Rate Of Bacterial Colonization Research Articles

Engineering a Novel Probiotic Toolkit in Escherichia coli Nissle 1917 for Sensing and Mitigating Gut Inflammatory Diseases.

Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation with no cure and limited treatment options that often have systemic side effects. In this study, we developed a target-specific system to potentially treat IBD by engineering the probiotic bacterium Escherichia coli Nissle 1917 (EcN). Our modular system comprises three components: a transcription factor-based sensor (NorR) capable of detecting the inflammation biomarker nitric oxide (NO), a type 1 hemolysin secretion system, and a therapeutic cargo consisting of a library of humanized anti-TNFα nanobodies. Despite a reduction in sensitivity, our system demonstrated a concentration-dependent response to NO, successfully secreting functional nanobodies with binding affinities comparable to the commonly used drug Adalimumab, as confirmed by enzyme-linked immunosorbent assay and in vitro assays. This newly validated nanobody library expands EcN therapeutic capabilities. The adopted secretion system, also characterized for the first time in EcN, can be further adapted as a platform for screening and purifying proteins of interest. Additionally, we provided a mathematical framework to assess critical parameters in engineering probiotic systems, including the production and diffusion of relevant molecules, bacterial colonization rates, and particle interactions. This integrated approach expands the synthetic biology toolbox for EcN-based therapies, providing novel parts, circuits, and a model for tunable responses at inflammatory hotspots.

Updates on Antibiotic Regimens in Acute Cholecystitis.

Acute cholecystitis is one of the most common surgical diseases, which may progress from mild to severe cases. When combined with bacteremia, the mortality rate of acute cholecystitis reaches up to 10-20%. The standard of care in patients with acute cholecystitis is early laparoscopic cholecystectomy. Percutaneous cholecystostomy or endoscopic procedures are alternative treatments in selective cases. Nevertheless, antibiotic therapy plays a key role in preventing surgical complications and limiting the systemic inflammatory response, especially in patients with moderate to severe cholecystitis. Patients with acute cholecystitis have a bile bacterial colonization rate of 35-60%. The most frequently isolated microorganisms are Escherichia coli, Klebsiella spp., Streptococcus spp., Enterococcus spp., and Clostridium spp. Early empirical antimicrobial therapy along with source control of infection is the cornerstone for a successful treatment. In these cases, the choice of antibiotic must be made considering some factors (e.g., the severity of the clinical manifestations, the onset of the infection if acquired in hospital or in the community, the penetration of the drug into the bile, and any drug resistance). Furthermore, therapy must be modified based on bile cultures in cases of severe cholecystitis. Antibiotic stewardship is the key to the correct management of bile-related infections. It is necessary to be aware of the appropriate therapeutic scheme and its precise duration. The appropriate use of antibiotic agents is crucial and should be integrated into good clinical practice and standards of care.

Clinical study of prone positioning in invasive respiratory support for neonatal respiratory distress syndrome

To assess the effectiveness and safety of prone positioning in the treatment of neonatal respiratory distress syndrome (NRDS) using invasive respiratory support. A prospective study was conducted from June 2020 to September 2023 at Suining County People's Hospital, involving 77 preterm infants with gestational ages less than 35 weeks requiring invasive respiratory support for NRDS. The infants were randomly divided into a supine group (37 infants) and a prone group (40 infants). Infants in the prone group were ventilated in the prone position for 6 hours followed by 2 hours in the supine position, continuing in this cycle until weaning from the ventilator. The effectiveness and safety of the two approaches were compared. At 6 hours after enrollment, the prone group showed lower arterial blood carbon dioxide levels, inspired oxygen concentration, oxygenation index, rates of tracheal intubation bacterial colonization, and Neonatal Pain, Agitation and Sedation Scale scores compared to the supine group (P<0.05). There were no significant differences between the groups in terms of pH, arterial oxygen pressure, positive end-expiratory pressure, duration of mechanical ventilation, accidental extubation, ventilator-associated pneumonia, air leak syndrome, skin pressure sores, feeding intolerance, and grades II-IV intraventricular hemorrhage (P>0.05). Compared to supine positioning, prone ventilation effectively improves oxygenation, increases comfort, and reduces tracheal intubation bacterial colonization in neonates requiring mechanical ventilation for NRDS, without significantly increasing adverse reactions.

Characteristics of intestinal microbiota in preterm infants and the effects of probiotic supplementation on the microbiota.

In this study, we investigated the characteristics of the intestinal microbiota of preterm infants, and then analyzed the effects of probiotics supplementation on intestinal microbiota in preterm infants. This study enrolled 64 infants born between 26 and 32 weeks gestational age (GA) and 22 full-term infants. 34 premature infants received oral probiotic supplementation for 28 days. Stool samples were obtained on the first day (D1) and the 28th day (D28) after birth for each infant. Total bacterial DNA was extracted and sequenced using the Illumina MiSeq Sequencing System, specifically targeting the V3-V4 hyper-variable regions of the 16S rDNA gene. The sequencing results were then used to compare and analyze the composition and diversity index of the intestinal microbiota. There was no significant difference in meconium bacterial colonization rate between premature and full-term infants after birth (p > 0.05). At D1, the relative abundance of Bifidobacterium, Bacteroides, and Lactobacillus in the stool of preterm infants was lower than that of full-term infants, and the relative abundance of Acinetobacter was higher than that of full-term infants. The Shannon index and Chao1 index of intestinal microbiota in preterm infants are lower than those in full-term infants (p < 0.05). Supplementation of probiotics can increase the relative abundance of Enterococcus and Enterobacter, and reduce the relative abundance of Escherichia and Clostridium in premature infants. The Chao1 index of intestinal microbiota decreased in preterm infants after probiotic supplementation (p < 0.05). The characteristics of intestinal microbiota in preterm infants differ from those in full-term infants. Probiotic supplementation can reduce the relative abundance of potential pathogenic bacteria and increase the abundance of beneficial microbiota in premature infants.

Epidemiology and outcomes of multidrug-resistant bacterial infection in non-cystic fibrosis bronchiectasis

PurposeMultidrug-resistant (MDR) bacteria impose a considerable health-care burden and are associated with bronchiectasis exacerbation. This study investigated the clinical outcomes of adult patients with bronchiectasis following MDR bacterial infection.MethodsFrom the Chang Gung Research Database, we identified patients with bronchiectasis and MDR bacterial infection from 2008 to 2017. The control group comprised patients with bronchiectasis who did not have MDR bacterial infection and were propensity-score matched at a 1:2 ratio. The main outcomes were in-hospital and 3-year mortality.ResultsIn total, 554 patients with both bronchiectasis and MDR bacterial infection were identified. The types of MDR bacteria that most commonly affected the patients were MDR- Acinetobacter baumannii (38.6%) and methicillin-resistant Staphylococcus aureus (18.4%), Extended-spectrum-beta-lactamases (ESBL)- Klebsiella pneumoniae (17.8%), MDR-Pseudomonas (14.8%), and ESBL-E. coli (7.5%). Compared with the control group, the MDR group exhibited lower body mass index scores, higher rate of chronic bacterial colonization, a higher rate of previous exacerbations, and an increased use of antibiotics. Furthermore, the MDR group exhibited a higher rate of respiratory failure during hospitalization (MDR vs. control, 41.3% vs. 12.4%; p < 0.001). The MDR and control groups exhibited in-hospital mortality rates of 26.7% and 7.6%, respectively (p < 0.001); 3-year respiratory failure rates of 33.5% and 13.5%, respectively (p < 0.001); and 3-year mortality rates of 73.3% and 41.5%, respectively (p < 0.001). After adjustments were made for confounding factors, the infection with MDR and MDR bacteria species were determined to be independent risk factors affecting in-hospital and 3-year mortality.ConclusionsMDR bacteria were discovered in patients with more severe bronchiectasis and were independently associated with an increased risk of in-hospital and 3-year mortality. Given our findings, we recommend that clinicians identify patients at risk of MDR bacterial infection and follow the principle of antimicrobial stewardship to prevent the emergence of resistant bacteria among patients with bronchiectasis.

Preoperative oral hygiene treatment reduces bacterial transport and colonization during intubation for orthopedic surgery

The process of infection by bacteria and viruses involves invasion, establishment, growth, and parasitization. Poor oral hygiene and dysbiosis are significant risk factors for pneumonia. The aim of this study was to evaluate bacterial transport into the trachea during intubation for orthopedic surgery and the impact of oral hygiene treatment. The study cohort included 53 patients with fracture who underwent surgical procedures under general anesthesia and were divided into two groups: an oral hygiene treatment (OHT) group (n = 27) and a control group (n = 26). Before intubation, the OHT group underwent preoperative oral hygiene treatment. Microbiological culture was used for detection and counting of bacteria from the oropharynx, trachea, and tip of the endotracheal tube (ETT). Patients in the OHT group had a lower pathogen detection rate and lower degree of bacterial colonization in the oropharynx, trachea, and ETT tip. Preoperative oral hygiene treatment is able to reduce bacterial transport and colonization during orthopedic surgery, thus providing an important adjunct to pre-anesthesia care.

Microbial Profile of Tourniquets Used in Phlebotomy at a Rural Tertiary Care Teaching Hospital.

Background Reusable phlebotomy tourniquets may become contaminated through repeated use on the skin surfaces of multiple patients, the hands of healthcare workers, or various surfaces. Noncompliance with the protocol guidelines for managing tourniquets can contribute to the cross-transmission of microorganisms among patients. This study was conducted to determine the microbial flora and antimicrobial sensitivity pattern of reusable phlebotomy tourniquets. Methodology Tourniquets were randomly sampled across the different areas of the hospital and were transported to the microbiology laboratory for isolation, identification, and antibiotic susceptibility testing of microorganisms using standard microbiological techniques. Results The overall bacterial colonization rate of the 50 tourniquets was 80%. The most prevalent isolate on tourniquets was Coagulase-negative Staphylococcus (9, 22.54%), followed by Micrococcus (6, 15%), Staphylococcus aureus (5, 12.5%), diphtheroid (5, 12.5%), Acinetobacter (4, 10%) Enterococcus (3, 7.5%), Pseudomonas (3, 7.5%), Bacillus (3, 7.5%), and Escherichia coli (2, 5%). Conclusions Regular surveillance and disinfection of reusable tourniquets in resource-poor settings are recommended to decrease healthcare infections and the transmission of multidrug-resistant (MDR) strains.

Disinfection of vascular catheter connectors that are protected by antiseptic caps is unnecessary.

Determination of whether vascular catheter disinfecting antiseptic-containing caps alone are effective at decreasing microbial colonization of connectors compared to antiseptic-containing caps plus a 5-second alcohol manual disinfection. The study was conducted in a 718-bed, tertiary-care, academic hospital. A convenience sample of adult patients across intensive care units and acute care wards with peripheral and central venous catheters covered with antiseptic-containing caps. Quality improvement study completed over 5 days. The standard-of-care group consisted of catheter connectors with antiseptic-containing caps cleaned with a 5-second alcohol wipe scrub prior to culture. The comparison group consisted of catheter connectors with antiseptic-containing caps without a 5-second alcohol wipe scrub prior to culture. The connectors were pressed directly onto blood agar plates and incubated. Plates were assessed for growth after 48-72 hours. In total, 356 catheter connectors were cultured: 165 in the standard-of-care group, 165 in the comparison group, and 26 catheters connectors without an antiseptic-containing cap, which were designated as controls. Overall, 18 catheter connectors (5.06%) yielded microbial growth. Of the 18 connectors with microbial growth, 2 (1.21%) were from the comparison group, 1 (0.61%) was from the standard-of-care group, and 15 were controls without an antiseptic-containing cap. Bacterial colonization rates were similar between the catheter connectors cultured with antiseptic-containing caps alone and catheter connectors with antiseptic-containing caps cultured after a 5-second scrub with alcohol. This finding suggests that the use of antiseptic-containing caps precludes the need for additional disinfection.

An Evaluation of the Risk Factors and Respiratory Function Test Change of Children with Cystic Fibrosis Who Contracted COVID-19 Infection

Abstract Objective Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020, with millions of infected cases worldwide. Although the course is usually mild in the pediatric age group, there are unknown factors in patients with chronic lung diseases. The aim of this study was to determine the demographic characteristics and the clinical course of patients with cystic fibrosis who contracted COVID-19 infection. Methods A total of 128 patients with cystic fibrosis who were under follow-up in our clinic were separated into two groups: those who had been infected with COVID-19 and those who had not. The COVID-19-positive patients were then grouped as those who were hospitalized and those treated as outpatients. In the COVID-19 group, the spirometry values of the patients before the infection were compared with those measured at 3 and 6 months after the infection. Results The COVID-19 group comprised 34 (25.6%) cystic fibrosis patients with a mean age of 108.2 ± 60.8 months who contracted COVID-19 between April 2020 and October 2022. The rates of chronic bacterial colonization and allergic bronchopulmonary aspergillosis were significantly higher in the COVID-19 group (p = 0.001 and 0.005). Eight of the 34 patients were hospitalized, and 26 were isolated at home. Five patients required oxygen, and the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) values were lower. Conclusion A severe course of COVID-19 was not seen in any of the cystic fibrosis patients. A greater number of patients with chronic respiratory tract bacterial colonization and allergic bronchopulmonary aspergillosis were hospitalized.

Effect of probiotic administration in inflammatory responses of thermal burns

Objectives &amp; Introduction It is possible to damage the natural intestinal barrier following severe burn injuries. Oral probiotics' positive effects on the innate immune system or intestinal epithelial layer are proven. This research aimed to evaluate the role of probiotics on plasma inflammatory changes and bacterial colonization in the burned wound after high-grade thermal trauma. Methods This double-blinded randomized controlled trial was conducted on 80 patients with a total body surface area of 20–70%. Patients were allocated to two groups based on four blocks randomization model. Intervention and control groups received daily LactoCare and placebo capsules for 14 consecutive days. Obtaining demographic data, burn and gastrointestinal symptoms were registered by filling out a questionnaire. Additionally, measuring plasma levels of highly sensitive C-reactive protein(hs-CRP), IgA, absolute neutrophilic, and lymphocytic count were performed cumulatively four times prior to and after the intervention. Results Considering eligible data, following the study period analysis showed significant mitigation of inflammatory status in probiotic receivers. The hs-CRP reduced following probiotic (21.38 ± 44.45) consumption compared with placebo (−36.36 ± 79.03) intake ( p &lt; 0.001). Also, the plasma level of IgA significantly decreased in the intervention group (0.88 ± 0.65) than in the control group (0.79 ± 0.18) ( p &lt; 0.001). Wound cultures showed no significant difference between groups, although the incidence rate of bacterial colonization was slightly lower after using probiotics ( p = 0.159). Regarding wound healing, data illustrated that probiotics could accelerate wound healing after 14 days of regular consumption ( p &lt; 0.001). Conclusion Probiotics have advantages for the mitigation of inflammation and wound healing following severe thermal burn injuries. Trends toward Improvement Immune system by increasing IgA level and lymphocytic count and possible Reduction of wound area with exogenous probiotic administration in patients with burns suggest that further investigation in larger sample size is necessary to corroborate our initial, promising findings.

Prevention of Ventriculostomy Related Infection: Effectiveness of Impregnated Biomaterial.

External ventricular drain(EVD) exposes the patient to infectious complications which are associated with significant morbidity and economic burden. Biomaterials impregnated with various antimicrobial agents have been developed to decrease the rate of bacterial colonization and subsequent infection. While promising, antibiotics and silver-impregnated EVD showed conflicting clinical results. The aim of the present review is to discuss the challenges associated with the development of antimicrobial EVD catheters and their effectiveness from the bench to the bedside.

Evaluating the Use of Neonatal Colonization Screening for Empiric Antibiotic Therapy of Sepsis and Pneumonia

(1) Background: Since 2013, weekly screening for multidrug-resistant Gram-negative (MDRGN) bacteria has been performed in German neonatal intensive care units (NICU). National guidelines recommend considering these colonization analyses for antibiotic treatment regimens. Our retrospective single center study provides insight into the clinical dichotomy of bacterial colonization and infection rates in neonates. (2) Methods: We analyzed microbiological data of neonates admitted to our tertiary level NICU over nine years. Colonization with MDRGN/Serratia marcescens (SERMA) was compared to microbiological findings in sepsis and pneumonia. (3) Results: We analyzed 917 blood and 1799 tracheal aspirate samples. After applying criteria from the Nosocomial Infection Surveillance for Neonates (NEO-KISS), we included 52 and 55 cases of sepsis and pneumonia, respectively; 19.2% of sepsis patients and 34.5% of pneumonia patients had a prior colonization with MDRGN bacteria or SERMA. In these patients, sepsis was not attributable to MDRGN bacteria yet one SERMA, while in pneumonias, ten MDRGN bacteria and one SERMA were identified. We identified late-onset pneumonia and cesarean section as risk factors for MDRGN/SERMA acquisition. (4) Conclusions: Colonization screening is a useful tool for hygiene surveillance. However, our data suggest that consideration of colonization with MDRGN/SERMA might promote extensive use of last resort antibiotics in neonates.

Surface modification of additively manufactured metallic biomaterials with active antipathogenic properties

Bacterial infection is one of the most common complications following the implantation of biomaterials and can lead to aseptic loosening, prosthesis failure, and even morbidity or mortality. Some physicochemical surface properties of metallic implants such as surface topography, roughness, pore size, and degree of porosity, play key roles in bone formation. However, highly porous and roughened surfaces result in weaker mechanical properties and more bacterial adhesion. Due to existing complications in removing bacterial biofilms, more attention is needed to produce porous and/or rough additively manufactured materials that exhibit high biocompatibility and antimicrobial efficacy. The rough surfaces generated by additive manufacturing technologies require researchers to discover methods for biofilm removal via the incorporation of additional biofunctionalities to reduce the rate of bacterial colonization of implants. Furthermore, complex 3D-printed structures fabricated by additive manufacturing methods possess larger surface areas and thus are more susceptible to bacterial infection. This necessitates the development of non-pharmacological techniques to reduce the danger of bacterial colonization. The current review provides insight into the formation of pathogens on the surfaces of additively manufactured metallic biomaterials and discusses active antipathogenic surface modifications to inhibit or control infection. • The adhesion of pathogens to the surface of 3D printed metallic biomaterials. • Active antipathogenic surface modifications and coatings prevent biofilm formation. • Important role of printing parameters and antipathogenic strategies for successful implantation.

Vibrio spp and other potential pathogenic bacteria associated to microfibers in the North-Western Mediterranean Sea.

Microfibers, whether synthetic or natural, have increased dramatically in the environment, becoming the most common type of particles in the ocean, and exposing aquatic organisms to multiple negative impacts. Using an approach combining morphology (scanning electron microscopy-SEM) and molecular taxonomy (High-Throughput DNA Sequencing- HTS), we investigated the bacterial composition from floating microfibers (MFs) collected in the northwestern Mediterranean Sea. The average number of bacteria in 100 μm2 on the surface of a fiber is 8 ± 5.9 cells; by extrapolating it to a whole fiber, this represents 2663 ± 1981 bacteria/fiber. Attached bacterial communities were dominated by Alteromonadales, Rhodobacterales, and Vibrionales, including the potentially human/animal pathogen Vibrio parahaemolyticus. This study reveals a high rate of bacterial colonization on MFs, and shows that these particles can host numerous bacterial species, including putative pathogens. Even if we cannot confirm its pathogenicity based only on the taxonomy, this is the first description of such pathogenic Vibrio living attached to MFs in the Mediterranean Sea. The identification of MFs colonizers is valuable in assessing health risks, as their presence can be a threat to bathing and seafood consumption. Considering that MFs can serve as vector for potentially pathogenic microorganisms and other pollutants throughout the ocean, this type of pollution can have both ecological and economic consequences.

Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants.

Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.

Ventilator Associated Pneumonia in Neonates: Do the Body Positions Really Have a Role in Prevention

Background: Ventilator associated pneumonia (VAP) is a relatively common and sometimes deadly complication of mechanical ventilation seen in neonatal ICUs around the globe. Objective: The study aimed to analyze the effect of three different infant positions on the rate of ventilator associated pneumonia in newborns in NICU. And compare the bacterial growth on tracheal aspirates in all three groups. Study design: It was randomized controlled trial study conducted for the duration of six months from 1st January 2021 to 30th June 2021 at Neonatal ICU department of Children Hospital PIMS, Islamabad. Material and Methods: The sample size was calculated by WHO sample size calculator, with power of test 80% and level of confidence 05%. Population proportion for group 1 was 67% (rate of bacterial colonization in supine group). Population proportion for group 2 was 47% (rate of bacterial colonization in lateral group). Sample size was turned out to be 50 in each group and a total of 150 patients were included in the study. The patients were randomized to one of the three groups using lottery method. The ethical and review board committee of the hospital approved the study. Results: First group patients were in supine position after the procedure of endotracheal intubation on the ventilator. The second group was the one in which infants were put in prone position by following protocol. And the third group contained patients in lateral positions. The goal of the study was to study the effect of these three positions on the incidence of ventilator associated pneumonia in case of infants admitted in hospital. The other goal was to do a comparison on the bacterial growth produced on tracheal aspirates in case of all these groups. Infants were kept in these positions and there was no information collected for 10 minutes as there could be any potential instability in respiration. After the patients were stable data was collected. Conclusion: There was no difference found in the incidence of VAP in case of all three positions and the bacterial colonization was found to be increased in case of supine position as compared to other groups. Keywords: Ventilator associated pneumonia (VAP), Neonatal ICUs, Respiratory tract.

Risk factors for antibiotic-resistant bacteria colonisation in children with chronic complex conditions

To assess drug-resistant bacterial colonisation rates and associated risk factors in children with complex chronic conditions admitted to a national reference unit in Spain. Cross-sectional study that included all children admitted to our unit from September 2018 to July 2019. Rectal swabs were obtained to determine multidrug-resistant Gram-negative bacilli (MR-GNB) colonisation, and nasal swab to determine S. aureus and methicillin-resistant S. aureus (MRSA) colonisation. Medical records were reviewed. 100 children were included, with a median of four complex chronic conditions. Sixteen percent had S. aureus colonisation, including two MRSA. S. aureus colonisation was associated with technology-dependent children, while being on antibiotic prophylaxis or having undergone antibiotic therapy in the previous month were protective factors. The prevalence of MR-GNB colonisation was 27%, which was associated with immunosuppressive therapy (aOR 31; 2.02–47]; p = 0.01), antibiotic prophylaxis (aOR 4.56; 1.4–14.86; p = 0.012), previously treated skin-infections (aOR 2.9; 1.07–8.14; p = 0.03), surgery in the previous year (aOR 1.4; 1.06–1.8; p = 0.014), and hospital admission in the previous year (aOR 1.79; [1.26–2.56]; p = 0.001). The rate of S. aureus nasal colonisation in this series was not high despite the presence of chronic conditions, and few cases corresponded to MRSA. Antibiotic prophylaxis, immunosuppressive therapies, history of infections, previous surgeries, and length of admission in the previous year were risk factors for MR-GNB colonisation.

Infections During Short-Term Mechanical Circulatory Support

<h3>Purpose</h3> Infections remains a significant cause of death in short-term MCS patients. There is controversy regarding the indication and duration of antimicrobial (ATB) prophylaxis. We aimed to review our most recent experience and the impact of patient origin on the infection rate and prevalence of MDR bacterial (multi-resistant) colonization. <h3>Methods</h3> An observational retrospective study was conducted of all consecutive short-term support devices implanted inside a tertiary university hospital from 2014 - 2020 (n=57). Infection rate, clinical characteristics of infections, duration and type of AB prophylaxis, and prevalence of MDR bacterial colonization were recorded. As a secondary analysis, patients were divided into two groups according to the length of admission before support was initiated: Community acquired infections, when MCS was implanted less than three days from hospital admission (CO n=22) and Hospital-acquired infections, in patients with MCS implanted more than three days from hospital admission (H n=35). <h3>Results</h3> Fifty-seven patients were included, of which 77,2% were male. Medium age at implant was 54,3 years (SD 14 years). The most common etiology was ischemic heart disease, and the median LVEF was 20%. 95% of patients were on preoperative inotropes, and 38,6% were on ECLS support. 84,21% were intubated, and 47,36% were on renal replacement therapy.100% of patients received antibiotic prophylaxis, all covered gram-negative rods and gram-positive cocci including <i>MRSA</i>. Duration varied between 1 and 20 days. After classifying patients according to their preoperative length of stay, we found that in H patients infections were more frequent than in CO patients. The rate of MDR was also higher in the first group. It is noteworthy that all sternal infections happened after transplant and that in the Hospital-acquired group, sternal infections were fungal. There were no differences in survival. <h3>Conclusion</h3> There were no differences in antibiotic prophylaxis depending on the preimplant LOS. Most infections occurred once support had been removed and were more frequent after heart transplant. Mediastinitis is a rare complication, but post-transplant fungal infections may appear despite adequate antifungal prophylaxis. Further clinical studies are needed to reduce the risk of infection in short-term MCS patients.

Oropharyngeal Pathogenic Bacteria: Carriage, Antimicrobial Susceptibility Pattern and Associated Risk Factors among Febrile Patients

Background: Pharyngeal and respiratory infections due to bacteria are global concerns especially because of the emergence of multi-drug resistant strains. The Oropharynx is one of the regions of the human body that is heavily colonized by microbial flora. So, the Oropharyngeal carriage is a major risk factor for an invasion and developing the disease. Therefore, this study was aimed at determining the carriage rate of potential pathogenic Oropharyngeal bacteria, associated risk factors, and antimicrobial susceptibility patterns among febrile patients at AHMC. Methods: A Cross-sectional study was conducted from November 2018 to April 2019. A systematic random technique was implemented to collect Oropharyngeal samples from 253 selected febrile patients. Specimen collection and processing were done following standard bacteriological procedures in Adama Public Health, Research, and Referral Laboratory. Antimicrobial susceptibility testing was done using the disk diffusion method in accordance with the Clinical and Laboratory Standard Institutes guideline. Data were analyzed using SPSS version 20. Results: Overall oropharyngeal bacteria carriage rate was 75.1%. A total of 190 bacterial organisms were isolated with 96 Coagulase-Negative Staphylococci (CNS), 55 Streptococcus pyogenes, and 19 Staphylococcus aureus were dominant isolates among gram-positive. Klebsiella pneumoniae, Neisseria meningitides, Moraxella catarrhalis, and Escherichia coli were among gram-negative bacteria isolates. Living in urban, cigarette smoking, and poor oral hygiene was significantly associated with the Oropharyngeal bacterial carriage rate. The majority of CNS, S.aureus, and S. pyogenes were resistant to different classes of antibiotics. Conclusion: Potentially pathogenic Oropharyngeal bacterial colonization rate was high. Place of living and behavioral factors are risk factors that were associated with bacterial colonization of the oropharynx. Several bacterial isolates were resistant to frequently prescribed antibiotic classes. Therefore, determining the antimicrobial susceptibility pattern of the isolates is important to intervene and prevent the risk of infection and also the emergence of multiple drug-resistant strains and disease management.

Impact of COVID-19 on Radiology Trainee Safety, Education, and Wellness: Challenges Experienced and Proposed Solutions for the Future.

Impact of COVID-19 on Radiology Trainee Safety, Education, and Wellness: Challenges Experienced and Proposed Solutions for the Future.