Antimicrobial Resistance in Ventilator-Associated Pneumonia: Predictive Microbiology and Evidence-Based Therapy

Infectious Diseases and Therapy, Год журнала: 2023, Номер 12(6), С. 1527 - 1552

Опубликована: Июнь 1, 2023

Ventilator-associated pneumonia (VAP) is a serious intensive care unit (ICU)-related infection in mechanically ventilated patients that frequent, as more than half of antibiotics prescriptions ICU are due to VAP. Various risk factors and diagnostic criteria for VAP have been referred different settings. The estimated attributable mortality can go up 50%, which higher cases antimicrobial-resistant When the diagnosis patient made, initiation effective antimicrobial therapy must be prompt. Microbiological required optimize timely since early treatment fundamental better outcomes, with controversy continuing regarding optimal sampling testing. Understanding role resistance context crucial era continuously evolving clones represent an urgent threat global health. This review focused on adult its novel microbiological tools. It aims summarize current evidence-based knowledge about mechanisms caused by multidrug-resistant bacteria clinical settings focus Gram-negative pathogens. highlights management prevention drug-resistant also addresses emerging concepts related predictive microbiology sheds lights coronavirus disease 2019 (COVID-19).

Язык: Английский

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Incidence of Bacterial and Fungal Secondary Infections in COVID-19 Patients Admitted to the ICU

International Journal of General Medicine, Год журнала: 2022, Номер Volume 15, С. 7475 - 7485

Опубликована: Сен. 1, 2022

Secondary infections have been observed among coronavirus disease 2019 (COVID-19) patients, especially in the intensive care unit (ICU) setting, which is associated with worse clinical outcomes. The current study aimed to investigate incidence, common pathogens, and outcome of bacterial fungal secondary ICU patients COVID-19.A retrospective chart review all admitted at King Fahd Hospital University Saudi Arabia. All adult aged ≥18 for ≥48 hours positive COVID-19 reverse transcription-polymerase chain reaction test during period between March 2020 till September 2021 were included.Out 314 critically ill 133 (42.4%) developed infections. incidence infection was 32.5% Pseudomonas aeruginosa (n = 34), Acinetobacter baumannii 33), Klebsiella pneumoniae 17) being predominant while 25.2% mainly caused by Candida albicans 43). Invasive mechanical ventilation significantly development (odds ratio [OR] 17.702, 95% confidence interval [CI] 7.842-39.961, p < 0.001) (OR 12.914, CI 5.406-30.849, 0.001). Mortality 69.2% 92). longer hospital stays a median 25 days (interquartile range [IQR] 17-42) 19 (IQR 13-32), respectively.Bacterial are predominance gram-negative bacteria species. invasive ventilation. Poor outcomes observed, demonstrated prolonged higher mortality.

Язык: Английский

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Extracellular Vesicles as a Translational Approach for the Treatment of COVID-19 Disease: An Updated Overview

Viruses, Год журнала: 2023, Номер 15(10), С. 1976 - 1976

Опубликована: Сен. 22, 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic in the years 2020–2022. With high prevalence, an easy route of transmission, and long incubation time, SARS-CoV-2 spread quickly affected public health socioeconomic conditions. Several points need to be elucidated about its mechanisms infection, particular, capability evade immune system escape from neutralizing antibodies. Extracellular vesicles (EVs) are phospholipid bilayer-delimited particles that involved cell-to-cell communication; they contain biological information such as miRNAs, proteins, nucleic acids, viral components. Abundantly released fluids, their dimensions highly variable, which used divide them into exosomes (40 150 nm), microvesicles 10,000 apoptotic bodies (100–5000 nm). EVs many physiological pathological processes. In this article, we report latest evidence EVs’ roles infections, focusing on dual role promoting inhibiting infection. The involvement mesenchymal stromal/stem cells (MSCs) MSC-derived COVID-19 treatment, use translational diagnostical/therapeutic approach, is also investigated. These elucidations could useful better direct discovery future diagnostical tools new exosome-derived biomarkers, can help achieve optimal therapeutic interventions implement vaccine strategies.

Язык: Английский

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Microbial dynamics, risk factors and outcomes of secondary pneumonia in critically ill patients with COVID-19: A multicenter retrospective cohort study

Journal of the Formosan Medical Association, Год журнала: 2024, Номер 123(11), С. 1186 - 1193

Опубликована: Июль 16, 2024

Secondary pneumonia has a significant clinical impact on critically ill patients with COVID-19.

Язык: Английский

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Fungal–Bacterial Co-Infections and Super-Infections among Hospitalized COVID-19 Patients: A Systematic Review

Journal of Fungi, Год журнала: 2023, Номер 9(6), С. 598 - 598

Опубликована: Май 23, 2023

This study systematically reviewed fungal–bacterial co-infections and super-infections among hospitalized COVID-19 patients. A PRISMA systematic search was conducted. On September 2022, Medline, PubMed, Google Scholar, PsychINFO, Wiley Online Library, NATURE, CINAHL databases were searched for all relevant articles published in English. All that exclusively reported the presence of patients included. Seven produced 6937 as a result literature search. Twenty-four met inclusion criteria included final analysis. The total number samples across studies 10,834, with 1243 (11.5%) admitted to intensive care unit (ICU). Of these patients, 535 underwent mechanical ventilation (4.9%), 2386 (22.0%) male, 597 (5.5%) died. Furthermore, have somewhat high rate (23.5%) super-infections. Moreover, SARS-CoV-2 who chest X-ray suggests bacterial infection, require immediate ICU admission, or seriously immunocompromised condition, empiric antibiotic therapy should be taken into consideration. Additionally, prevalence may an impact on diagnosis treatment. It is crucial check fungal

Язык: Английский

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Development and validation of machine learning-based models for predicting healthcare-associated bacterial/fungal infections among COVID-19 inpatients: a retrospective cohort study

Antimicrobial Resistance and Infection Control, Год журнала: 2024, Номер 13(1)

Опубликована: Апрель 14, 2024

Abstract Background COVID-19 and bacterial/fungal coinfections have posed significant challenges to human health. However, there is a lack of good tools for predicting coinfection risk aid clinical work. Objective We aimed investigate the factors among patients develop machine learning models estimate coinfection. Methods In this retrospective cohort study, we enrolled adult inpatients confirmed with in tertiary hospital between January 1 July 31, 2023, China collected baseline information at admission. All data were randomly divided into training set testing ratio 7:3. developed generalized linear random forest assessed performance set. Decision curve analysis was performed evaluate applicability. Results A total 1244 included 62 healthcare-associated infections, while 534 22 infections. found that comorbidities (diabetes, neurological disease) greater than those without (OR = 2.78, 95%CI 1.61–4.86; OR 1.93, 1.11–3.35). An indwelling central venous catheter or urinary also associated an increased 2.53, 1.39–4.64; 2.28, 1.24–4.27) coinfections. Patients PCT > 0.5 ng/ml 2.03 times (95%CI 1.41–3.82) more likely be infected. Interestingly, IL-6 concentration < 10 pg/ml 1.69, 0.97–2.94). low creatinine levels had decreased coinfections(OR 0.40, 0.22–0.71). The demonstrated favorable receiver operating characteristic curves (ROC 0.87, 0.80–0.94; ROC 0.88, 0.82–0.93) high accuracy, sensitivity specificity 0.86vs0.75, 0.82vs0.86, 0.87vs0.74, respectively. corresponding calibration evaluation P statistics 0.883 0.769. Conclusions Our achieved strong predictive ability may effective decision-support identifying guiding antibiotic administration. cytokines, such as IL-6, affect status

Язык: Английский

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Evaluation of Serial Procalcitonin Levels for the Optimization of Antibiotic Use in Non-Critically Ill COVID-19 Patients

Pharmaceuticals, Год журнала: 2024, Номер 17(5), С. 624 - 624

Опубликована: Май 12, 2024

Background: Procalcitonin (PCT) has been used as a biomarker to guide antibiotic therapy in various patient populations. However, its role optimizing use COVID-19 patients not well studied date. Thus, we aimed evaluate the of serial PCT monitoring an antimicrobial stewardship tool for patients. Methods: This retrospective study included 240 who were admitted tertiary medical institution Saudi Arabia between January 2020 and February 2022. Patients received empiric community-acquired pneumonia (CAP) had procalcitonin levels included. The divided into two groups: normal arm (PCT level < 0.5 ng/mL) elevated > ng/mL). primary secondary outcomes effect on duration exposure length hospital stay, respectively. To measure accuracy PCT, receiver-operating characteristic area under curve (ROC-AUC) was determined. Results: Among patients, 142 (median 0.12 ng/mL), 78 4.04 baseline characteristics similar arms, except higher prevalence kidney disease arm. There no statistically significant difference arms duration: 7 days both arms). stay significantly shorter 9 days) than 13 days; p = 0.028). ROC-AUC value 0.54 (95% CI: 0.503–0.595). Conclusions: Serial did lead reduction it associated with stay. These findings suggest that may be useful improving While PCT-guided algorithms have potential enable stewardship, their context treatment requires further investigation.

Язык: Английский

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"Multidrug-Resistant Bacteria Related to Covid-19 Infection: A Minireview"

Biomedical Journal of Scientific & Technical Research, Год журнала: 2024, Номер 55(3)

Опубликована: Март 5, 2024

The World Health Organization recorded antimicrobial multidrug resistance as one of the biggest health risks in 2019. inappropriate use antibiotics results their consequent ineffectiveness treatment bacterial infections, hindering therapeutic alternatives and increasing risk poor prognosis. In late 2019, a single-stranded RNA zoonotic virus, SARS-CoV-2, was identified caused Coronavirus Disease-19 pandemic. prophylactically for secondary infections measures taken emergency scenario.

Язык: Английский

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Critically ill children with SARS-COV-2 Omicron infection at a national children medical center, Guangdong, China

BMC Pediatrics, Год журнала: 2024, Номер 24(1)

Опубликована: Апрель 15, 2024

Abstract Background SARS-CoV-2 infection is described as asymptomatic, mild, or moderate disease in most children. related death children and adolescents rare according to the current reports. COVID-19 cases increased significantly China during omicron surge, clinical data regarding pediatric critical patients infected with variant limited. In this study, we aim provide an overview of characteristics outcomes critically ill admitted a national children’s medical center Guangdong Province, China, outbreak infection. Methods We conducted retrospective study from November 25, 2022, February 8, 2023, which included 63 children, under age 18, diagnosed The were referred institutions province. records these analyzed summarized. Results median was 2 years (Interquartile Range, IQR: 1.0–8.0), sex-ratio (male/female) 1.52. 12 (19%) (age ≥ 3 years) vaccinated. length hospital stay 14 days (IQR: 6.5–23) cases, duration fever 5 3-8.5), intensive care unit (PICU) 8 (IQR 4.0–14.0) 57 cases. 30 (48%) had clear contact history family members who SARS-CoV-2. Three tested positive for did not show any abnormalities on chest imaging examination. Out total patients, 33 (52%) bacterial co-infection, Staphylococcus aureus being commonly detected pathogen. Our cohort exhibited respiratory nervous system involvement primary features. Furthermore, fifty (79%) required mechanical ventilation, 7 3.75–13.0). Among 35 (56%) developed failure, 16 (25%) experienced deteriorating progression symptoms ultimately succumbed illness, septic shock common condition among (15 cases), followed by multiple organ failure encephalopathy identified Conclusion present case series variant. While there evidence suggesting that Omicron may cause less severe symptoms, it important continue striving measures can minimize pathogenic impact

Язык: Английский

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The Rapidly Changing Patterns in Bacterial Co-infections Reveal Peaks in Limited Gram-Negatives during COVID and Their Sharp Drop Post- Vaccinations Implying Potential Evolution of Co-protection during Vaccine-Virus-Bacterial Interplay

Опубликована: Дек. 5, 2023

The SARS-CoV-2 have caused a devastating pandemic of all times in the recent human history. However, there is serious paucity high quality data on aggravating factors and mechanisms co-infection. This study aimed to identify trending patterns bacterial co-infections types associated outcomes three phases pandemic. Using hospital data, we investigated fatality rates, profiles, before, during, after COVID-19 vaccinations. Out 389 isolates used different aspects, 298 was examined before during (n=149 n=149 during), death rates were 32% compared only 7.4% with significant association (P value = 0.000000075). Death rate 34% co-infected (n 170) non-co-infected patients 128) indicating highly 0.00000000000088). analysis without other respiratory problems (n=28) indicated that among remaining 270 patients, 30% (n=150) 0.8% non-coinfected (n=120) P value= 0.00000000076. vaccinations showed decline Staphylococcus aureus concomitant peaks Gram-negatives totals (n= 149 before/n= during): Klebsiella pneumonia 11/49 before/during; E. coli n=10/24, A. baumannii n=8/25, Ps. Aeruginosa n= 5/16, S. 13/1. Nevertheless, post vaccination phase, 91) gender-specific for potential differences susceptibility. Methicillin resistant (MRSA) dominated both genders followed by males females latter gender showing higher isolations species. pneumoniae declined third place mostly male patients. drastic K. post-vaccination strongly imply co-protection vaccines. Future would gain more insights into molecular mimicry.

Язык: Английский

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