Impact of universal screening on MRSA bacteremias in a single acute NHS organisation (2006–12): interrupted time-series analysis

Sarma, Jogesh; Marshall, Bryan E.; Cleeve, V.; Tate, David F.; Oswald, T

doi:10.1186/2047-2994-2-2

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…Although the majority of isolates were staphylococci and streptococci species as in other studies, a falling number of isolated Staphylococcus aureus strains and an increase in Gram‐negative species, predominantly E. coli and Klebsiella pneumonia , in the absence of a change in anaerobic species have been demonstrated. These data may reflect the effectiveness of anti‐MRSA interventions across UK hospitals, which coincides with the study period [30, 31]. However, this pattern was also seen in patients presenting as an emergency from the community.…”

Section: Discussionmentioning

confidence: 69%

A 16‐year Longitudinal Cohort Study of Incidence and Bacteriology of Necrotising Fasciitis in England

et al. 2020

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Background Necrotising fasciitis (NF) is a rapidly progressive, destructive soft tissue infection with high mortality. The primary aim of this study was to evaluate the incidence and mortality of NF amongst patients admitted to English National Health Service (NHS) hospitals. The secondary aims included the identification of risk factors for mortality and causative pathogens. Methods The Hospital Episodes Statistics database identified patients with NF admitted to English NHS Trusts from 1/1/2002 to 31/12/2017. Information on patient demographics, co-morbid conditions, microbiology specimens, surgical intervention and in-hospital mortality was collected. Uni-and multivariable analyses were performed to investigate factors related to in-hospital mortality. Results A total of 11,042 patients were diagnosed with NF. Age-standardised incidence rose from 9 per million in 2002 to 21 per million in 2017 (annual percentage change = 6.9%). Incidence increased with age and was higher in men. Age-standardised mortality rate remained at 16% over the study period, while in-hospital mortality declined. On multivariable analysis, the following factors were associated with increased risk of in-hospital mortality: emergency admission, female sex, history of congestive heart failure, peripheral vascular disease, chronic kidney disease and cancer. Admission year and diabetes, which was significantly prevalent at 27%, were not associated with increased risk of mortality. Gram-positive pathogens, particularly Staphylococci, decreased over the study period with a corresponding increase in Gram-negative pathogens, predominantly E. coli. Conclusion The incidence of NF increased markedly from 2002 to 2017 although in-hospital mortality did not change. There was a gradual shift in the causative organisms from Gram-positive to Gram-negative.

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Section: Discussionmentioning

confidence: 69%

A 16‐year Longitudinal Cohort Study of Incidence and Bacteriology of Necrotising Fasciitis in England

et al. 2020

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“…During the animal experimental period, the chickens in the NC8-ChIL17B + IBV group displayed obvious improvements in growth compared to the NC8-P+IBV group. Although it is common sense that the probiotic effect of L. plantarum promotes growth performance by changing the microbial balance of the intestinal flora, the expression of cytokines such as IL-2, IL-4, IL-6 IFN-γ, and IL-22, which participate in the cytokine–endocrine hormone interaction network, affect the growth of epithelial cells in the digestive tract, improving digestion and metabolism [ 39 , 40 ]. Similar results were observed in our previous study, in that the fusion cytokine IL-4/6 promoted the growth performance of piglets [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

The Construction and Immunoadjuvant Activities of the Oral Interleukin-17B Expressed by Lactobacillus plantarum NC8 Strain in the Infectious Bronchitis Virus Vaccination of Chickens

et al. 2020

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Interleukin-17B (IL-17B) is a protective cytokine of the IL-17 family and plays an essential role in the regulation of mucosal inflammation. However, little is known about the role of IL-17B in the control of viral infections. In this study, a recombinant Lactobacillus plantarum, designated as NC8-ChIL17B, was constructed to express the chicken IL-17B (ChIL-17B) gene. The recombinant ChIL17B (rChIL17B) protein was about 14 kDa and was anchored to the surface of NC8 cells. In vitro, it was found that the rChIL17B protein inhibited the proliferation of the infectious bronchitis virus (IBV) through activation of nuclear factor kappa B (NF-κB) and the JAK (Janus kinase)-STAT (signal transducers and activators of transcription) signaling. Moreover, to evaluate the immunoadjuvant activities of NC8-ChIL17B, 40 three-day-old specific pathogen-free (SPF) chickens were divided into four groups. Three groups were orally vaccinated with fresh NC8, NC8-ChIL17B, and phosphate buffered saline (PBS), along with the infectious bronchitis virus vaccine, and the other group was the PBS-negative control. The results of the IBV-specific antibody titer and the concentration of the cytokines IL-2, IL-4, IL-6, and interferon gamma (IFN-γ) in sera, as well as the concentration of secretory immunoglobulin A (sIgA) in the tracheal and small intestinal mucosa, the number of cluster of differentiation 4 positive (CD4+) and cluster of differentiation 8 positive (CD8+) T cells in the blood, and the expression of immune-related genes all indicated that NC8-ChIL17B efficiently enhanced the humoral and cellular immune responses to IBV vaccine. Moreover, the viral loads in the NC8-ChIL17B- and IBV-vaccinated group were significantly lower than in the control groups, suggesting a significant promotion of the immunoprotection of IBV vaccination against the virulent IBV strain. Therefore, ChIL-17B is a promising, effective adjuvant candidate for chicken virus vaccines.

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“…Epidemiological surveillance of bacterial infection and resistance to antibiotics are essential for awareness creation, implementation of control measures and effective management of infections. This is important in developing countries particularly in sub-Saharan Africa where studies have indicated that many hospitals have rudimentary and poor enforcement of infection control measures and marginal awareness on the extent of infections caused by multi-drug resistant bacteria which have resulted in increased morbidity and mortality [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana

Agyepong

Govinden

Owusu-Ofori

et al. 2018

Antimicrob Resist Infect Control

111

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BackgroundMultidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana.To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana.MethodsBacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system. Patient information was retrieved from the hospital data.ResultsOf the 200 isolates, consisting of K. pneumoniae, A. baumannii, P. aeruginosa, Enterobacter spp., E. coli, Yersinia spp., Proteus mirabilis, Pasteurella spp., Chromobacterium violaceum, Salmomella enterica, Vibrio spp., Citrobacter koseri, Pantoea spp., Serratia spp., Providencia rettgeri Burkholderia cepacia, Aeromonas spp., Cadecea lapagei and Sphingomonas paucimobilis, 101 (50.5%) and 99 (49.5%) recovered from male and female patients respectively The largest proportion of patients were from age-group ≥60 years (24.5%) followed by < 10 years (24.0%) and least 10–19 years (9.5%) with a mean patient age of 35.95 ± 27.11 (0.2–91) years. The decreasing order of specimen source was urine 97 (48.5%), wound swabs 47 (23.5%), sputum 22 (11.0%) bronchial lavage, nasal and pleural swabs 1 (0.50%). Urinary tract infection was diagnosed in 34.5% of patients, sepsis in 14.5%, wound infections (surgical and chronic wounds) in 11.0%, pulmonary tuberculosis in 9.0% and appendicitis, bacteremia and cystitis in 0.50%. The isolates showed high resistance to ampicillin (94.4%), trimethoprim/sulfamethoxazole (84.5%), cefuroxime (79.0%) and cefotaxime (71.3%) but low resistance to ertapenem (1.5%), meropenem (3%) and amikacin (11%). The average multi-drug resistance was 89.5%, and ranged from 53.8% in Enterobacter spp. to 100.0% in Acinetobacter spp. and P. aeruginosa.ConclusionBacterial infections caused by multi-drug resistant (isolates resistant to at least one agent in three or more antibiotic classes) Gram-negative pathogens among patients at Komfo Anokye Teaching Hospital in Kumasi, Ghana are rife and interventions are necessary for their containment.

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Impact of universal screening on MRSA bacteremias in a single acute NHS organisation (2006–12): interrupted time-series analysis

Cited by 7 publications

References 16 publications

A 16‐year Longitudinal Cohort Study of Incidence and Bacteriology of Necrotising Fasciitis in England

A 16‐year Longitudinal Cohort Study of Incidence and Bacteriology of Necrotising Fasciitis in England

The Construction and Immunoadjuvant Activities of the Oral Interleukin-17B Expressed by Lactobacillus plantarum NC8 Strain in the Infectious Bronchitis Virus Vaccination of Chickens

Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana

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