Treatment outcomes of Acinetobacter baumannii-associated pneumonia and/or bacteraemia at the intensive care unit of Universitas Academic Hospital, Bloemfontein, South Africa

Maasdorp, S D; Potgieter, Samantha; Glover, E; Joubert, Gina

doi:10.7196/ajtccm.2021.v27i1.122

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Govender, Todd, Nel, et al [21], claim that candida is the primary cause of healthcare-associated BSIs in SA, with an estimated national incidence risk of 84 cases per 100,000 hospital admissions from 2016 to 2017 (95% CI 81-86). Interestingly, Nogbou, Phofa, Nchabeleng, Musyoki, et al [22,23] identified multidrug-resistant (MDR) Acinetobacter baumannii as a leading cause of HAIs in SA with high mortality rates.…”

Section: Literature Reviewmentioning

confidence: 99%

Case Study Protocol to Evaluate the Impact of Training Intervention on Cleaners’ Knowledge Level, Perceptions and Practices regarding Correct Cleaning Techniques at Selected Care Facilities in Limpopo Province, South Africa

Tshitangano

2024

Nursing Reports

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Despite being preventable, healthcare-associated infections are known primary causes of patient mortality and morbidity, threatening global public health. Though it is believed that one competent and dedicated cleaning staff member given the right tools and enough time can prevent more health-care-associated infectious diseases than a room full of doctors and nurses can cure, it was discovered in Letaba Hospital of the Limpopo Province, South Africa, that knowledge and practices of infection control among cleaning staff were not optimal. The proposed study aims to evaluate the impact of training interventions on cleaners’ knowledge levels and practices. In Phase 1, cleaners’ pre-training knowledge level, practices, and perceptions regarding correct cleaning techniques will be assessed through qualitative, individual, in-depth interviews. The initial question will read, “Describe the steps you follow when cleaning at this health facility and why?” In Phase 2a, a cleaning training program will be developed based on the South African Qualification Authority ID 118730 Healthcare Cleaner: Occupational Certificate Curriculum and the Center for Diseases Control and ICAN’s Best Practices for Environmental Cleaning in Healthcare Facilities in Resource-Limited Settings. In Phase 2b, a cleaning training intervention will be implemented. In Phase 3, cleaners’ post-training knowledge level, practices, and perceptions will be reassessed and compared to pre-training findings. The Standard Protocol Items: Recommendations for an Interventional Trial, commonly known as SPIRIT, guided the development of this protocol. This protocol received ethical clearance number FHS/22/PH/04/3005 in August 2023 from the University of Venda Human and Clinical Trials Research Ethics Committee. The protocol approval was granted by the Limpopo Provincial Department of Health (LP_2022-05-028) in October 2023. This protocol is registered with the South African National Clinical Trial Registry. The findings of this study may provide baseline data upon which healthcare facilities’ cleaner training qualification curriculum may be developed. In addition, this protocol contributes to the application of qualitative methodology in an intervention trial.

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Section: Literature Reviewmentioning

confidence: 99%

Case Study Protocol to Evaluate the Impact of Training Intervention on Cleaners’ Knowledge Level, Perceptions and Practices regarding Correct Cleaning Techniques at Selected Care Facilities in Limpopo Province, South Africa

Tshitangano

2024

Nursing Reports

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“…Maasdorp et al . [1] have shown that the combination of colistin and tigecycline is considerably more effective in treating Acinetobacter baumannii ( A. baumannii ) infection than colistin alone in a retrospective cross-sectional case series. The number of patients enrolled in the study was small (16 in total), but there was considerably better ICU survival in the colistin-tigecycline treatment group (77.8%) than the colistin only group (28.6%), with survival to hospital discharge being 55.6% and 28.6%, respectively.…”

Section: Editorialmentioning

confidence: 99%

Management of Acinetobacter baumannii infection in intensive care units

Raine

Dheda

2021

Afr J Thorac Crit Care Med

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Multidrug-resistant organisms (MDRO) are very common and troublesome accompaniments of treating patients in intensive care units. Invasive treatment modalities (endotracheal tubes, intravascular and urinary catheters, among others), broad-spectrum antibiotic use and comorbidities are major contributing factors to colonisation and infection. Treatment of MDRO is often very difficult. Maasdorp et al. [1] have shown that the combination of colistin and tigecycline is considerably more effective in treating Acinetobacter baumannii (A. baumannii) infection than colistin alone in a retrospective cross-sectional case series. The number of patients enrolled in the study was small (16 in total), but there was considerably better ICU survival in the colistin-tigecycline treatment group (77.8%) than the colistin only group (28.6%), with survival to hospital discharge being 55.6% and 28.6%, respectively. A. baumannii is an organism with apparent variable pathogenicity, implying that treatment is not always necessary. The distinction between colonisation (with no need for antibiotic treatment) and invasive infection is very important. This study excluded patients with colonisation on the basis of absence of fever and other markers of active infection. Ntusi et al. [2] reported on a cohort of patients admitted to the intensive care units at Groote Schuur Hospital and identified 38 patients out 251 (15.1%) with positive cultures for A. baumannii as having colonisation. Bloodstream infection was present in over 70% of patients who died in this cohort and was an independent predictor of mortality. [2] Other risk factors for mortality included age, HIV-reactivity, low CD4 count, and multiple organ dysfunction occurring after onset of A. baumannii infection. Bloodstream infection was present in 44% of the Maasdorp cohort, but there was no apparent association with mortality, though this might reflect the small sample size. The challenge, and one that exists with many infections, is to identify patients with colonisation v. disease. That A. baumannii can be associated with severe pneumonia in a community-based setting, [3] its association with poor prognostic markers that are clinically meaningful, and a clear response to treatment in some individuals suggest that ignoring this organism, when identified, is an unsatisfactory approach (and which has been adopted by some clinicians). The identification of biomarkers that portend disease rather than colonisation, in large prospective studies, is an urgent unmet need in the field. Antibiotic treatment of infection is important, but is only one component of the complete management of MDRO infection. Measures to prevent the development and spread of MDRO are essential given the limited availability of effective antibiotics, particularly in an era when carbapenem-resistant enterobacteriaceae are becoming a greater problem than A. baumannii. Measures to prevent the spread of MDRO were discussed in a previous editorial. [4] Infection prevention and control measures that are essential include...

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Treatment outcomes of Acinetobacter baumannii-associated pneumonia and/or bacteraemia at the intensive care unit of Universitas Academic Hospital, Bloemfontein, South Africa

Cited by 2 publications

References 15 publications

Case Study Protocol to Evaluate the Impact of Training Intervention on Cleaners’ Knowledge Level, Perceptions and Practices regarding Correct Cleaning Techniques at Selected Care Facilities in Limpopo Province, South Africa

Case Study Protocol to Evaluate the Impact of Training Intervention on Cleaners’ Knowledge Level, Perceptions and Practices regarding Correct Cleaning Techniques at Selected Care Facilities in Limpopo Province, South Africa

Management of Acinetobacter baumannii infection in intensive care units

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