Posts filed under ‘Infecciones asociadas a catater IV’

2019-11 Hospital-Acquired Infections in New York State, 2018 –  N York State Department of Health 24 Pags

Contents

Introduction ………………………………………………………………………………………………………… 3

Surgical Site Infections (SSIs)………………………………………………………………………………………………. 4

Catheter-Associated Infections ………………………………………………………………………………………………………… 5

Laboratory-identified (LabID) infections………………………………………………………………………………………. 6

Clostridioides difficile Infections (CDI)……………………………………………………………………………………………….. 7

Carbapenem-resistant Enterobacteriaceae (CRE) Infections………………………………………………………………………………………. 8

Methicillin-resistant Staphylococcus aureus (MRSA) Infections………………………………………………………………………………………. 9

Hospital Performance …………………………………………………………………………………………………………10

Role of the State Health Department…………………………………………………………………………………….23

What Patients Can do to Prevent Infections………………………………………………………………………………………..24

PDF

https://www.health.ny.gov/statistics/facilities/hospital/hospital_acquired_infections/2018/docs/hospital_acquired_infection_p1.pdf

November 20, 2019 at 7:11 am

Understanding the Mechanism of Bacterial Biofilms Resistance to Antimicrobial Agents.

Open Microbiol J. 2017 Apr 28;11:53-62.

Singh S1, Singh SK2, Chowdhury I3, Singh R2.

1 Department of Kriya Sharir, Institute of Medical Sciences, Banaras Hindu University, Varanasi- 221 005 UP India.

2 Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, USA.

3 Department of Obstetrics and Gynecology; Morehouse School of Medicine, Atlanta, GA, USA.

Abstract

A biofilm is a group of microorganisms, that causes health problems for the patients with indwelling medical devices via attachment of cells to the surface matrix. It increases the resistance of a microorganism for antimicrobial agents and developed the human infection. Current strategies are removed or prevent the microbial colonies from the medical devices, which are attached to the surfaces. This will improve the clinical outcomes in favor of the patients suffering from serious infectious diseases. Moreover, the identification and inhibition of genes, which have the major role in biofilm formation, could be the effective approach for health care systems. In a current review article, we are highlighting the biofilm matrix and molecular mechanism of antimicrobial resistance in bacterial biofilms.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427689/pdf/TOMICROJ-11-53.pdf

 

October 14, 2018 at 10:44 am

Biofilms: survival mechanisms of clinically relevant microorganisms.

Clinical Microbiology Reviews April 2002 V.15 N.2 P.167-93.

Donlan RM1, Costerton JW.

1 Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. rld8@cdc.gov

Abstract

Though biofilms were first described by Antonie van Leeuwenhoek, the theory describing the biofilm process was not developed until 1978. We now understand that biofilms are universal, occurring in aquatic and industrial water systems as well as a large number of environments and medical devices relevant for public health. Using tools such as the scanning electron microscope and, more recently, the confocal laser scanning microscope, biofilm researchers now understand that biofilms are not unstructured, homogeneous deposits of cells and accumulated slime, but complex communities of surface-associated cells enclosed in a polymer matrix containing open water channels. Further studies have shown that the biofilm phenotype can be described in terms of the genes expressed by biofilm-associated cells. Microorganisms growing in a biofilm are highly resistant to antimicrobial agents by one or more mechanisms. Biofilm-associated microorganisms have been shown to be associated with several human diseases, such as native valve endocarditis and cystic fibrosis, and to colonize a wide variety of medical devices. Though epidemiologic evidence points to biofilms as a source of several infectious diseases, the exact mechanisms by which biofilm-associated microorganisms elicit disease are poorly understood. Detachment of cells or cell aggregates, production of endotoxin, increased resistance to the host immune system, and provision of a niche for the generation of resistant organisms are all biofilm processes which could initiate the disease process. Effective strategies to prevent or control biofilms on medical devices must take into consideration the unique and tenacious nature of biofilms. Current intervention strategies are designed to prevent initial device colonization, minimize microbial cell attachment to the device, penetrate the biofilm matrix and kill the associated cells, or remove the device from the patient. In the future, treatments may be based on inhibition of genes involved in cell attachment and biofilm formation.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC118068/pdf/0012.pdf

October 14, 2018 at 10:41 am

Biofilm formation: a clinically relevant microbiological process.

Clinical Infectious Disseases October 15, 2001 V.33 N.8 P.1387-92.

Donlan RM1.

1 Biofilm Laboratory, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. rld8@cdc.gov

Abstract

Microorganisms universally attach to surfaces and produce extracellular polysaccharides, resulting in the formation of a biofilm. Biofilms pose a serious problem for public health because of the increased resistance of biofilm-associated organisms to antimicrobial agents and the potential for these organisms to cause infections in patients with indwelling medical devices. An appreciation of the role of biofilms in infection should enhance the clinical decision-making process.

FULL TEXT

https://academic.oup.com/cid/article/33/8/1387/347551

PDF (CLIC en PDF)

 

October 14, 2018 at 10:39 am

Bacterial biofilms: resistance to antimicrobial agents.

Journal of Antimicrobial & Chemotherapy June 1996 V.37 N.6 P.1047-50.

Gander S1.

1 Department of Microbiology, Nottingham City Hospital, UK.

FULL TEXT

https://academic.oup.com/jac/article/37/6/1047/863249

PDF (CLIC en PDF)

October 14, 2018 at 10:36 am

Comparison Between Carbapenems and β-Lactam/β-Lactamase Inhibitors in the Treatment for Bloodstream Infections Caused by Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: A Systematic Review and Meta-Analysis

Open Forum Infect Dis. 16 May 2017;4(2):ofx099.

Muhammed M, Flokas ME, Detsis M, Alevizakos M, y col.  

Background.

Carbapenems are widely used for the management of bloodstream infections (BSIs) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE). However, the wide use of carbapenems has been associated with carbapenem-resistant Enterobacteriaceae development.

Methods.

We searched the PubMed and Scopus databases (last search date was on June 1, 2016) looking for studies that reported mortality in adult patients with ESBL-PE BSIs that were treated with carbapenems or β-lactam/β-lactamase inhibitors (BL/BLIs).

Results.

Fourteen studies reported mortality data in adult patients with ESBL-PE BSI that were treated with carbapenems or BL/BLIs. Among them, 13 studies reported extractable data on empiric therapy, with no statistically significant difference in mortality of patients with ESBL-PE BSI that were treated empirically with carbapenems (22.1%; 121 of 547), compared with those that received empiric BL/BLIs (20.5%; 109 of 531; relative risk [RR], 1.05; 95% confidence interval [CI], 0.83–1.37; I2 = 20.7%; P = .241). In addition, 7 studies reported data on definitive therapy. In total, 767 patients (79.3%) received carbapenems and 199 patients (20.6%) received BL/BLIs as definitive therapy, and there was again no statistically significant difference (RR, 0.62; 95% CI, 0.25–1.52; I2 = 84.6%; P < .001). Regarding specific pathogens, the use of empiric BL/BLIs in patients with BSI due to ESBL-Escherichia coli was not associated with a statistically significant difference in mortality (RR, 1.014; 95% CI, 0.491–2.095; I2 = 62.5%; P = .046), compared with the use of empiric carbapenems.

Conclusions.

These data do not support the wide use of carbapenems as empiric therapy, and BL/BLIs might be effective agents for initial/empiric therapy for patients with BSI caused by likely ESBL-PE, and especially ESBL-E coli.

FULL TEXT

https://academic.oup.com/ofid/article/4/2/ofx099/3828264

PDF (HACER CLIC en PDF)

 

September 20, 2018 at 3:31 pm

Bloodstream infections in cancer patients. Risk factors associated with mortality

International Journal of Infectious Diseases June 2018 V.71 P.59-64

Beda Islas-Muñoz, Patricia Volkow-Fernández, Cynthia Ibanes-Gutiérrez, Alberto Villamar-Ramírez, Diana Vilar-Compte, Patricia Cornejo-Juárez

Highlights

  • Bloodstream infections (BSI) cause severe complications in cancer patients.
  • Secondary BSI and central-related BSI were the most common in solid tumors.
  • Primary BSI and mucosal barrier injury BSI were described in hematological patients.
  • Mortality at 30-days was increased with multidrug resistant Gram-negative bacteria.
  • Inappropriate antimicrobial treatment in the first 24 h was related with mortality.

Objective

The aim of this study was to evaluate the clinical characteristics and risk factors associated with mortality in cancer patients with bloodstream infections (BSI), analyzing multidrug resistant bacteria (MDR).

Methods

We conducted a prospective observational study at a cancer referral center from August 2016 to July 2017, which included all BSI.

Results

4220 patients were tested with blood cultures; 496 were included. Mean age was 48 years. In 299 patients with solid tumors, secondary BSI and Central Line-Associated BSI (CLABSI) were the most common (55.9% and 31.8%, respectively). In 197 hematologic patients, primary and mucosal barrier injury (MBI) BSI were the main type (38.6%). Gram-negative were the most frequent bacteria (72.8%), with Escherichia coli occupying the first place (n = 210, 42.3%), 48% were Extended-Spectrum Beta-Lactamase (ESBL) producers, and 1.8% were resistant to carbapenems. Mortality at day 30, was 22%, but reached 70% when patients did not receive an appropriate antimicrobial treatment. Multivariate analysis showed that progression or relapse of the oncologic disease, inappropriate antimicrobial treatment, and having resistant bacteria were independently associated with 30-day mortality.

Conclusions

Emergence of MDR bacteria is an important healthcare problem worldwide. Patients with BSI, particularly those patients with MDR bacteria have a higher mortality risk.

PDF

https://www.ijidonline.com/article/S1201-9712(18)30081-X/pdf

July 14, 2018 at 7:25 pm

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