Nosocomial Research Articles

Clinical characteristics and outcomes of critically ill COVID-19 patients with CAUTI: a study in Vietnam.

Urethral catheterization is commonly required in coronavirus disease 2019 (COVID-19) patients hospitalized in intensive care units (ICUs). However, this increases their vulnerability to nosocomial infections such as catheter-associated urinary tract infections (CAUTIs). Existing studies on nosocomial infections in COVID-19 patients usually report CAUTI prevalence but neglect the clinical differences between CAUTI and non-CAUTI patients. This study aimed to assess clinical features, microbiological characteristics, and outcomes of COVID-19 patients with CAUTI vs non-CAUTI patients in an ICU. We analyzed the clinical data from a retrospective cohort study of 527 critically ill COVID-19 patients who required urethral catheterization at the ICU of Bach Mai hospital in Ho Chi Minh City, Vietnam, from August to October 2021. A total of 69 patients (n = 37 CAUTI vs n = 32 non-CAUTI) were selected for urine culture, and their clinical features, microbiological characteristics, and outcomes were recorded for analysis. COVID-19 patients with CAUTI had a higher mortality rate compared to those without CAUTI (p = 0.02). The length of stay in the ICU was 1.4 times longer for CAUTI patients compared to the non-CAUTI group (p = 0.03). Fungi was the most common microbiological cause of UTI in COVID-19 ICU (91.4%), and Pseudomonas aeruginosa was a significant risk factor of CAUTI. P. aeruginosa, number of antibiotics used, and duration of catheterization had a strong association with the patients' survival time in ICU. This study provides a better understanding of CAUTI in COVID-19 patients, thus facilitating their future treatment.

Evaluation of Biocides Susceptibility and Expression of Qace-Δ1 And Suge1 Genes of Pseudomonas Aeruginosa in Exposure to Biocides and Meropenem

Pseudomonas aeruginosa is a species of medical significance that plays a role in nosocomial infections, particularly those resulting from burns and wounds. Bacterial antibiotic resistance may have developed as a result of the abuse of biocides in hospitals. This study aimed to determine the minimum inhibitory concentrations (MICs) of carbapenem-resistant P. aeruginosa isolates in relation to ethylenediaminetetraacetic acid (EDTA), chlorohexidine (CHX), and resazurin dye using a microtiter plate assay. Additionally, it evaluated the expression of the efflux pump genes (qacE-Δ1 and sugE1) at sub-inhibitory concentrations of the biocides using RT-qPCR (delta delta Ct method) to improve their efflux pump system. The MICs of 24 P. aeruginosa isolates (14 isolates were resist to carbapenems and 10 isolates sensitive to carbapenems) against Chloroxylenol (Dettol) revealed that the range of MICs were (0. 125-2%). The results of MICs of Chlorohexidine (CHX) revealed that the range of inhibitory activity was (0.8-102.4 µg/ml), also the findings of MICs of EDTA demonstrated that the range of inhibitory activity was (125-2000 µg/ml). The genes involved in efflux pump (qacE -Δ1 and sugE1) were found to be significantly up-regulated in the local isolates, according to our findings.. The four isolates' sugE1 gene expression folds ranged from 1.81 to 5.39; this result was more than the fold of the control (the fold change is 1), with the meropenem isolate having the highest fold value (5.39) and sub-MIC value (8 µg/ml). Furthermore, the four isolates' qacE-Δ1 gene expression folds ranged from 2.11 to 5.01, which was higher than the fold of the control, where the highest fold value was recorded for the EDTA (5.01) with the sub-MIC value (125-500 µg/ml). Also, a high value of upregulation of the gene qacE –Δ1, during the treatment with dettol with sub-MIC (0.25-0.5%), and the fold change was 4.19. In conclusion, the present findings indicated to the significant relationship between the treatments with meropenem and the high values of gene expression of the gene sugE1 in comparison with the control and other agents, Furthermore, compared to the antibiotic and control, there was a strong correlation found between the high fold changes of the gene qacE -Δ1 with the presence of dettol and EDTA.

HYGIENE DES DISPOSITIFS MEDICAUX REUTILISABLES DANS LA GESTION DES VOIES AERIENNES EN ANESTHESIE AU CHUD/ BORGOU-ALIBORI

Introduction :Nosocomial infection is a priority concern for hospitals. The aim of this study was to investigate the hygiene of reusable medical devices (DMR) used in anesthesia at CHUD-B/A. Methods :The study was observational, cross-sectional, descriptive and analytical. It surveyed nursing staff in the anesthesia department of CHUD Borgou/Alibori. Sampling was non-random, with a census of all staff. Data analysis was performed using IBM SPSS Statistics 21 software. Observations in the study were presented in proportions for qualitative variables and quantitative data using central tendency parameters such as mean with standard deviation, median as appropriate, mode and extremums. Results :A total of 14 caregivers were surveyed. Intermediate risks were related to semi-critical materials, according to 64.3% of subjects. Knowledge of DMR processing steps was affirmed by 92.2% of staff. Decontamination followed by cleaning and rinsing was confirmed by 84.6% of respondents. It was observed that equipment was immersed in a small jar containing a small volume of non-renewed decontamination solution, that there was no decontamination protocol, that hand hygiene was observed in 25 cases, and that gloves were worn in 30 cases. Conclusion:The absence of a DMR management protocol is apparent. Device hygiene needs to be improved. The development of a protocol for DMR treatment and the promotion of single-use equipment are necessary.

INFECTION CONTROL AMONG ANESETHSIA PRACTICE

Nosocomial infections, or hospital-acquired infections, are complex and have multiple causes. They interfere with patient recovery, increase hospital stays, and lead to higher morbidity, mortality, and costs. The CDC estimates that a third of these infections result from not following established infection control practices. Anesthesia practices are critical in controlling the spread of these infections due to the invasive nature of procedures like catheter and airway management. Although direct cause-and-effect data is limited, most anesthesia-related infections are preventable. Anesthesia personnel must understand the epidemiology and pathogens to implement preventive measures. Risk factors include invasive procedures, cross-contamination, and hand transmission. Common signs of infection include fever, tachycardia, tachypnea, skin rash, and general malaise. The main sources of healthcare-associated infections are bloodstream infections (28%), pneumonia (21%), and urinary tract infections (15%), often linked to invasive devices. Standard precautions should be applied to all patients to prevent infection transmission. Additional transmission-based precautions are necessary for patients with specific pathogens. Infection control programs in the US are mandated by the Joint Commission for Accreditation of Healthcare Organizations (TCAHO) and guided by the CDC.

Genomic epidemiology describes introduction and outbreaks of antifungal drug-resistant Candida auris

AbstractCandida auris is a globally emerged fungal pathogen causing nosocomial invasive infections. Here, we use cutting-edge genomic approaches to elucidate the temporal and geographic epidemiology of drug-resistant C. auris within the UK. We analysed a representative sample of over 200 isolates from multiple UK hospitals to assess the number and timings of C. auris introductions and infer subsequent patterns of inter- and intra-hospital transmission of azole drug-resistant isolates. We identify at least one introduction from Clade I and two from Clade III into the UK, and observe temporal and geographical evidence for multiple transmission events of antifungal drug resistant isolates between hospitals and identified local within-hospital patient-to-patient transmission events. Our study confirms outbreaks of drug-resistant C. auris are linked and that transmission amongst patients occurs, explaining local hospital outbreaks, and demonstrating a need for improved epidemiological surveillance of C. auris to protect patients and healthcare services.

FUNGAL ENDOCARDITIS OF THE RIGHT SIDE HEART: A DIAGNOSTIC AND THERAPEUTIC CHALLENGE A CASE REPORT AND LITERATUREREVIEW

Infectiveendocarditisisdefined as an infection of one or more heart valves by bacteria, more rarely by intracellulargerms or yeasts. Involvement of the parietalendocardiumislesscommon. Infectiveendocarditisis rare but serious (1). Even rarerisfungalendocarditis of the rightsideheart. We report here the case of afemale 48-year-old patient withcrohnsdiseaseunder immunosuppressive therapyadmitted to intensive care for management of a febriledisorder of consciousness. Biological and radiological investigations revealedavegetation of the tricuspid valve and candida fungemia, indicating a diagnosis of fungalendocarditis of the right heart. The patient was put on fluconazole 800mg/daywith a good initial course, followed by a worsening of herclinical and biological condition in connectionwithpulmonaryempyema and a nosocomial infection withmulti-resistantacinetobacterbaumanii, whichcompromisedherprognosis. The patient died in multiple organfailure. Certain riskfactors, such as intravenousdrug use, immunodepression and intravenouscatheters, predispose to both right-heart and fungalendocarditis. The clinicalpresentationis not verydifferentfromthat of the leftheart, but specialmethods are needed to detectit. Treatmentisessentiallybased on antifungal agents and surgery.

Antibiotic Resistance Patterns of Pseudomonas aeruginosa Bacterial Species Isolated from Various Clinical Samples

Pseudomonas aeruginosa infections have become a real burden in healthcare settings, contributing substantially to nosocomial infections. The emergence of several drug-resistant strains was the major issue causing massive mortality. Multiple-drug resistant Pseudomonas aeruginosa isolates containing beta-lactamase were becoming more prevalent. Objective: To investigate and characterize the antibiotic resistance patterns of Pseudomonas aeruginosa isolated from different clinical samples. Methods: A total of 618 different clinical samples including blood, pus and urine samples were collected from the patients visiting Indus Medical College Hospital Tando Muhammad Khan, Sindh, Pakistan. All the clinical samples were processed for the isolation of bacterial species using specific culture media. The identification of Pseudomonas aeruginosa strains was achieved based on Gram’s staining and certain biochemical tests including Cetrimide test. Moreover, antibiotic susceptibility testing was determined by Kirby-Bauer disc diffusion method. Results: A total of 452 bacterial strains were isolated and pure cultured from different clinical samples. Among these, 60.62% were Gram-negative and 25% of the total isolates were found to be Pseudomonas aeruginosa strains. Antibiotic sensitivity testing results revealed the highest resistance ratio of Pseudomonas aeruginosa strains against Ticarcillin (46.02%), while Colistin showed the lowest resistance (3.54%). Overall, 14.15% of the isolates of Pseudomonas aeruginosa strains were found to be multi-drug-resistant bacteria. Conclusion: The results of the present study reveal an increased ratio of antibiotic resistance particularly of Ticarcillin, piperacillin and imipenem in Pseudomonas aeruginosa isolated from various clinical samples.

Nursing Knowledge and Preventive Practices of Ventilator-Associated Pneumonia as Perceived by Intensive Care Nurses in Hail City, KSA

Context: Ventilator-associated Pneumonia (VAP) is a recognized nosocomial infection and a leading cause of high morbidity and mortality. Intensive Care Unit (ICU) nurses are in the best position to put the known evidence-based strategies into practice to prevent VAP. Aim: The study assessed nursing knowledge and preventive practices of ventilator-associated pneumonia as perceived by intensive care nurses in Hail City, Saudi Arabia. Methods: Data were collected using a descriptive cross-sectional research design. The study was conducted in intensive care units of Government hospitals in Hail City on a convenient sample of all available critical care nurses who met the inclusion criteria during the data collection period. The sample size (n) for this analysis was 84. Data were collected using a structured interview questionnaire including sociodemographic data and nurses' knowledge of VAP. The second tool is nurses’ practice observational checklist regarding VAP prevention. Results: revealed that age median (IQR) is 30(6), median years of experience (IQR) 6(6), 67.9% had received VAP prevention training, and 78.6% had received information for preventing VAP. The study also reveals that 38.09% of the nurses had poor knowledge regarding VAP prevention, and they had a good median (IQR) 6(4) in the preventive practice of VAP. Age, experience in nursing, in the ICU, training on VAP prevention, and receiving information on preventing VAP significantly affected nurses' knowledge about preventing VAP in ICU patients. Experience in ICU and educational institutions as source of information and more than one source of information significantly affect the nurses' total preventive practice regarding VAP. Correlation analysis between overall knowledge and practice indicates no statistically significant correlation (the p-value for the correlation was 0.060). Conclusion: Over one-third of the nurses had poor knowledge regarding VAP. The study recommended that there should be in-service training and periodic educational programs targeting nurses to improve nurse’s knowledge and practices regarding VAP guidelines by the Ministry of Health.

Risk factors and predictive model for nosocomial infections by extensively drug-resistant Acinetobacter baumannii.

Extensively drug-resistant Acinetobacter baumannii (XDRAB) has become a significant pathogen in hospital environments, particularly in intensive care units (ICUs). XDRAB's resistance to conventional antimicrobial treatments and ability to survive on various surfaces pose a substantial threat to patient health, often resulting in severe infections such as ventilator-associated pneumonia (VAP) and bloodstream infections (BSI). We retrospectively analyzed clinical data from 559 patients with XDRAB infections admitted to Jinhua Central Hospital between January 2021 and December 2023. Patients were randomly divided into a training set (391 cases) and a testing set (168 cases). Variables were selected using Lasso regression and logistic regression analysis, and a predictive model was constructed and validated internally and externally. Model performance and clinical utility were evaluated using the Hosmer-Lemeshow test, C-index, ROC curve, decision curve analysis (DCA), and clinical impact curve (CIC). Lasso regression analysis was used to screen 35 variables, selecting features through 10-fold cross-validation. We chose lambda.1se=0.03450 (log(lambda.1se)=-3.367), including 10 non-zero coefficient features. These features were then included in a multivariate logistic regression analysis, identifying 8 independent risk factors for XDRAB infection: ICU stay of 1-7 days (OR=3.970, 95%CI=1.586-9.937), ICU stay >7 days (OR=12.316, 95%CI=5.661-26.793), hypoproteinemia (OR=3.249, 95%CI=1.679-6.291), glucocorticoid use (OR=2.371, 95%CI=1.231-4.564), urinary catheterization (OR=2.148, 95%CI=1.120-4.120), mechanical ventilation (OR=2.737, 95%CI=1.367-5.482), diabetes mellitus (OR=2.435, 95%CI=1.050-5.646), carbapenem use (OR=6.649, 95%CI=2.321-19.048), and β-lactamase inhibitor use (OR=4.146, 95%CI=2.145-8.014). These 8 factors were used to construct a predictive model visualized through a nomogram. The model validation showed a C-index of 0.932 for the training set and 0.929 for the testing set, with a Hosmer-Lemeshow test p-value of 0.47, indicating good calibration. Furthermore, the DCA curve demonstrated good clinical decision-making performance, and the CIC curve confirmed the model's reliable clinical impact. Regression analysis identified ICU stay duration, hypoproteinemia, glucocorticoid use, urinary catheterization, mechanical ventilation, diabetes mellitus, carbapenem use, and β-lactamase inhibitor use as independent risk factors for XDRAB infection. The corresponding predictive model demonstrated high accuracy and stability.

Establishing Nursing-Sensitive Quality Indicators for the Central Sterile Supply Department: A Modified Delphi Study.

Previous studies have shown that improving quality management in the central sterile supply department (CSSD) is an effective measure to control and decrease hospital-acquired infections. This study aimed to establish nursing-sensitive quality indicators for CSSD nursing in China. We drafted nursing-sensitive quality indicators on the basis of the Structure-Process-Outcome model, and then conducted 2 rounds of consultation with experts using a modified Delphi method to determine the indicators and scientific methods of measurement. We identified five CSSD nursing-sensitive quality indicators. Recovery rates of the 2 rounds of valid questionnaires were 100%. Expert authority coefficients were 0.810 and 0.902, respectively. Kendall's coefficients of concordance were 0.168 and 0.210, respectively ( P < .05). Evidence-based nursing-sensitive quality indicators for the CSSD were established.

A SEGURANÇA DO PACIENTE

Objective: Promote training for nursing team professionals to reduce the risks of infections caused by invasive procedures. Methods: This study was based on a quantitative research, of an exploratory nature, conducted through field research. Results: The aim was to decrease hospital-acquired infections by raising awareness among the nursing team about the importance of following safety protocols. This included reducing the percentage of devices that could potentially aggravate risks for clients/patients. Final Considerations: The study highlighted the need for targeted training using the presented approach. It emphasized the importance of the entire team remaining vigilant in hygiene practices, handwashing, equipment cleaning, and proper execution of invasive procedures to minimize the risks of infection transmission and spread.

Bovine Neutrophil β-Defensin-5 Provides Protection against Multidrug-Resistant Klebsiella pneumoniae via Regulating Pulmonary Inflammatory Response and Metabolic Response.

Klebsiella pneumoniae (K. pneumoniae), a kind of zoonotic bacteria, is among the most common antibiotic-resistant pathogens, and it causes nosocomial infections that pose a threat to public health. In this study, the roles of synthetic bovine neutrophil β-defensin-5 (B5) in regulating inflammatory response and metabolic response against multidrug-resistant K. pneumoniae infection in a mouse model were investigated. Mice were administrated intranasally with 20 μg of B5 twice and challenged with K. pneumoniae three days after B5 pretreatment. Results showed that B5 failed to directly kill K. pneumoniae in vitro, but it provided effective protection against multidrug-resistant K. pneumoniae via decreasing the bacterial load in the lungs and spleen, and by alleviating K. pneumoniae-induced histopathological damage in the lungs. Furthermore, B5 significantly enhanced the mRNA expression of TNF-α, IL-1β, Cxcl1, Cxcl5, Ccl17, and Ccl22 and obviously enhanced the rapid recruitment of macrophages and dendritic cells in the lungs in the early infection phase, but significantly down-regulated the levels of TNF-α, IL-1β, and IL-17 in the lungs in the later infection phase. Moreover, RNA-seq results showed that K. pneumoniae infection activated signaling pathways related to natural killer cell-mediated cytotoxicity, IL-17 signaling pathway, inflammatory response, apoptosis, and necroptosis in the lungs, while B5 inhibited these signaling pathways. Additionally, K. pneumoniae challenge led to the suppression of glycerophospholipid metabolism, the phosphotransferase system, the activation of microbial metabolism in diverse environments, and metabolic pathways in the lungs. However, B5 significantly reversed these metabolic responses. Collectively, B5 can effectively regulate the inflammatory response caused by K. pneumoniae and offer protection against K. pneumoniae. B5 may be applied as an adjuvant to the existing antimicrobial therapy to control multidrug-resistant K. pneumoniae infection. Our study highlights the potential of B5 in enhancing pulmonary bacterial clearance and alleviating K. pneumoniae-caused inflammatory damage.

The Effectiveness of Giving 25% Green Betel Leaf Extract Formula (Piper Betle) in Reducing Germ Numbers on the Emergency Room Floor of RSU "X" Ponorogo Regency

Hospitals are places of service that aim to achieve optimal health for the community. In addition to seeking cures, hospitals are also a source of various diseases for both patients and visitors. The disease is caused by pathogenic microorganisms that multiply in the air, water, floor, food, medical and non-medical equipment. One of the most common hospital-acquired infections in the Emergency Department (ER) is nosocomial infection. The purpose of this study is to determine the effectiveness of the use of green betel leaf extract (Piper betel) in reducing the number of germs on the emergency room floor at the x Hospital of Ponorogo Regency. The method used in this study is experimental, with the analysis being Quasi-Experimental and using Pretest-posttest Group Design. The percentage of effectiveness in reducing the number of germs in the 25% formula is 86.78%, the 20% formula is 85.40%, the 15% formula is 8 1.96%, and the 10% formula is 75%. There was a decrease in the number of germs on the floor of the emergency room using green betel leaf extract (Piper Beetle). The effectiveness of green betel leaf extract on the floor swab test is found in the 25% formula. In addition, a long soaking method and a higher formula can be used to measure the effectiveness of green betel leaf extract as an antibacterial in reducing the number of germs on the floor.

Occupational Risks Prevention Practices Among Medical Waste Handlers in Ogun State, Nigeria

Background: Medical waste handlers are at immediate risk of needle stick injuries and exposure to infectious materials from medical waste. Adequate knowledge and safe practices on the part of the workers are essential for the prevention of nosocomial infections. Objective: To assess and compare the factors involved in occupational risk prevention practices among medical waste handlers in two tertiary hospitals in Ogun State, Nigeria. Methods: This descriptive, cross-sectional study compared medical waste handlers and the risk prevention measures available in a specialist hospital and a teaching hospital. The 100 participants were randomly selected and surveyed using an interviewer-administered questionnaire. Results: The prevalence of needle stick injury at the teaching hospital and specialist hospital were 38% and 28%, respectively. Hepatitis B vaccine uptake was 6% in the teaching hospital compared to 70% at the specialist hospital. There was a significant difference concerning the provision of safety equipment (p&lt;0.001), personal protective equipment (PPE) (p&lt;0.001), Hepatitis vaccine (p&lt;0.001), training (p&lt;0.001) and availability of waste management policy (p = 0.015) but no significant difference concerning the regular supply of water and soap (p = 0.494) between both institutions. Conclusion: The waste handlers at the specialist hospital were better equipped for safety than those at the teaching hospital. A safer environment, equipment, and training for medical waste handlers are needed to enable them to practise occupational risk prevention more effectively.

Contribution of the Mobilome to the Configuration of the Resistome of Corynebacterium striatum

Corynebacterium striatum, present in the microbiota of human skin and nasal mucosa, has recently emerged as a causative agent of hospital-acquired infections, notable for its resistance to multiple antimicrobials. Its mobilome comprises several mobile genetic elements, such as plasmids, transposons, insertion sequences and integrons, which contribute to the acquisition of antimicrobial resistance genes. This study analyzes the contribution of the C. striatum mobilome in the transfer and dissemination of resistance genes. In addition, integrative and conjugative elements (ICEs), essential in the dissemination of resistance genes between bacterial populations, whose role in C. striatum has not yet been studied, are examined. This study examined 365 C. striatum genomes obtained from the NCBI Pathogen Detection database. Phylogenetic and pangenome analyses were performed, the resistance profile of the bacterium was recognized, and mobile elements, including putative ICE, were detected. Bioinformatic analyses identified 20 antimicrobial resistance genes in this species, with the Ermx gene being the most predominant. Resistance genes were mainly associated with plasmid sequence regions and class 1 integrons. Although an ICE was detected, no resistance genes linked to this element were found. This study provided valuable information on the geographic spread and prevalence of outbreaks observed through phylogenetic and pangenome analyses, along with identifying antimicrobial resistance genes and mobile genetic elements that carry many of the resistance genes and may be the subject of future research and therapeutic approaches.

Etiology of Leukemoid Reaction in Patients Undergoing Extracorporeal Membrane Oxygenation.

Nosocomial infections are frequent in patients receiving extracorporeal membrane oxygenation (ECMO). Leukemoid reaction, defined as >50,000 white blood cells (WBCs) per microliter, has been associated with infections in some populations. As ECMO is associated with significant inflammation activation between the patient's immune system and the circuit components, it is hypothesized that leukemoid reactions may have low specificity for identifying new infections in patients receiving ECMO. A retrospective cohort study was performed on all adult patients admitted to the Brooke Army Medical Center who received ECMO for greater than 72 hours between 2018 and 2022. Maximum WBCs were obtained for all charts. For those with leukemoid reaction, demographic information and clinical management was obtained. This study was determined to be exempt by Brooke Army Medical Center Institutional Review Board. Among 182 patients receiving ECMO for greater than 72 hours, 15 (8%) developed a leukemoid reaction while on ECMO. The median (Interquartile range, IQR) WBC was 53.94 (50.98 to 62.55). Fourteen (93%) patients underwent an infectious evaluation. Patients had a median of 2 (IQR: 2 to 3) etiologies contributing to their leukemoid reaction. At the time of leukemoid reaction, 11 (73%) patients were receiving treatment for a known infection, 6 (40%) were found to have a new thrombus, and 4 (27%) were receiving glucocorticoids. Only 1 (7%) patient was found to have a new infection, an Acinetobacter baumannii bacteremia. Leukemoid reactions occur infrequently in patients receiving ECMO and are generally multifactorial. In this cohort, leukemoid reactions rarely occurred in the setting of a new infection and suggest low utility to starting or broadening antimicrobials for these patients. Future studies identifying useful infectious markers are needed for patients receiving ECMO.

Research advances of complications regarding temporomandibular joint prosthesis replacement

Replacement of the temporomandibular joint (RTJ) has undergone decades of technological improvements and is now an important treatment for end-stage joint disease. The main complications of RTJ include aseptic loosening, heterotopic ossification, postsurgical infection, hypersensitivity reaction, prosthesis loosening or malposition, nerve injury and severe bleeding. Improvement in clinical technique is now the key to resolving complications. In the future, improvements in prosthetic materials may be an important development for newer iterations. With the development and popularity of TMJ surgical techniques, prosthesis-related complications will increasingly come into clinical view. This article provides a systematic review of the complications of RTJ prosthesis replacement and the measures to deal with them, and looks forward to the direction of the development of this field from the perspective of reducing complications, so as to provide a reference for clinical work.

Preparation of Zinc Oxide Nanoparticles and the Evaluation of their Antibacterial Effects.

Nosocomial bacterial infections have become increasingly challenging due to their inherent resistance to antibiotics. The emergence of multidrug-resistant bacterial strains in hospitals has been attributed to the extensive and varied use of antibiotics, further exacerbating the problem of antibiotic resistance. Metal nanomaterials have been widely studied as an alternative solution for eradicating antibiotic-resistant bacterial cells. Metallic nanoparticles attack bacterial cells through various mechanisms, such as the release of antibacterial ions, generation of reactive oxygen species, or physical disruption, against which bacteria cannot develop resistance. Among the actively researched antimicrobial metal nanoparticles, zinc oxide nanoparticles, which are FDA-approved, are known for their biocompatibility and antibacterial properties. In this study, we focused on successfully developing a precipitation method for synthesizing zinc oxide nanoparticles, analyzing the properties of these nanoparticles, and conducting antimicrobial tests. Zinc oxide nanoparticles were characterized using transmission electron microscopy (TEM), dynamic light scattering (DLS), ultraviolet/visible spectroscopy, and X-ray diffraction (XRD). Antibacterial tests were conducted using the broth microdilution test with the multidrug-resistant strains of methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa. This study demonstrated the potential of zinc oxide nanoparticles in inhibiting the proliferation of antibiotic-resistant bacteria.

Exploring AMR and virulence in Klebsiella pneumoniae isolated from humans and pet animals: A complement of phenotype by WGS-derived profiles in a One Health study in Egypt

Klebsiella pneumoniae is a ubiquitous nosocomial pathogen associated with various types of infections in hospitalized patients and different animal species. In the current study, 49 Klebsiella strains isolated from humans, dogs, and cats were investigated using NGS technology. MALDI-TOF failed to identify newly discovered K. variicola and K. quasipneumoniae isolates correctly. MLST analysis revealed different sequence types among K. pneumoniae isolates, and the most frequent STs were ST29, ST219, and ST37. Three ST23 that are generally known as hypervirulent type were identified but they lacked major discriminatory determinants for hypervirulent K. pneumoniae (hvKp). K. pneumoniae isolates showed high diversity, and several isolates from humans and animals were assigned to the same ST and were almost identical. Isolates from humans exhibited more pronounced resistance patterns compared to the animal isolates. High levels of resistance were observed for piperacillin, trimethoprim/sulfamethoxazole, and cephalosporins, and resistance to carbapenem compounds was only found in isolates of human origin. Three strains of human origin were extensively drug-resistant (XDR). A diverse range of resistance genes primarily confer resistance to beta-lactams., phenicol/quinolone, aminoglycoside, macrolide, sulfonamides, and fosfomycin were identified in silico. However, there were inconsistencies between the phenotypic characterization of isolates and the set of resistance genes detected in silico in this set of Klebsiella isolates. Further research using a larger number of isolates from various sources is necessary to fully comprehend the relationship between the presence of antimicrobial resistance determinants and phenotypic data. It is also necessary to monitor the spread of K. pneumoniae from a One Health perspective in Egypt.

Assessment of Level of Implementation of Infection Control Guidelines in Sub District Hospitals in Gadag District by using Kayakalp Assessment Tool

Infection control is one of the main tenets of the "Kayakalp" movement. Well-kept and sanitary surroundings improve the hospital's image in the eyes of both patients and visitors. They also help the healthcare facility (HCF) create an atmosphere that reduces the number of hospital-acquired infections (HAI). Patients within hospitals and other healthcare establishments are vulnerable to healthcare-associated infections, commonly referred to as "nosocomial" or "hospital" infections, which are neither present nor in an incubating stage at the moment of admission. This category also encompasses occupational ailments among healthcare personnel and diseases contracted by patients during their hospitalization, which manifest after their discharge. Globally, nosocomial (hospital-acquired) infections constitute a significant and escalating concern. In the absence of adequate preventive strategies, individuals receiving medical treatment in any healthcare establishment face the risk of acquiring an infection. Healthcare-associated infections not only result in additional suffering but also impose substantial financial burdens on patients and their families, akin to numerous other issues related to patient safety. Antibiotic resistance is a result of infections, which also lengthen hospital stays, cause chronic disability, greatly increase the financial burden on healthcare systems, raise costs for patients and their families, and result in avoidable deaths. The present study results are intended to clarify the current state of infection control practices in the Gadag district's sub-district hospitals and identify possible areas for improvement.