scholarly journals Unravelling the Features of Success of VIM-Producing ST111 and ST235 Pseudomonas aeruginosa in a Greek Hospital

2020 ◽  
Vol 8 (12) ◽  
pp. 1884
Author(s):  
Costas C. Papagiannitsis ◽  
Aggeliki Verra ◽  
Vasiliki Galani ◽  
Stelios Xitsas ◽  
Ibrahim Bitar ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
University Hospital ◽  
Type I ◽  
Illumina Platform ◽  
Minimal Inhibitory Concentrations ◽  
Greek Hospital ◽  
Clonal Spread ◽  
The University ◽  
Encoding Genes

The objective of this study was to analyze the characteristics that contribute to the successful dissemination of VIM-producing Pseudomonas aeruginosa (P. aeruginosa), belonging to ST111 and ST235, in a Greek hospital. A total of 120 non-repetitive P. aeruginosa, which had meropenem minimal inhibitory concentrations (MICs) greater than 2 mg/L, were studied. VIM-encoding genes were amplified and sequenced within their integrons. Isolates were typed by multilocus sequence typing (MLST). Six VIM-producers, representative of different integron structures and sequence types (STs), were completely sequenced using Illumina platform. Sixty-one P. aeruginosa were confirmed to produce VIM-type carbapenemases. ST111 dominated (n = 34) among VIM-producers, while 15 VIM-producers belonged to ST235. The blaVIM-like genes were located in three integron types, including In59, In595 and In1760, which were integrated into P. aeruginosa chromosomes. Whole genome sequencing (WGS) data demonstrated that ST111 and ST235 MBL producers carried several resistance and virulence genes. Additionally, the presence of type I-C and type I-E clustered regularly interspaced short palindromic repeats (CRISPR)/Cas locus was observed in ST235 and ST395 isolates, respectively. In conclusion, our findings confirmed the clonal spread of ST111 P. aeruginosa, carrying the VIM-2-encoding integron In59, in the University Hospital of Larissa (UHL). In addition, they highlighted the important role of high-risk clones, ST111 and ST235, in the successful dissemination and establishment into hospital settings of clinically important pathogens carrying resistance determinants.

scholarly journals Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11534
Author(s):  
Stefano Sartini ◽  
Laura Massobrio ◽  
Ombretta Cutuli ◽  
Paola Campodonico ◽  
Cristina Bernini ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Adverse Outcome ◽  
University Hospital ◽  
Rt Pcr ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
The University

COVID-19 respiratory failure is a life-threatening condition. Oxygenation targets were evaluated in a non-ICU setting. In this retrospective, observational study, we enrolled all patients admitted to the University Hospital of Genoa, Italy, between 1 February and 31 May 2020 with an RT-PCR positive for SARS-CoV-2. PaO2, PaO2/FiO2 and SatO2% were collected and analyzed at time 0 and in case of admission, patients who required or not C-PAP (groups A and B) were categorized. Each measurement was correlated to adverse outcome. A total of 483 patients were enrolled, and 369 were admitted to hospital. Of these, 153 required C-PAP and 266 had an adverse outcome. Patients with PaO2 <60 and >100 had a higher rate of adverse outcome at time 0, in groups A and B (OR 2.52, 3.45, 2.01, respectively). About the PaO2/FiO2 ratio, the OR for < 300 was 3.10 at time 0, 4.01 in group A and 4.79 in group B. Similar odds were found for < 200 in any groups and < 100 except for group B (OR 11.57). SatO2 < 94% showed OR 1.34, 3.52 and 19.12 at time 0, in groups A and B, respectively. PaO2 < 60 and >100, SatO2 < 94% and PaO2/FiO2 ratio < 300 showed at least two- to three-fold correlation to adverse outcome. This may provide simple but clear targets for clinicians facing COVID-19 respiratory failure in a non ICU-setting.

Differential subcellular distribution of rat prostatic steroid 5α-reductase isozyme activities

1996 ◽  
Vol 134 (3) ◽  
pp. 386-392 ◽  
Author(s):  
Paul N Span ◽  
CGJ Sweep ◽  
Theo J Benraad ◽  
Anthony GH Smals
Keyword(s):  
Nuclear Localization ◽  
Subcellular Distribution ◽  
Subcellular Fractions ◽  
University Hospital ◽  
Type I ◽  
Target Tissue ◽  
Type Ii ◽  
Rat Prostate ◽  
Isozyme Activity

Span PN, Sweep CGJ, Benraad TJ, Smals AGH. Differential subcellular distribution of rat prostatic steroid 5α-reductase isozyme activities. Eur J Endocrinol 1996;134:386–92. ISSN 0804–4643 The rat prostate, a classical androgen-target tissue, contains both known isozymes of steroid 5α-reductase, i.e. type I and type II. So far, the role of the type I isozyme has been proposed as catabolic. The abundant expression of type I 5α-reductase in an androgen-target tissue is therefore puzzling. Assessment of the subcellular localization of 5α-reductase isozymes in rat prostate might contribute in elucidating their possibly distinct roles. After obtaining crude subcellular fractions by differential centrifugation, both isozyme activities were measured at neutral pH by plotting according to Eadie–Scatchard. The observations were extended by assessment of pH-dependent velocity ratios and type II 5α-reductase inhibitor sensitivities in these subcellular fractions. The results indicated a preferentially—although not exclusively—nuclear localization for the type I and a predominantly microsomal localization for the type II isozyme activity in the rat prostate. In conclusion, the nuclear localization of the type I isozyme seems not to concur with its proposed catabolic role. AGH Smals, Department of Medicine, Division of Endocrinology, University Hospital Nijmegen, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands

scholarly journals No Association Between Statin Use and the Prognosis of Endometrial Cancer in Women With Type 2 Diabetes

2021 ◽  
Vol 12 ◽  
Author(s):  
Elina Urpilainen ◽  
Anne Ahtikoski ◽  
Reetta Arima ◽  
Ulla Puistola ◽  
Peeter Karihtala
Keyword(s):  
Type 2 Diabetes ◽  
Endometrial Cancer ◽  
Cancer Diagnosis ◽  
Progression Free Survival ◽  
Epidemiological Studies ◽  
University Hospital ◽  
Type I ◽  
Statin Use

Preclinical studies have suggested statins have antiproliferative and anti-metastatic effects on endometrial cancer cells. Similarly, most previous epidemiological studies have reported a better prognosis of endometrial cancer in patients who used statins. In this study, we explored the role of statins in the prognosis of endometrial cancer in women with type 2 diabetes in a hospital-based cohort. This retrospective cohort consisted of 119 women with type 2 diabetes who were diagnosed and treated for endometrial cancer at Oulu University Hospital, Finland, between 2007 and 2014. The patients were classified as statin users (n = 58) and nonusers (n = 61) based on the type of medication they were using at the time of endometrial cancer diagnosis. Statin use showed no association with progression-free survival or overall survival in the whole cohort nor the subgroups with type I or type II histology, in lower or higher body mass index groups, or at an early or advanced stage. The results remained similar in the multivariate analysis after adjusting for the patient’s age, cancer stage, and histology. Furthermore, statin use seemed not to have any association with most of the prognostic factors at the time of endometrial cancer diagnosis.

scholarly journals Risk factors for and role of OprD protein in increasing minimal inhibitory concentrations of carbapenems in clinical isolates of Pseudomonas aeruginosa

2017 ◽  
Vol 66 (11) ◽  
pp. 1562-1572 ◽  
Author(s):  
Aki Hirabayashi ◽  
Daizo Kato ◽  
Yuka Tomita ◽  
Mitsutaka Iguchi ◽  
Keiko Yamada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Clinical Isolates ◽  
Minimal Inhibitory Concentrations

scholarly journals Role of Aminoglycoside-Modifying Enzymes (AMEs) in Resistance to Aminoglycosides among Clinical Isolates of Pseudomonas aeruginosa in the North of Iran

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Leila Ahmadian ◽  
Zahra Norouzi Bazgir ◽  
Mohammad Ahanjan ◽  
Reza Valadan ◽  
Hamid Reza Goli
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Resistance Pattern ◽  
Dilution Method ◽  
The North ◽  
Agar Diffusion Test ◽  
North Of Iran ◽  
Encoding Genes

In recent years, the prevalence of resistance to aminoglycosides among clinical isolates of Pseudomonas aeruginosa is increasing. The aim of this study was to investigate the role of aminoglycoside-modifying enzymes (AMEs) in resistance to aminoglycosides in clinical isolates of P. aeruginosa. The clinical isolates were collected from different hospitals. Disk agar diffusion test was used to determine the antimicrobial resistance pattern of the clinical isolates, and the minimum inhibitory concentration of aminoglycosides was detected by microbroth dilution method. The PCR was performed for discovery of aminoglycoside-modifying enzyme-encoding genes. Among 100 screened isolates, 43 (43%) isolates were resistant to at least one tested aminoglycosides. However, 13 (13%) isolates were resistant to all tested aminoglycosides and 37 isolates were detected as multidrug resistant (MDR). The resistance rates of P. aeruginosa isolates against tested antibiotics were as follows: ciprofloxacin (41%), piperacillin-tazobactam (12%), cefepime (32%), piperacillin (26%), and imipenem (31%). However, according to the MIC method, 13%, 32%, 33%, and 37% of the isolates were resistant to amikacin, gentamicin, tobramycin, and netilmicin, respectively. The PCR results showed that AAC(6 ′ )-Ib was the most commonly (26/43, 60.4%) identified AME-encoding gene followed by AAC(6 ′ )-IIa (41.86%), APH(3 ′ )-IIb (34.8%), ANT(3 ″ )-Ia (18.6), ANT(2 ″ )-Ia (13.95%), and APH(3 ″ )-Ib (2.32%). However, APH(3 ′ )-Ib was not found in any of the studied isolates. The high prevalence of AME-encoding genes among aminoglycoside-resistant P. aeruginosa isolates in this area indicated the important role of AMEs in resistance to these antibiotics similar to most studies worldwide. Due to the transmission possibility of these genes between the Gram-negative bacteria, we need to control the prescription of aminoglycosides in hospitals.

scholarly journals Implementation of Antibiotic Stewardship in a University Hospital Setting

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 93
Author(s):  
Milan Kolar ◽  
Miroslava Htoutou Sedlakova ◽  
Karel Urbanek ◽  
Patrik Mlynarcik ◽  
Magdalena Roderova ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Antibiotic Stewardship ◽  
Bacterial Infections ◽  
Hospital Setting ◽  
University Hospital ◽  
Beta Lactam ◽  
Stewardship Program ◽  
Clonal Spread

The article describes activities of an antibiotic center at a university hospital in the Czech Republic and presents the results of antibiotic stewardship program implementation over a period of 10 years. It provides data on the development of resistance of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus to selected antibiotic agents as well as consumption data for various antibiotic classes. The genetic basis of resistance to beta-lactam antibiotics and its clonal spread were also assessed. The study showed significant correlations between aminoglycoside consumption and resistance of Escherichia coli and Klebsiella pneumoniae to gentamicin (r = 0.712, r = 0.869), fluoroquinolone consumption and resistance of Klebsiella pneumoniae to ciprofloxacin (r = 0.896), aminoglycoside consumption and resistance of Pseudomonas aeruginosa to amikacin (r = 0.716), as well as carbapenem consumption and resistance of Pseudomonas aeruginosa to meropenem (r = 0.855). Genotyping of ESBL- positive isolates of Klebsiella pneumoniae and Escherichia coli showed a predominance of CTX-M-type; in AmpC-positive strains, DHA, EBC and CIT enzymes prevailed. Of 19 meropenem-resistant strains of Klebsiella pneumoniae, two were identified as NDM-positive. Clonal spread of these strains was not detected. The results suggest that comprehensive antibiotic stewardship implementation in a healthcare facility may help to maintain the effectiveness of antibiotics against bacterial pathogens. Particularly beneficial is the work of clinical microbiologists who, among other things, approve administration of antibiotics to patients with bacterial infections and directly participate in their antibiotic therapy.

scholarly journals Longitudinal Study of Viral and Bacterial Contamination of Hospital Pediatricians’ Mobile Phones

2020 ◽  
Vol 8 (12) ◽  
pp. 2011
Author(s):  
Aymeric Cantais ◽  
Florence Grattard ◽  
Julie Gagnaire ◽  
Olivier Mory ◽  
Aurélie Plat ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Mobile Phones ◽  
Healthcare Workers ◽  
Winter Season ◽  
University Hospital ◽  
Infectious Agents ◽  
Study Results ◽  
Before And After ◽  
The University

Mobile phones (MPs) of healthcare workers (HCWs) may represent an important source of transmission of infectious agents. This longitudinal study documents the contamination of these tools. Ten MPs handled by senior pediatricians were sampled once a week during 23 weeks in three pediatric wards of the University Hospital of Saint-Etienne, France. Cultures were performed for bacteria and multiplex PCR assays for a panel of respiratory and enteric viruses. A questionnaire on hygiene habits regarding phoning and care was filled-in by pediatricians before and after the study. From a total of 230 samples, 145 (63%) were contaminated by at least one pathogen. The MPs from emergency departments were the most impacted. Viruses were detected in 179 samples; bacteria were isolated in 59 samples. Contamination increased during the winter epidemic peak. A cross-contamination by Paracoccus yeei between hands and MPs of different HCWs was demonstrated. The communication of the study results influenced the hygiene behaviors. This study highlights the contamination of MPs by pathogens that are resistant in the environment, and its sustainability along the winter season. The role of MPs as vectors of nosocomial infection needs to be better investigated.

The use of visual distraction to improve the tolerability of flexible laryngoscopy

2018 ◽  
Vol 132 (8) ◽  
pp. 739-741 ◽  
Author(s):  
T C Biggs ◽  
A Henderson ◽  
F Shelton ◽  
N N Patel
Keyword(s):  
Analogue Scale ◽  
Cost Effective ◽  
University Hospital ◽  
Video Monitor ◽  
Topical Anaesthetic ◽  
Visual Distraction ◽  
Flexible Laryngoscopy ◽  
Cost Effective Alternative ◽  
The University

AbstractBackgroundFlexible laryngoscopy is a commonly performed procedure in otolaryngology. Although this procedure is not considered painful, many patients describe it as uncomfortable. This study investigated the role of visual distraction as a form of pain relief during flexible laryngoscopy.MethodsThe study included patients undergoing flexible laryngoscopy at the University Hospital Southampton. Patients were self-allocated to one of four groups: with or without co-phenylcaine anaesthetic spray; and with and without visual distraction. Visual distraction involved the patient watching the procedure concurrently with the clinician, via a video monitor. Pre- and post-procedural discomfort was assessed using a visual analogue scale.ResultsThe use of topical anaesthetic spray was not associated with significantly reduced discomfort scores (p > 0.05). Discomfort scores were significantly reduced in the visual distraction groups (p = 0.04), irrespective of the use of topical anaesthetic spray.ConclusionThis small study showed that visual distraction should be considered as a simple and cost-effective alternative to local anaesthetic for flexible laryngoscopy.

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