scholarly journals Emergence of Candida auris in Brazil in a COVID-19 Intensive Care Unit

2021 ◽  
Vol 7 (3) ◽  
pp. 220
Author(s):  
João N. de Almeida ◽  
Elaine C. Francisco ◽  
Ferry Hagen ◽  
Igor Brandão ◽  
Felicidade M. Pereira ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antifungal Susceptibility ◽  
Candida Auris ◽  
Minimal Inhibitory Concentrations ◽  
First Case ◽  
Asian Clade ◽  
Travel Restrictions ◽  
Clade C ◽  
The City

In December 2020, Candida auris emerged in Brazil in the city of Salvador. The first two C. auris colonized patients were in the same COVID-19 intensive care unit. Antifungal susceptibility testing showed low minimal inhibitory concentrations of 1 µg/mL, 2 µg/mL, 0.03 µg/L, and 0.06 µg/mL for amphotericin B, fluconazole, voriconazole, and anidulafungin, respectively. Microsatellite typing revealed that the strains are clonal and belong to the South Asian clade C. auris. The travel restrictions during the COVID-19 pandemic and the absence of travel history among the colonized patients lead to the hypothesis that this species was introduced several months before the recognition of the first case and/or emerged locally in the coastline Salvador area.

scholarly journals Ongoing Challenges with Healthcare-Associated Candida auris Outbreaks in Oman

2019 ◽  
Vol 5 (4) ◽  
pp. 101 ◽  
Author(s):  
Al Maani ◽  
Paul ◽  
Al-Rashdi ◽  
Wahaibi ◽  
Al-Jardani ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Environmental Isolates ◽  
Candida Auris ◽  
Minimal Inhibitory Concentrations ◽  
High Dependency ◽  
Rdna Sequencing

Candida auris has emerged in the past decade as a multi-drug resistant public health threat causing health care outbreaks. Here we report epidemiological, clinical, and microbiological investigations of a C. auris outbreak in a regional Omani hospital between April 2018 and April 2019. The outbreak started in the intensive care areas (intensive care unit (ICU), coronary care unit (CCU), and high dependency unit) but cases were subsequently diagnosed in other medical and surgical units. In addition to the patients’ clinical and screening samples, environmental swabs from high touch areas and from the hands of 35 staff were collected. All the positive samples from patients and environmental screening were confirmed using MALDI-TOF, and additional ITS-rDNA sequencing was done for ten clinical and two environmental isolates. There were 32 patients positive for C. auris of which 14 (43.8%) had urinary tract infection, 11 (34.4%) had candidemia, and 7 (21.8%) had asymptomatic skin colonization. The median age was 64 years (14–88) with 17 (53.1%) male and 15 (46.9%) female patients. Prior to diagnosis, 21 (65.6%) had been admitted to the intensive care unit, and 11 (34.4%) had been nursed in medical or surgical wards. The crude mortality rate in our patient’s cohort was 53.1. Two swabs collected from a ventilator in two different beds in the ICU were positive for C. auris. None of the health care worker samples were positive. Molecular typing showed that clinical and environmental isolates were genetically similar and all belonged to the South Asian C. auris clade I. Most isolates had non-susceptible fluconazole (100%) and amphotericin B (33%) minimal inhibitory concentrations (MICs), but had low echinocandin and voriconazole MICs. Despite multimodal infection prevention and control measures, new cases continued to appear, challenging all the containment efforts.

scholarly journals Candida auris Infection Among Patients With Cancer in an Oncology Center in Eastern India

2020 ◽  
Vol 41 (S1) ◽  
pp. s146-s147
Author(s):  
Sanjay Bhattacharya ◽  
Parijat Das ◽  
Gaurav Goel ◽  
Sudipta Mukherjee ◽  
Pralay Shankar Ghosh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antifungal Susceptibility ◽  
Control Group ◽  
Solid Organ ◽  
Candida Auris ◽  
Icu Stay ◽  
Hospital Infection Control ◽  
Its Gene ◽  
Oncology Center

Background: The multidrug-resistant fungus Candida auris is emerging as a major cause of healthcare-associated infection globally. Understanding the epidemiology of these infections in vulnerable groups such as cancer patients is important for hospital infection control and their effective management. In this report we present diagnostic, clinical, antifungal resistance and outcome data of 11 cases of C. auris infection from an oncology center in India. Methods:C. auris strains were identified by Sanger-based DNA sequencing of the internal transcriber spacer (ITS) gene. Antifungal susceptibility testing (AFST) was performed using the broth dilution method. Identification and AFST were checked by the WHO Collaborating Center for Reference & Research on Fungi of Medical Importance. Patients had both empirical as well as directed therapy with antifungal agents based on AFST results and clinical assessment. Results: Between November 2018 and March 2019, 11 cases of C. auris (8 from patients with solid-organ tumors and 3 from hematological malignancy) were detected. Two distinct genetic clusters were identified by ITS gene sequencing; one of these clusters showed 100% homology with a previously unknown C. auris isolate (GenBank accession no. MK881076) and the other cluster had a 100% identity score with isolates from Japan and South Korea (GenBank accession nos. MH071441, KY657027, and EU884189). All 11 strains were resistant to fluconazole. With voriconazole, 1 isolate was susceptible, 3 were resistant, and 7 showed dose-dependent susceptibility. Two isolates were resistant to amphotericin B. Resistance to caspofungin or anidulafungin was noted in 1 of 11 isolates (9%); most showed intermediate susceptibility (63% to caspofungin). Among all of the patients, 72% were from the intensive care unit (ICU) or the high-dependency unit. The 30-day all-cause mortality was 5 of 11 (45%) in the C. auris group and 4 of 11 (36%) the control group (ie, infections with other Candida spp during same period). Duration of ICU stay in the C. auris group was 12 days and in the control group it was 6 days. The median cost (in terms of hospital bill at the time of discharge or death) for management of Candida auris infection and the primary medical condition was US$10,121 for the C. auris groups and US$8,608 for the control group. Most cases (10 of 11) were detected in wards without isolation rooms, and 8 of the 11 C. auris cases (73%) were detected in patients in the intensive care unit. Conclusions: Morbidity, mortality, ICU stay, and healthcare costs are significant in C. auris infection.Funding: NoneDisclosures: None

scholarly journals The role of the nurse in the neonatal intensive care unit: between the ideal, the real and the possible

2011 ◽  
Vol 19 (2) ◽  
pp. 301-308 ◽  
Author(s):  
Liciane Langona Montanholi ◽  
Miriam Aparecida Barbosa Merighi ◽  
Maria Cristina Pinto de Jesus
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Public And Private ◽  
Public And Private Hospitals ◽  
The City ◽  
Social Phenomenology ◽  
The Ideal

The nurse is one of the professionals responsible for the care directed toward the physical, mental and social development of newborns in the Neonatal Intensive Care Unit. This study aimed to comprehend the experience of nurses working in a Neonatal Intensive Care Unit. Data collection was performed in 2008, through interviews with 12 nurses working in public and private hospitals of the city of São Paulo. The units of meaning identified were grouped into three categories: Developing actions; Perceiving their actions and Expectations. The analysis was based on social phenomenology. It was concluded that the overload of activities, the reduced number of staff, the lack of materials, equipment and the need for professional improvement are the reality of the work of the nurse in this sector. To supervise the care is the possible; integral care of the newborn, involving the parents, is the ideal desired.

scholarly journals Billing of nursing procedures at an intensive care unit

2011 ◽  
Vol 19 (3) ◽  
pp. 573-580 ◽  
Author(s):  
Raquel Silva Bicalho Zunta ◽  
Valéria Castilho
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Private Hospital ◽  
Quantitative Approach ◽  
Essential Information ◽  
Nursing Managers ◽  
Important Argument ◽  
The City ◽  
Hospital Revenues ◽  
Safe Care

This study aimed to: estimate the billing of nursing procedures at an intensive care unit and calculate how much of total ICU revenues are generated by nursing. An exploratory-descriptive, documentary research with a quantitative approach was carried out. The study was performed at a general ICU of a private hospital in the city of Sao Paulo. The sample consisted of 159 patients. It was concluded that the nursing procedures were responsible for 15.1% of total ICU revenues, which breaks down to an average 11.3% of revenues coming from nursing prescriptions and 3.8% from medical prescriptions. Demonstrating how much nursing contributes to hospital revenues is essential information for nursing managers, as it is an important argument to obtain resources and guarantee safe care.

scholarly journals Candidemia by Candida parapsilosis in a neonatal intensive care unit: human and environmental reservoirs, virulence factors, and antifungal susceptibility

2020 ◽  
Vol 51 (3) ◽  
pp. 851-860
Author(s):  
Ralciane de Paula Menezes ◽  
Sávia Gonçalves de Oliveira Melo ◽  
Meliza Arantes Souza Bessa ◽  
Felipe Flávio Silva ◽  
Priscila Guerino Vilela Alves ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Virulence Factors ◽  
Neonatal Intensive Care ◽  
Candida Parapsilosis ◽  
Antifungal Susceptibility

Markov models to detect the deterioration of patients in a pediatric intensive care unit: analytical observational study Ledys M. Izquierdo MD, MSc, Luis F. Niño PhD Jhon S. Rojas (Preprint)

2021 ◽  
Author(s):  
Ledys Izquierdo
Keyword(s):  
Data Mining ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Confusion Matrix ◽  
Pediatric Intensive Care ◽  
Warning Signs ◽  
Classification Model ◽  
Military Hospital ◽  
The City

BACKGROUND In the field of continuous vital-sign monitoring in critical care settings, it has been observed that the “early-warning signs” of impending physiological deterioration can fail to be detected timely and sometimes by resource constrained clinical staff. OBJECTIVE to develop a probabilistic model to detect the deterioration of patients in a pediatric intensive care unit. METHODS cross-sectional cohort study, pediatric intensive care unit of the Central Military Hospital in the city of Bogota, Colombia. Children from 1 to 18 years old from January 2018 to January 2020. The CRISP-DM (CRoss-Industry Standard Process for Data Mining) methodology was used as a data mining process and then we used Markov chains to identify the clinical states through which the patient passes. Then, a Hidden Markov model (HMM) based approach is applied for classification and prediction of patient's deterioration by computing the probability of future clinical states. RESULTS Both learning models were trained and evaluated using six vital signs data from 94,678 patient records, collected from the database of real patients who were in the Pediatric Intensive Care Unit of the Central Military Hospital in the city of Bogota, Colombia. To obtain the HMM based classification model, 10-fold cross validation was performed. the confusion matrix showed, Accuracy :0,7, precision: 0.75 and the F1 score:0.65. CONCLUSIONS classification analysis in medical applications can be very useful if considered as a very significant support tool for health professionals. CLINICALTRIAL does not apply

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