Incidence Of Nosocomial Infections Research Articles

Evaluation of High-dose versus Standard-dose of Dexamethasone on Mortality among the Mechanically Ventilated COVID-19 Patients.

Anti-inflammatory agents like dexamethasone (DEX) are a mainstay of treatment for COVID-19. Despite randomized trials demonstrating that a 6 mg daily dose of DEX improved patient outcomes in hospitalized COVID-19 patients receiving oxygen, clinicians often prescribe higher doses of corticosteroids without evidence to support this practice. The purpose of this study was to compare outcomes of ventilated COVID-19 patients who received standard dose (SD) versus high dose (HD) DEX. This was a multi-site, retrospective, observational study on ventilated COVID-19-positive patients who received DEX for at least three days between June 1, 2020, and January 31, 2022. The primary outcome of this study was the association between mortality and SD (<6mg daily) versus HD (>10mg daily) DEX in ventilated COVID-19 patients. Secondary outcomes included average blood glucose (BG), number of BG readings above 200, incidence of bacterial nosocomial infection, ventilator-free days, length of stay (LOS), and ICU LOS. Of the 212 included patients, 53 (25%) received SD DEX, and 159 (75%) received HD DEX. There was no significant effect of DEX dose on mortality, number of BG readings >200, incidence of nosocomial infections, LOS, or ventilator-free days (p >0.05). After controlling for confounding factors, no difference in mortality persisted (OR 1.34 95% CI 0.62- 2.90). Average daily BG and ICU LOS were significantly greater in the HD group compared to the SD group (p = 0.003, p = 0.019, respectively). There was no association between HD DEX and mortality among ventilated COVID-19 patients compared to SD DEX. Moreover, HD DEX is associated with detrimental effects such as prolonged ICU LOS and higher average daily BG. This study supports the use of SD DEX in ventilated COVID-19 patients.

Clinical significance of lower respiratory tract culture within 48 h of admission in patients with viral pneumonia: an observational study

BackgroundThe aim of this retrospective study was to examine the risk factors of positive lower respiratory tract cultures and to investigate whether nosocomial infections are common in patients with positive lower respiratory tract cultures.MethodsWe enrolled 86 patients diagnosed with influenza A-related critical illness who were treated at Fuzhou Pulmonary Hospital of Fujian in China between 1st October 2013 and 31st March 2019. The of admission were used to divide the enrolled patients into two groups. Sputum and bronchoalveolar lavage fluid specimens were collected within 48 h after admission for culture. All samples were cultured immediately after sampling. Nosocomial infections are defined as any symptom or sign of pulmonary infiltration, confirmed by X-ray, after 5 days of admission and positive results from one or more cultures.ResultsThe average age of this cohort was (54.13 ± 16.52) years. Based on the culture results, Staphylococcus aureus and Candida albicans had the highest positive rates (3.40% (3/86) and 20.90% (18/86), respectively). In patients with positive lower respiratory tract cultures, the incidence of nosocomial infection was 73.30% (22/30) five days after admission. However, the incidence of nosocomial infection was lower (42.80%, 24/56) in patients with negative lower respiratory tract cultures. Hemoptysis, systolic pressure at admission, and blood urea nitrogen level at admission were all independent risk factors for positive lower respiratory tract cultures within 48 h of admission.ConclusionOur data showed that a significant proportion of patients with pneumonia exhibited co-infections with bacteria or fungi within five days of hospital admission. Hemoptysis, systolic pressure, and blood urea nitrogen levels at admission emerged as the key risk factors. These findings underscore the necessity of closely monitoring patients with influenza infection, particularly for positive bacterial or fungal cultures within the initial 48 h of admission.

Prediction of Concomitant Nosocomial Infection in Patients Previously Colonized Colorectally by Multidrug-Resistant Bacteria in an SDD Setting

Background: Antibiotic resistance is a worldwide concern. This study retrospectively analyzed patients admitted to the ICU of a tertiary hospital over a period of 7 months who were rectally colonized by multidrug-resistant microorganisms. The incidence of concomitant nosocomial infections was estimated, thus providing the risk of a colonizing microorganism producing a nosocomial infection. Methods: Infections with the same microorganism (concomitant) or different microorganisms (non-concomitant) were analyzed in order to adjust the empirical antibiotic treatment. Patients with rectal colonization by at least one multidrug-resistant bacterium (MDRB) on admission or after ICU admission were included. All patients had complete selective digestive decontamination (SDD) prophylaxis. For univariate analysis, categorical variables are expressed as frequencies and percentages and continuous variables as means and standard deviations, or as medians and interquartile ranges. For multivariate analysis, the model is summarized with p-values and hazard ratios with 95% confidence intervals. Survival analysis was conducted using the Kaplan–Meier method, which was performed to evaluate the time elapsed from colonization to infection by the same bacteria. Statistical significance was considered at p &lt; 0.05. Results: Of the 130 patients with MDRB bacterial colonization analyzed, 98 remained free of infection, while 22 developed non-concomitant infections and 10 had infections concomitant to rectal colonizing bacteria. OXA-48-producing bacteria and MDR-Pseudomonas spp. incidences were 18.9% (95% CI: 7.96–35.2) and 44.4% (CI: 13.7–78.8), respectively. Conclusions: OXA-48-producing bacteria and MDR-Pseudomonas spp. were the only bacteria associated with the development of infections concomitant to rectal colonization in an SDD setting. The incidence of MDRB infections was low.

Risk assessment and prediction of nosocomial infections based on surveillance data using machine learning methods

BackgroundNosocomial infections with heavy disease burden are becoming a major threat to the health care system around the world. Through long-term, systematic, continuous data collection and analysis, Nosocomial infection surveillance (NIS) systems are constructed in each hospital; while these data are only used as real-time surveillance but fail to realize the prediction and early warning function. Study is to screen effective predictors from the routine NIS data, through integrating the multiple risk factors and Machine learning (ML) methods, and eventually realize the trend prediction and risk threshold of Incidence of Nosocomial infection (INI).MethodsWe selected two representative hospitals in southern and northern China, and collected NIS data from 2014 to 2021. Thirty-nine factors including hospital operation volume, nosocomial infection, antibacterial drug use and outdoor temperature data, etc. Five ML methods were used to fit the INI prediction model respectively, and to evaluate and compare their performance.ResultsCompared with other models, Random Forest showed the best performance (5-fold AUC = 0.983) in both hospitals, followed by Support Vector Machine. Among all the factors, 12 indicators were significantly different between high-risk and low-risk groups for INI (P < 0.05). After screening the effective predictors through importance analysis, prediction model of the time trend was successfully constructed (R2 = 0.473 and 0.780, BIC = -1.537 and -0.731).ConclusionsThe number of surgeries, antibiotics use density, critical disease rate and unreasonable prescription rate and other key indicators could be fitted to be the threshold predictions of INI and quantitative early warning.

Respiratory multiple infections by bacteria, viruses, fungi, and parasites in a COPD patient: A case report

SARS-CoV-2 is the causative agent of COVID-19, an infection that can manifest with mild to severe respiratory symptoms. A 70-year-old man with COVID-19 and COPD presented to a hospital complaining of breathing difficulties. A sample was taken, leading to the finding of the Acanthamoeba parasite. Stenotrophomonas maltophilia, a bacterium known for its resistance to most antibiotics and its significance as a nosocomial pathogen, was identified. Furthermore, for the first time, the Gloeotinia fungus was discovered as an endosymbiont of Acanthamoeba. The patient underwent successful treatment and was discharged from the hospital. Immunocompromised people should be concerned about the increasing incidence of nosocomial infections. The presence of Acanthamoeba should not be overlooked in respiratory disorders, as it has the potential to carry numerous pathogenic microorganisms as endosymbionts.

Safety of Early Discharge After Coronary Artery Bypass Grafting: A Nationwide Readmissions Analysis

BackgroundWe determined the safety of early discharge after coronary artery bypass grafting (CABG) in patients with uncomplicated postoperative courses and compared outcomes with routine discharge in a national cohort. We identified preoperative factors associated with readmission after early discharge after CABG. MethodsThe Nationwide Readmissions Database was queried to identify patients undergoing CABG from January 2016 to December 2018. Patients were stratified based on length of stay (LOS) as early (≤4 days) vs routine (5-10 days) discharge. Patients were excluded with hospital courses indicative of complicated stays (emergent procedures, LOS >10 days, discharge to extended care facility or with home health, index hospitalization mortality). Propensity score matching was performed to compare outcomes between cohorts. Multivariable logistic regression models were used to identify factors associated with readmission after early discharge. ResultsDuring the study period, 91,861 patients underwent CABG with an uncomplicated postoperative course (∼20% of CABG population). Of these, 31% (28,790 of 91,861) were discharged early, and 69% (63,071 of 91,861) were routinely discharged. After propensity score matching, patients discharged early had lower readmission rates at 30 days, 90 days, and up to 1 year (P < .001 for all). The index hospitalization cost was lower with early discharge ($26,676 vs $32,859; P < .001). Early discharge was associated with a lower incidence of nosocomial infection at the index hospitalization (0.17% vs 0.81%, P < .001) and readmission from infection (14.5% vs 18%, P = .016). ConclusionsEarly discharge after uncomplicated CABG can be considered in a highly selective patient population. Early-discharge patients are readmitted less frequently than matched routine-discharge patients, with a lower incidence of readmission from infection. Appropriate postdischarge processes to facilitate early discharge after CABG should be further pursued.

Incidence and mortality of community-acquired and nosocomial infections in Japan: a nationwide medical claims database study

BackgroundIt is important to determine the prevalence and prognosis of community-acquired infection (CAI) and nosocomial infection (NI) to develop treatment strategies and appropriate medical policies in aging society.MethodsPatients hospitalized between January 2010 and December 2019, for whom culture tests were performed and antibiotics were administered, were selected using a national claims-based database. The annual trends in incidence and in-hospital mortality were calculated and evaluated by dividing the patients into four age groups.ResultsOf the 73,962,409 inpatients registered in the database, 9.7% and 4.7% had CAI and NI, respectively. These incidences tended to increase across the years in both the groups. Among the patients hospitalized with infectious diseases, there was a significant increase in patients aged ≥ 85 years (CAI: + 1.04%/year and NI: + 0.94%/year, P < 0.001), while there was a significant decrease in hospitalization of patients aged ≤ 64 years (CAI: -1.63%/year and NI: -0.94%/year, P < 0.001). In-hospital mortality was significantly higher in the NI than in the CAI group (CAI: 8.3%; NI: 14.5%, adjusted mean difference 4.7%). The NI group had higher organ support, medical cost per patient, and longer duration of hospital stay. A decreasing trend in mortality was observed in both the groups (CAI: -0.53%/year and NI: -0.72%/year, P < 0.001).ConclusionThe present analysis of a large Japanese claims database showed that NI is a significant burden on hospitalized patients in aging societies, emphasizing the need to address particularly on NI.

Outcomes of patients with thrombotic thrombocytopenic purpura treated in an intensive care unit.

Background Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder characterized by widespread microthrombosis that can predispose to multiple organ failure. The literature is sparse on the outcomes of critically ill patients with TTP managed in intensive care units (ICUs). We aimed to determine the mortality of ICU patients admitted with TTP and evaluate the predictors of survival. We also compared the incidence of nosocomial infection among those who did or did not receive plasma exchange (PE). Methods We conducted a retrospective study in a tertiary ICU. Two authors screened patients for eligibility from the hospital information system based on peripheral smear reports. Adult critically ill TTP patients managed in ICU were included. Patients with a diagnosis of haemolytic uraemic syndrome, autoimmune causes of haemolysis and pregnancy-related conditions, etc. were excluded. Two authors extracted data from medical charts. No imputation of missing variables was done. Non-parametric statistics were used to report data. Statistical analyses were performed using Stata version 16. Results Of the 535 records that were screened, 33 patients were deemed eligible. Mortality among TTP patients was 14 (42%). The women to men ratio was 7:3. At admission, greater degree of anaemia, thrombocytopenia, and higher lactate dehydrogenase levels were observed in non-survivors compared to survivors (5.4 g/dl [4.8-7.1] v. 7.6 g/dl [6.1-8.9], p=0.05; 17x103 μl v. 21x103 μl, p=0.63; and 2987 (1904-3614) U/L v. 2126 U/L (1941-3319), p=0.71; respectively]. Nineteen (57%) patients had acute kidney injury (AKI), of which 11 survived: 6 recovered completely from renal failure and 5 progressed to end-stage renal disease. Nosocomial infection rates were not different among those receiving and not receiving PE therapy (7 [33%] v. 3 [25%], respectively). Conclusion TTP is more common in women and has a high mortality. Older age, low haemoglobin and higher platelet transfusions are predictors of poor survival. Nosocomial infection rates were similar irrespective of receiving PE therapy.

Epidemiological and Prognostic Assessment of Nosocomial Infections in the Surgical Emergency Resuscitation Department IBN Tofail Hospital

Nosocomial infection is an infection acquired in a healthcare establishment. It is acquired more than 48 hours after admission [1]. Intensive care units are considered a reservoir of multi-resistant bacteria due to the critical condition of patients and the practice of certain invasive care [2]. NI constitute a public health problem marked by high morbidity and mortality. The objectives of our study are:  Detail the epidemiological profile of IN  List ATB-resistant germs  Determine the main prognostic factors We carried out a prospective study from January to June 2022 including patients hospitalized during the period in the HIT RUCH department. Patients whose stay was less than 48 hours were excluded. The diagnosis of IN was suggested based on clinical and paraclinical signs and then confirmed by bacteriological analyses. The resistance profile of the germs to ATB was reported by the results of the antibiogram. Among the 92 patients who stayed more than 48 hours in intensive care, 19 presented with IN, an incidence of 20.65%, of which 89% were male and the median age was 51.7 years. The time to IN acquisition was 5.1 days. IN at the pulmonary site were predominant with a percentage of 36.84%. The germs responsible for IN were dominated by BGN including acinetobacter baumanii with 42.1% and its resistance to ATB was 100% to C3G, 65.6% to amikacin; CGP germs were represented by staphylococcus aureus with 15%. IN-related mortality was 42%. It appears in the light of our results that IN and resistance of germs to ATB are worrying. Judicious use of ATB, hand washing and use of sterile equipment are essential to reduce the incidence of nosocomial infection.

Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis

BackgroundAn increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult.MethodsWe searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary endpoints included time to infection, source of infection, ECMO duration, Intensive care and hospital length of stay (LOS), ECMO survival and overall survival. Incidence of NI was reported as pooled proportions and 95% confidence intervals (CIs), while dichotomous outcomes were presented as risk ratios (RR) as the effective index and 95% CIs using a random-effects model.ResultsAmong the 4,733 adult patients who received ECMO support in the 30 included studies, 1,249 ECMO-related NIs per 1000 ECMO-days was observed. The pooled incidence of NIs across 18 studies involving 3424 patients was 26% (95% CI 14–38%).Ventilator-associated pneumonia (VAP) and bloodstream infections (BSI) were the most common NI sources. Infected patients had lower ECMO survival and overall survival rates compared to non-infected patients, with risk ratio values of 0.84 (95% CI 0.74–0.96, P = 0.01) and 0.80 (95% CI 0.71–0.90, P < 0.001), respectively.ConclusionResults showed that 16% and 20% lower of ECMO survival and overall survival in patients with NI than patients without NI, respectively. However, NI increased the risk of in-hospital mortality by 37% in infected patients compared with non-infected patients. In addition, this study identified the significant positive correlation between ECMO duration and ECMO-related NI.

Nosocomial Infections in the Neonatal Intensive Care Unit.

Nosocomial infections are relatively common in the NICU. These infections increase morbidity and mortality, particularly in the smallest and most fragile infants. The impact of these infections on long-term outcomes and health-care costs is devastating. Worldwide efforts to decrease the incidence of nosocomial infections have focused on implementing specific prevention protocols such as handwashing, central line teams, care bundles, and antimicrobial stewardship. This review summarizes common nosocomial infections in patients in the NICU.

Effectiveness of Nursing Strategies on Risk for Pneumonia Among Patients Connected to Mechanical Ventilator in Intensive Care Unit

It has been reported that the incidence of nosocomial infections in the ICU is about 2–5 times higher than in the general in-patient hospital population. The study's objective was to evaluate the effectiveness of Nursing Strategies on Risk for Pneumonia among Patients connected to Mechanical Ventilator in Intensive Care Unit. The study adopted randomized controlled trial. Forty patients were enrolled in the study after screening using CPIS scale. If the score &lt;6 the patients were included in the study and eligibility criteria were age between 25 to 60 years, duration of ventilator 48 hours and medical patients with respiratory, renal, MODS, and sepsis diagnosis. Patients subjected to surgery and connected with non-invasive ventilation were excluded from the study. Standardized questionnaire such as demographic variables, clinical variables, and Clinical Pulmonary Infection Scoring (CPIS). The data was analyzed using descriptive statistics, independent ‘t’ test, paired t test and ANOVA were used to analyze the data. Seven (35%) of them were in the age group of 51-60 years in the study group, whereas six (30%) of the patients were in the age group of 61-70 years in the control group. 12(60%) of the patients were male and eight (40%) of them were female in the study group and 10(50%) of patients were male and female respectively in the control group. Regarding mode of ventilation, 12(50%) and six (30%) of patients ventilator setting were CMV and ASV respectively, in the study group, whereas seven (35%) and six (30%) of patients ventilator settings were ASV and CMV respectively in the control group. The pretest CPIS mean score was 4.40 with a standard deviation of 0.59 and the posttest III mean value was 2.60 with a standard deviation of 0.58 and the mean difference was 1.80 between the pretest and the posttest III, which was statistically significant at p&lt;0.001 in the study group. Nursing strategies such as demand suctioning, second hourly position change, changing ventilator flow sensor every 72 hours, and oral care every fourth hour with chlorhexidine help reduce ventilator-associated pneumonia.

Clinical Profile and Outcome of Covid-19 Intensive Care Patients with Nosocomial Infections: A Single-Centred Experience from India

Background: Incidences of nosocomial infections in COVID-19 patients admitted to the intensive care unit (ICU) have become a common occurrence. Hospital-acquired infections (HAI) present increased mortality, cost-of-care, especially relevant in multidrug resistant (MDR) infections. Our study aimed to assess the clinical implications associated with HAI-infected COVID-19 patients. Patients and Methods: We conducted retrospective single-centred study on ICU-admitted adult COVID-19 patients for a year i.e., 2021-22 at a tertiary Indian institute and collated data of HAI epidemiological, clinical and microbiological reports. Results: Rate of HIA at our centre was estimated to be 10.29% and the mortality rate was 40.4%. 10 different organisms(Bacteria: 8, Fungi: 2) were detected in HAI, of which the incidence of Gram-negative infections (GNI) was highest i.e., 60% and that of Gram-positive infections (GPI)/Fungi (Fungi infected) were 20% each. Mortality was highest among GPI (36.67%), FI (13.46%), followed by and GPI (7.69%). Tocilizumab treatment decreased the risk of survivability with no significant difference in the treatment outcomes. Conclusion: This study provides a comprehensive picture of nosocomial infections characteristics among COVID-19patients and provides insights regarding the impact of treatment on the outcome of these patients with suggestions for strategies. We found that critically ill patients with COVID- 19 are at a high risk of developing HAI, especially MDR mediated CLABSI and CAUTI. Clinicians must therefore be cautious and mindful during implementing protocols for management of infectious complications with COVID-19 patients.

Early enteral nutrition versus early supplemental parenteral nutrition in patients undergoing major abdominal surgery: a secondary analysis of 2 randomized clinical trials

BackgroundThe effect of early isoenergetic feeding routes [early enteral nutrition (E-EN) or early supplemental parenteral nutrition (E-SPN)] on the outcome of patients undergoing major abdominal surgery is controversial. ObjectivesThe aim of this study was to investigate the impact of early isoenergetic EN compared with early isoenergetic SPN on nosocomial infections in patients undergoing major abdominal surgery. MethodsThis study is a secondary, post hoc analysis of data from 2 open-label randomized clinical trials. Participants were recruited from the general surgery department of 11 academic hospitals in China undergoing major abdominal surgery and with Nutritional Risk Screening 2002 score ≥3. All eligible patients were categorized into 2 groups based on their achievement of the 100% energy target on postoperative day (POD) 3: the E-EN group (n = 199) and the E-SPN group (n = 115). The primary outcome was the incidence of nosocomial infections between POD 3 and hospital discharge. ResultsIn total, 314 patients [mean (SD) age, 59.2 (11.4) y; 113 (36.0%) females] were included. Patients in the E-EN group showed no significant difference in nosocomial infections compared with those in the E-SPN group {17/199 [8.5%] compared with 10/115 [8.7%], risk difference, 0.2% [95% confidence interval (CI): –6.3, 6.6]}. The hematological nutritional status of the E-EN group showed a significant improvement at discharge compared with the E-SPN group (albumin: 38.0 ± 6.0 g/L compared with 35.5 ± 7.6 g/L; mean difference, –2.5 g/L; 95% CI: –4.0, –1.0 g/L; prealbumin: 200.0 ± 8.0 mg/L compared with 158.4 ± 38.1 mg/L; mean difference, –41.6 mg/L; 95% CI: –41.7, –36.1 mg/L). Other indicators were comparable between groups. ConclusionE-EN compared with isoenergetic SPN may not be associated with a reduced rate of nosocomial infection in patients undergoing major abdominal surgery, but may be associated with improved hematological nutritional status. Trial registration numberThis trial was registered at clinicaltrials.gov as NCT03115957 (https://clinicaltrials.gov/ct2/show/NCT03115957) and NCT03117348 (https://clinicaltrials.gov/ct2/show/NCT03117348).

Impact of the COVID-19 pandemic on the incidence and type of infections in hospitalized patients with cirrhosis: a retrospective study

Infections are a major cause of morbidity and mortality in cirrhosis, especially those caused by multi-drug resistant bacteria. During the COVID-19 pandemic, the incidence and type of infection in these patients may have been influenced by the restrictive measures implemented. We aimed to compare the infections in patients with cirrhosis hospitalized before the COVID-19 pandemic versus those hospitalized during the pandemic. We retrospectively compared infections in patients with cirrhosis hospitalized in the hepatology unit during the pre-pandemic period (3/2019–2/2020) with infections in patients hospitalized during the pandemic (3/2020–2/2021). Baseline characteristics, type of infections, type of bacteria, antimicrobial resistance and mortality were evaluated. There were 251 hospitalizations in 170 patients during the pre-pandemic period and 169 hospitalizations in 114 patients during the pandemic period. One or more infections were identified in 40.6% of hospitalizations during the pre-pandemic period and 43.8% of hospitalizations during the pandemic, P = 0.52. We found 131 infections in the pre-pandemic period and 75 infections during the pandemic. The percentage of nosocomial infections decreased in the pandemic period (25.3% vs. 37.4% in the pre-pandemic period, P = 0.06). We found a non-significant trend to a higher incidence of infections by multi-drug resistant organisms (MDRO) in the pandemic period than in the pre-pandemic period (6.5% vs. 4%). The incidence of infections was similar in both periods. However, during the pandemic, we observed a trend to a lower incidence of nosocomial infections with a higher incidence of MDRO infections.

Personalized corticosteroid treatment of patients with severe new coronavirus infection complicated by pneumonia: a prospective comparative study

INTRODUCTION: A new coronavirus infection caused by the SARS-CoV-2 coronavirus and the associated disease COVID-19 is accompanied by a high incidence of acute respiratory distress syndrome (ARDS) and pneumonia with respiratory failure. Corticosteroids are a therapeutic treatment option. OBJECTIVE: To determine the advantage of personalized corticosteroid dosing to reduce inflammation in pneumonia in patients with comorbid diseases. MATERIALS AND METHODS: A prospective comparative study was conducted among adult patients in the Republican Clinical Infectious Hospital and the Clinical Emergency Hospital (Ufa, Republic of Bashkortostan) from May 2020 to May 2021. Patients were divided into two groups: personalized corticosteroid administration in accordance with the level of the inflammation biomarker C-reactive protein (CRP) (n = 30) compared with conventional therapy (n = 28). Measurements of CRP levels in blood samples were carried out at the time of hospitalization and then daily during the first 5 days of treatment. RESULTS: The intervention group had fewer days of respiratory support (9.4 [6.2–15.6] vs. 14.3 [7.1–21.4]; p = 0.003) and no differences in cumulative outcome (persistent dependence of respiratory support or death) and the incidence of nosocomial infection compared with the control group. Daily distribution of the biomarker CRP showed significantly lower levels on 2–4 days of treatment in the intervention group compared with the control group. CONCLUSIONS: In critically ill patients with pneumonia caused by COVID-19, and comorbid diseases, a personalized approach to the corticosteroids prescribing slightly reduced the frequency of treatment ineffectiveness and statistically significantly reduced the duration of respiratory support.

Retracted: Application Effect of the 6S Care Model in Sterilization in the Department of Stomatology and Its Impact on the Incidence of Nosocomial Infection.

[This retracts the article DOI: 10.1155/2022/4266087.].

Evaluation of the prevention effect of high-quality nursing quality control in disinfection supply center on nosocomial infection.

To explore the application effect of high-quality nursing quality control in disinfection supply center. The control group consisted of 1850 medical devices managed using the conventional quality control mode from January 2021 to December 2021, while the observation group consisted of 1900 medical devices managed using the high-quality nursing quality control mode from January 2022 to December 2022. The qualified rates of equipment cleaning, sterilization, and packaging were analyzed in both the observation and control groups. The occurrence of nosocomial infections in 2021 and 2022 were compared, and the changes in the Beck-Srivaatava stress scale index (BSSI) and Symptom Checklist-90 scores of the staff before and after implementing the high-quality nursing quality control mode were analyzed. The qualified rate of equipment cleaning, sterilization, and packaging in the observation group were 99.08%, 99.73%, and 99.78%, respectively, which were significantly higher than those in the control group (P < .05). The incidence of nosocomial infections in interventional and surgical cases in 2022 was 0.79%, which was significantly lower than that in 2021 (P < .05). The BSSI score of female staff was (68.76 ± 7.81) points, which was higher than that of male staff (P < .05). After the implementation of the high-quality nursing quality control mode, the BSSI score of the staff was (47.76 ± 9.12) points, which was significantly lower than that before implementation (P < .05). After the implementation of the high-quality nursing quality control mode, the staff's Symptom Checklist-90 scores for somatization, compulsion, interpersonal sensitivity, depression, hostility, and paranoia were (1.28 ± 0.29), (1.53 ± 0.24), (1.50 ± 0.21), (1.46 ± 0.32), (1.44 ± 0.26), and (1.38 ± 0.30) points, respectively, showing a decrease compared to before implementation (P < .05). The high-quality nursing quality control mode has great application value in the disinfection supply center. It can effectively improve the qualified rates of equipment cleaning, sterilization, and packaging, prevent nosocomial infections and improve the working pressure and psychological health of staff.

Cytomegalovirus Reactivation in Severe Coronavirus Disease 2019: Case Series from a Tertiary Care Center in the Western State of India

Abstract Introduction: Cytomegalovirus (CMV) reactivation in patients who have been admitted to the intensive care unit (ICU) is linked to higher mortality and health-care costs. There is a dearth of published research on CMV reactivation in patients with severe SARS-CoV-2. Materials and Methods: Objectives: The objective of this study was to describe clinical and laboratory profiles and outcomes of CMV reactivation in patients with severe SARS-CoV-2 illness. In this retrospective study carried out at a tertiary care hospital ICU in the Western state of India, patients with severe SARS-CoV-2 who were admitted from January 1, 2021, to May 31, 2021, and who got CMV viral load testing by reverse transcriptase polymerase chain reaction were analyzed. Results: During the study period, 27 out of 277 admitted patients were subjected to plasma CMV viral load testing, of which 13 patients had detectable viral load giving a prevalence of 4.7%. Patients who tested positive for CMV had significantly higher mortality (P = 0.020) and ventilator support needs (P = 0.004). Both fungal and bacterial bloodstream infections were frequent in CMV-positive patients, but neither was statistically significant (P = 0.065 and P = 0.571, respectively). In this case series, there was no difference in CMV reactivations according to the degree of lymphopenia (P = 0.149), usage of steroids (P = 0.766), or immunomodulatory medications (tocilizumab/bevacizumab, P = 0.926). Conclusions: In SARS-CoV-2 patients with severe illness, CMV reactivation was associated with an increased need for ventilator support, a higher incidence of nosocomial infection (bacterial and fungal), and overall mortality.

Comparation of n-Heksan and Etanol in Bawang Dayak (Elutherine palmifolia L. Merr) Extraction for Inhibiting Pseudomonas aeruginosa

Pseudomonas aeruginosa is one of the bacteria that causes nosocomial infections. The incidence of nosocomial infections caused by Pseudomonas aeruginosa is around 10-15%. Nosocomial infections caused by these bacteria are increasingly difficult to treat. This happens because more and more strains are resistant to several antibiotics (Multidrug Resistance), so the selection of antibiotics against Pseudomonas aeruginosa is very difficult. This study aims to determine and analyze the effect of using polar and nonpolar solvents on Dayak onion bulb extract on the inhibitory ability of Pseudomonas aeruginosa. The method used in this study was Kirby-Bauer disk diffusion using 8 sample and 5 replication with assay solvent 96% ethanol and n-hexane extract of Dayak onion bulbs (Eleutherine palmifolia L. Merr) with concentration variations of 75%, 80%, and 85%. Positive control used ciprofloxacin 5 µg and positive control DMSO 10%. The results showed that on phytochemical screening of solvent ethanol 96% contained flavonoids and n-hexane contained triterpenoids. Ethanol 96% solvent obtained a higher presentase yield than n-heksan solvents and the highest inhibition zone diameter was 85% concentration in 96% ethanol solvent. The results of statistical analysis with Mann Whitney test showed a significant difference between the treatment groups (p&lt;0.05).