Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide h...Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.展开更多
BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients...BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients.VAP incidence showed wide variability between countries.AIM To define the VAP incidence in the intensive care unit(ICU)in the central gove-rnment hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility pattern.METHODS The research was a prospective cross-sectional observational study over six months from November 2019 to June 2020.It included adult and adolescent patients(>14 years old)admitted to the ICU and required intubation and mechanical ventilation.VAP was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score,which considers the clinical,laboratory,microbiological,and radiographic evidence.RESULTS The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was 155.Forty-six patients developed VAP during their ICU stay(29.7%).The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period,with a mean age of 52 years±20.Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96±6.55.Gram-negative contributed to most VAP cases in our unit,with multidrug-resistant Acinetobacter being the most identified pathogen.CONCLUSION The reported VAP rate in our ICU was relatively high compared to the international benchmark,which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle.展开更多
Granulicatella adiacens (G. adiacens), formerly classified as a nutritionally variant streptococci (NVS), is a commensal organism in the mouth. It is known to be a rare cause of infective endocarditis (IE). This case ...Granulicatella adiacens (G. adiacens), formerly classified as a nutritionally variant streptococci (NVS), is a commensal organism in the mouth. It is known to be a rare cause of infective endocarditis (IE). This case report presents a case of IE caused by G. adiacens in a 63-year-old man with mitral valve prolapse (MVP), severe mitral regurgitation (MR), and dual vessel disease (DVD). G. adiacens was isolated from two of three blood cultures, and the organism was sensitive to penicillin, vancomycin, cefotaxime, and gentamicin. He was successfully treated with a combination of ceftriaxone and gentamicin. Prompt identification of the organism and determination of antibiotic sensitivity pattern led to successful treatment. This case report showcases the challenges in diagnosis, and treatment, giving insight to healthcare providers on a rare entity.展开更多
Objective:To assess multidrug resistant(MDR)Escherichia coli(E.coli)isolates from patients with urinary tract infection.Methods:From February to June 2014,a cross sectional study was conducted among urinary tract infe...Objective:To assess multidrug resistant(MDR)Escherichia coli(E.coli)isolates from patients with urinary tract infection.Methods:From February to June 2014,a cross sectional study was conducted among urinary tract infection patients at the University of Gondar Hospital.Culture and disk diffusion method were used for E.coli isolation and to determine the antibiotic susceptibility patterns.Data were entered and analyzed using SPSS version 20.P<0.05 was considered as statistically significant.Results:A total of 112 E.coli isolates were identified and the rate of isolation was higher among female participants(28.7%;P=0.03).Of the isolates,104(92.9%)were MDR E.coli;and the isolates showed high resistance rates towards ampicillin(99%),cotrimoxazole(69%),chloramphenicol(58.7%),gentamycin(56.7%)and ceftazidime(55.8%).However,comparative isolates showed low resistance rates to ciprofloxacin(1%),cefepime(8.7%),and ceftriaxone(11.5%).Moreover,resistance rates of MDR E.coli isolates were significantly higher than non-MDR strains for ceftazidime(55.8%versus 12.5%;P=0.015),and ampicillin(99%versus 87.5%;P=0.018).Conclusions:High prevalence of MDR E.coli isolates was observed in this study.Regular monitoring of antibiotic resistance rates is necessarily required to improve and revise empirical antibiotic therapy protocols.展开更多
文摘Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.
文摘BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients.VAP incidence showed wide variability between countries.AIM To define the VAP incidence in the intensive care unit(ICU)in the central gove-rnment hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility pattern.METHODS The research was a prospective cross-sectional observational study over six months from November 2019 to June 2020.It included adult and adolescent patients(>14 years old)admitted to the ICU and required intubation and mechanical ventilation.VAP was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score,which considers the clinical,laboratory,microbiological,and radiographic evidence.RESULTS The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was 155.Forty-six patients developed VAP during their ICU stay(29.7%).The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period,with a mean age of 52 years±20.Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96±6.55.Gram-negative contributed to most VAP cases in our unit,with multidrug-resistant Acinetobacter being the most identified pathogen.CONCLUSION The reported VAP rate in our ICU was relatively high compared to the international benchmark,which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle.
文摘Granulicatella adiacens (G. adiacens), formerly classified as a nutritionally variant streptococci (NVS), is a commensal organism in the mouth. It is known to be a rare cause of infective endocarditis (IE). This case report presents a case of IE caused by G. adiacens in a 63-year-old man with mitral valve prolapse (MVP), severe mitral regurgitation (MR), and dual vessel disease (DVD). G. adiacens was isolated from two of three blood cultures, and the organism was sensitive to penicillin, vancomycin, cefotaxime, and gentamicin. He was successfully treated with a combination of ceftriaxone and gentamicin. Prompt identification of the organism and determination of antibiotic sensitivity pattern led to successful treatment. This case report showcases the challenges in diagnosis, and treatment, giving insight to healthcare providers on a rare entity.
文摘Objective:To assess multidrug resistant(MDR)Escherichia coli(E.coli)isolates from patients with urinary tract infection.Methods:From February to June 2014,a cross sectional study was conducted among urinary tract infection patients at the University of Gondar Hospital.Culture and disk diffusion method were used for E.coli isolation and to determine the antibiotic susceptibility patterns.Data were entered and analyzed using SPSS version 20.P<0.05 was considered as statistically significant.Results:A total of 112 E.coli isolates were identified and the rate of isolation was higher among female participants(28.7%;P=0.03).Of the isolates,104(92.9%)were MDR E.coli;and the isolates showed high resistance rates towards ampicillin(99%),cotrimoxazole(69%),chloramphenicol(58.7%),gentamycin(56.7%)and ceftazidime(55.8%).However,comparative isolates showed low resistance rates to ciprofloxacin(1%),cefepime(8.7%),and ceftriaxone(11.5%).Moreover,resistance rates of MDR E.coli isolates were significantly higher than non-MDR strains for ceftazidime(55.8%versus 12.5%;P=0.015),and ampicillin(99%versus 87.5%;P=0.018).Conclusions:High prevalence of MDR E.coli isolates was observed in this study.Regular monitoring of antibiotic resistance rates is necessarily required to improve and revise empirical antibiotic therapy protocols.
