scholarly journals Nutritional Composition Assessment of 3000 Individualized Parenteral Nutrition Bags in a Tertiary Referral Hospital: Current Prescribing Patterns

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1079
Author(s):  
Beatriz Pelegrina-Cortés ◽  
Laura Bermejo ◽  
Bricia López-Plaza ◽  
Samara Palma-Milla ◽  
Natalia García-Vázquez ◽  
...  
Keyword(s):  
Parenteral Nutrition ◽  
Scientific Evidence ◽  
Hospital Setting ◽  
Nutritional Composition ◽  
Referral Hospital ◽  
Prescribing Patterns ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Prescribing Pattern ◽  
Carbohydrate To Lipid Ratio

Individualized parenteral nutrition is the most specialized type of nutritional support in the hospital setting. The composition and prescribing patterns for parenteral nutrition have evolved due to new emerging scientific evidence. In the last few years, there has been a tendency to increase the nitrogen and lipid content and decrease the carbohydrate content. To assess the prescribing pattern in a tertiary referral hospital in Spain, the nutritional composition of individualized parenteral nutrition was evaluated retrospectively from January to December of 2016. A total of 3029 parenteral nutrition units were analysed, corresponding to 257 hospitalized adult patients. Medical specialists in General Surgery and Haematology were the most common petitioners. The three most frequently prescribed parenteral nutrition formulae contained 13.4 (28.8%), 15.7 (19.54%) and 17.9 (17.79%) g of nitrogen. The quantity of carbohydrates and lipids showed a mean non-protein calories-to-nitrogen ratio of approximately 78:1 and a carbohydrate-to-lipid ratio that was near 50:50 in most cases. These results suggest a trend towards the administration of parenteral nutrition with a high content of nitrogen and smaller proportion of the non-protein components.

scholarly journals Occurrence of Acquired 16S rRNA Methyltransferase-Mediated Aminoglycoside Resistance in Clinical Isolates of Enterobacteriaceae within a Tertiary Referral Hospital of Northeast India

2017 ◽  
Vol 61 (6) ◽  
Author(s):  
Jayalaxmi Wangkheimayum ◽  
Deepjyoti Paul ◽  
Debadatta Dhar ◽  
Rajlakshmi Nepram ◽  
Shiela Chetri ◽  
...  
Keyword(s):  
16S Rrna ◽  
Hospital Setting ◽  
Referral Hospital ◽  
Clinical Isolates ◽  
Tertiary Referral ◽  
Pcr Assay ◽  
Tertiary Referral Hospital ◽  
Aminoglycoside Resistance ◽  
Content Type ◽  
Resistance Determinants

ABSTRACT The methylation of a ribosomal target leads to a high level of resistance to all clinically relevant aminoglycoside antibiotics, so early detection of these resistance determinants will help to reduce the incidence of treatment failures as well as lessen the dissemination rate. Here, we characterized different 16S rRNA methyltransferases responsible for aminoglycoside resistance and their epidemiological background in clinical isolates of Enterobacteriaceae in a tertiary referral hospital in India. All aminoglycoside-resistant isolates were screened for different 16S rRNA methyltransferases by PCR assay, and incompatibility typing of the conjugable plasmid harboring resistance genes was performed by PCR-based replicon typing. An assay for the stability and elimination of these resistance plasmids was performed. The coexistence of extended-spectrum β-lactamases and metallo-β-lactamases was also detected, and the heterogeneity of these isolates was determined by enterobacterial repetitive intergenic consensus PCR. The PCR assay revealed the presence of armA, rmtA, rmtB, rmtC, and rmtD in single and multiple combinations, and these were carried by a diverse group of Inc plasmids. Plasmids harboring these resistance determinants were highly stable and maintained until the 55th serial passage, but SDS treatment could easily eliminate the plasmids harboring the resistance determinants. The coexistence of bla TEM, bla PER, bla GES, and bla SHV, as well as bla VIM and bla NDM, within these isolates was also detected. Strains with different clonal patterns of aminoglycoside resistance were found to spread in this hospital setting. We observed that the 16S rRNA methyltransferase genes were encoded within different Inc plasmid types, suggesting diverse origins and sources of acquisition. Therefore, the present study is of epidemiological importance and can have a role in infection control policy in hospital settings.

Micafungin use in a UK tertiary referral hospital

2018 ◽  
Vol 15 ◽  
pp. 82-87 ◽  
Author(s):  
David A. Enoch ◽  
Michael E. Murphy ◽  
Christianne Micallef ◽  
Huina Yang ◽  
Nicholas M. Brown ◽  
...  
Keyword(s):  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

scholarly journals Mortality in children with COVID-19: Lessons learned from a tertiary referral hospital in Indonesia

2021 ◽  
Author(s):  
Rismala Dewi ◽  
Nastiti Kaswandani ◽  
Mulya Rahma Karyanti ◽  
Darmawan Budi Setyant ◽  
Antonius Hocky Pudjiadi ◽  
...  
Keyword(s):  
Lessons Learned ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital

scholarly journals Carbapenemase screening in an Irish tertiary referral hospital: Best practice, or can we do better?

2020 ◽  
Vol 2 (4) ◽  
pp. 100100
Author(s):  
S. Fahy ◽  
J.A. O'Connor ◽  
D. O'Brien ◽  
L. Fitzpatrick ◽  
M. O'Connor ◽  
...  
Keyword(s):  
Best Practice ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital
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