-
Antibiotics (Basel, Switzerland) Feb 2023() is among the most common pathogens associated with healthcare-acquired infections, and is often antibiotic resistant, causing significant morbidity and mortality in... (Review)
Review
() is among the most common pathogens associated with healthcare-acquired infections, and is often antibiotic resistant, causing significant morbidity and mortality in cases of bacteremia. It remains unclear how the incidence of bacteremia changed during the Coronavirus Disease 2019 (COVID-19) pandemic, with studies showing almost contradictory conclusions despite enhanced infection control practices during the pandemic. This systematic review sought to examine published reports with incidence rates for bacteremia during (defined as from March 2020 onwards) and prior to the COVID-19 pandemic. A systematic literature search was conducted in accordance with PRISMA guidelines and performed in Cochrane, Embase, and Medline with combinations of the key words (pseudomonas aeruginosa OR PAE) AND (incidence OR surveillance), from database inception until 1 December 2022. Based on the pre-defined inclusion criteria, a total of eight studies were eligible for review. Prior to the pandemic, the prevalence of was on an uptrend. Several international reports found a slight increase in the incidence of bacteremia during the COVID-19 pandemic. These findings collectively highlight the continued importance of good infection prevention and control and antimicrobial stewardship during both pandemic and non-pandemic periods. It is important to implement effective infection prevention and control measures, including ensuring hand hygiene, stepping up environmental cleaning and disinfection efforts, and developing timely guidelines on the appropriate prescription of antibiotics.
PubMed: 36830319
DOI: 10.3390/antibiotics12020409 -
International Journal of Environmental... Dec 2022Mouthwashes are used as oral care for critical care patients to prevent infections. However, there are conflicting data concerning whether mouthwashes are needed as a... (Meta-Analysis)
Meta-Analysis
Mouthwashes are used as oral care for critical care patients to prevent infections. However, there are conflicting data concerning whether mouthwashes are needed as a part of daily oral care for critical care patients. This study aimed to evaluate the anti-inflammatory and anti-bacterial effects of mouthwashes for critical care patients. The PubMed, EMBASE, CENTRAL, and grey literature databases were searched by descriptors combining population (intensive care unit patients) and intervention (mouthwashes). After the screening, only randomized controlled trials (RCTs) evaluating the anti-inflammatory and anti-bacterial effects of mouthwashes in patient critical care were included. From the 1531 articles, 16 RCTs satisfied the eligibility criteria for systematic review and 10 were included in the meta-analyses. A significant difference was found in the incidence of ventilator associated pneumonia (VAP) (odds ratio [OR] 0.53, 95% confidential interval [95% CI] 0.33 to 0.86) between the mouthwash and placebo groups, while no significant difference was found in the mortality (OR 1.49, 95%CI 0.92 to 2.40); the duration of mechanical ventilation (weighted mean difference [WMD] -0.10, 95%CI -2.01 to 1.81); and the colonization of (OR 0.88, 95%CI 0.34 to 2.30), (OR 1.19, 95%CI 0.50 to 2.82), and (OR 1.16, 95%CI 0.27 to 4.91) between the two groups. In conclusion, mouthwashes were effective in decreasing the incidence of VAP. Thus, mouthwashes can be used as part of daily oral care for critical care patients.
Topics: Humans; Mouthwashes; Respiration, Artificial; Pneumonia, Ventilator-Associated; Intensive Care Units; Anti-Inflammatory Agents
PubMed: 36613055
DOI: 10.3390/ijerph20010733 -
Journal of Clinical Medicine Mar 2023Bacterial co-infections increase the severity of respiratory viral infections and are frequent causes of mortality in COVID-19 infected subjects. During the COVID-19... (Review)
Review
Bacterial co-infections increase the severity of respiratory viral infections and are frequent causes of mortality in COVID-19 infected subjects. During the COVID-19 period, especially at the beginning of the pandemic, an inappropriate use of broad-spectrum antibiotic treatments has been frequently described, mainly due to prolonged hospitalization, especially in intensive care unit departments, and the use of immune-suppressive treatments as steroids. This misuse has finally led to the occurrence of infections by multi-drug resistant (MDR) bacteria in hospitalized COVID-19 patients. Although different reports assessed the prevalence of Gram-negative infections in COVID-19 infected patients, scarce data are currently available on bloodstream infections caused by in hospitalized COVID-19 patients. The aim of our systematic review is to describe data on this specific population and to discuss the possible implications that these co-infections could have in the management of COVID-19 pandemics in the future. We systematically analysed the current literature to find all the relevant articles that describe the occurrence of bloodstream infections in COVID-19 patients. We found 40 papers that described in detail HAIs-BSI in COVID-19 patients, including 756,067 patients overall. The occurrence of severe infections due to MDR bacteria had a significant impact in the management of hospitalized patients with COVID-19 infections, leading to a prolonged time of hospitalization and to a consequent increase in mortality. In the near future, the increased burden of MDR bacteria due to the COVID-19 pandemic might partially be reduced by maintaining the preventive measures of infection control implemented during the acute phase of the COVID-19 pandemic. Finally, we discuss how the COVID-19 pandemic changed the role of antimicrobial stewardship in healthcare settings, according to the isolation of MDR bacteria and how to restore on a large scale the optimization of antibiotic strategies in COVID-19 patients.
PubMed: 36983256
DOI: 10.3390/jcm12062252 -
Journal of Clinical Medicine Apr 2021Cystic fibrosis (CF) is a rare, progressive, multi-organ genetic disease. Ivacaftor, a small-molecule CF transmembrane conductance regulator modulator, was the first... (Review)
Review
Cystic fibrosis (CF) is a rare, progressive, multi-organ genetic disease. Ivacaftor, a small-molecule CF transmembrane conductance regulator modulator, was the first medication to treat the underlying cause of CF. Since its approval, real-world clinical experience on the use of ivacaftor has been documented in large registries and smaller studies. Here, we systematically review data from real-world observational studies of ivacaftor treatment in people with CF (pwCF). Searches of MEDLINE and Embase identified 368 publications reporting real-world studies that enrolled six or more pwCF treated with ivacaftor published between January 2012 and September 2019. Overall, 75 publications providing data from 57 unique studies met inclusion criteria and were reviewed. Studies reporting within-group change for pwCF treated with ivacaftor consistently showed improvements in lung function, nutritional parameters, and patient-reported respiratory and sino-nasal symptoms. Benefits were evident as early as 1 month following ivacaftor initiation and were sustained over long-term follow-up. Decreases in pulmonary exacerbations, prevalence, and healthcare resource utilization also were reported for up to 66 months following ivacaftor initiation. In studies comparing ivacaftor treatment to modulator untreated comparator groups, clinical benefits similarly were reported as were decreases in mortality, organ-transplantation, and CF-related complications. The safety profile of ivacaftor observed in these real-world studies was consistent with the well-established safety profile based on clinical trial data. Our systematic review of real-world studies shows ivacaftor treatment in pwCF results in highly consistent and sustained clinical benefit in both pulmonary and non-pulmonary outcomes across various geographies, study designs, patient characteristics, and follow-up durations, confirming and expanding upon evidence from clinical trials.
PubMed: 33917386
DOI: 10.3390/jcm10071527 -
Archives of Gynecology and Obstetrics Sep 2022Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Globally, antimicrobial resistance (AMR) restricted the armamentarium of the health care providers against infectious diseases, mainly due to the emergence of multidrug resistant. This review is aimed at providing contemporary bacterial profile and antimicrobial resistance pattern among pregnant women with significant bacteriuria.
METHODS
Electronic biomedical databases and indexing services such as PubMed/MEDLINE, Web of Science, EMBASE and Google Scholar were searched. Original records of research articles, available online from 2008 to 2021, addressing the prevalence of significant bacteriuria and AMR pattern among pregnant women and written in English were identified and screened. The relevant data were extracted from included studies using a format prepared in Microsoft Excel and exported to STATA 14.0 software for the outcome measure analyses and subgrouping.
RESULTS
The data of 5894 urine samples from 20 included studies conducted in 8 regions of the country were pooled. The overall pooled estimate of bacteriuria was 15% (95% CI 13-17%, Iā=ā77.94%, pā<ā0.001) with substantial heterogeneity. The pooled estimate of Escherichia coli recovered from isolates of 896 urine samples was 41% (95% CI 38-45%) followed by coagulase-negative Staphylococci, 22% (95% CI 18-26%), Staphylococcus aureus, 15% (95% CI 12-18%), Staphylococcus saprophytic, 12% (95% CI 6-18%) Proteus mirabilis, 7% (95% CI 4-10%), Enterococcus species, 6% (0-12%), Pseudomonas aeruginosa, 4% (2-6%), Citrobacter species, 4% (95% CI 2-4%), Group B streptococcus, 3% (1-5%), and Enterobacter species, 2% (1-4%). Multidrug resistance proportions of E. coli, Klebsiella species, Staphylococcus aureus and Coagulase negative staphylococci, 83% (95% CI 76-91%), 78% (95% CI 66-90%), 89% (95% CI 83-96%), and 78% (95% CI 67-88%), respectively.
CONCLUSION
The result of current review revealed the occurrence of substantial bacteriuria among pregnant women in Ethiopia. Resistance among common bacteria (E. coli, Klebsiella species, Staphylococci species) causing UTIs in pregnant women is widespread to commonly used antibiotics. The high rate of drug resistance in turn warrants the need for regular epidemiological surveillance of antibiotic resistance and implementation of an efficient infection control and stewardship program.
Topics: Anti-Bacterial Agents; Bacteria; Bacteriuria; Coagulase; Drug Resistance, Bacterial; Escherichia coli; Ethiopia; Female; Humans; Microbial Sensitivity Tests; Pregnancy; Pregnant Women; Staphylococcal Infections; Staphylococcus aureus
PubMed: 35032208
DOI: 10.1007/s00404-021-06365-4 -
International Journal of Microbiology 2020The burden of bloodstream infections (BSIs) has been warranted in Ethiopia. Globally, the emergency and raised resistance rate of bacterial antimicrobial resistance is... (Review)
Review
INTRODUCTION
The burden of bloodstream infections (BSIs) has been warranted in Ethiopia. Globally, the emergency and raised resistance rate of bacterial antimicrobial resistance is becoming a prominent problem, and it is difficult to treat patients having sepsis. In this review, we aimed to determine the pooled prevalence of bacterial isolates among presumptive patients with bloodstream infections in Ethiopia.
METHODS
A systematic search was performed from PubMed/MEDLINE, Scopus, HINARI, ScienceDirect, and Google Scholar electronic databases using PRISMA guidelines. The data analysis was carried out using STATA version 14 after the records were cleaned and sorted out.
RESULTS
A total of 26 studies with 8,958 blood specimens and 2,382 culture-positive bacterial isolates were included for systematic review and meta-analysis. The meta-analysis derived a pooled culture-positive bacterial prevalence which was 25.78% (95% CI: 21.55-30.01%). The estimated pooled prevalence of Gram-positive and Gram-negative bacterial isolates was 15.50% (95% CI: 12.84-18.15%) and 10.48 % (95% CI: 8.32-12.63%), respectively. The two common Gram-positive bacteria isolated from patients suspected of BSIs were coagulase-negative with a pooled prevalence of 5.75% (95% CI: 4.58-6.92%) and 7.04 % (95% CI: 5.37-8.72%). Similarly, the common Gram-negative bacterial isolates and their estimated pooled prevalence were 1.69% (95% CI: 1.21-2.16%), species 7.04 % (95% CI: 5.37-8.72%), species 0.39% (95% CI: 0.08-0.70%), species 1.09% (95% CI: 0.79-1.38%), and 0.88% (95% CI: 0.54-1.22%).
CONCLUSION
The prevalence of bacterial isolates among presumptive patients suspected to BSIs in Ethiopia remains high. Furthermore, we found a remarkable variation in the pathogen distribution across the study setting.
PubMed: 32963541
DOI: 10.1155/2020/8853053 -
Frontiers in Microbiology 2024Legumes are renowned for their distinctive biological characteristic of forming symbiotic associations with soil bacteria, mostly belonging to the familiy, leading to... (Review)
Review
Legumes are renowned for their distinctive biological characteristic of forming symbiotic associations with soil bacteria, mostly belonging to the familiy, leading to the establishment of symbiotic root nodules. Within these nodules, rhizobia play a pivotal role in converting atmospheric nitrogen into a plant-assimilable form. However, it has been discerned that root nodules of legumes are not exclusively inhabited by rhizobia; non-rhizobial endophytic bacteria also reside within them, yet their functions remain incompletely elucidated. This comprehensive review synthesizes available data, revealing that and are the most prevalent genera of nodule endophytic bacteria, succeeded by , , , , and . To date, the bibliographic data available show that followed by and are the main hosts for nodule endophytic bacteria. Clustering analysis consistently supports the prevalence of and as the most abundant nodule endophytic bacteria, alongside , , and . Although non-rhizobial populations within nodules do not induce nodule formation, their presence is associated with various plant growth-promoting properties (PGPs). These properties are known to mediate important mechanisms such as phytostimulation, biofertilization, biocontrol, and stress tolerance, emphasizing the multifaceted roles of nodule endophytes. Importantly, interactions between non-rhizobia and rhizobia within nodules may exert influence on their leguminous host plants. This is particularly shown by co-inoculation of legumes with both types of bacteria, in which synergistic effects on plant growth, yield, and nodulation are often measured. Moreover these effects are pronounced under both stress and non-stress conditions, surpassing the impact of single inoculations with rhizobia alone.
PubMed: 38812696
DOI: 10.3389/fmicb.2024.1386742 -
SAGE Open Medicine 2022Antimicrobial resistance is one of the serious threats in the world, including Ethiopia. Even though several studies were conducted to estimate common bacteria and their... (Review)
Review
OBJECTIVE
Antimicrobial resistance is one of the serious threats in the world, including Ethiopia. Even though several studies were conducted to estimate common bacteria and their antibiotic-resistance profile in Ethiopia, it is difficult to estimate the overall resistant patterns due to the lack of a nationwide study. This systematic review aimed to determine the prevalence of gram-negative bacteria isolates and their antibiotic-resistance profile among pediatrics patients in Ethiopia.
METHODS
A web-based search using PubMed, EMBASE, Science Direct, the Cochrane Database for Systematic Reviews, Scopus, Hinari, Sci-Hub, African Journals Online Library, and free-text web searches using Google Scholar was conducted from August to September 16, 2021. Each of the original articles was searched by Boolean search technique using various keywords and was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The data were extracted using Microsoft Excel format and exported to STATA 14.0 for statistical analyses.
RESULTS
The database search delivered a total of 2,684 studies. After articles were removed by duplications, title, reading the abstract, and assessed for eligibility criteria, 19 articles were included in the systematic review. Of a total of 1372 (16.77%) culture-positive samples, 735 (53.57%) were gram-negative. was the most frequently isolated bacteria followed by species, 139/1372 (10.13%), and 125/1372(9.11%), respectively. More than 66.67% of isolates were resistant to ampicillin except for which was 32.35% (11/34). , species, and species were 100% resistance for cefepime. was 100% resistant to meropenem. were 93.30%, 78.26%, and 63.64% resistant to tetracycline, chloramphenicol, and cotrimoxazole, respectively.
CONCLUSION
Gram-negative bacteria were identified as the common pathogen causing infection in pediatrics and the level of resistance to commonly prescribed antibiotics was significantly higher in Ethiopia. Culture and susceptibility tests and well-designed infection control programs are important measures.
PubMed: 35509958
DOI: 10.1177/20503121221094191 -
Cancers May 2024We performed a systematic review of studies that compared beta-lactams vs. beta-lactams plus aminoglycosides for the treatment of febrile neutropenia in cancer patients. (Review)
Review
UNLABELLED
We performed a systematic review of studies that compared beta-lactams vs. beta-lactams plus aminoglycosides for the treatment of febrile neutropenia in cancer patients.
METHOD
We searched CENTRAL, MEDLINE, and Embase for studies published up to October 2023, and randomized controlled trials (RCTs) that compared anti-Pseudomonas aeruginosa beta-lactam monotherapy with any combination of an anti-Pseudomonas aeruginosa beta-lactam and an aminoglycoside were included.
RESULT
The all-cause mortality rate of combination therapy showed no significant differences compared with that of monotherapy (RR 0.99, 95% CI 0.84 to 1.16, high certainty of evidence). Infection-related mortality rates showed that combination therapy had a small positive impact compared with the intervention with monotherapy (RR 0.83, 95% CI 0.66 to 1.05, high certainty of evidence). Regarding treatment failure, combination therapy showed no significant differences compared with monotherapy (RR 0.99, 95% CI 0.94 to 1.03, low certainty of evidence). In the sensitivity analysis, the treatment failure data published between 2010 and 2019 showed better outcomes in the same beta-lactam group (RR 1.10 [95% CI, 1.01-1.19]). Renal failure was more frequent with combination therapy of any daily dosing regimen (RR 0.46, 95% CI 0.36 to 0.60, high certainty of evidence).
CONCLUSION
We found combining aminoglycosides with a narrow-spectrum beta-lactam did not spare the use of broad-spectrum antibiotics. Few studies included antibiotic-resistant bacteria and a detailed investigation of aminoglycoside serum levels, and studies that combined the same beta-lactams showed only a minimal impact with the combination therapy. In the future, studies that include the profile of antibiotic-resistant bacteria and the monitoring of serum aminoglycoside levels will be required.
PubMed: 38792012
DOI: 10.3390/cancers16101934 -
Journal of Clinical Medicine Jan 2024: Chronic obstructive pulmonary disease (COPD) is a major health concern. Acute exacerbations (AECOPD) may require intensive care unit (ICU) admission and mechanical... (Review)
Review
: Chronic obstructive pulmonary disease (COPD) is a major health concern. Acute exacerbations (AECOPD) may require intensive care unit (ICU) admission and mechanical ventilation. Acute infections and chronic colonization of the respiratory system are known to precipitate AECOPD. Detailed knowledge of the respiratory microbiome could lead to effective treatment and prevention of exacerbations. : The aim of this review is to summarize the available evidence on the respiratory microbiome of patients with a severe AECOPD requiring mechanical ventilation and intensive care admission. : A systematic literature search was conducted to identify the published papers until January 2023. The collected data were then subjected to qualitative analysis. After the first analysis, a secondary focused review of the most recent publications studying the relationship between microbiome and mortality in AECOPD was performed. : Out of 120 screened articles six articles were included in this review. Potentially pathogenic microorganisms (PPMs) were identified in 30% to 72% of the patients with community-acquired bacteria, gram-negative enteric bacilli, and being the most frequently isolated. During hospitalization, 21% of patients experienced colonization by PPMs. Adequate antimicrobial therapy resulted in the eradication of 77% of the identified PPMs. However, 24% of the bacteria displayed multi-drug resistance leading to prolonged or failure of eradication. : PPMs are prevalent in a significant proportion of patients experiencing an AECOPD. The most identified PPMs include community-acquired pathogens and gram-negative enteric bacilli. Notably, no differences in mortality or duration of ventilation were observed between patients with and without isolated PPMs. However, the included studies did not investigate the virome of the patients, which may influence the microbiome and the outcome of infection. Therefore, further research is essential to comprehensively investigate the complete microbial and viral composition of the lower respiratory system in COPD patients admitted to the ICU.
PubMed: 38256606
DOI: 10.3390/jcm13020472