isolates into species and to determine their antibiotic susceptibilityJournal Pre-Proof
The study found that Ivermectin, an FDA-approved anti-parasitic drug, is able to inhibit the replication of SARS-CoV-2, the virus that causes COVID-19, in vitro. A single dose of Ivermectin resulted in a 5000-fold reduction in viral RNA at 48 hours in infected Vero-hSLAM cells. The authors hypothesize that Ivermectin acts by inhibiting the nuclear import of viral proteins through interaction with importin proteins. They conclude that Ivermectin warrants further investigation for potential benefits against COVID-19 in humans.
SALMONELLA ARIZOANE: AN UNCOMMON UROPATHOGEN?
Salmonella arizonae is usually an uncommon uropathogen from many studies. But from this study, it was the second most prevalent uropathogen after E.coli.
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NRAMP1 and VDR Gene Polymorphisms in Susceptibility to Tuberculosis in Venezu...
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Dr Jay Lucidarme @ MRF's Meningitis & Septicaemia in Children & Adults 2015
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"Biomarkers in sepsis and septic shock" by Prof. Jérôme Pugin
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A novel coronavirus associated with severe acute respiratory syndrome
A novel coronavirus associated with severe acute respiratory syndrome
Directly acting antivirals and Visceral Leishmaniasis: A case report
Directly acting antivirals and Visceral Leishmaniasis: A case report
The relationship between the molecular epidemiology of hepatitis c and the be...
The relationship between the molecular epidemiology of hepatitis c and the be...
Investigating Foodborne Illness Outbreaks With Attorney William Marler
Investigating Foodborne Illness Outbreaks With Attorney William Marler
Mechanisms and management of staphylococal toxic shock syndrome
Mechanisms and management of staphylococal toxic shock syndrome
Risk pathways and prevalence in slaughtered pig blood of Streptococcus suis i...
Risk pathways and prevalence in slaughtered pig blood of Streptococcus suis i...
ANTIBIOTICS SUSCEPTIBILITY PATTERN OF COAGULASE NEGATIVE STAPHYLOCOCCI ISOLAT...
ANTIBIOTICS SUSCEPTIBILITY PATTERN OF COAGULASE NEGATIVE STAPHYLOCOCCI ISOLAT...
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Teaching and Learning Bulletin 8 23 feb
Revision techniques will be discussed at an upcoming learning team meeting. Effective revision requires teaching students strategies like self-testing their memory and spacing out practice over time. Highlighting textbooks is ineffective. Later in the year, the importance of a growth mindset will be introduced to students. Feedback to students must have an impact on learning and progress, be frequent, timely, and inform future planning. The power of peer and assessment feedback as well as feedback that disconfirms existing ideas can also positively impact learning.
PSZJ PCG Brochure
This document summarizes the post-confirmation bankruptcy services provided by Pachulski Stang Ziehl & Jones LLP (PSZJ), the largest bankruptcy firm in the US. It describes their expertise in areas like avoidance/preference analysis and litigation, claim reconciliation and litigation, asset recovery and liquidation, asset sales, and wind downs. It highlights their proprietary software and unique litigation approaches. It also provides brief biographies of four partners in the firm's Post Confirmation Group and lists some representative matters they have handled.
БОРИС БЕЛОЗЕРСКИЙ: пионер крымского архитектурного авангарда
Архитектура Бориса Белозерского 20-30 х годов прошлого века это образец конструктивизма в версии крымской традиции. Эстетская детализация и обилие декоративных элементов не характерно для материкового "правоверного конструктивизма", и скорее олицетворяет победу довоенного ар-деко 30-х. Причём "декоративный конструктивизм Белозерского" это именно крымский архитектурный авангард, пионером которого он был, совместив несовместимое. Родившийся в Казани, закончивший питерский Институт Гражданских Инженеров, он сумел сохранив внутреннюю верность суровому стилю северного модерна, на крымской земле трансформировать его в совершенно уникальную историю)) При этом запутав будущих исследователей:) Вот он настоящий Авангард: актуальный, идентичный и безумно искренний в своих противоречиях
WorldFuture 2015: Five Keys to an Engaged and Innovative Culture
Carrie Vanston provides individuals & organizations five keys to create and grow an engaged & innovative culture that is cutting-edge, with a strong purpose and the inclusion of all stakeholders. Such a conscious business culture is increasingly important to succeed and thrive in the rapidly changing world of the future.
Keys include:
Connecting: Caring about others at all levels
Discovering: Looking out for minitrends and ideas
Developing: Growing as individuals and a company
Collaborating: Including many in analytic process
Incorporating: Making best decisions for organization
Manual da tigre
O documento é um manual técnico da Tigre sobre instalações hidráulicas prediais. Ele apresenta a história da Tigre, suas soluções para sistemas prediais de água fria, água quente e esgoto, além de orientações técnicas para dimensionamento e instalação desses sistemas. O manual também fornece informações sobre as unidades da Tigre no Brasil e no exterior.
Developing a performance management system at the community outreach agency: ...
CASE DESCRIPTIONThe primary subject matter of this case concerns developing, implementing, and m...
Sex ed ppt
This document defines atypical sexual behaviors as uncommon types of sexual expression or abnormal forms of behavior not typically expressed in society. It categorizes atypical behaviors as either non-coercive or coercive and provides examples such as fetishism, transvestic fetishism, sexual sadism and masochism, exhibitionism, and zoophilia. The document notes that those who engage in atypical behaviors are often males aged 20-30 who are married or divorced and have issues with shyness, insecurity, and intimacy. Treatment options mentioned include behavior therapy, drug treatment, social skills training, and psychotherapy.
Ellia's Class Presentation
Ellia Shultz is an 8 year old who created this presentation to share with her class during September for Craniofacial Acceptance Month 2015 and presented to her Diversity Club at her school.
Craniofacial Acceptance Month is celebrated every September and exists to widen the circle of acceptance for individuals with facial differences. The goal is to create awareness of craniofacial differences and to get people to see that “beyond the face is a heart.”
nettit - infografía Hitonettit 100M
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El documento narra la historia de Purim según el libro bíblico de Ester. Relata cómo el malvado Amán planeó destruir al pueblo judío, pero fue frustrado por la intervención de la reina Ester y Mardoqueo. Nos enseña que aunque los enemigos de Dios pueden tener planes malignos, Dios siempre protegerá a su pueblo si permanecen fieles a él.
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Fairfax va tomorrow quality living today music & science twin
Rapid urbanization changes our way of life & culture of our community of 1.2 million people. These changes mostly positive (economic opportunties) & few negative (loss of green space) , are often in a way noone anticipated, different even a generation or two ago. I have lived here in Fairfax, Virginia for many years past.
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БОРИС БЕЛОЗЕРСКИЙ: пионер крымского архитектурного авангарда
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WorldFuture 2015: Five Keys to an Engaged and Innovative Culture
WorldFuture 2015: Five Keys to an Engaged and Innovative Culture
Developing a performance management system at the community outreach agency: ...
Developing a performance management system at the community outreach agency: ...
Fairfax va tomorrow quality living today music & science twin
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Similar to Risk Factors for Fluoroquinolone Resistance in Nosocomial Urinary Tract Infections caused by Gram-Negative Bacilli 3.5.10
2010Ketorolac
This document reports on a case study where researchers found high mortality in mice given the pain medication ketorolac after embryo transfer surgery. Between October and December 2009, 14 out of 49 mice (29%) died 1-2 days after surgery when treated with ketorolac, compared to only 1 death out of 75 mice treated with the alternative pain medication ketoprofen in a previous period. Autopsies of the deceased ketorolac-treated mice found acute kidney damage and gastrointestinal bleeding, suggesting the postoperative toxicity of ketorolac caused the deaths. The researchers concluded ketorolac analgesia was associated with increased postoperative mortality in mice after embryo transfer surgery.
Cystistat 15.03.07
This document describes a study that evaluated the effect of intravesical instillation of hyaluronic acid (HA) on the recurrence rate of uncomplicated urinary tract infections (UTIs) in women. Twenty women with a history of recurrent UTIs received weekly then monthly HA instillations for one year. Urine cultures were taken before, during, and after treatment. The results showed a reduction in both UTI recurrence rate and average number of UTIs per year after HA treatment. The recurrence rate was 35%, with most patients experiencing either one or two UTIs over the study period compared to three to five UTIs previously. This suggests intravesical HA instillation may be an effective way to prevent recurrent UT
OBASM-fd
This document summarizes a study examining the characteristics of pathogens in pediatric patients using clean intermittent catheterization. The study recruited 50 patients using either conventional or LoFric brand catheters and collected urine samples to analyze bacterial species and antibiotic resistance. Preliminary results found Escherichia coli, Proteus mirabilis, and Enterococcus faecalis to be the most common pathogens. E. coli often demonstrated resistance to commonly used antibiotics. Patients performing overnight catheterization were more likely to carry potential pathogens. The study aims to determine if LoFric catheters may reduce urinary tract infections in this population compared to conventional catheters.
Prevalence of Urinary Tract Infection among Patients with Diabetes Melitus in...
Background: & Objectives: Urinary tract infection is one of the most commonly occurring infections among the patients with diabetes mellitus.
Methods This investigation was based to evaluate the incidence of UTI in patients with DM. Between January, 2013 to November, 1000 diabetic urine samples were collected. All urine samples were processed in the lab following standard laboratory protocol.
Results: A total of 25 UTI organisms were isolated from 361 urine samples collected from the diabetic patients attending the Department of Emergency, University Hospital Center "Mother Theresa” (QSUT) from. The incidence of UTI was recorded to 36.1%. Escherichia coli (54%) was found to be the major cause of UTI. About 5 different types of organisms isolated from the UTI samples were randomly chosen to test against the UTI antibiotics.
Interpretation & Conclusion: The antibiotic susceptibility pattern revealed that ciprofloxacin and nitrofurantoin were most effective to e.coli 79.6%, and 89.4%. These data may be used to determine trends in antimicrobial susceptibilities, to formulate local antibiotic policies and to assist clinicians in the choice of antibiotic therapy to prevent misuse, or overuse of antibiotics.
Key Words: Diabetes mellitus (DM), Urinary Tract Infection (UTI), Bacteria, antimicrobial resistance
Mai nEnteric Bacteria Isolated from Diarrheal Patients in Korea in 2014
Characterizes the pathogens responsible
for causing diarrhea according to season, region of isolation, patient age, and sex
The prevalence of Escherichia coli Causing Urinary Tract Infections in Aminu ...
Urinary Tract infections (UTIs) are one of the most common causes of hospital visit worldwide. The study intends to find the prevalence of Escherichia coli in Urinary tract infection cases in Aminu Kano Teaching Hospital (AKTH), Kano. A comprehensive study was conducted on E coli for its prevalence in urine samples, of queried cases of urinary tract infection in patients attending Aminu Kano Teaching Hospital (AKTH), Kano. Two hundred and fourteen urine specimens comprising of 123(57.5%) females and 91(42.5%) males of all age group were screened for bacteria. Of the 214 samples, 68 representing (31.80%) were culture positive with E. coli having 32(47.06%), Klebsiella spp 18(26.47%), Staphylococcus spp 10(14.70%), Proteus spp 6(8.82%) and Pseudomonas spp 2(2.94%). Out of the 32(47.6%) of E. coli isolated, 22 were from female and 10 were from males, the highest prevalence occurred within the age range of 21-30 with females taking the lead. Antibiogram of the isolated E. coli showed a markedly good sensitivity of ofloxacin (96.87%), nitrofurantoin and nalidixic acid (93.70%), colistin phosphate (90.62%) and gentamicin (68.75%). E. coli showed the least sensitivity to ampicillin (18.75%). The frequency of E. coli obtained suggests its high prevalence. And this can be reduced using Flouroquinolones as exhibited by the susceptibility profile in this study.
Dprajani
The document summarizes a study on antimicrobial resistance patterns of organisms isolated from urine cultures in the Surat region of India. The study found that Escherichia coli was the most commonly isolated pathogen, responsible for 70.52% of urinary tract infections. Gram-negative pathogens showed high resistance to commonly used antibiotics like ampicillin but were highly sensitive to amikacin, netromycin, piperacillin/tazobactum and cefoperazone/sulbactum. The prevalence of urinary tract infections was significantly higher in women than men.
3.10 Nv Poster Draft
This summarizes a retrospective study of a 2008 norovirus outbreak at a long-term care facility in North Carolina. The outbreak lasted 16 days and infected 71 patients (57% attack rate) and 24 staff (20% attack rate). Risk factors for infection included being female, having diabetes, and low levels of independence. The facility implemented enhanced hygiene measures, staff self-quarantine, and restricted admissions and visitors, which may have contained the outbreak. The total estimated cost to the facility was $34,000.
Acae Nicu Paper Final Subm Correction
This study analyzed blood cultures from neonatal intensive care unit patients from 1997 to 2001 in Tripoli Medical Center, Libya. A total of 1431 blood culture sets from 1092 patients were positive for bacterial growth in 801 sets, representing 648 cases of neonatal bacteraemia. The most common causative agents were members of the Enterobacteriaceae family including Serratia, Klebsiella, and Enterobacter species as well as coagulase-negative and positive Staphylococci. Antibiotic susceptibility testing found high levels of resistance among the most frequent pathogens, though resistance to newer antibiotics like aztreonam and imipenem was less common. Resistance in Staphylococcus to anti-stap
D p ppp
Escherichia coli was the predominant pathogen isolated (70.52%) from the urine cultures of 538 patients with urinary tract infections in Surat, India. Antibiotics like ampicillin showed high resistance rates of over 90% among isolated gram-negative pathogens. However, gram-negative pathogens demonstrated the highest sensitivity to amikacin, netromycin, piperacillin/tazobactum and cefoperazone/sulbactum with resistance rates below 5%. The study highlights the increasing antimicrobial resistance seen with commonly used antibiotics and identifies alternative antibiotic options for empirical therapy of urinary tract infections in the region.
Pneumococcal Disease - Epidemiology & Resistance
Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, responsible for over 1 million deaths annually. It is the leading cause of bacterial pneumonia. Certain populations are at higher risk of pneumococcal disease, including the elderly, young children, smokers, and those with chronic medical conditions. Pneumococcal infections have seasonal peaks in the winter. Multidrug resistant strains are increasing globally. Guidelines from organizations like the WHO and ACIP recommend pneumococcal vaccination for high risk groups like all adults over 65 and those with chronic lung, heart or liver disease.
Comparative Study of the Prevalence and Antibiogram of Bacterial Isolates fro...
The study compared the prevalence and antibiogram of bacterial isolates from the urinary and
genital tracts of pregnant women attending ante-natal clinics in Imo State. Urine and High vaginal swab (HVS)
samples were collected from across the three geopolitical zones of Imo State (Owerri, Orlu and Okigwe).
Federal Medical Centre (FMC) Owerri, Imo State University Teaching Hospital (IMSUTH) Orlu and General
Hospital Okigwe (GHO) were used as focal points. A total of 1197 samples were obtained from women and
used. Infection was significantly more with the urine samples than the HVS samples (P < 0.05) while
polymicrobial growth was more observed with the HVS samples. Escherichia coli was the predominantly
isolated organism (38.3%) from the urine samples while Staphylococcus aureus (29.1%) was the predominant
bacterial isolates in HVS. Other commonly isolated bacterial species include; Enterococcus faecalis and
Staphylococcus epidermidis, Klebsiella pneumoniae, Proteus mirabilis and Bacteriodes were solely isolated
from urine while Lactobacillus was solely isolated from HVS. Overall antibiogram showed ciprofloxacin to be
the most effective antibiotic followed by nalidixic acid and pefloxac in for both specimens. Generally, multidrug
resistance was more in urine isolates (55.7%) than vaginal isolates (53.6%) with many showing the same
resistance patterns. The rate of multi/drug resistance in both samples is high (>50%) and worrisome. These call
for routine HVS as well as urine culture to be carried out on all antenatal women to ensure holistic antenatal care/ management.
Prevalence of Antimicrobial Resistance in Bacterial Isolates Causing Urinary ...
Prevalence of Antimicrobial Resistance in Bacterial Isolates Causing Urinary ...SSR Institute of International Journal of Life Sciences
ABSTRACT- This study was an attempt to estimate the prevalence of Antimicrobial resistance in patients attending the OPD and IPD of IIMS&R, hospital, Lucknow. Total 453 urine samples were included in this study. Urinary isolates from symptomatic UTI cases were identified by conventional methods. Of the 453 processed samples 166 samples showed significant colony count of pathogens among which the most prevalent were E. coli (49.39%) followed by Klebsiella species (7.83%). The majority of the isolates were from female (68.67%) while the remaining was from male (31.32%). Dysuria was the most common clinical presentation followed by fever and abdominal pain. Diabetes and urogenital instrumentation were the major risk factors for UTI. Among the 166 urine samples which showed significant colony count, 152 (91.56%) of specimen showed pus cells in wet film examination. Among the gram-negative enteric bacilli high prevalence of resistance was observed against Ampicillin, Cefotaxime, Ciprofloxacin, Nalidixic acid and co-trimoxazole. 44% of isolates were detected to produce ESBL among the gram negative bacteria. Carbapenemase production was seen in 13 (11.71%) isolates. Among the 32 Enterococcus isolates 14 (43.75%) were resistant to High level Gentamicin, 2 (6.25%) were resistant to High level Streptomycin while 12 (37.50%) of isolates were resistant to both of the antimicrobial drugs. Among the 16 Staphylococcus species, 8 (50%) were MRSA.
KEYWORDS- MRSA, Antimicrobial resistance, UTI, ESBL, Gram-negative bacteria
Characteristic and outcomes of patients with ptb requiring icu care
This document summarizes a study of 58 patients with active pulmonary tuberculosis who required admission to an intensive care unit. The mean age was 48 years and 37.9% required mechanical ventilation. The in-hospital mortality rate was 25.9% with a mean survival of 53.6 days for those who died. Factors independently associated with increased mortality included acute renal failure, need for mechanical ventilation, chronic pancreatitis, sepsis, acute respiratory distress syndrome, and hospital-acquired pneumonia. The study identified risk factors for high mortality rates in tuberculosis patients requiring intensive care.
A Clinical Prediction Rule for Fluoroquinolone Resistance 3 14 11
A Clinical Prediction Rule for Fluoroquinolone Resistance 3 14 11Leonard Davis Institute of Health Economics
This study aimed to develop and validate a clinical prediction score to identify patients with healthcare-acquired urinary tract infections caused by fluoroquinolone-resistant gram-negative bacteria. Researchers analyzed data from a case-control study of 514 patients from two hospitals to identify risk factors for fluoroquinolone resistance. A prediction score was developed based on risk factors like prior antibiotic use, medical conditions, and place of residence. The score was validated in a separate cohort and demonstrated 75% sensitivity and 73% specificity in identifying resistant infections, with an area under the ROC curve of 0.816. External validation is still needed before implementing the score in clinical practice to optimize antibiotic treatment.Nosocomial infection
Nosocomial infections, also known as hospital-acquired infections, are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting. The document discusses the epidemiology, sources, common microorganisms, types of infections, diagnosis, treatment and prevention of nosocomial infections. It notes that approximately 2 million patients suffer from hospital-acquired infections annually worldwide, with around 100,000 deaths. Common types of nosocomial infections mentioned include urinary tract infections, respiratory infections, surgical site infections, ventilator-associated pneumonia, and septicemia. Prevention strategies focus on proper hand hygiene, limiting unnecessary procedures and devices, and following infection control protocols.
Isolation, identification and characterization of urinary tract infectious ba...
This document discusses a study on urinary tract infections (UTIs) which isolated and characterized urinary pathogens and tested their antibiotic susceptibility. The main findings were:
1. Escherichia coli was the most common urinary pathogen isolated, followed by Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Proteus mirabilis, and Enterococcus faecalis.
2. The antibiotics chloramphenicol and ciprofloxacin were the most effective against the urinary pathogens, with 100% susceptibility. Tetracycline, gentamicin and kanamycin were also highly effective at 83% susceptibility.
3. Some isolates showed resistance to commonly prescribed
An AIDS-Defining Illness Presenting during Acute Retroviral Syndrome: A Case ...
An AIDS-Defining Illness Presenting during Acute Retroviral Syndrome: A Case ...UC San Diego AntiViral Research Center
Wesley Campbell, MD, of U.S. Navy Medicine, presents "An AIDS-Defining Illness Presenting during Acute Retroviral Syndrome: A Case Discussion and Review of the Literature" for AIDS Clinical Rounds at UC San Diego Antibiogram of Bacterial Isolates at Hail General Hospital, KSA June 1 – Dece...
This research study focused on the antibiogram of bacterial isolates at Hail General Hospital,
Kingdom of Saudi Arabia. It sought to answer the following questions: (1) What is the percentage distribution of
the isolates on the specimens when classified according to the following bacteria? Enterobacter aerogenes,
Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Proteus spp., Pseudomonas aeruginosa,
Raoultella (K.) ornithinolytica. (2) What is the antibiogram result of the bacterial isolates? Descriptive research
using content analysis was employed wherein the Automated Sensitivity Testing Machine data obtained from the
Microbiology section of Hail General Hospital. The statistical tools were frequency and percentage. The results
revealed that based on the percentage distribution of the specimens, the highest number of isolates for
Enterobacter aerogenes, Enterobacter cloacae, Klebsiella pneumoniae and Proteus spp. was from throat swab,
urine for Escherichia coli and Psedomonas aeruginosa, ward swab and high vaginal swab for Raoultella (K.)
ornithinolytica. On antibiogram result, the most sensitive antibiotics for Enterobacter aerogenes was
Meropenem; Cirpofloxacin and Levofloxacin for Enterobacter cloacae; Imipenem for Escherichia coli;
Amikacin for Klebsiella pneumoniae; Ertapenem, Imipenem and Pip/Tazo for Proteus spp.; Pip/Tazo for
Pseudomonas aeruginosa, and Imipenem for Raoultella (K.) ornithinolytica. The most resistant antibiotics for
Enterobacter aerogenes, Escherichia coli, Klebsiella pneumonaie and Raoultella (K.) ornithinolytica was
Ampicillin; Amox/K Clav, Cefazolin and Cefoxitin for Enterobacter cloacae; Cefotaxime for Pseudomonas
aeruginosa and for Proteus spp. was Cefazolin. The researchers recommend for the conduct of an annual
antibiogram study by institution, disseminate the information through seminars/fora especially to clinicians,
conduct another study to include other hospitals and other types of bacteria.
Hospital Acquired Urinary Tract Infection: An Epidemiological Study Carried o...
Hospital Acquired Urinary Tract Infection: An Epidemiological Study Carried o...SSR Institute of International Journal of Life Sciences
ABSTRACT- Urinary Tract Infections (UTI) is a major threat to human health. It is caused due to various physiological changes of the urinary tract by the activity of microorganisms. Urinary Tract infections has also been a major type of hospital acquired infection. Hospital acquired infections (HAI) are of various types: Respiratory Tract Infection (RTI), Urinary Tract Infection (UTI), Blood Stream Infection (BSI), and Surgical Site Infection (SSI) and the most common are Urinary Tract (39%) and Respiratory Tract (20-22%) infection. The main aim of this study was to assess various urine samples collected from patients of the ICU of a tertiary care hospital for microbial growth and create a statistical picture on the contribution of UTI to nosocomial infections. Certain governing factors for UTI like presence of pus cells, epithelial cells, and diabetes mellitus were also kept under consideration along with various patient details like age, sex, primary illness and prior antibiotic treatment. The key findings of the study were: the
mean age of patients with symptomatic and asymptomatic UTI was 51 years and people from both genders within the age group of 41-60 were equally susceptible. E. coli was the most common causative organism (35.7%) followed by Citrobacter (21.42%) and Klebsiella (14.28%). Other organisms included Pseudomonas, Enterococcus and Candida. The rate of UTI was 56.22/1000 days of catheterization. Most of the organisms isolated were found to be multi drug resistant. UTI has been hence concluded to play a major contribution in nosocomial infections which needs to be controlled by integrating proper monitoring of hospital data and surveillance of hospital acquired urinary tract infection.
Key-words- ICU, Urinary Tract Infection, Center for Disease Control, Multi drug resistant, antibiotics, Microorganism
Similar to Risk Factors for Fluoroquinolone Resistance in Nosocomial Urinary Tract Infections caused by Gram-Negative Bacilli 3.5.10 (20)
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The Effects of Federal Parity on Substance Use Disorder Treatment_Andrew Epst...Leonard Davis Institute of Health Economics
This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
1) There was no change in the use of substance use disorder services or the total annual spending per enrollee on these services (which increased by only $10 per enrollee).
2) There was also no change in out-of-pocket spending for substance use disorder treatment users or several HEDIS quality measures related to identification and initiation of treatment.
3) This suggests that concerns about parity greatly increasing health care costs related to substance use disorder treatment were unfounded.Epstein,andy ispor poster_2013
This study analyzed insurance claims data from before and after the implementation of the Federal Mental Health Parity and Addiction Equity Act to examine the effects of parity on substance use disorder treatment. The results showed:
1) There was no change in the use of substance use disorder services or the total annual spending per enrollee on these services (which increased by only $10 per enrollee).
2) There was also no change in out-of-pocket spending for substance use disorder treatment users or several HEDIS quality measures related to identification and initiation of treatment.
3) This suggests that concerns about parity greatly increasing health care costs related to substance use disorder treatment were unfounded.
Does a Wireless Incentive Structure Improve Retention, Subject Satisfaction a...
Does a Wireless Incentive Structure Improve Retention, Subject Satisfaction a...Leonard Davis Institute of Health Economics
This study compared retention rates, satisfaction, and safety between intimate partner violence (IPV) research participants paid via wireless gift cards versus cash. Participants receiving gift cards completed significantly more of the 12 weekly phone surveys (average 8.3 vs 6 calls). Over 90% of gift card recipients expressed satisfaction, and 60% preferred this method. While safety did not differ, wireless incentives may improve retention in repetitive IPV research that can involve remote data collection.Characterizing Emergency Department Utilization By A Population-based Cohort...
Characterizing Emergency Department Utilization By A Population-based Cohort...Leonard Davis Institute of Health Economics
This study analyzed data from 658 insured pregnant women in a Midwestern county to compare risks and outcomes between those who did and did not utilize the emergency department (ED) during their peripartum period. The study found that 218 women (33%) visited the ED at least once during this time. ED users were more likely to experience psychosocial risks like postpartum depression and smoking, have poorer birth outcomes like prematurity, and have inadequate prenatal care. After adjusting for demographic factors, ED use was associated with a higher likelihood of postpartum depression, smoking during pregnancy, unstable housing, delayed prenatal care initiation, and missing a postpartum visit.Non-Medically Indicated Delivery Prior to 39 Weeks Gestation in United State...
Non-Medically Indicated Delivery Prior to 39 Weeks Gestation in United State...Leonard Davis Institute of Health Economics
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A Qualitative Study of Adverse Childhood Experiences of Low-Income Youth in P...Leonard Davis Institute of Health Economics
This study explored a broader range of adverse childhood experiences reported by low-income adults from Philadelphia compared to those measured in previous research. The researchers conducted focus groups with 119 participants who generated a list of childhood stressors across 10 domains. The most commonly reported experiences were issues within family relationships, community safety threats, personal victimization, and economic hardship. The study concludes that considering a wider range of adversities is important for understanding health impacts on low-income urban populations.The Intersection of Attitudes and Organizational Factors by Provider Type in ...
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This study piloted a modified social skills intervention for children with ASD implemented by school personnel in public school settings. The intervention focused on facilitating peer engagement during lunch and recess. Results showed improvements in social network centrality and joint engagement for children who received the immediate treatment compared to those in the waitlist control. However, barriers like unclear staff roles, lack of support, and loss of recess time prevented long-term sustainability. Future work is needed to address school-level barriers to implementation and adapt interventions to fit individual school contexts.Healthcare System Supports for Internists Caring for Young Adult Patients wit...
Healthcare System Supports for Internists Caring for Young Adult Patients wit...Leonard Davis Institute of Health Economics
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Elderly Adults with Dementia and Young Adults with Developmental Disabilities...Leonard Davis Institute of Health Economics
Most internists found more similarities than differences in caring for young adults with intellectual and developmental disabilities (I/DD) and elderly adults with dementia. Both populations require longer office visits and more staffing resources due to complex health histories. Obtaining records and coordinating care can be difficult for both. Reliance on advocates, community services for transportation and supervision, and vulnerability to insurance changes are also similarities. While specific diseases differ, models for geriatric care could potentially address supervision and caretaking needs for adults with I/DD. Strengthening safety net services would help low-income families and elderly patients with dementia or I/DD.Is the quality of case management in a medical home associated with patient s...
Is the quality of case management in a medical home associated with patient s...Leonard Davis Institute of Health Economics
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Comparison of HIV Testing with other Markers of Chronic Disease Screening 4_...Leonard Davis Institute of Health Economics
This document analyzes survey data from 2002-2010 on HIV testing rates and chronic disease screening in Southeastern Pennsylvania. It finds that HIV testing rates are lower than screening for other chronic diseases. Populations receiving care at community health clinics, emergency rooms, or with no primary care are more likely to get HIV testing than those at private clinics. While community health clinics perform similar to private clinics on chronic disease screening, those using emergency rooms or with no primary care are less likely to receive routine chronic disease screening. Primary care physicians adhere to guidelines for screening of conditions like blood pressure and cancer but may neglect appropriately screening for HIV.Comparison of HIV Testing with other Markers of Chronic Disease Screening
Comparison of HIV Testing with other Markers of Chronic Disease Screening Leonard Davis Institute of Health Economics
This study analyzed survey data from 50,698 individuals in Southeastern Pennsylvania between 2002-2010 to compare HIV testing rates to other routine health screenings. It found that HIV testing rates were lower than for other conditions. Those receiving care at community health clinics, emergency rooms, or with no primary care had higher odds of receiving an HIV test compared to private clinics. While community health clinics performed similarly to private clinics on other screenings, emergency rooms and no primary care had lower rates. The study suggests primary care physicians may neglect appropriate HIV screening of patients despite adhering to other screening guidelines.High Value Cost Conscious Care: Is it Rationing or Rational Care? 1_11_13
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2. It notes that health care costs in the US continue to rise significantly each year, with diagnostic imaging being a major driver of increasing costs.
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This document summarizes key findings from RAND research on health care spending in the United States. It finds that between 1999-2009, health care costs grew substantially for a median-income American family, consuming money that could have otherwise been used to pay down debt, save for retirement, or pay for education. While Americans received more medical services, the quality of care was still suboptimal, with recommended care received only about 55% of the time. The document also examines different approaches to reducing health care costs, finding that high-deductible health plans with deductibles over $1,000 were effective in reducing spending.CMHPSR/LDI Research Seminar_New Models for Childrens Mental Health Services D...
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LDI Charles Leighton Memorial Lecture with Mark Chassin, MD 5_4_12
LDI Charles Leighton Memorial Lecture with Mark Chassin, MD 5_4_12Leonard Davis Institute of Health Economics
1) Current state of quality and safety in healthcare is poor, with routine safety processes failing regularly and preventable adverse events occurring commonly.
2) High reliability organizations like commercial aviation have achieved much higher levels of safety through effective process improvement, a strong safety culture, and principles of collective mindfulness.
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