Left-Sided Brain Injury Associated With More Hospital-Acquired Infections During Inpatient Rehabilitation

Abstract

Objective To test the hypothesis that a left-dominant brain immune network (LD-BIN) might affect the occurrence of infection during inpatient rehabilitation of stroke and traumatic brain injury (TBI). Design A retrospective analysis was performed on electronic medical records between January 2009 and December 2010. All patients with left-or right-sided stroke or TBI were included into the study. The LD-BIN hypothesis was tested by comparing HAI rates depending on whether patients had left- or right-sided brain lesions. Setting A large inpatient rehabilitation hospital. Participants Among the patients (N=2236) with stroke or TBI who had either a left- or right-sided brain lesion, 163 patients were identified with HAIs. Intervention Not applicable. Main Outcome Measure Frequency of HAIs. Results In the 163 patients identified with HAIs with a diagnosis of stroke or TBI, chi-square analysis revealed a significantly higher proportion of HAIs among patients with left-sided (n=98; 60.1%) relative to right-sided (n=65; 39.9%) brain injuries (χ2=6.68, P<.01). These effects could not be attributed to either clinical or demographic factors. Conclusions Our findings are consistent with the hypothesis that an LD-BIN may mediate vulnerability to infection during rehabilitation of patients with stroke or TBI. Further translational research investigating novel means of managing patients based on brain lesion location, and modulating the LD-BIN via behavioral and physiologic interventions, may result in neuroscience-based methods to improve infection resistance in brain-injured patients.

Crystal structure of 2-amino-4-(3-phenoxyphenyl)-5-oxo-5,6,7,8-tetrahydro-4H-chromene-3-carbonitrile, C22H18N2O3

“…Dihydropyran is one of the most commonly encountered heterocycles, which forms the important component of pharmacophores for a number of compounds having medicinal signi cance including anticancer, antiviral, antibacterial, antioxidant, anti-HIV, antihyperglycemic and anti-dyslipidemic activities [1][2][3][4][5]. Recognizing the considerable importance of the compounds, research focused on the synthesis of new dihydropyran derivatives.…”

Synthesis of Biscoumarin and Dihydropyran Derivatives and Evaluation of Their Antibacterial Activity

“…Few candidate drugs that offer benefits over existing drugs are available, and few drugs that will treat infections due to the so-called “ESKAPE” pathogens ( Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , and Enterobacter spp.) are being developed [3]. The need for newer, more effective treatment options for multidrug-resistant (MDR) pathogens induced the Infectious Diseases Society of America (IDSA) to launch the 10 × 20 initiative against a range of resistant “ESKAPE” pathogens including MRSA and to develop 10 new effective antimicrobial drugs to treat the infections caused by these pathogens by 2020 [4].…”

Synthesis, antibacterial activities, and theoretical studies of dicoumarols

“…Staphylococcus aureus (S. aureus) is a main pathogen responsible for a number of diseases ranging from skin and soft tissue infections to life-threatening endocarditis in hospitals and community settings. S. aureus infections are a leading cause of healthcare-associated infections and associated with in-hospital mortality as high as 15% to 60%, especially in critically ill patients [1][2][3] . Methicillin-resistant S. aureus (MRSA) is the cause of major outbreaks and epidemics in hospitalized patients because of the emergence, spread, and rapid evolution of resistance genes developing among pathogens.…”

“…S. aureus infections are a leading cause of healthcare-associated infections and are associated with in-hospital mortality as high as 15% to 60%, especially in critically ill patients. [1][2][3] Methicillin-resistant S. aureus (MRSA) is the cause of major outbreaks and epidemics in hospitalized patients because of the emergence, spread, and rapid evolution of resistant genes developing among pathogens. As such, the mortality and morbidity rates of patients affected by MRSA are high.…”