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Al‐Harthi F, Al‐Noumani H, Matua GA, Al‐Abri H, Joseph A. Nurses' compliance to ventilator-associated pneumonia prevention bundle and its effect on patient outcomes in intensive care units. Nurs Crit Care 2025; 30:e70043. [PMID: 40276934 PMCID: PMC12022936 DOI: 10.1111/nicc.70043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2024] [Revised: 03/13/2025] [Accepted: 03/25/2025] [Indexed: 04/26/2025]
Abstract
BACKGROUND Ventilator-associated pneumonia (VAP) is a significant healthcare-associated infection. Compliance with VAP guidelines reduces infection and leads to better patient outcomes. AIM The study investigated the VAP rate, nurses' compliance with the VAP bundle and the correlation between nurses' compliance with the VAP bundle and key patient-related outcomes. STUDY DESIGN This descriptive correlational prospective study was conducted at two tertiary hospitals. All intensive care unit patients on mechanical ventilators who met the inclusion criteria for 48 h or more were recruited. Data were analysed using descriptive statistics, Chi-square, independent t-test and Spearman's rank correlation. RESULTS Out of the 103 patients recruited, 22.3% of patients developed VAP, with a VAP rate of 5.6 per thousand ventilator days. Nurses' compliance with VAP guidelines in both hospitals was 69% and decreased over the admission period. Compliance with the VAP bundle was linked to less length of stay (rho = -0.260, p < .008), fewer mechanical ventilation days (rho = -0.300, p < .002) and less hospital cost (rho = -0.266, p < .007). The mean compliance with the VAP care bundle was higher in the non-VAP group (M = 72.9, SD = 23.79) than in patients who developed VAP (M = 56.6, SD = 18.96). CONCLUSIONS The findings underscore the critical need for healthcare organizations to prioritize strategies to enhance compliance with VAP guidelines for improved patient outcomes. RELEVANCE TO CLINICAL PRACTICE Ongoing quality improvement efforts through regular audits of the VAP bundle implementation are crucial for reducing infections and complications and improving patient outcomes. Future research is recommended to investigate factors that impact nurses' adherence to VAP guidelines to develop interventions to enhance compliance.
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Affiliation(s)
- Fatma Al‐Harthi
- Sultan Qaboos University, College of NursingMuscatOman
- University Medical CityMuscatOman
| | | | | | | | - Annie Joseph
- Sultan Qaboos University, College of NursingMuscatOman
- University Medical CityMuscatOman
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2
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Vladimirov S, Klimenko I, Matiushkov N, Protsenko D, Sergeev D. Incidence and clinical outcomes of ventilator-associated events in Russian tertiary care settings: an analysis of electronic health records. BMC Res Notes 2025; 18:172. [PMID: 40234949 PMCID: PMC12001673 DOI: 10.1186/s13104-025-07240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2025] [Accepted: 04/03/2025] [Indexed: 04/17/2025] Open
Abstract
OBJECTIVE This research aimed to evaluate the epidemiological and clinical characteristics of ventilator-associated events (VAE) using the CDC framework in a tertiary hospital in Moscow, Russia. RESULTS In this cohort study, we analyzed electronic health records from 407 mechanically ventilated adults who were admitted to the Kommunarka Moscow Multipurpose Clinical Center between September 2022 and December 2023. We identified a total of 35 VAE, resulting in an incidence rate of 8.39 (95% confidence interval, 5.84 to 11.67) events per 1,000 ventilator-days. The presence of VAE was associated with higher ICU mortality by day 30 from the start of mechanical ventilation (adjusted hazard ratio, 1.58; 95% confidence interval, 1.01 to 2.48), particularly in patients with infection-related ventilator-associated complications (adjusted hazard ratio, 2.09; 95% confidence interval, 1.17 to 3.74). The median durations of mechanical ventilation and ICU length of stay were comparable between patients with VAE and those without. Implementing surveillance measures and developing tailored preventive strategies for VAE may be beneficial in similar healthcare settings to improve outcomes for mechanically ventilated patients.
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Affiliation(s)
- Sergei Vladimirov
- Saint Petersburg Information Technologies, Mechanics and Optics University (ITMO) University, Kronverkskiy prospekt, 49, St, Petersburg, 197101, Russia.
- Kommunarka Moscow Multi-Purpose Clinical Center, Sosensky Stan Street, bldg 8, Moscow, 108814, Russia.
| | - Ilia Klimenko
- Kommunarka Moscow Multi-Purpose Clinical Center, Sosensky Stan Street, bldg 8, Moscow, 108814, Russia
| | - Nikita Matiushkov
- Kommunarka Moscow Multi-Purpose Clinical Center, Sosensky Stan Street, bldg 8, Moscow, 108814, Russia
- Pirogov Russian National Research Medical University, Ostrovityanova ulitsa,1 bldg. 6, Moscow, 117513, Russia
| | - Denis Protsenko
- Kommunarka Moscow Multi-Purpose Clinical Center, Sosensky Stan Street, bldg 8, Moscow, 108814, Russia
- Pirogov Russian National Research Medical University, Ostrovityanova ulitsa,1 bldg. 6, Moscow, 117513, Russia
| | - Dmitry Sergeev
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
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Fei Y, Hao Z, Zheng X, Ji X, Zhao W. Microbiological and clinical predictors of sepsis-associated encephalopathy in bloodstream infections: a retrospective cohort study. Front Cell Infect Microbiol 2025; 15:1548370. [PMID: 40125514 PMCID: PMC11925888 DOI: 10.3389/fcimb.2025.1548370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Accepted: 02/14/2025] [Indexed: 03/25/2025] Open
Abstract
Background Sepsis-associated encephalopathy (SAE) is a common and severe complication of sepsis, significantly contributing to morbidity and mortality. The impact of specific blood-borne pathogens on SAE risk and prognosis remains unclear. This study investigates the microbiological and clinical factors associated with bloodstream infection-induced SAE. Methods We analyzed data from the MIMIC-IV database, including 16,141 sepsis patients who met inclusion criteria. Patients were divided into SAE and non-SAE groups for comparison. Multivariate regression identified independent risk factors for SAE and associated outcomes, including in-hospital mortality. Results Coagulase-negative staphylococci (CoNS) was identified as a key microbial risk factor for SAE (HR=1.919, P<0.001), though it was not associated with in-hospital mortality. Higher SOFA scores, mechanical ventilation, and prolonged antibiotic use significantly increased SAE risk. Laboratory tests revealed higher white blood cell counts, platelet levels, and metabolic abnormalities in SAE patients. Methicillin-resistant Staphylococcus aureus (MRSA) was linked to increased mortality in SAE patients (HR=3.423, P<0.001). Conclusion Coagulase-negative staphylococci is a significant risk factor for SAE development, but not for mortality. Advanced age, female gender, higher SOFA scores, and mechanical ventilation further contribute to SAE risk. Early identification and targeted management of pathogens, particularly methicillin-resistant Staphylococcus aureus, are crucial for improving SAE outcomes.
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Affiliation(s)
| | | | | | - Xiang Ji
- Department of Emergency, Tianjin Huanhu Hospital, Tianjin, China
| | - Wenjuan Zhao
- Department of Emergency, Tianjin Huanhu Hospital, Tianjin, China
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Hlinkova S, Moraucikova E, Strzelecka A, Mrazova M, Littva V. Ventilator-Associated Pneumonia in Intensive Care Units: A Comparison of Pre-Pandemic and COVID-19 Periods. J Clin Med 2025; 14:1000. [PMID: 39941669 PMCID: PMC11818295 DOI: 10.3390/jcm14031000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2024] [Revised: 01/08/2025] [Accepted: 02/01/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: The COVID-19 pandemic has significantly increased the burden of ventilator-associated pneumonia (VAP) in intensive care units (ICUs) globally. However, epidemiological data on VAP in Slovak ICUs, particularly in the context of the pandemic, remain limited. This study aimed to evaluate the incidence, microbial profiles, and risk factors of VAP in Slovak ICU settings, particularly during the COVID-19 pandemic. Methods: A retrospective analysis of VAP data was conducted for respiratory intensive care unit (ICU) patients in a Slovak university hospital, comparing data from the pre-pandemic and pandemic periods. The CDC/NHSN definitions for VAP were applied, and statistical analyses were performed using STATISTICA 13.1. Results: A total of 803 patients were analyzed, representing 8385 bed days and 5836 mechanical ventilator days. VAP rates increased significantly during the pandemic by 111%, from 8.46 to 17.86 events per 1000 MV days (p < 0.001). VAP rates in non-COVID-19 patients increased by 86% during the pandemic compared to pre-pandemic levels. Pandemic conditions also increased ICU mortality from 25.66% to 40.52% (p < 0.001). VAP was identified as a critical determinant of ICU mortality, contributing to a 21.62% higher mortality rate among patients during the pandemic. Younger age, prolonged mechanical ventilation, and medical (vs. surgical) hospitalizations were associated with higher VAP incidence. Gram-negative bacteria dominated the pathogen profiles, with significant increases observed in Pseudomonas aeruginosa (183%), Klebsiella pneumoniae (150%), and Acinetobacter spp. (100%). Conclusions: The COVID-19 pandemic has significantly affected the incidence and epidemiology of VAP in Slovak ICUs, highlighting systemic vulnerabilities in HAI surveillance and IPC practices.
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Affiliation(s)
- Sona Hlinkova
- Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia; (E.M.); (V.L.)
- Central Military Hospital SNP Ružomberok FN, ul. Gen. Miloša Vesela 21, 034 26 Ružomberok, Slovakia
| | - Eva Moraucikova
- Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia; (E.M.); (V.L.)
- Faculty of Humanities, Tomas Bata University in Zlin, Štefánikova 5670, 760 01 Zlín, Czech Republic
| | - Agnieszka Strzelecka
- Faculty of Health Sciences, Collegium Medicum, Jan Kochanowski University in Kielce, Al. IX Wieków Kielc 19A, 25-317 Kielce, Poland;
| | - Mariana Mrazova
- Institute for Healthcare Disciplines, St.Elisabeth University in Bratislava, Námestie 1. Mája 1, 810 01 Bratislava, Slovakia;
| | - Vladimir Littva
- Faculty of Health, Catholic University in Ružomberok, Námestie Andreja Hlinku 48, 034 01 Ružomberok, Slovakia; (E.M.); (V.L.)
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Rosenthal VD, Memish ZA, Bearman G. Preventing ventilator-associated pneumonia: A position paper of the International Society for Infectious Diseases, 2024 update. Int J Infect Dis 2025; 151:107305. [PMID: 39551087 DOI: 10.1016/j.ijid.2024.107305] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 11/11/2024] [Accepted: 11/12/2024] [Indexed: 11/19/2024] Open
Abstract
OBJECTIVES This review by a panel of experts convened by the International Society for Infectious Diseases aims to consolidate current recommendations for preventing ventilator-associated pneumonia (VAP). It provides insights into VAP rates, the attributable extra length of stay, costs, mortality, and risk factors in high-income and low- and middle-income countries (LMICs). METHODS A comprehensive review of existing recommendations and evidence-based strategies for preventing VAP was conducted. The expert panel analyzed data on VAP incidence, associated healthcare burdens, and risk factors across different economic settings to formulate applicable preventive measures. RESULTS The review identifies significant differences in VAP rates, healthcare costs, extra length of hospital stay, and mortality between high-income and LMICs. Evidence-based strategies for preventing VAP were highlighted, demonstrating their effectiveness across different healthcare settings. CONCLUSION The recommendations and insights provided in this position paper aim to guide healthcare professionals in effectively preventing VAP. The adoption of evidence-based preventive strategies can potentially reduce VAP rates, and associated costs, and improve patient outcomes in both high-income and LMICs.
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Affiliation(s)
- Victor Daniel Rosenthal
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; International Nosocomial Infection Control Consortium, Miami, FL, USA; International Society for Infectious Diseases, Boston, MA, USA.
| | - Ziad A Memish
- International Society for Infectious Diseases, Boston, MA, USA; Research and Innovation Center, King Saud Medical City, Riyadh, Saudi Arabia
| | - Gonzalo Bearman
- International Society for Infectious Diseases, Boston, MA, USA; Healthcare Infection Prevention Program, Virginia Commonwealth University Health System, Richmond, VA, USA
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Grotowska M, Skalec T, Wójtowicz I, Kędziora J, Goździk W, Duszyńska W. Early tracheostomy in ventilated COVID-19 patients reduces incidence of ventilator-associated pneumonia. Sci Rep 2024; 14:29472. [PMID: 39604564 PMCID: PMC11603353 DOI: 10.1038/s41598-024-81115-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 11/25/2024] [Indexed: 11/29/2024] Open
Abstract
Tracheostomy can reduce mechanical ventilation (MV) duration, ICU and hospital length of stay (LOS), and ventilator-associated pneumonia (VAP) risk in critically ill patients. The timing of tracheostomy in COVID-19 patients has been studied, but its impact on VAP incidence has rarely been analyzed. This study investigated tracheostomy timing's impact on VAP incidence, ventilation time, ICU and hospital LOS, and mortality in critically ill COVID-19 patients. It was conducted at the University Hospital in Wroclaw, Poland, from October 1, 2020, to June 30, 2021. Of 60 tracheostomized patients, 21 (35%) developed VAP. Early tracheostomy (≤ 13 days) resulted in 8/42 (19%) VAP cases, while late tracheostomy (> 13 days) had 13/18 (72%) VAP cases, showing a significantly lower VAP risk in the early group (p < 0.05). VAP incidence rates were 7.9 and 22.8 per 1000 patient-days for early and late groups, respectively. Early tracheostomy patients had shorter median MV duration (18 vs. 33 days, p < 0.05), ICU LOS (20 vs. 31 days, p < 0.05) and hospital LOS (25 vs. 47 days, p < 0.05). Early tracheostomy in critically ill COVID-19 patients significantly reduced VAP risk, MV duration, ICU, and hospital LOS.
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Affiliation(s)
- Małgorzata Grotowska
- Faculty of Medicine, Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, 50-556, Poland.
| | - Tomasz Skalec
- Faculty of Medicine, Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, 50-556, Poland
| | - Iga Wójtowicz
- Clinic of Anesthesiology and Intensive Therapy, University Hospital in Wroclaw, Wroclaw, 50-556, Poland
| | - Jarosław Kędziora
- Faculty of Medicine, Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, 50-556, Poland
| | - Waldemar Goździk
- Faculty of Medicine, Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, 50-556, Poland
| | - Wiesława Duszyńska
- Faculty of Medicine, Clinical Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, 50-556, Poland
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7
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Rosenthal VD, Yin R, Jin Z, Alkhawaja SA, Zuñiga-Chavarria MA, Salgado E, El-Kholy A, Zuniga Moya JC, Patil P, Nadimpalli G, Pattabhiramarao RN, Zala D, Villegas-Mota I, Ider BE, Tumu N, Duszynska W, Nguyet LTT, Nair PK, Memish ZA. International Nosocomial Infection Control Consortium (INICC) report of health care-associated infections, data summary of 25 countries for 2014 to 2023, Surgical Site Infections Module. Am J Infect Control 2024; 52:1144-1151. [PMID: 38604442 DOI: 10.1016/j.ajic.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Surgical site infection (SSI) rates are higher in low-resource countries (LRC) than in high-income counterparts. METHODS Prospective cohort study using the INICC Surveillance Online System, from 116 hospitals in 75 cities across 25 Latin-American, Asian, Eastern-European, and Middle-Eastern countries: Argentina, Bahrain, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Egypt, Honduras, India, Kosovo, Kuwait, Lebanon, Mexico, Mongolia, Pakistan, Papua New Guinea, Philippines, Poland, Romania, Saudi Arabia, Thailand, Turkey, Venezuela, Vietnam. CDC/NHSN definitions were applied. Surgical procedures (SPs) were categorized according to the International Classification of Diseases criteria. RESULTS From 2014 to 2023, we collected data on 1,251 SSIs associated with 56,617 SPs. SSI rates were significantly higher in SPs of INICC compared to CDC/NHSN data: hip prosthesis (3.68% vs 0.67%, relative risk [RR]=5.46, 95% confidence interval [CI]=3.71-8.03, P<.001), knee prosthesis (2.02% vs 0.58%, RR=3.49, 95% CI=1.87-6.49, P<.001), coronary artery bypass (4.16% vs 1.37%, RR=3.03, 95% CI=2.35-3.91, P<.001), peripheral vascular bypass (15.69% vs 2.93%, RR=5.35, 95% CI=2.30-12.48, P<.001), abdominal aortic aneurysm repair (8.51% vs 2.12%, RR=4.02, 95% CI=2.11-7.65, P<.001), spinal fusion (6.47% vs 0.70%, RR=9.27, 95% CI=6.21-13.84, P<.001), laminectomy (2.68% vs 0.72%, RR=3.75, 95% CI=2.36-5.95, P<.001), among others. CONCLUSIONS Elevated SSI rates in LRCs emphasize the need for effective interventions.
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Affiliation(s)
- Victor Daniel Rosenthal
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; INICC Foundation, International Nosocomial Infection Control Consortium, Miami, USA, Miami, FL, USA.
| | - Ruijie Yin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Zhilin Jin
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | - Estuardo Salgado
- Department of Infection Control, Marie Curie Hospital, Quito, Ecuador
| | - Amani El-Kholy
- Department of Infection Control, Cairo University Dar Alfouad Hospital, 6th of October City, Egypt
| | - Julio C Zuniga Moya
- Department of Infection Control, Hospital Noroccidental Mario Catarino Rivas, San Pedro Sula, Honduras
| | - Priyanka Patil
- Department of Infection Control, Breach Candy Hospital Trust, Mumbai, India
| | - Gita Nadimpalli
- Department of Infection Control, Rao Nursing Home, Pune, India
| | | | - Dolatsinh Zala
- Department of Infection Control, School of Applied Science and Technology, Gujrat Technological University, Ahmedabad, India
| | | | - Bat-Erdene Ider
- Department of Infection Control, Intermed Hospital, Ulaanbaatar, Mongolia
| | - Nellie Tumu
- Department of Infection Control, Port Moresby General Hospital, Port Moresby, Papua New Guinea
| | - Wieslawa Duszynska
- Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Le Thi Thu Nguyet
- Department of Infection Control, Thanh Nhan Hospital, Hanoi, Vietnam
| | - Pravin K Nair
- Department of Infection Control, Holy Spirit Hospital, Mumbai, India
| | - Ziad A Memish
- Department of Infection Control, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
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Wouters M, Van Moll L, De Vooght L, Choińska E, Idaszek J, Szlązak K, Heljak MK, Święszkowski W, Cos P. Polymyxin B Peptide Hydrogel Coating: A Novel Approach to Prevent Ventilator-Associated Pneumonia. Int J Mol Sci 2024; 25:10269. [PMID: 39408597 PMCID: PMC11477085 DOI: 10.3390/ijms251910269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/19/2024] [Accepted: 09/19/2024] [Indexed: 10/20/2024] Open
Abstract
Ventilator-associated pneumonia (VAP) remains one of the most common hospital-acquired infections (HAI). Considering the complicated diagnosis and the lack of effective treatment, prophylactic measures are suggested as the new standard to prevent the disease. Although VAP often manifests a polymicrobial nature, Pseudomonas aeruginosa remains one of the pathogens associated with the highest morbidity and mortality rates within these mechanically ventilated patients. In this paper, we report on the development of an antibacterial hydrogel coating using the polymyxin B (PMB) peptide to prevent bacterial adhesion to the polymeric substrate. We fully characterized the properties of the coating using atomic force microscopy (AFM), scanning electron microscopy (SEM), wettability analyses and Fourier-transform infrared (FTIR) and Raman spectroscopy. Furthermore, several biological assays confirmed the antibacterial and anti-biofilm effect of the tubing for at least 8 days against P. aeruginosa. On top of that, the produced coating is compliant with the requirements regarding cytocompatibility stated in the ISO (International Organization for Standardization) 10993 guidelines and an extended release of PMB over a period of at least 42 days was detected. In conclusion, this study serves as a foundation for peptide-releasing hydrogel formulas in the prevention of VAP.
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Affiliation(s)
- Milan Wouters
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Wilrijk, 2000 Antwerp, Belgium; (M.W.); (L.V.M.); (L.D.V.)
| | - Laurence Van Moll
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Wilrijk, 2000 Antwerp, Belgium; (M.W.); (L.V.M.); (L.D.V.)
| | - Linda De Vooght
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Wilrijk, 2000 Antwerp, Belgium; (M.W.); (L.V.M.); (L.D.V.)
| | - Emilia Choińska
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (E.C.); (J.I.); (K.S.); (M.K.H.)
| | - Joanna Idaszek
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (E.C.); (J.I.); (K.S.); (M.K.H.)
| | - Karol Szlązak
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (E.C.); (J.I.); (K.S.); (M.K.H.)
| | - Marcin K. Heljak
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (E.C.); (J.I.); (K.S.); (M.K.H.)
| | - Wojciech Święszkowski
- Faculty of Materials Sciences and Engineering, Warsaw University of Technology, Woloska 141, 02-507 Warsaw, Poland; (E.C.); (J.I.); (K.S.); (M.K.H.)
| | - Paul Cos
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Wilrijk, 2000 Antwerp, Belgium; (M.W.); (L.V.M.); (L.D.V.)
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Sleziak J, Pilarczyk K, Matysiak M, Duszynska W. Pneumonia Characteristics in an Intensive Care Unit Setting during and after the COVID-19 Pandemic-A Single-Center Prospective Study. J Clin Med 2024; 13:2824. [PMID: 38792365 PMCID: PMC11121790 DOI: 10.3390/jcm13102824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/03/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Background: During and after the COVID-19 pandemic, there was a suspicion of varying rates of respiratory tract infections (RTIs), particularly pneumonia (PN). Methods: This research evaluated epidemiological indicators of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in the COVID-19 pandemic and post-pandemic period, including pathogens, ventilator-associated pneumonia (VAP), selected risk factors, and PN mortality. Results: At 1740 patients, throughout the 22,774 patient-days (Pt-D) and 18,039 ventilation days (Vt-D), there were 681 PN cases (39.14%): CAP 336 (19.31%) and HAP 345 (19.83%). CAP caused by SARS-CoV-2 was diagnosed in 257/336 (76.49%) patients. The clinical manifestations of PNs were CAP with 336/681 (49.34%), VAP with 232/681 (34.07%), and non-ventilator HAP (NV-HAP) with 113/681 cases (16.59%). The incidence rate of CAP/1000 Pt-D has been over 3 times higher in the pandemic period of 2020-2021 (20.25) than in the post-pandemic period of 2022 (5.86), p = 0.000. Similarly, higher incidence rates of VAP/1000 Pt-D were found in the pandemic period (p = 0.050). For NV-HAP, this difference was not statistically significant (p = 0.585). VAP occurred more frequently in the group of patients with PN in the course of COVID-19 compared to patients without COVID-19 (52/234 [22.2%] vs. 180/1506 [11.95%]); (p = 0.000). The most common CAP pathogen (during the pandemic) was SARS CoV-2 234/291 (80.4%), followed by MSSA/MRSA 8/291 (2.75%), whereas the most common VAP/NV-HAP pathogen was Acinetobacter baumannii XDR/MDR. The highest PN mortality was found in the patients with CAP caused by SARS-CoV-2 159/257 (61.87%). Conclusions: Pneumonias were diagnosed in nearly 40% of Intensive Care Unit (ICU) patients. Surveillance of pneumonias during the specific observation period was beneficial in the epidemiological and microbiological analysis of the ICU patients.
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Affiliation(s)
- Jakub Sleziak
- The Students Scientific Association by Department and Clinic of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, L. Pasteura Street 1, 50-367 Wroclaw, Poland; (J.S.); (K.P.); (M.M.)
| | - Katarzyna Pilarczyk
- The Students Scientific Association by Department and Clinic of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, L. Pasteura Street 1, 50-367 Wroclaw, Poland; (J.S.); (K.P.); (M.M.)
| | - Michal Matysiak
- The Students Scientific Association by Department and Clinic of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, L. Pasteura Street 1, 50-367 Wroclaw, Poland; (J.S.); (K.P.); (M.M.)
| | - Wieslawa Duszynska
- Department and Clinic of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, L. Pasteura Street 1, 50-367 Wroclaw, Poland
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Hoang HM, Dao CX, Huy Ngo H, Okamoto T, Matsubara C, Do SN, Bui GTH, Bui HQ, Duong NT, Nguyen NT, Vuong TX, Van Vu K, Phạm TT, Van Bui C. Efficacy of compliance with ventilator-associated pneumonia care bundle: A 24-month longitudinal study at Bach Mai Hospital, Vietnam. SAGE Open Med 2024; 12:20503121231223467. [PMID: 38249955 PMCID: PMC10798102 DOI: 10.1177/20503121231223467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction To decrease the risk of complications from ventilator-associated pneumonia, it is essential to implement preventative measures in all ICU patients. Since 2018, with the help of Japanese experts, we have applied a ventilator-associated pneumonia care bundle with 10 basic standards in patient care and monitoring. Therefore, we conducted a study to evaluate the results of applying 10 solutions to prevent ventilator-associated pneumonia over 24 months. Methods A cross-sectional descriptive study with longitudinal follow-up for 24 months on 170 mechanically ventilated patients at the Center for Critical Care Medicine, Bach Mai Hospital. According to the Centers for Disease Control (CDC, 2021), the diagnosis of ventilator-associated pneumonia is when pneumonia appears 48 h after intubation by confirmation by at least two doctors. Evaluate compliance with each solution in the care bundle through camera monitoring, medical records, and directly on patients daily. Results The rate of ventilator-associated pneumonia is 12.9%, the frequency of occurrence is 16.54 of 1000 days. The compliance rate for complete compliance with a 10-item ventilator-associated pneumonia was only 1.8%, while the average value was 84.1%. Average values of compliance with each solution for hand hygiene, head elevation 30-45 degrees, oral hygiene, stopping sedation, breathing circuit management, cuff pressure management, hypoplastic suction, Spontaneous breathing trial (SBT) daily and assessed extubation, mobilization and early leaving bed, ulcer and thrombosis prevention were 96.9%, 97.3%, 99.4%, 81.5%, 99.9%, 99.9%, 86.3%, 83.5%, 49.3%, and 46.4%, respectively. The time to appear ventilator-associated pneumonia in the high compliance group was 46.7 ± 5.0 days, higher than in the low compliance group, 10.3 ± 0.7 days, p < 0.001. Conclusions A 10-item ventilator-associated pneumonia care bundle has helped reduce the incidence of ventilator-associated pneumonia. To reduce the risk of ventilator-associated pneumonia and shorten ICU and hospital stays, it is essential to fully adhere to subglottic secretion suction, daily SBT, and early mobilization and leaving the bed.
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Affiliation(s)
- Hoan Minh Hoang
- Bach Mai Hospital, Hanoi, Vietnam
- Nam Dinh University of Nursing, Nam Dinh, Vietnam
| | - Co Xuan Dao
- Bach Mai Hospital, Hanoi, Vietnam
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | | | - Tatsuya Okamoto
- National Center for Global Health and Medicine Research Institute, Tokyo, Japan
| | | | - Son Ngoc Do
- Bach Mai Hospital, Hanoi, Vietnam
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
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