Health Concern In Hospitals Research Articles

ANTIBIOTIC RESISTANCE OF ACINETOBACTER BAUMANNII: AN URGENT NEED FOR NEW THERAPY AND INFECTION CONTROL

Acinetobacter baumannii (A. baumannii) infections became an emerging health concern in hospitals across the globe and are often related to nosocomial infections with poorer clinical outcomes in patients with prolonged hospital stay. Management of infections involves prompt identification of the infecting strain, isolating the source of infection, and proper choice of antibiotic regimen. However, resistance to first-line antimicrobial drugs, combined with a scarcity of equally effective alternatives, complicates the treatment of multidrug-resistant (MDR) A. baumannii. Presently, MDR A. baumannii may be a serious health concern in hospitals and long-term care facilities accounting for up to 20% of infections in intensive care units, and 7% of infections in patients who are physically connected to medical equipments. Immediate and sustained prevention efforts are needed to control the speed of incidence. Antibiotic use is largely under-regulated in Egypt leading to the emergence of resistant isolates. This review describes genetic markers and other factors that influence the incidence of MDR A. baumannii. Current and emerging treatments as well as infection control strategies are discussed.

A comprehensive evaluation of monochloramine disinfection on water quality, Legionella and other important microorganisms in a hospital

Opportunistic pathogens such as Legionella are of significant public health concern in hospitals. Microbiological and water chemistry parameters in hot water throughout an Ohio hospital were monitored monthly before and after the installation of a monochloramine disinfection system over 16 months. Water samples from fifteen hot water sampling sites as well as the municipal water supply entering the hospital were analyzed using both culture and qPCR assays for specific microbial pathogens including Legionella, Pseudomonas spp., nontuberculous Mycobacteria [NTM], as well as for heterotrophic bacteria. Legionella culture assays decreased from 68% of all sites being positive prior to monochloramine addition to 6% positive after monochloramine addition, and these trends were parallel to qPCR results. Considering all samples, NTMs by culture were significantly reduced from 61% to 14% positivity (p<0.001) after monochloramine treatment. Mycobacterium genus-specific qPCR positivity was reduced from 92% to 65%, but the change was not significant. Heterotrophic bacteria (heterotrophic bacteria plate counts [HPCs]) exhibited large variability which skewed statistical results on a per room basis. However, when all samples were considered, a significant decrease in HPCs was observed after monochloramine addition. Lastly, Pseudomonas aeruginosa and Vermamoeba vermiformis demonstrated large and significant decrease of qPCR signals post-chloramination. General water chemistry parameters including monochloramine residual, nitrate, nitrite, pH, temperature, metals and total trihalomethanes (TTHMs) were also measured. Significant monochloramine residuals were consistently observed at all sampling sites with very little free ammonia present and no water quality indications of nitrification (e.g., pH decrease, elevated nitrite or nitrate). The addition of monochloramine had no obvious impact on metals (lead, copper and iron) and disinfection by-products.

Antibiotic resistance of Acinetobacter baumannii: an urgent need for new therapy and infection control

Acinetobacter baumannii (A. baumannii) is a Gram-negative coccobacillus, non-motile, catalase-positive, oxidase-negative, non-fastidious, and strictly aerobic bacterium.Acinetobacter baumannii (A. baumannii) infections became an emerging health concern in hospitals across the globe and are often related to nosocomial infections with poorer clinical outcomes in patients with prolonged hospital stay. Management of infections involves prompt identification of the infecting strain, isolating the source of infection, and proper choice of antibiotic regimen. However, resistance to first-line antimicrobial drugs, combined with a scarcity of equally effective alternatives, complicates the treatment of multidrug-resistant (MDR) A. baumannii. Presently, MDR A. baumannii may be a serious health concern in hospitals and long-term care facilities accounting for up to 20% of infections in intensive care units, and 7% of infections in patients who are physically connected to medical equipments. Immediate and sustained prevention efforts are needed to control the speed of incidence. Antibiotic use is largely under-regulated in Egypt leading to the emergence of resistant isolates. This review describes genetic markers and other factors that influence the incidence of MDR A. baumannii. Current and emerging treatments as well as infection control strategies are discussed.

Comparative Study on Antibacterial Activity of Metal Ions, Monometallic and Alloy Noble Metal Nanoparticles Against Nosocomial Pathogens

Unbeatable widespread antimicrobial resistance in nosocomial pathogens is a major public health concern in hospitals. In the present study, aqueous stem extract of C. tagal (CTSE) is used as a bioreducing agent for synthesis of various monometallic and alloy nanoparticles. Nanoparticle formation was dependent on time, temperature, and metal salts’ concentration. UV-Visible spectroscopy demonstrated peaks at 444 and 556 nm for silver and gold nanoparticles, respectively, while both alloy Ag–Au nanoparticles exhibited peaks at 535 nm. Transmission electron microscopy (TEM), X-ray diffraction (XRD), and attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy results revealed shape, size, and involvement of functional groups in formation of stable nanoparticles. Further, minimum inhibitory concentration (MIC) of two metal ions, four monometallic nanoparticles, and two alloy noble metal nanoparticles was evaluated against nosocomial pathogens. Silver nanoparticles synthesized from AgNO3 and Ag2SO4 exhibited cytotoxicity against all tested microorganisms. Alloy (Ag–Au) nanoparticles from salts of silver nitrate and gold were more effective than alloy nanoparticles prepared from salts of silver sulfate and gold. However, gold and copper nanoparticles were effective only against Staphylococcus aureus and Escherichia coli respectively. Ionic silver was more cytotoxic as compared to copper ions and monometallic and alloy nanoparticles. This is the first report on comparative antimicrobial activity of metal ions and various nanoparticles synthesized from CTSE against nosocomial pathogens from the intensive care unit (ICU) and burn wound intensive care unit (BWICU).

Laboratory-confirmed hospital-acquired infections: An analysis of a hospital's surveillance data in Nigeria

ObjectiveHospital-acquired infections (HAI) are a global problem and a major public health concern in hospitals throughout the world. Quantification of HAI is needed in developing countries; hence we describe the results of a 2-year surveillance data in a tertiary hospital in Nigeria. MethodologyThis study is a 2-year review using secondary data collected at a tertiary referral center in northwestern Nigeria. The data was collected using surveillance forms modeled based on the Centre for Disease Control (CDC) protocol. Descriptive statistics were used to present results as frequencies and percentages. Result518 patients developed HAI out of 8216 patients giving an overall prevalence of 6.3%. The mean age of the patients was 35.98 years (±15.92). Males constituted 281 (54.2%). UTI 223 (43.1%) was the most prevalent HAI. Overall, E. coli 207 (40.0%) was the most frequent isolates followed by P. aerugenosa 80 (15.4%). There was a high prevalence of cloxacillin resistant S. aureus (67.9%) and gram-negative rods resistant to third-generation cephalosporins. Trimethoprim-sulfamethoxazole resistance across the board was more than 90%. ConclusionThere is a high burden of HAI especially UTI in our hospital with resistance to commonly used antibiotics documented.