1
|
Blackmon S, Avendano E, Nirmala N, Chan CW, Morin RA, Balaji S, McNulty L, Argaw SA, Doron S, Nadimpalli ML. Socioeconomic status and the risk for colonization or infection with priority bacterial pathogens: a global evidence map. medRxiv 2024:2024.04.24.24306293. [PMID: 38712194 PMCID: PMC11071581 DOI: 10.1101/2024.04.24.24306293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Low socioeconomic status (SES) is thought to exacerbate risks for bacterial infections, but global evidence for this relationship has not been synthesized. We systematically reviewed the literature for studies describing participants' SES and their risk of colonization or community-acquired infection with priority bacterial pathogens. Fifty studies from 14 countries reported outcomes by participants' education, healthcare access, income, residential crowding, SES deprivation score, urbanicity, or sanitation access. Low educational attainment, lower than average income levels, lack of healthcare access, residential crowding, and high deprivation were generally associated with higher risks of colonization or infection. There is limited research on these outcomes in low- and middle-income countries (LMICs) and conflicting findings regarding the effects of urbanicity. Only a fraction of studies investigating pathogen colonization and infection reported data stratified by participants' SES. Future studies should report stratified data to improve understanding of the complex interplay between SES and health, especially in LMICs.
Collapse
Affiliation(s)
- Sarah Blackmon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Nanguneri Nirmala
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Courtney W. Chan
- University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA
| | - Rebecca A. Morin
- Hirsh Health Sciences Library, Tufts University, Boston, MA, USA
| | - Sweta Balaji
- Department of Quantitative Theory and Methods, Emory University, Atlanta, GA
| | - Lily McNulty
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Samson Alemu Argaw
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Shira Doron
- Division of Geographic Medicine and Infectious Disease, Department of Medicine, Tufts Medical Center, Boston, MA, USA
- Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance (Levy CIMAR), Tufts University, Boston, MA, USA
| | - Maya L. Nadimpalli
- Stuart B. Levy Center for Integrated Management of Antimicrobial Resistance (Levy CIMAR), Tufts University, Boston, MA, USA
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
2
|
Forrester JD, Cao S, Schaps D, Liou R, Patil A, Stave C, Sokolow SH, Leo GD. Influence of Socioeconomic and Environmental Determinants of Health on Human Infection and Colonization with Antibiotic-Resistant and Antibiotic-Associated Pathogens: A Scoping Review. Surg Infect (Larchmt) 2022; 23:209-225. [DOI: 10.1089/sur.2021.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Joseph D. Forrester
- Division of General Surgery, Department of Surgery, Stanford University, Stanford, California, USA
| | - Siqi Cao
- School of Medicine, Stanford University, Stanford, California, USA
| | - Diego Schaps
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Raymond Liou
- School of Medicine, Stanford University, Stanford, California, USA
| | | | - Christopher Stave
- School of Medicine, Stanford University, Stanford, California, USA
- Lane Medical Library, Stanford University, Stanford, California, USA
| | - Susanne H. Sokolow
- Woods Institute for the Environment, Stanford University, Stanford, California, USA
- Marine Science Institute, University of California Santa Barbara, Santa Barbara, California, USA
| | - Giulio De Leo
- Woods Institute for the Environment, Stanford University, Stanford, California, USA
- Hopkins Marine Station, Stanford University, Stanford, California, USA
| |
Collapse
|
3
|
Mosselhy DA, Assad M, Sironen T, Elbahri M. Nanotheranostics: A Possible Solution for Drug-Resistant Staphylococcus aureus and their Biofilms? Nanomaterials (Basel) 2021; 11:E82. [PMID: 33401760 PMCID: PMC7824312 DOI: 10.3390/nano11010082] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/24/2020] [Accepted: 12/30/2020] [Indexed: 12/14/2022]
Abstract
Staphylococcus aureus is a notorious pathogen that colonizes implants (orthopedic and breast implants) and wounds with a vicious resistance to antibiotic therapy. Methicillin-resistant S. aureus (MRSA) is a catastrophe mainly restricted to hospitals and emerged to community reservoirs, acquiring resistance and forming biofilms. Treating biofilms is problematic except via implant removal or wound debridement. Nanoparticles (NPs) and nanofibers could combat superbugs and biofilms and rapidly diagnose MRSA. Nanotheranostics combine diagnostics and therapeutics into a single agent. This comprehensive review is interpretative, utilizing mainly recent literature (since 2016) besides the older remarkable studies sourced via Google Scholar and PubMed. We unravel the molecular S. aureus resistance and complex biofilm. The diagnostic properties and detailed antibacterial and antibiofilm NP mechanisms are elucidated in exciting stories. We highlight the challenges of bacterial infections nanotheranostics. Finally, we discuss the literature and provide "three action appraisals". (i) The first appraisal consists of preventive actions (two wings), avoiding unnecessary hospital visits, hand hygiene, and legislations against over-the-counter antibiotics as the general preventive wing. Our second recommended preventive wing includes preventing the adverse side effects of the NPs from resistance and toxicity by establishing standard testing procedures. These standard procedures should provide breakpoints of bacteria's susceptibility to NPs and a thorough toxicological examination of every single batch of synthesized NPs. (ii) The second appraisal includes theranostic actions, using nanotheranostics to diagnose and treat MRSA, such as what we call "multifunctional theranostic nanofibers. (iii) The third action appraisal consists of collaborative actions.
Collapse
Affiliation(s)
- Dina A. Mosselhy
- Nanochemistry and Nanoengineering, Department of Chemistry and Materials Science, School of Chemical Engineering, Aalto University, 02150 Espoo, Finland;
- Microbiological Unit, Fish Diseases Department, Animal Health Research Institute, Dokki, Giza 12618, Egypt
- Department of Virology, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014 Helsinki, Finland;
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
| | - Mhd Assad
- Nanochemistry and Nanoengineering, Department of Chemistry and Materials Science, School of Chemical Engineering, Aalto University, 02150 Espoo, Finland;
| | - Tarja Sironen
- Department of Virology, Faculty of Medicine, University of Helsinki, P.O. Box 21, 00014 Helsinki, Finland;
- Department of Veterinary Biosciences, Faculty of Veterinary Medicine, University of Helsinki, P.O. Box 66, 00014 Helsinki, Finland
| | - Mady Elbahri
- Nanochemistry and Nanoengineering, Department of Chemistry and Materials Science, School of Chemical Engineering, Aalto University, 02150 Espoo, Finland;
- Nanochemistry and Nanoengineering, Institute for Materials Science, Faculty of Engineering, Kiel University, 24143 Kiel, Germany
- Center for Nanotechnology, Zewail City of Science and Technology, Sheikh Zayed District, Giza 12588, Egypt
| |
Collapse
|
4
|
Ghia CJ, Waghela S, Rambhad G. A Systemic Literature Review and Meta-Analysis Reporting the Prevalence and Impact of Methicillin-Resistant Staphylococcus aureus Infection in India. Infect Dis (Lond) 2020; 13:1178633720970569. [PMID: 33223835 PMCID: PMC7656882 DOI: 10.1177/1178633720970569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 10/09/2020] [Indexed: 12/19/2022] Open
Abstract
Aim and objective This systematic review and meta-analysis was conducted to assess the prevalence, burden and epidemiology of methicillin-resistant S. aureus (MRSA). This systemic review was also aimed to highlight the challenges in the diagnosis and management of methicillin-resistant S. aureus (MRSA) in India (for all age groups). We also examined the published literature on the available treatment options and the role of prevention in the management of MRSA in India. By summarizing the currently available data, our objectives were to highlight the need for the prevention of MRSA infections and also emphasize the role of vaccination in the prevention of MRSA infections in India. Methodology Electronic databases such as PubMed and databases of the National Institute of Science Communication and Information Resources and Indian Council of Medical Research Embase were searched for relevant literature published from 2005/01/01 to 2020/05/13 in English language, according to the predefined inclusion and exclusion criteria. A manual search was also conducted using the key term "MRSA 'or' Methicillin Resistant Staphylococcus aureus 'and' India." An independent reviewer extracted data from the studies using a structured Microsoft Excel spreadsheet, and a meta-analysis of proportion for MRSA prevalence with a corresponding 95% confidence interval (CI) for all included individual studies were performed. Result A total of 34 studies involving 16 237 patients were included in the final meta-analysis. The pooled proportion of patients with MRSA infection was 26.8% (95% CI: 23.2%-30.7%). The MRSA infection was more prevalent among male patients (60.4%; 95% CI: 53.9%-66.5%) as compared to female patients (39.6%; 95% CI: 33.5%-46.1%), while the prevalence of MRSA was higher among adults (18 years and above; 32%; 95% CI: 5%-80%) in comparison to pediatric patients (0-18 years; 68%; 95% CI: 20%-94.8%). The degree of heterogeneity was found to be significant. Conclusion The prevalence of MRSA in India was relatively high at 27% with a higher proportion observed among men aged >18 years. The high prevalence of MRSA infections in India necessitates the implementation of surveillance and preventive measures to combat the spread of MRSA in both hospital and community settings.
Collapse
Affiliation(s)
| | - Shaumil Waghela
- Medical and Scientific Affairs, Pfizer Limited, Mumbai, India
| | - Gautam Rambhad
- Medical and Scientific Affairs, Pfizer Limited, Mumbai, India
| |
Collapse
|
5
|
Khan KS, Torpiano G, McLellan M, Mahmud S. The impact of socioeconomic status on 30-day mortality in hospitalized patients with COVID-19 infection. J Med Virol 2020; 93:995-1001. [PMID: 32729937 DOI: 10.1002/jmv.26371] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/20/2022]
Abstract
Socioeconomic status (SES) impacts outcome in a number of diseases. Our aim was to compare the outcome of hospitalized coronavirus disease 219 (COVID-19) patients in low and high SES group. Prospective cohort study of hospitalized patients with confirmed COVID-19 in three acute hospitals. Electronic case notes were analyzed for baseline characteristics and admission investigations. Scottish index for multiple deprivation (SIMD) was used to divide patients into two groups: more deprived (SIMD 1-5) and less deprived (SIMD 6-10) and results compared. Poor outcome was defined as either need for intubation and/or death. One hundred and seventy-three patients were identified, one was excluded. One hundred and eight (62.8%) were males, mean age was 68.5 ± 14.7 years. Commonest comorbidity was hypertension 87 (50.6%). One hundred and seventeen (68.0%) patients were in more deprived group. Baseline characteristics, admission blood profile and reason for admission were evenly matched in both groups. Outcomes were comparable in both groups: transfer to critical care (27.4% vs 27.3%; P = .991), intubation (18.8% vs 20.2%; P = .853), 30-day all-cause mortality (19.7% vs 14.5%; P = .416) and overall poor outcome (30.8% vs 30.9%; P = .985). Median time to discharge was 7 days longer (17 vs 10 days; P = .018) and median time to death was 4.5 days longer in more deprived group (17 vs 12.5 days; P = .388). Contrary to recent literature on COVID-19 in other geographical areas, our study suggests that the SES does not have any impact on outcome of hospitalized patients with COVID-19, however it negatively impacts length of stay.
Collapse
Affiliation(s)
- Khurram Shahzad Khan
- Department of Surgery, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Giuliana Torpiano
- Department of Surgery, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Morag McLellan
- Department of Surgery, University Hospital Hairmyres, East Kilbride, Scotland, UK
| | - Sajid Mahmud
- Department of Surgery, University Hospital Hairmyres, East Kilbride, Scotland, UK
| |
Collapse
|
6
|
Abstract
OBJECTIVES The purposes of this paper are to study clinicobacteriological profile, treatment modalities and outcome of pediatric empyema thoracis and to identify changes over a decade. DESIGN This is a retrospective study. SETTING Department of Pediatrics of a tertiary care hospital in North India. PATIENTS We enrolled 205 patients (1 month-12 years) of empyema thoracis admitted over 5 years (2007-11) and compared the profile with that of a previous study from our institute (1989-98). RESULTS Pleural fluid cultures were positive in 40% (n = 82) cases from whom 87 isolates were obtained. Staphylococcus aureus was the most common isolate (66.7%). Methicillin-sensitive S. aureus accounted for 56%, Methicillin-resistant S. aureus (MRSA) 10% and gram-negative organisms 18.3% of isolates. Intercostal drainage tube (ICDT) was inserted in 97.5%, intrapleural streptokinase was administered in 33.6%, and decortication performed in 27.8% cases. Duration of hospital stay was 17.2 (±6.3) days, duration of antibiotic (intravenous and oral) administration was 23.8 (±7.2) days and mortality rate was 4%. In the index study (compared with a previous study), higher proportion of cases received parenteral antibiotics (51.7% vs. 23.4%) and ICDT insertion (20.5% vs. 7%) before referral and had disseminated disease (20.5% vs. 14%) and septic shock (11.2% vs. 1.6%), less culture positivity (40% vs. 48%), more MRSA (10.3% vs. 2.5%) and gram-negative organisms (18.4% vs. 11.6%), increased use of intrapleural streptokinase and surgical interventions (27.8% vs. 19.7%), shorter hospital stay (17 vs. 25 days) and higher mortality (3.9% vs. 1.6%). CONCLUSIONS Over a decade, an increase in the incidence of empyema caused by MRSA has been noticed, with increased use of intrapleural streptokinase and higher number of surgical interventions.
Collapse
Affiliation(s)
- Suresh Kumar Angurana
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kumar
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meenu Singh
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Verma
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ram Samujh
- Pediatric Surgery, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunit Singhi
- Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
7
|
Andreatos N, Shehadeh F, Pliakos EE, Mylonakis E. The impact of antibiotic prescription rates on the incidence of MRSA bloodstream infections: A county-level, US-wide analysis. Int J Antimicrob Agents 2018; 52:195-200. [PMID: 29656062 DOI: 10.1016/j.ijantimicag.2018.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 03/14/2018] [Accepted: 04/04/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To investigate the association of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection with socioeconomic factors and antibiotic prescriptions at the county level. METHODS MRSA bloodstream infection rates were extracted from the Medicare Hospital Compare database. Data on socioeconomic factors and antibiotic prescriptions were obtained from the US Census Bureau and the Medicare Part D database, respectively. RESULTS In multivariate analysis, antibiotic prescriptions demonstrated a powerful positive association with MRSA bloodstream infection rates [Coefficient (Coeff): 0.432, 95% Confidence Interval (CI): 0.389, 0.474, P < 0.001], which was largely attributable to lincosamides (Coeff: 0.257, 95% CI: 0.177, 0.336, P < 0.001), glycopeptides (Coeff: 0.223, 95% CI: 0.175, 0.272, P < 0.001), and sulfonamides (Coeff: 0.166, 95% CI: 0.082, 0.249, P < 0.001). Sociodemographic factors, such as poverty (Coeff: 0.094, 95% CI: 0.034, 0.155, P=0.002) exerted a secondary positive impact on MRSA bloodstream infection. Conversely, college education (Coeff: -0.037, 95% CI: -0.068, -0.005, P=0.024), a larger median room number per house (Coeff: -0.107, 95% CI: -0.134, -0.081, P < 0.001), and an income above the poverty line (100% < income < 150% of the poverty line) (Coeff: -0.257, 95% CI: -0.314, -0.199, P < 0.001) were negatively associated with MRSA incidence rates. A multivariate model that incorporated socioeconomic data and antibiotic prescription rates predicted 39.1% of the observed variation in MRSA bloodstream infection rates (Pmodel < 0.001). CONCLUSIONS MRSA bloodstream infection rates were strongly associated with county-level antibiotic use and socioeconomic factors. If the causality of these associations is confirmed, antimicrobial stewardship programs that extend outside acute healthcare facilities would likely prove instrumental in arresting the spread of MRSA.
Collapse
Affiliation(s)
- Nikolaos Andreatos
- Infectious Diseases Division, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
| | - Fadi Shehadeh
- Infectious Diseases Division, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
| | - Elina Eleftheria Pliakos
- Infectious Diseases Division, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI
| | - Eleftherios Mylonakis
- Infectious Diseases Division, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI.
| |
Collapse
|
8
|
Oestergaard LB, Schmiegelow MD, Bruun NE, Skov RL, Petersen A, Andersen PS, Torp-Pedersen C. The associations between socioeconomic status and risk of Staphylococcus aureus bacteremia and subsequent endocarditis - a Danish nationwide cohort study. BMC Infect Dis 2017; 17:589. [PMID: 28841914 PMCID: PMC5574102 DOI: 10.1186/s12879-017-2691-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Staphylococcus aureus bacteremia (SAB) is the leading cause of infective endocarditis in several countries. Since socioeconomic status (SES) is known to influence the risk of infectious diseases in general, we aimed to investigate the association between SES and SAB, and risk of subsequent endocarditis in a nationwide adult population. METHODS All Danish residents were consecutively included at age ≥ 30 years during 1996-2010. We obtained information on SES (highest attained educational level), comorbidities, and microbiologically verified SAB by cross-linking nationwide registries. The incidence rate ratios (IRRs) of SAB and later endocarditis were investigated using Poisson regression models adjusted for sex, age and year (reference = highest SES). RESULTS Our study population comprised 3,394,936 individuals (median age = 43.2 years). Over a median follow-up of 15.9 years, 13,181 individuals acquired SAB. SES was inversely associated with SAB acquisition, which declined with increasing age, e.g. in individuals with lowest SES, IRRs were 3.78 (95% confidence interval [CI] = 2.89-4.95) in age 30-50 years, 1.87 (CI = 1.60-2.18) in age > 50-70 years and 1.31 (CI = 1.11-1.54) in age > 70 years (interaction-p < 0.0001). Adjustment for comorbidities attenuated the IRRs, but the pattern persisted. No association between SES and endocarditis risk among patients with SAB was observed. CONCLUSIONS Decreasing SES was associated with an increased risk of SAB, particularly in younger adults. SES was not associated with risk of subsequent endocarditis.
Collapse
Affiliation(s)
- Louise Bruun Oestergaard
- The Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark. .,Department of Cardiology, Copenhagen University Hospital, Gentofte; Kildegaards Vej 28, Post-635, 2900, Hellerup, Denmark.
| | - Michelle D Schmiegelow
- Department of Cardiology, Copenhagen University Hospital, Gentofte; Kildegaards Vej 28, Post-635, 2900, Hellerup, Denmark
| | - Niels Eske Bruun
- Department of Cardiology, Copenhagen University Hospital, Gentofte; Kildegaards Vej 28, Post-635, 2900, Hellerup, Denmark.,Clinical Institute, Aalborg University, Aalborg, Denmark
| | - Robert L Skov
- The Department of Microbiology and Infection Control, Statens Serum Institut (SSI), Copenhagen, Denmark
| | - Andreas Petersen
- The Department of Microbiology and Infection Control, Statens Serum Institut (SSI), Copenhagen, Denmark
| | - Paal Skytt Andersen
- The Department of Microbiology and Infection Control, Statens Serum Institut (SSI), Copenhagen, Denmark
| | | |
Collapse
|