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The Laryngoscope Aug 2015The purpose of this systematic review was to critically analyze infectious complications and treatment following transcartilaginous ear piercing. (Review)
Review
OBJECTIVES/HYPOTHESIS
The purpose of this systematic review was to critically analyze infectious complications and treatment following transcartilaginous ear piercing.
DATA SOURCES
MEDLINE Pubmed database.
REVIEW METHODS
A MEDLINE PubMed database search using free text, including "ear chondritis," "ear perichondritis," "ear cartilage piercing," and "auricle piercing," yielded 483 titles. Based on set inclusion and exclusion criteria, the titles, abstracts, and full text articles were reviewed for inclusion and underwent data extraction. Pooled outcomes are reported.
RESULTS
A total of 29 articles met inclusion criteria, including 66 patients. The mean age of the patients was 18.7 ± 7.6 years (range: 11-49), 87.5% female. Ear deformity was more likely to occur following postpiercing perichondritis of the scapha 100% versus the helix 43% (P = 0.003). Mean duration of symptoms prior to patients seeking medical attention was 6.1 ± 4.1 days. Greater than 5 days of symptoms prior to seeking treatment was significantly more likely to result in hospitalization. Pseudomonas aeruginosa accounted for 87.2% infections. Of the patients with Pseudomonas, 92.3% were hospitalized versus 75% of the patients infected with Staphylococcus aureus. Initial oral antibiotics prescribed did not target the cultured bacterium in 53.3% of cases; of these, 87.5% were hospitalized.
CONCLUSIONS
Transcartilaginous postpiercing infection may lead to ear deformity and hospitalization. Patients (customers) and practitioners must be aware of optimal treatment strategies to minimize associated morbidity. Scapha piercing and delay in presentation are associated with poorer outcomes. Pseudomonas is the most common bacterial infection. Initial antibiotic selection must be optimized accordingly.
Topics: Body Piercing; Cartilage Diseases; Ear Cartilage; Humans; Surgical Wound Infection
PubMed: 25825232
DOI: 10.1002/lary.25238 -
Frontiers in Medicine 2023Carbapenem-resistant (CRE) and multidrug-resistant Pseudomonas aeruginosa (MDR-PA) infections are associated with a high risk of morbidity, mortality, and treatment...
, and clinical studies comparing the efficacy of ceftazidime-avibactam monotherapy with ceftazidime-avibactam-containing combination regimens against carbapenem-resistant and multidrug-resistant isolates or infections: a scoping review.
INTRODUCTION
Carbapenem-resistant (CRE) and multidrug-resistant Pseudomonas aeruginosa (MDR-PA) infections are associated with a high risk of morbidity, mortality, and treatment costs. We aimed to evaluate , and clinical studies comparing the efficacy of ceftazidime-avibactam (CZA) combination regimens with CZA alone against CRE and/or MDR-PA isolates or infections.
METHODS
We systematically reviewed the relevant literature in CINAHL/MEDLINE, Pubmed, Cochrane, Web of Science, Embase, and Scopus until December 1, 2022. Review articles, grey literature, abstracts, comments, editorials, non-peer reviewed articles, non-English articles, and in vitro synergy studies conducted on single isolates were excluded.
RESULTS
22 , 7 and 20 clinical studies were evaluated. studies showed reliable synergy between CZA and aztreonam against metallo-β-lactamase (MBL)-producing isolates. Some studies indicated good in vitro synergy between CZA and amikacin, meropenem, fosfomycin and polymyxins against CRE isolates. For MDR-PA isolates, there are comparatively fewer or studies. In observational clinical studies, mortality, clinical cure, adverse events, and development of CZA resistance after exposure were generally similar in monotherapy and combination therapy groups. However, antibiotic-related nephrotoxicity and infection relapses were higher in patients receiving CZA combination therapies.
DISCUSSION
The benefit, if any, of CZA combination regimens in MDR-PA infections is elusive, as very few clinical studies have included these infections. There is no currently documented clinical benefit for the use of CZA combination regimens rather than CZA monotherapy. CZA combined with aztreonam for serious infections due to MBL producers should be evaluated by randomized controlled trials.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=278552, CRD42021278552.
PubMed: 37727767
DOI: 10.3389/fmed.2023.1249030 -
Emerging Microbes & Infections Mar 2016Whether carbapenem resistance is associated with mortality in patients with Pseudomonas aeruginosa bacteremia is controversial. To address this issue, we conducted a... (Meta-Analysis)
Meta-Analysis Review
Whether carbapenem resistance is associated with mortality in patients with Pseudomonas aeruginosa bacteremia is controversial. To address this issue, we conducted a systematic review and meta-analysis based on cohort studies. We searched PubMed and Embase databases to identify articles (up to April 2015). The DerSimonian and Laird random-effect model was used to generate a summary estimate of effect. Associations were evaluated in subgroups based on different patient characteristics and study quality criteria. Seven studies with a total of 1613 patients were finally included, of which 1 study had a prospective design, and the other 6 were retrospective. Our meta-analysis showed patients with carbapenem-resistant P. aeruginosa bacteremia were at a higher risk of death compared with those with carbapenem-susceptible P. aeruginosa bloodstream infections (pooled odds ratio (OR) from three studies reporting adjusted ORs: 3.07, 95% confidence interval (CI), 1.60-5.89; pooled OR from 4 studies only reporting crude ORs: 1.46, 95% CI, 1.10-1.94). The results were robust across a number of stratified analyses and a sensitivity analysis. We also calculated that 8%-18.4% of deaths were attributable to carbapenem resistance in four studies assessing the outcome with 30-day mortality, and these were 3% and 14.6%, respectively, in two studies using 7-day mortality or mortality during bacteremia as an outcome of interest. Carbapenem resistance had a deleterious impact on the mortality of P. aeruginosa bacteremia; however, the results should be interpreted cautiously because only three studies reporting adjusted ORs were included. More large-scale, well-designed prospective cohorts, as well as mechanistic studies, are urgently needed in the future.
Topics: Anti-Bacterial Agents; Bacteremia; Carbapenems; Cohort Studies; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests; Odds Ratio; Prospective Studies; Pseudomonas Infections; Pseudomonas aeruginosa; Retrospective Studies; Risk Factors
PubMed: 27004762
DOI: 10.1038/emi.2016.22 -
Frontiers in Public Health 2022This systematic review describes the role of the human microbiome and microbiota in healthcare-associated infections (HAIs). Studies on the microbiota of patients,...
OBJECTIVE
This systematic review describes the role of the human microbiome and microbiota in healthcare-associated infections (HAIs). Studies on the microbiota of patients, healthcare environment (HE), medical equipment, or healthcare workers (HCW) and how it could be transmitted among the different subjects will be described in order to define alarming risk factors for HAIs spreading and to identify strategies for HAIs control or prevention.
METHODS
This review was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After retrieval in databases, identification, and screening of available records, 36 published studies were considered eligible and included in the review.
RESULTS
A multifaceted approach is required and the analyses of the many factors related to human microbiota, which can influence HAIs onset, could be of paramount importance in their prevention and control. In this review, we will focus mainly on the localization, transmission, and prevention of ESKAPE (, and ) bacteria and Clostridium difficile which are the most common pathogens causing HAIs.
CONCLUSIONS
Healthcare workers' microbiota, patient's microbiota, environmental and medical equipment microbiota, ecosystem characteristics, ways of transmission, cleaning strategies, and the microbial resistome should be taken into account for future studies on more effective preventive and therapeutic strategies against HAIs.
Topics: Humans; Cross Infection; Microbiota; Delivery of Health Care
PubMed: 36530685
DOI: 10.3389/fpubh.2022.989496 -
International Journal of Infectious... Feb 2024The objective of this systematic review and meta-analysis was to estimate the global prevalence of multi-drug resistant (MDR) Pseudomonas aeruginosa causing... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The objective of this systematic review and meta-analysis was to estimate the global prevalence of multi-drug resistant (MDR) Pseudomonas aeruginosa causing ventilator-associated pneumonia (VAP).
METHODS
The systematic search was conducted in four databases. Original studies describing MDR P. aeruginosa VAP prevalence in adults from 2012- 2022 were included. A meta-analysis, using the random effects model, was conducted for overall, subgroups (country, published year, study duration, and study design), and European data, respectively. Univariate meta-regression based on pooled estimates was also conducted. Systematic review registered in International Prospective Register of Systematic Review (CRD42022384035).
RESULTS
In total of 31 studies, containing a total of 7951 cases from 16 countries, were included. The overall pooled prevalence of MDR among P. aeruginosa causing VAP was 33% (95% confidence interval [CI] 27.7-38.3%). The highest prevalence was for Iran at 87.5% (95% CI 69-95.7%), and the lowest was for the USA at 19.7% (95% CI 18.6-20.7%). The European prevalence was 29.9% (95% CI 23.2-36.7%).
CONCLUSIONS
This review indicates that the prevalence of MDR P. aeruginosa in patients with VAP is generally high and varies significantly between countries; however, data are insufficient for many countries. The data in this study can provide a reference for VAP management and drug customisation strategies.
Topics: Adult; Humans; Anti-Bacterial Agents; Pneumonia, Ventilator-Associated; Prevalence; Pseudomonas aeruginosa; Pseudomonas Infections
PubMed: 38013153
DOI: 10.1016/j.ijid.2023.11.023 -
European Journal of Microbiology &... Jan 2023This review aimed to evaluate the contamination rate of dental unit waterlines (DUWL) with Pseudomonas aeruginosa and Legionella pneumophila in several countries in the... (Review)
Review
This review aimed to evaluate the contamination rate of dental unit waterlines (DUWL) with Pseudomonas aeruginosa and Legionella pneumophila in several countries in the Middle East.Literature search was conducted in databases such as PubMed, Scopus, Web of Science, and Google Scholar to gather studies published from the beginning of 2000 to 30th April 2020. Medical Subject Headings (MeSH) terms were; "Legionellosis"; "Legionnaire", "Legionellosis", "L. pneumophila", "dent", "dental", "dentistry", "Dental Unit Waterlines", "dental water", "DUWL", "Middle East", "P. aeruginosa", "Iran", "Turkey", "Iraq", and "Jordan". The search was independently conducted by two of the authors. Data was analyzed using Comprehensive Meta-Analysis software.Almost all studies included in this review reported a high rate of bacterial contamination of DUWL, which exceeded the current standard bacterial contamination level of <200 (CFU) mL-1 recommended by the American Dental Association (ADA). The combined prevalence of L. pneumophila from four countries (Iran, Jordan, Turkey, and Iraq) was 23.5% (95% Cl: 6.5-57.7), and the combined prevalence of P. aeruginosa was reported 21.7% (95% Cl: 7.1-50.1%).This study showed a high bacterial contamination rate of DUWL with opportunistic pathogens. So, it is recommended to prevent biofilm formation in DUWL, some measures should be extended by practical approaches allowing for water quality control and improvement on-site in the dental practices such as mobile filtration units, chlorination and disinfection chemicals.
PubMed: 36626121
DOI: 10.1556/1886.2022.00023 -
Le Infezioni in Medicina Mar 2020Biofilm formation is one of the important resistance mechanisms in Pseudomonas aeruginosa. This study aimed to consider the correlation between biofilm formation and... (Meta-Analysis)
Meta-Analysis
Biofilm formation is one of the important resistance mechanisms in Pseudomonas aeruginosa. This study aimed to consider the correlation between biofilm formation and antibiotic resistance in Pseudomonas aeruginosa through a systematic review and meta-analysis. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) strategies. Scientific databases were searched by MeSH terms and keywords such as "Pseudomonas aeruginosa", "biofilm formation", "antibiotic resistance", "prevalence" AND "Iran", to obtain articles published from 1st January 2016 to 30th November 2019. Studies recording biofilm formation and antibiotic resistance in P. aeruginosa recovered from clinical samples of Iranian patients were included. Data analysis was performed using CMA software. The combined biofilm formation rate was reported as 87.6 % (95% CI: 80-92.5). The heterogeneity index among the selected articles was Q2=96.5, I2=85.5, and t=0.26 (p=0.16). The pooled occurrences of strong, moderate and weak biofilms were 47.7% (95% CI: 28.7-67.3), 30.2% (95% CI: 19.4-43.8), and 27.4% (95% CI: 8.8-59.8), respectively. The pooled prevalence of MDR P. aeruginosa strains was as follows: 62.5% (95% CI: 40-77.2). The highest combined rates of antibiotic resistance were against ceftriaxone and tobramycin with the rates of 79.2.9% (95% CI: 54.2-96.2) and 64.4% (95% CI: 36.3-92), respectively. Also, the lowermost antibiotic resistance rates were against colistin and polymyxin B, with the prevalence of 2.1% (95% CI: 0.2-18.1), and 3% (95% CI: 0.5-17.3), respectively. More than half of the studies included in the present review showed a significant correlation between biofilm formation and antibiotic resistance pattern.
Topics: Anti-Bacterial Agents; Biofilms; Ceftriaxone; Colistin; Drug Resistance, Bacterial; Humans; Iran; Polymyxin B; Pseudomonas aeruginosa; Tobramycin
PubMed: 32172260
DOI: No ID Found -
Journal of Cystic Fibrosis : Official... Sep 2014A systematic literature review of the last 40 years on the research of serum antibodies to Pseudomonas aeruginosa in cystic fibrosis and its utility as a diagnostic tool. (Review)
Review
BACKGROUND
A systematic literature review of the last 40 years on the research of serum antibodies to Pseudomonas aeruginosa in cystic fibrosis and its utility as a diagnostic tool.
METHODS
Research papers in English, Portuguese, and Spanish were accessed through electronic databases (PubMed, Medline, LILACS, and SciELO).
RESULTS
26 studies were assessed. ELISA technique was the most commonly used technique to detect serum P. aeruginosa antibodies. The most consistent results were those in which the response against the antigen St-Ag:1-17 was evaluated. The accuracy levels of the ELISA technique remain controversial, but most studies showed a good correlation between antibody titers and microbiological culture.
CONCLUSIONS
The detection of serum antibodies to P. aeruginosa shows capacity for early detection of this pathogen and potential utility and viability of incorporation in the diagnostic routine of patients with cystic fibrosis.
Topics: Antibodies, Bacterial; Cystic Fibrosis; Enzyme-Linked Immunosorbent Assay; Humans; Pseudomonas Infections; Pseudomonas aeruginosa
PubMed: 24522086
DOI: 10.1016/j.jcf.2014.01.005 -
BMJ Open Respiratory Research Sep 2023Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of...
OBJECTIVE
Epidemiological information is essential in providing appropriate empiric antimicrobial therapy for pneumonia. This study aimed to clarify the epidemiology of community-acquired pneumonia (CAP) by conducting a systematic review of published studies in Japan.
DESIGN
Systematic review.
DATA SOURCE
PubMed and Ichushi web database (January 1970 to October 2022).
ELIGIBILITY CRITERIA
Clinical studies describing pathogenic micro-organisms in CAP written in English or Japanese, excluding studies on pneumonia other than adult CAP, investigations limited to specific pathogens and case reports.
DATA EXTRACTION AND SYNTHESIS
Patient setting (inpatient vs outpatient), number of patients, concordance with the CAP guidelines, diagnostic criteria and methods for diagnosing pneumonia pathogens as well as the numbers of each isolate. A meta-analysis of various situations was performed to measure the frequency of each aetiological agent.
RESULTS
Fifty-six studies were included and 17 095 cases of CAP were identified. Pathogens were undetectable in 44.1% (95% CI 39.7% to 48.5%). was the most common cause of CAP requiring hospitalisation or outpatient care (20.0% (95% CI 17.2% to 22.8%)), followed by (10.8% (95% CI 7.3% to 14.3%)) and (7.5% (95% CI 4.6% to 10.4%)). However, when limited to CAP requiring hospitalisation, was the third most common at 4.9% (95% CI 3.9% to 5.8%). was more frequent in hospitalised cases, while atypical pathogens were less common. Methicillin-resistant accounted for 40.7% (95% CI 29.0% to 52.4%) of cases. In studies that used PCR testing for pan-respiratory viral pathogens, human enterovirus/human rhinovirus (9.4% (95% CI 0% to 20.5%)) and several other respiratory pathogenic viruses were detected. The epidemiology varied depending on the methodology and situation.
CONCLUSION
The epidemiology of CAP varies depending on the situation, such as in the hospital versus outpatient setting. Viruses are more frequently detected by exhaustive genetic searches, resulting in a significant variation in epidemiology.
PubMed: 37751988
DOI: 10.1136/bmjresp-2023-001800 -
Euro Surveillance : Bulletin Europeen... May 2023BackgroundAntimicrobial resistance (AMR) is of public health concern worldwide.AimWe aimed to summarise the German AMR situation for clinicians and... (Meta-Analysis)
Meta-Analysis
BackgroundAntimicrobial resistance (AMR) is of public health concern worldwide.AimWe aimed to summarise the German AMR situation for clinicians and microbiologists.MethodsWe conducted a systematic review and meta-analysis of 60 published studies and data from the German (ARS). Primary outcomes were AMR proportions in bacterial isolates from infected patients in Germany (2016-2021) and the case fatality rates (2010-2021). Random and fixed (common) effect models were used to calculate pooled proportions and pooled case fatality odds ratios, respectively.ResultsThe pooled proportion of meticillin resistance in infections (MRSA) was 7.9% with a declining trend between 2014 and 2020 (odds ratio (OR) = 0.89; 95% CI: 0.886-0.891; p < 0.0001), while vancomycin resistance in (VRE) bloodstream infections increased (OR = 1.18; (95% CI: 1.16-1.21); p < 0.0001) with a pooled proportion of 34.9%. Case fatality rates for MRSA and VRE were higher than for their susceptible strains (OR = 2.29; 95% CI: 1.91-2.75 and 1.69; 95% CI: 1.22-2.33, respectively). Carbapenem resistance in Gram-negative pathogens (, , spp. and ) was low to moderate (< 9%), but resistance against third-generation cephalosporins and fluoroquinolones was moderate to high (5-25%). exhibited high resistance against carbapenems (17.0%; 95% CI: 11.9-22.8), third-generation cephalosporins (10.1%; 95% CI: 6.6-14.2) and fluoroquinolones (24.9%; 95% CI: 19.3-30.9). Statistical heterogeneity was high (I2 > 70%) across studies reporting resistance proportions.ConclusionContinuous efforts in AMR surveillance and infection prevention and control as well as antibiotic stewardship are needed to limit the spread of AMR in Germany.
Topics: Humans; Anti-Bacterial Agents; Drug Resistance, Bacterial; Microbial Sensitivity Tests; Methicillin-Resistant Staphylococcus aureus; Fluoroquinolones; Germany; Escherichia coli; Cephalosporins
PubMed: 37199987
DOI: 10.2807/1560-7917.ES.2023.28.20.2200672