scholarly journals The role and importance of fungal infections in intensive care units, ICU

2003 ◽  
Vol 56 (11-12) ◽  
pp. 537-541 ◽  
Author(s):  
Milanka Tatic ◽  
Danica Stanic-Canji ◽  
Biljana Draskovic ◽  
Aleksandar Komarcevic ◽  
Djordje Gajdobranski
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Units ◽  
Fungal Infections ◽  
Clinical Manifestations ◽  
Blood Stream ◽  
Fungal Colonization ◽  
Transplant Patients ◽  
Tract Infections ◽  
Inadequate Nutrition

Introduction The incidence of fungal infections is constantly increasing, especially in Intensive Care Units (ICU). On the one hand ICU are places for treatment of most difficult, often immunodeficient patients, and on the other hand their treatment often requires invasive procedures, support of vital organs and adequate monitoring. Epidemiology In approximately 78% of patients the cause of infection are Candida species with mortality rate of 57%. Less common causative agents are Aspergillus species, but with very high mortality rate of up to 100%. Pathogenesis Candida albicans is a normal inhabitant of the oropharingeal and digestive systems. Hospitalization, trauma, loss of immunity and use of strong antibiotics facilitate fungal colonization. Inadequate nutrition, poor perfusion, ischemia and corticosteroids therapy lead to damage of intestinal mucosa. Combined with improper production of IG A, it predisposes to translocation of fungi through mucosa and invasion of the blood stream. Clinical manifestations Most common forms are urinary tract infections, intraabdominal candidiasis, disseminated candidiasis and candidemia. Diagnosis Diagnosis of fungal infections is very difficult. It is based on clinical picture, microbiological, histological, radiological, serologic and molecular examinations. Treatment Treatment is usually based on systemic antimycotic agents (Amphotericin B, Azoles: Fluconazole, Flucytosine). Prophylactic treatment is still a matter of debate. It is not routinely recommended in ICU, but is commonly used in transplant patients.

Antibiotic Molecules Involved in Increasing Microbial Resistance

2019 ◽  
Vol 70 (7) ◽  
pp. 2622-2626 ◽  
Author(s):  
Letitia Doina Duceac ◽  
Constantin Marcu ◽  
Daniela Luminita Ichim ◽  
Irina Mihaela Ciomaga ◽  
Elena Tarca ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Enterobacter Aerogenes ◽  
Healthcare Associated Infections ◽  
Medical Department ◽  
Microbial Resistance ◽  
Antimicrobial Sensitivity ◽  
Interpretation Criteria ◽  
Tract Infections ◽  
Healthcare Associated

Over the past two decades, the resistance to antibiotics, especially for Gram-negative bacteria, has increased at an alarming rate, requiring constant concern for resolving and controlling this extremely important therapeutic aspect in any medical department but in particular, in Anaesthesia and Intensive Care Units, in units of neonatology, paediatrics, neurosurgery, burned patients and immunosuppressed. Specialists note a particular concern for the resistance of Enterobacteriaceae to third-generation cephalosporins and aztreonam, with a resistance profile frequently associated with the expression of extended-spectrum �-lactamases (ESBL). The Enterobacter genus comprises 14 species, but two are of medical interest, Enterobacter aerogenes and E. cloacae, which are involved in inducing healthcare-associated infections such as urinary tract infections, pneumonia associated with mechanical ventilation, bacteremia, septicemia, etc. The purpose of the study was to highlight the antibiotic molecules in which microbial resistance of some circulating strains of enterobacteria was detected. A descriptive and retrospective study was conducted between 2012-2017, on a batch of 35 patients, admitted to the Sf. Maria Emergency Clinical Hospital for Children of Iasi, from whom various pathological products were collected to highlight the Enterobacter sp strains involved in the production of infections associated with the inpatient medical care. The antimicrobial sensitivity of each strain was determined by diffusimetric method, while the interpretation criteria were considered to be those of the laboratory standards. Most cases were reported in 2017 (31.42%). The majority were registered in new-borns (42.85%) and infants (25.71%). The Anaesthesia and Intensive Care Units and Neonatology Anaesthesia and Intensive Care Units departments were the most involved. Microbial antibacterial resistance of Enterobacter sp isolates showed that all manifested resistance to ampicillin, amoxicillin and clavulanic acid, 48.57% were resistant to Cefuroxime, 42.85% resistant to Ceftazidime and Ceftriaxone, 14.28% to ciprofloxacin, 11.42% to ertapenem, 5.71% to Meronem. Although it showed relatively few cases with infections associated with healthcare in which strains of Enterobacter sp. were isolated our study, which was carried out over a period of 5 years, provides useful indications regarding the prevalence of healthcare associated infections with Enterobacter sp in paediatric patients and guidelines for antibiotic therapy.

scholarly journals Central line associated blood stream infectious cause by multi drug resistance coagulaso-negative Staphylococci in newborns from neonatial intensive care units in Poland

2011 ◽  
Vol 5 (Suppl 6) ◽  
pp. P205
Author(s):  
M Brzychczy-Wloch ◽  
J Wojkowska-Mach ◽  
M Borszewska-Kornacka ◽  
M Sulik ◽  
E Gulczynska ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Blood Stream ◽  
Central Line ◽  
Multi Drug Resistance

Healthcare-Associated Infection in Italy Annual Point-Prevalence Surveys, 2002–2004

2009 ◽  
Vol 30 (7) ◽  
pp. 659-665 ◽  
Author(s):  
Simone Lanini ◽  
William R. Jarvis ◽  
Emanuele Nicastri ◽  
Gaetano Privitera ◽  
Giovanni Gesu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Univariate Analysis ◽  
National Health System ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Point Prevalence ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated

Objective.Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality worldwide. During the period from 2002 through 2004, a group of Italian hospitals was recruited to conduct HAI point-prevalence surveys.Design.Three point-prevalence surveys.Methods.A total of 9,609 patients were surveyed.Results.The overall frequency of HAI was 6.7% (645 infections among the 9,609 surveyed patients). The most frequent HAIs were lower respiratory tract infections, which accounted for 35.8% (231 of 645 HAIs) of all HAIs, followed by urinary tract infections (152 [23.6%] of 645 HAIs), bloodstream infections (90 [14.0%] of 645 HAIs), and surgical site infections (79 [12.2%] of 645 HAIs). In both multivariate and univariate analysis, invasive procedures, duration of stay, chemotherapy, trauma, coma, and the location of the hospital were all factors statistically significantly associated with the occurrence of an HAL Enterobacteriaceae were the most common isolates recovered in medical and surgical wards, whereas gram-negative aerobic bacilli were the most common isolates recovered in intensive care units. Approximately one-half of all of the patients surveyed were receiving antibiotics at the time of our study; the most used antibiotic classes were fluoroquinolones in medical wards, cephalosporins in surgical wards, and penicillins and glycopeptides in intensive care units.Conclusion.Our study emphasizes the need for implementing further HAI surveillance to provide the National Health System with proper tools to prevent and manage infection in hospitalized patients.

Trends in Catheter-Associated Urinary Tract Infections in Adult Intensive Care Units—United States, 1990–2007

2011 ◽  
Vol 32 (8) ◽  
pp. 748-756 ◽  
Author(s):  
Deron C. Burton ◽  
Jonathan R. Edwards ◽  
Arjun Srinivasan ◽  
Scott K. Fridkin ◽  
Carolyn V. Gould
Keyword(s):  
United States ◽  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Urinary Tract Infections ◽  
Asymptomatic Bacteriuria ◽  
The United States ◽  
Symptomatic Urinary Tract Infection ◽  
Prevention Guidelines ◽  
Tract Infections

Background.Over the past 2 decades, multiple interventions have been developed to prevent catheter-associated urinary tract infections (CAUTIs). The CAUTI prevention guidelines of the Healthcare Infection Control Practices Advisory Committee were recently revised.Objective.To examine changes in rates of CAUTI events in adult intensive care units (ICUs) in the United States from 1990 through 2007.Methods.Data were reported to the Centers for Disease Control and Prevention (CDC) through the National Nosocomial Infections Surveillance System from 1990 through 2004 and the National Healthcare Safety Network from 2006 through 2007. Infection preventionists in participating hospitals used standard methods to identify all CAUTI events (categorized as symptomatic urinary tract infection [SUTI] or asymptomatic bacteriuria [ASB]) and urinary catheter–days (UC-days) in months selected for surveillance. Data from all facilities were aggregated to calculate pooled mean annual SUTI and ASB rates (in events per 1,000 UC-days) by ICU type. Poisson regression was used to estimate percent changes in rates over time.Results.Overall, 36,282 SUTIs and 22,973 ASB episodes were reported from 367 facilities representing 1,223 adult ICUs, including combined medical/surgical (505), medical (212), surgical (224), coronary (173), and cardiothoracic (109) ICUs. All ICU types experienced significant declines of 19%–67% in SUTI rates and 29%–72% in ASB rates from 1990 through 2007. Between 2000 and 2007, significant reductions in SUTI rates occurred in all ICU types except cardiothoracic ICUs.Conclusions.Since 1990, CAUTI rates have declined significantly in all major adult ICU types in facilities reporting to the CDC. Further efforts are needed to assess prevention strategies that might have led to these decreases and to implement new CAUTI prevention guidelines.

GRYBELINĖS INFEKCIJOS INTENSYVIOSIOS TERAPIJOS SKYRIUJE

2021 ◽  
Vol 31 (1) ◽  
pp. 15-18
Author(s):  
Martynas Zaremba ◽  
Vykinta Zeleckytė ◽  
Valdonė Ališkevičiūtė
Keyword(s):  
Candida Albicans ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Fungal Infections

Grybelinės infekcijos vis dažniau diagnozuojamos intensyviosios terapijos skyriuose ir tampa viena iš dažniausių sunkios būklės pacientų mirties priežasčių. Manoma, jog grybelinės infekcijos riziką didina netinkamai taikoma antibiotikoterapija, didelis imunosupresinių pacientų kiekis ir jiems atliekamos sudėtingos intervencinės procedūros. Didžioji dalis grybelinių infekcijų yra sukelta Candida genties grybelių, dažniausiai – Candida albicans. EPIC II 2007 metais atliktame tyrime 1265 pacientams iš 75 šalių buvo rasta, jog 19 proc. patogenų intensyviosios terapijos skyriuose sudarė grybeliai. Dažniausia gentis – Candida bei Aspergillus. Darbo tikslas – apžvelgti dažniausiai pasitaikančias grybelines infekcijas intensyviosios terapijos skyriuose, jų diagnostiką bei gydymą, atsižvelgiant į publikuotus mokslinius šaltinius. Literatūros šaltinių paieška buvo vykdoma tarptautinėse medicinos duomenų bazėse PubMed, UpToDate, Medscape. Į sisteminę apžvalgą įtraukti anglų kalba 2010–2020 m. publikuoti atsitiktinių imčių kontroliuojami tyrimai, originalūs stebėjimo tyrimai, atvejų ataskaitos, atvejų serijos ir apžvalgos pagal raktinius žodžius ir jų derinius: fungal infections, fungal infections in the intensive care units (ICU), fungal infections diagnostics and treatment. Mokslinių leidinių analizės rezultatai parodė grybelinės infekcijos intensyviosios terapijos skyriuose dažnėjimą, nes dėl radikalaus gydymo bei invazinių procedūrų daugėja imunosupresiškų pacientų. Dažniausia grybelinės infekcijos diagnostikos priemonė yra pasėlis. Grybelinės infekcijos gydymas priklauso nuo specifinio sukėlėjo. Dažniausiai vartojamos vaistų grupės yra azolai bei polienai.

Culturing practices and the care of the urinary catheter in reducing NHSN-defined catheter-associated urinary tract infections: The tale of two teaching hospitals

2018 ◽  
Vol 39 (12) ◽  
pp. 1494-1496 ◽  
Author(s):  
Ana Cecilia Bardossy ◽  
Takiah Williams ◽  
Karen Jones ◽  
Susan Szpunar ◽  
Marcus Zervos ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Intensive Care Units ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Urinary Catheter ◽  
Teaching Hospitals ◽  
Positive Urine ◽  
Tract Infections ◽  
Catheter Care

AbstractWe compared interventions to improve urinary catheter care and urine culturing in adult intensive care units of 2 teaching hospitals. Compared to hospital A, hospital B had lower catheter utilization, more compliance with appropriate indications and maintenance, but higher urine culture use and more positive urine cultures per 1,000 patient days.

scholarly journals Overview on the Prevalence of Fungal Infections, Immune Response, and Microbiome Role in COVID-19 Patients

2021 ◽  
Vol 7 (9) ◽  
pp. 720
Author(s):  
Maryam Roudbary ◽  
Sunil Kumar ◽  
Awanish Kumar ◽  
Lucia Černáková ◽  
Fatemeh Nikoomanesh ◽  
...  
Keyword(s):  
Immune Response ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Fungal Infections ◽  
Fungal Species ◽  
Fungal Diseases ◽  
Severe Illness ◽  
Rising Incidence ◽  
Cryptococcus Spp

Patients with severe COVID-19, such as individuals in intensive care units (ICU), are exceptionally susceptible to bacterial and fungal infections. The most prevalent fungal infections are aspergillosis and candidemia. Nonetheless, other fungal species (for instance, Histoplasma spp., Rhizopus spp., Mucor spp., Cryptococcus spp.) have recently been increasingly linked to opportunistic fungal diseases in COVID-19 patients. These fungal co-infections are described with rising incidence, severe illness, and death that is associated with host immune response. Awareness of the high risks of the occurrence of fungal co-infections is crucial to downgrade any arrear in diagnosis and treatment to support the prevention of severe illness and death directly related to these infections. This review analyses the fungal infections, treatments, outcome, and immune response, considering the possible role of the microbiome in these patients. The search was performed in Medline (PubMed), using the words “fungal infections COVID-19”, between 2020–2021.

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