Risk Factors For Development Of Infection Research Articles

Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU

Infections have become one of the main complications of patients with severe SARS-CoV-2 pneumonia admitted in ICU. Poor immune status, frequent development of organic failure requiring invasive supportive treatments, and prolonged ICU length of stay in saturated structural areas of patients are risk factors for infection development. The Working Group on Infectious Diseases and Sepsis GTEIS of the Spanish Society of Intensive Medicine and Coronary Units SEMICYUC emphasizes the importance of infection prevention measures related to health care, the detection and early treatment of major infections in the patient with SARS-CoV-2 infections. Bacterial co-infection, respiratory infections related to mechanical ventilation, catheter-related bacteremia, device-associated urinary tract infection and opportunistic infections are review in the document.

Management of infectious complications associated with coronavirus infection in severe patients admitted to ICU

Las infecciones se han convertido en una de las principales complicaciones de los pacientes con neumonía grave por SARS-CoV-2 que ingresan en UCI. El deficiente estado inmunitario, el desarrollo frecuente de fracaso orgánico con necesidad de tratamientos de soporte invasivos y las estancias prolongadas en áreas estructurales en gran medida saturadas de enfermos son factores de riesgo para el desarrollo de infecciones. El Grupo de Trabajo de Enfermedades Infecciosas y Sepsis GTEIS de la Sociedad Española de Medicina Intensiva y Unidades Coronarias SEMICYUC enfatiza la importancia de las medidas de prevención de infecciones relacionadas con los cuidados sanitarios, y de la detección y tratamiento precoz de las principales infecciones en el paciente con infección por SARS-CoV-2. La coinfección bacteriana, las infecciones respiratorias relacionadas con la ventilación mecánica, bacteriemia relacionada con el catéter, infección del tracto urinario asociado a dispositivo e infecciones oportunistas son desarrolladas.

Surgical Site Infections in Aesthetic Surgery.

Surgical site infections represent one of the most common postoperative complications in patients undergoing aesthetic surgery. As with other postoperative complications, the incidence of these infections may be influenced by many factors and varies depending on the specific operation performed. Understanding the risk factors for infection development is critical because careful patient selection and appropriate perioperative counseling will set the right expectations and can ultimately improve patient outcomes and satisfaction. Various perioperative prevention measures may also be employed to minimize the incidence of these infections. Once the infection occurs, prompt diagnosis will allow management of the infection and any associated complications in a timely manner to ensure patient safety, optimize the postoperative course, and avoid long-term sequelae.

Risk factors for infection development after transrectal prostate biopsy and the role of resistant bacteria in colonic flora.

In this study, we aimed to identify risk factors for the development of infectious complications after prostate biopsy and to investigate the role of intestinal colonization of bacteria that are resistant to prophylactic antibiotics. A total of 168 patients who had undergone transrectal prostate biopsy (TRPB) under ciprofloxacin and gentamycin prophylaxis were included in the study. Stool cultures and subsequent antibiotic susceptibility testing were performed in all patients before the start of antibiotic prophylaxis. Of the 168 patients, 17 (10.1%) developed urinary tract infection (UTI), while 6 (3.57%) developed sepsis within seven days after biopsy. Ciprofloxacin-resistant bacterial colonization was detected in 81 (48.2%) of the patients. None of the patients with ciprofloxacin-sensitive bacteria in intestinal flora developed a UTI. The colonization of intestinal ciprofloxacin-resistant bacteria increased UTI risk significantly after TRPB (p < 0.0001). Urolithiasis history, presence of permanent urinary catheterization, hospitalization history for more than 48 hours in the last year, and recent antibiotic usage significantly increased UTI risk after TRPB. Development of an infection was more frequent in patients with resistant bacterial colonization. We hope to guide more comprehensive studies designed to find a standard prophylactic regimen for TRPB that can be used all over the world.

Infections in a surgical intensive care unit of a university hospital in Greece

We aimed to evaluate the clinical and microbiological characteristics of the patients who developed an infection in our surgical intensive care unit (SICU). This was a prospective study of all patients who sustained an ICU-acquired infection from 2002 to 2004. Among 683 consecutive SICU patients, 123 (18.0%) developed 241 infections (48.3 infections per 1000 patient-days). The mean age of patients was 66.7+/-3.8 years, the mean APACHE II score (acute physiology and chronic health evaluation) on SICU admission was 18.2+/-2.4, and the mean SOFA score (sepsis-related organ failure assessment) at the onset of infection was 8.8+/-2. Of the study patients, 51.2% were women. Infections were: bloodstream (36.1%), ventilator-associated pneumonia (VAP; 25.3%, 20.3/1000 ventilator-days), surgical site (18.7%), central venous catheter (10.4%, 7.1/1000 central venous catheter-days), and urinary tract infection (9.5%, 4.6/1000 urinary catheter-days). The most frequent microorganisms found were: Acinetobacter baumannii (20.3%), Pseudomonas aeruginosa (15.7%), Candida albicans (13.2%), Enterococcus faecalis (10.4%), Klebsiella pneumoniae (9.2%), Enterococcus faecium (7.9%), and Staphylococcus aureus (6.7%). High resistance to the majority of antibiotics was identified. The complication and mortality rates were 58.5% and 39.0%, respectively. Multivariate analysis identified APACHE II score on admission (odds ratio (OR) 4.63, 95% confidence interval (CI) 2.69-5.26, p=0.01), peritonitis (OR 1.85, 95% CI 1.03-3.25, p=0.03), acute pancreatitis (OR 2.27, 95% CI 1.05-3.75, p=0.02), previous aminoglycoside use (OR 2.84, 95% CI 1.06-5.14, p=0.03), and mechanical ventilation (OR 3.26, 95% CI: 2.43-6.15, p=0.01) as risk factors for infection development. Age (OR 1.16, 95% CI 1.01-1.33, p=0.03), APACHE II score on admission (OR 2.53, 95% CI 1.77-3.41, p=0.02), SOFA score at the onset of infection (OR 2.88, 95% CI 1.85-4.02, p=0.02), and VAP (OR 1.32, 95% CI 1.04-1.85, p=0.03) were associated with mortality. Infections are an important problem in SICUs due to high incidence, multi-drug resistance, complications, and mortality rate. In our study, APACHE II score on admission, peritonitis, acute pancreatitis, previous aminoglycoside use, and mechanical ventilation were identified as risk factors for infection development, whereas age, APACHE II score on admission, SOFA score at the onset of infection, and VAP were associated with mortality.