Infections In Hospitalized Patients Research Articles

Time-varying risks of infection in patients as they proceed through the phases of ‘pre-RA’: results from the Scottish Early RA inception cohort

ObjectiveRheumatoid arthritis (RA) develops after progressing through sequential ‘pre-RA’ phases. The mechanisms driving progression from one phase to the next remain poorly understood. This study examined the longitudinal rates of...

Nasopharynx microflora features and its role in the spread of nosocomial infection

Introduction. The threat of the spread of nosocomial infection is exacerbated by a number of factors, among which we should note the increase in the number of multidisciplinary medical institutions of various forms of ownership, the creation of new types of medical instruments, devices, medical drugs, the introduction of new kinds of invasive (instrumental) diagnostic and therapeutic interventions, the increase in the number of patients with suppressed immunity (premature newborns, patients with chronic diseases of various origins, elderly people). The source of nosocomial infection can be patients, medical personnel, visitors, and objects of the hospital environment: tools, linen, furniture, air, and food. The main ways of transmission of nosocomial infections are aerosol (air-droplet, air-dust), contact (through tools, linen, furniture), parenteral (when administering drugs), fecal-oral (dirty hands), alimentary (through food). Aim: to investigate the microflora of the nasopharynx of visitors to medical and preventive care institutions, to reveal the prevalence of carriers of pathogenic strains. The role of visitors to hospital patients in the spread of nosocomial infections is an extremely relevant topic, as it is insufficiently studied and requires in-depth research. Materials and methods. 40 visitors to medical and preventive care institutions (MPCI) who had no signs of respiratory tract diseases and exacerbations of comorbid pathologies were examined. All the studied visitors of MPCI patients were divided into 3 age groups according to WHO recommendations: 1st group (n=15) – young patients (18-44 years old); 2nd group (n=14) – middle-aged patients (44-60 years old); The 3rd group (n=11) – elderly patients (60-75 years old). Compliance of the distribution of clinical trial data with the law of normal distribution was checked using the Shapiro–Wilk test. Arithmetic means to value and standard error (M±m) were used to describe the data. The concentration of bacteria in the sample was presented as a decimal logarithm. The results. Bacteriogram indicators of the mucous membrane of the back wall of the nasopharynx were analyzed in visitors to the MPCI patients in different age groups. Statistically significant differences were found in the concentration of representatives of the studied bacteriogram (p˂0.05), which indicates the influence of age on the composition of the microflora of the mucous membrane of the back wall of the nasopharynx A statistically significant difference was established in the concentration and composition of representatives of the bacteriogram of the mucous membrane of the back wall of the nasopharynx in visitors to the MPCI patients of different age groups (p˂0.05), which indicates the dependence of the composition of the microflora of the nasopharynx on age. A statistically significantly higher concentration of Staphylococcus aureus was found in the group of young patients (p˂0.05), which indicates the release of the most significant amount of this pathogen from the carriers of this group and an increase in the probability of developing infectious complications when in contact with visitors to the hospital, who were included in the added group, in comparison with other studied groups. Conclusion. Asymptomatic carriers of pathogenic strains of bacteria were found in all studied age groups of visitors to the hospital, which suggests the possibility that the studied patients may be a potential source of hospital infection in hospital patients, but this requires further research.

Rate of hepatitis B infection in hospital patients and blood donors in Ha'il, KSA and associated risk factors

HBV infection is HBV infection is still a major public health and economic concern worldwide. Therefore, epidemiological studies are still at high concern. There are no epidemiological studies conducted for the prevalence of hepatitis B infection in Ha'il in Saudi Arabia so far. This study aimed to estimate the rate of hepatitis B infection and identifying potential risk factors, among patients/blood donors at King Khalid general hospital in Ha'il, KSA. Therefore, a retrospective analysis was performed to estimate Hepatitis B surface antigen (HBsAg) positivity among patients/blood donors. Data of 3727 patients/blood donors for HBsAg test was collected and analyzed using Microsoft Excel. Correlations and regression analysis were performed using the statistical package for social sciences (SPSS) programs. The level of statistical significance for the study was set at p < 0.05. The results showed that the rate of HBsAg among patients/blood donors was 1.1%. The rate of HBsAg was higher in male, age group >50 years old, blood donors and kidney artificial unit as well as gastroenterology/hepatology patients and in September. Logistic regression analysis demonstrated that only male (P<0.01), progressing age (P<0.001), blood donors (P<0.05) as well as gastroenterology/hepatology patients (P<0.01) made significant contributions to prediction.

Genomic dissection of Klebsiella pneumoniae infections in hospital patients reveals insights into an opportunistic pathogen

Klebsiella pneumoniae is a major cause of opportunistic healthcare-associated infections, which are increasingly complicated by the presence of extended-spectrum beta-lactamases (ESBLs) and carbapenem resistance. We conducted a year-long prospective surveillance study of K. pneumoniae clinical isolates in hospital patients. Whole-genome sequence (WGS) data reveals a diverse pathogen population, including other species within the K. pneumoniae species complex (18%). Several infections were caused by K. variicola/K. pneumoniae hybrids, one of which shows evidence of nosocomial transmission. A wide range of antimicrobial resistance (AMR) phenotypes are observed, and diverse genetic mechanisms identified (mainly plasmid-borne genes). ESBLs are correlated with presence of other acquired AMR genes (median n = 10). Bacterial genomic features associated with nosocomial onset are ESBLs (OR 2.34, p = 0.015) and rhamnose-positive capsules (OR 3.12, p < 0.001). Virulence plasmid-encoded features (aerobactin, hypermucoidy) are observed at low-prevalence (<3%), mostly in community-onset cases. WGS-confirmed nosocomial transmission is implicated in just 10% of cases, but strongly associated with ESBLs (OR 21, p < 1 × 10−11). We estimate 28% risk of onward nosocomial transmission for ESBL-positive strains vs 1.7% for ESBL-negative strains. These data indicate that K. pneumoniae infections in hospitalised patients are due largely to opportunistic infections with diverse strains, with an additional burden from nosocomially-transmitted AMR strains and community-acquired hypervirulent strains.

Ofloxacin‐loaded HMPB NPs for Klebsiella pneumoniae eradication in the surgical wound with the combination of PTT

Klebsiella pneumoniae (K. pneumoniae) is a common bacterium whose drug-resistant can cause surgical failures and incurable infections in hospital patients. Thus, how to reverse or delay the resistance induction has become a great challenge for development antiresistant drug. Recently, the combination of nanomaterial-loaded antibiotics with photothermal therapy showed the efficient antibacteria ability under a low dosage of antibiotics. In this study, a nanocomposite of HMPB NPs with inherent photothermal therapy capability was used to eradicate K. pneumoniae after loading with Ofloxacin, an antibiotic against K. pneumoniae in vitro and in vivo. The nanocomplexes named as Ofloxacin@HMPB@HA NPs showed a higher effect against K. pneumoniae by destroying cell integrity and inducing ATP leakage with the assistance of laser irradiation, compared with sole Ofloxacin@HMPB@HA NPs or laser irradiation. Surgical wound infection assay further demonstrated the efficient killing K. pneumoniae and promoting the formation of new tissues, as well, which was reflected by the rapid healing of surgical wound. In summary, these results indicate the great potential of this combinational tactic based on Ofloxacin@HMPB@HA NPs for preventing the failure caused by K. pneumoniae infection.

Linkage study of surveillance and hospital admission data to investigate Clostridium difficile infection in hospital patients in Perth, Western Australia

ObjectivesIncreasing incidence rates of Clostridium difficile infection (CDI) and outbreaks of emerging strains have highlighted the need for continuous monitoring and surveillance of CDI in Australia. Active surveillance captures all hospital-identified CDI cases in Western Australia (WA), where all C. difficile isolates recovered are routinely PCR ribotyped. The aim of this study was to determine incidence rates and descriptive and molecular epidemiology of CDI among patients in Perth, WA using linkage of surveillance and hospital administrative records. MethodsAll CDI cases (confirmed by tcdB PCR) from July 2012 to June 2014 captured in the Hospital Infection Surveillance WA dataset for three hospitals were linked with hospital admission records from the Patient Administration System and ribotyping data to calculate incidence rates of CDI and the distribution of various ribotypes (RTs). ResultsThere were 381 individual cases of CDI identified among 354 hospital patients (including outpatients and ED) who experienced ≥1 CDI episode during the study period. CDI was hospital-associated in 62.7% of cases and community-associated (CA)-CDI in 31.2%. The overall incidence rate was 4.40/10,000 patient days (PD, 95% CI 3.98–4.86), females across all age groups experienced higher incidence (risk ratio 1.29, p < 0.05). The risk ratio for CA-CDI was highest (7.76, p < 0.01) for females vs males aged 15–29 years. Overall, 10.8% of cases were admitted to ICU, 15.2% had a recurrent infection and the mortality rate was 7.2%. C. difficile RT 014/020 predominated (34.9%) among 339 isolates of 71 different RTs. ConclusionsThe incidence of CDI in WA is high and RT 014/020 continues to be the dominant molecular type in an otherwise diverse array of strains. High strain diversity suggests CDI cases arise from exposure to many different reservoirs.

Frequency of Hepatitis C Infection in Hospital Patients in Ha'il, KSA: A Retrospective Analysis

Few studies have assessed the prevalence of hepatitis C infection in the general population of Ha&#39;il in KSA or among hospital patients. This study aimed to evaluate the prevalence, correlates, and patterns of HCV antibodies among individuals attending King Khalid general hospital. A retrospective analysis was applied to evaluate HCV seropositivity among individuals who attended a tertiary care system from June 2020 to June 2021 in the Ha&rsquo;il region, KSA. Clinical and demographic data of

Molecular identification and subtyping of Blastocystis sp. in hospital patients in Central China

Blastocystis is a common enteric protist that inhabits the gastrointestinal tract of approximately 1 billion people worldwide. In this study, a total of 1,070 patients from two hospitals in Zhengzhou, Central China were enrolled to know molecular characteristics of Blastocystis sp. The microorganism was identified and subtyped with a PCR amplification and sequencing of the small subunit ribosomal deoxyribonucleic acid (SSU-rDNA). The overall minimum prevalence of Blastocystis sp. in participants was 3.1% (33/1070). Although there were no significant differences on Blastocystis sp. infections among study sites, age groups, and gender, the higher infection was observed in the patients with gastrointestinal diseases (8.8%, 15/170). Sequence analysis of the 33 isolates revealed three known subtypes, such as ST1 (n = 7), ST3 (n = 23), and ST7 (n = 3). Among them, ST3 was the dominant subtype being detected in 23 isolates (69.7%), followed by ST1 (21.2%, 7/33) and ST7 (9.1%, 3/33). The phylogenetic analysis demonstrated that three subtypes (ST1, ST3 and ST7) were clustered with their reference sequences with good bootstrap support. The subtype determination of Blastocystis sp. isolates by the phylogenetic analysis was well supported by online platform. The present study provides the first molecular report of Blastocystis sp. infections in hospital patients in Central China.

Prioritization of Mur family drug targets against A. baumannii and identification of their homologous proteins through molecular phylogeny, primary sequence, and structural analysis

BackgroundThe World Health Organization (WHO) report stated that Acinetobacter baumannii had been classified as one of the most important pathogenic bacteria causing nosocomial infection in hospital patients due to multi-drug resistance (MDR). It is vital to find out new bacterial drug targets and annotated their structure and function for the exploration of new anti-bacterial agents. The present study utilized a systematic route to prioritize the potential drug targets that belong to Mur family of Acinetobacter baumannii and identify their homologous proteins using a computational approach such as sequence similarity search, multiple sequence alignment, phylogenetic analysis, protein sequence, and protein structure analysis. ResultsFrom the results of protein sequence analysis of eight Mur family proteins, they divided into three main enzymatic classes namely transferases (MurG, MurA and MraY), ligases (MurC, MurD, MurE, and MurF), and oxidoreductase (MurB). Based on the results of intra-comparative protein sequence analysis and enzymatic classification, we have chosen MurB, MurE, and MurG as the prioritized drug targets from A. baumannii and subjected them for further detailed studies of inter-species comparison. This inter-species comparison help us to explore the sequential and structural properties of homologous proteins in other species and hence, opens a gateway for new target identification and using common inhibitor for different bacterial species caused by various diseases. The pairwise sequence alignment results between A. baumannii’s MurB with A. calcoaceticus’s MurB, A. baumannii’s MurE with A. seifertii’s MurE, and A. baumannii’s MurG with A. pittii’s MurG showed that every group of the proteins are highly similar with each other and they showed sequence identity of 95.7% and sequence similarity of 97.2%. ConclusionTogether with the results of secondary and three-dimensional structure predictions explained that three selected proteins (MurB, MurE, and MurG) from A. baumannii and their related proteins (AcMurB, AsMurE, and ApMurG) belong to mixed αβ class and they are very similar.

Критерії діагностики інфекційного ураження нижніх сечовивідних шляхів та органів малого таза

Urinary tract infections are the third most prevalent in humans after respiratory and gastrointestinal infections. In fact, bacterial infections of the urinary tract are the most common cause of both hospital and community hospital infections in patients. Pelvic inflammatory diseases (PID) are infectious inflammatory diseases of the upper female genital tract. In addition, the infection can also spread to the abdomen. The classic patient with a high risk of developing a PMTCT is, first and foremost, a woman with multiple sexual partners and unprotected sex. Key words: urethritis, PID, laboratory diagnostics, PCR, cultural research.

Negative Pressure Wound Therapy in Obese Women After Cesarean Delivery: A Negative Finding

Surgical-site infections comprise 20% of infections in hospitalized patients (accounting for up to $10 billion in U.S. healthcare expenditures

Terapi Bermain Clay Terhadap Tingkat Kecemasan Pada Anak Usia Prasekolah (3-6 Tahun)

Kecemasan merupakan perasaan yang paling umum dialami oleh pasien anak yang sedang mengalami hospitalisasi. Terapi bermain adalah suatu kegiatan bermain yang dilakukan untuk membantu penyembuhan anak dan sarana dalam melanjutkan pertumbuhan dan perkembangan anak secara optimal. Dengan terapi bermain, diharapkan kecemasan anak segera menurun, sehingga dapat menjadikan anak lebih bekerjasama pada petugas kesehatan. Permainan yang cocok diterapkan untuk anak usia prasekolah salah satunya adalah permainan membentuk (kontruksi) seperti clay. Tujuan penelitian ini untuk mengetahui pengaruh terapi bermain clay terhadap tingkat kecemasan pada anak usia prasekolah (3-6 tahun) di RSUD Balaraja Tangerang. Metode dalam penelitian ini menggunakan desain penelitian Praeksperimen dengan rancangan One Group Pretest Posttest. Sampel yang diambil 24 responden dengan menggunakan Total Sampling. Instrumen yang digunakan adalah lembar observasi serta uji analisis yang digunakan adalah Wilcoxon Signed Rank Test. Hasil penelitian ini menunjukkan bahwa, nilai (Sig 0,000 &lt;0,05). Kesimpulan Berdasarkan hasil penelitian tersebut maka ada pengaruh terapi bermain clay terhadap tingkat kecemasan pada anak usia prasekolah (3-6 tahun).

Effectiveness of insertion and maintenance bundles in preventing peripheral intravenous catheter-related complications and bloodstream infection in hospital patients: A systematic review.

Evidence-based bundles have reduced central line bloodstream infection rates in adult intensive care units. To tackle peripheral intravenous catheter (PIVC) bloodstream infection, many hospitals have implemented PIVC insertion and maintenance bundles. However, the efficacy of PIVC bundles in preventing PIVC complications and infection in hospital patients is uncertain. The aim of this paper is to synthesize evidence on the effectiveness of PIVC insertion and maintenance bundles on preventing adverse events. In this systematic review, we searched multiple electronic databases, trial registries, and grey literature for eligible studies published in English (January 2000-December 2018) to identify intervention studies evaluating PIVC insertion or maintenance bundles with two or more components. Search terms: peripheral intravenous catheter/cannula, insertion, maintenance, bundle, infection, infiltration, extravasation, dislodgement, thrombosis, occlusion, and phlebitis. Two reviewers independently conducted data extraction and quality assessments using the Downs and Black checklist. Of 14,456 records screened, 13 studies (6 interrupted time-series, 7 before-and-after) were included. Insertion and maintenance bundles included multiple components (2-7 items per bundle). Despite testing different bundles, 12 studies reported reductions in phlebitis and bloodstream infection, and one study reported no change in bloodstream infection and an increase in phlebitis rate. Methodological quality of all studies ranked between 'low' and 'fair'. The effect of PIVC bundles on PIVC complications and bloodstream infection rates remains uncertain. Standardisation of bundle components and more rigorous studies are needed. PROSPERO registration number: CRD42017075142.

Analysis of risk factors of nosocomial infection in hospitalized patients with myelodysplastic syndrome

Analysis of risk factors of nosocomial infection in hospitalized patients with myelodysplastic syndrome

Analysis of Acinetobacter baumannii hospital infections in patients treated at the intensive care unit of the University Hospital, Wroclaw, Poland: a 6-year, single-center, retrospective study.

BackgroundAcinetobacter baumannii (AB) is one of the most frequently isolated strains of bacteria in intensive care unit (ICU) patients, which provides huge therapeutic problems due to its multidrug resistance (MDR).Patients and methodsThe overall purpose of the study was analysis of health care- associated infections in terms of the incidence of AB strain infections and the changing susceptibility of this strain within a 6-year observation (2011–2016). The study was carried out in an ICU of the University Hospital in Wroclaw (Poland).ResultsAmong 589 isolated strains responsible for 540 health care-associated infections (21.2%) in 2549 ICU patients, AB was the pathogen in 183 (31%) cases. The incidence of AB infection amounted to 6.4/1000 patient-days. An increase was noted in the total number of hospital infections caused by AB strain from 16.5% and 3.39/1000 patient-days in 2011 to 41% and 9.64/1000 in 2016 (p=0.0003 and p=0.000, respectively). AB infections most frequently concerned ventilator-associated pneumonia (73.8%). AB was susceptible to colistin, amikacin, imipenem, meropenem, and ciprofloxacin in 100%, 10.7%, 12.3%, 11.5%, and 2.4% respectively, and it was characterized by MDR in 98.36% of the strains.ConclusionThe study revealed a 3-fold increase in the incidence of AB strain infections, significant increase in the resistance to carbapenems in the observed period, and a very high MDR. The solution to this problem would be the implementation of a repair program aiming at inhibition of AB strain transmission, measures to prevent infections, and restricted use of antibiotics.

Analysis of pathogenic bacteria and risk factors in emergency patients with cerebral apoplexy

Objective: To investigate pathogen and risk factors of hospital infection in emergency patients with stroke. Methods: The clinical data of 412 patients with acute stroke in the emergency from August of 2015 to March of 2017 were analysed to analyse main risk factors. Results: Among 412 patients with acute stroke, 53 cases were hospital-acquired with an infection rate of 12.86%, of which gram-negative bacteria, gram-positive bacteria and fungi took a great proportion among infectious pathogens. Analysis of influence of risk factors for learned that emergency the influence factors of stroke patients hospital infection rates are high for: age 65 or higher, invasive operation, mechanical ventilation, diabetes, strength grade 3 or below level 3, the prophylactic use of antibiotics, etc. (P<0.05). Conclusion: The incidence of hospital infection in patients with acute stroke was high, especially in patients with hemorrhagic cerebral apoplexy. We should enhance the cerebrovascular disease of primary and secondary prevention measures, reduce the risks of stroke, and intensify efforts to control the risk factors. For risk factors, clinical workers should strictly control the use of antimicrobial agents, as far as possible to decrease the frequency of using various invasive operations and catheter indwelling time, in order to reduce the incidence of hospital infection.

Eeffects of cleaning staff's hand hygien management on staphylococcus aureus infection in hospitalized patients

Objective To explore the effects of cleaning staff's hygienic management intervention on the infection of staphylococcus aureus (SAU) in hospitalized patients. Methods Totals of 450 hospitalized patients from January to August 2016 in each department were selected. Starting from May 2016, the cleaning staff in charge of the departments were involved in the management of hand hygiene. The changes of hand hygiene awareness and infection control knowledge of the cleaning staff before and after the intervention were compared. Staphylococcus aureus infection was monitored in real time, and compared before and after the intervention. Results Before the intervention, the hygiene awareness of the cleaners was (39.81±3.28) , and the hand hygiene rate was 60.15%. After the intervention, the hygiene awareness was (45.22±4.83) , and the hand hygiene rate was 84.28%. The differences before and after intervention were statistically significant (t=2.219, χ2=4.463; P<0.05) . The average score of infection control knowledge before and after the intervention were (39.3±5.6) and (82.8±6.4) respectively, with a statistical difference (t=2.139, P=0.037) . There were 112 cases of staphylococcus aureus infectoin in all departments before the intervention, and 71 cases after the intervention, with a statistical difference (χ2=2.983, P=0.027) . Conclusions To strengthen the management of hand hygiene can effectively improve the hospitalization environment and reduce staphylococcus aureus infection. Key words: Infection; Staphylococcus aureus; Hospitalized patients; Hand hygiene management; Cleaning staff

Effects of cleaning and disinfection of thermoplastic masks on hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma

Objective To investigate the effects of cleaning and disinfection of thermoplastic masks on the hospital infection in patients receiving precise radiotherapy for nasopharyngeal carcinoma (NPC). Methods A prospective study was performed among 102 patients receiving precise radiotherapy for NPC from 2013 and 2016, consisting of 18 patients with early-stage (I, Ⅱ) disease and 84 patients with advanced (Ⅲ, IV) disease. All patients were randomly divided into group A and group B using a random number table. For group A, the marker lines of thermoplastic masks were sandwiched by double plastic tapes; cleaning and disinfection plus ultraviolet (UV) disinfection were applied to the masks 1 h prior to radiotherapy and immediately after radiotherapy. For group B, only conventional UV disinfection was applied to the masks. The surface of the masks was examined and hospital infection during radiotherapy was evaluated. Results At the 18th radiotherapy, group A had a significantly lower mask surface colony count than group B (7.90±6.50 vs. 139.05±129.29 CFU/cm2,P=0.000). Group A also had a significantly lower incidence of hospital infection than group B (72.5% vs. 88.2%, P=0.046). For the patients with early stage NPC, particularly, there was no significant difference in the incidence of infection between the two groups (55.6% vs. 66.7%, P=0.629). For patients with advanced NPC, group A had a significantly lower incidence of infection than group B (76.2% vs. 92.9%, P=0.035). There were no significant differences in incidence rates of oral mucosal, skin, and respiratory system infections between the two groups (47.1% vs. 51.0%, P=0.692; 17.6% vs. 23.5%, P=0.463; 7.8% vs. 13.7%, P=0.338). In both groups A and B, the incidence of oral mucosal infection was significantly higher than the incidence rates of skin infection (P=0.001, 0.000) and respiratory system infection (P=0.004, 0.000). Conclusions Thermoplastic mask is one of the risk factors for hospital infection in patients receiving precise radiotherapy for NPC. Timely cleaning and disinfection plus UV disinfection can significantly reduce the surface colony count and the incidence of hospital infection in patients with NPC, particularly in those with advanced NPC receiving precise radiotherapy. The incidence of hospital infection is the highest in the oral mucosa, followed by the skin and the respiratory system. Key words: Thermoplastic mask; Cleaning disinfection; Hospital infection; Nasopharyngeal neoplasms/radiotherapy

Unsuspected Strongyloides stercoralis infection in hospital patients with comorbidity in need of proper management.

BackgroundInvestigate the role of latent strongyloidiasis infection in patients at the University Hospital, Honduras.MethodsProspective observational cohort study during 20 non consecutive months from March 2009 to February 2011. Epidemiological and clinical data obtained from patients excreting Strongyloides stercoralis larvae in stool who consulted at the hospital were recorded and analyzed.ResultsThirty five (5 %) of 712 patients had S. stercoralis larvae in one stool sample; 62.8 % came from rural areas and 91.7 % were poor; 68.5 % (24/35) were 21 years old or older. Eight patients (22.8 %) had no predisposing illness; 3 (8.6 %) received steroid treatment, 29/35 (82.8 %) presented with persistent diarrhea and 24/35 (68.5 %) presented following comorbidities: HIV/AIDS (31.4 %), alcoholism alone (11.4 %) or with other associated illness (8.6 %), malignancy (8.6 %), renal failure (5.7 %) and hyperthyroidism (2.8 %). A combination of symptoms suggestive of strongyloidiasis but indistinguishable from those potentially associated to their comorbid condition included severe epigastric pain, diarrhea of weeks duration, peripheral eosinophilia, astenia, adynamia, fever, anemia and weight loss in 85.7 % of the cases, 3 of whom described skin lesions compatible with larva currens. None of the diagnostic clinical impressions mentioned Strongyloides infection. Ten strongyloidiasis patients received partial treatment with albendazole or ivermectin. Incomplete data, underestimation of the parasitic infection and no laboratory follow-up of the patients limited our observations.ConclusionsStrongyloides stercoralis is an unsuspected and neglected parasitic infection by health personnel in Honduras. Lack of awareness of its importance represents a strong barrier to proper treatment and follow-up, posing a threat of possible fatal complications in patients with comorbid conditions.

Healthcare-Associated Infections (HAI): The Perfect Storm has Arrived!

1. Rodney E. Rohde, PhD, MS, SV, SM (ASCP)CM, MBCM[⇑][1] 1. Clinical Laboratory Science Program, College of Health Professions, Texas State University, San Marcos, TX 2. Marilyn Felkner, DrPH, MT(ASCP) 1. Emerging and Acute Infectious Disease Branch (EAIDB), Infectious Disease Control Unit, Texas Department of State Health Services (DSHS), Austin, TX 3. Julie Reagan, PhD, JD, MPH 1. Georgia Southern University, Jiann-Ping Hsu College of Public Health, Statesboro, GA 4. Amber Hogan Mitchell, DrPH, MPH, CPH 1. The International Safety Center, Apopka, FL 5. Pat Tille, PhD, MT(ASCP) 1. Medical Laboratory Science, College of Pharmacy, South Dakota State University, SD 1. Address for Correspondence: Rodney E. Rohde, PhD, MS, SV, SM (ASCP)CM, MBCM, Professor & Chair, CLS Program; Associate Dean for Research, Clinical Laboratory Science Program, College of Health Professions, Texas State University, 601 University Drive, San Marcos, TX 78666, 512-245-2562, 512-245-7860, rrohde{at}txstate.edu INTRODUCTION On any given day approximately 1 of every 25 inpatients in U.S. acute care hospitals has at least one healthcare–associated infection (HAI), adding up to about 722,000 infections in 2011. Pneumonia and surgical-site infection are the most common infection types, and Clostridium difficile is the most common pathogen.1 The CDC Multistate Point-Prevalence Survey of Healthcare-Associated Infections, published in the New England Journal of Medicine, used 2011 data from 183 U.S. hospitals to estimate the burden of a wide range of infections in hospital patients. That year, about 721,800 infections occurred in 648,000 hospital patients. About 75,000 patients with HAI died during their hospitalizations. The most common healthcare-associated infections were pneumonia (22%), surgical site infections (22%), gastrointestinal infections (17%), urinary tract infections (13%), and bloodstream infections (10%). The most common germs causing HAI by rank were C. difficile (12%), Staphylococcus aureus , including Methicillin Resistant S. aureus (MRSA, 11%), Klebsiella (10%), E. coli (9%), Enterococcus (9%), and Pseudomonas (7%). Klebsiella and E. coli are members of the Enterobacteriaceae bacteria family, which has become increasingly resistant to last-resort antibiotics known as carbapenems, typically referred to as carbapenem resistant Enterobacteriaceae (CRE).1 Practically, what this means is that over 200 patients will die the day you read this article and every day until the global community is able to address this healthcare crisis. If you do the simple math you will realize this results in about 4% of hospitalized patients who developed one or more HAI due to the care received in the hospital… ABBREVIATIONS: CAUTI – Catheter-associated urinary tract infection, CDC – Centers for Disease Control and Prevention, CLABSI – Central line-associated blood stream infection, EVS – Environmental services, HAI – Healthcare-associated infections, HCW – Healthcare Worker, MRSA – Methicillin resistant Staphylococcus aureus , SSIs – Surgical site infections [1]: #corresp-1