Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings.
- 作者列表："Rosenthal VD","Bat-Erdene I","Gupta D","Rajhans P","Myatra SN","Muralidharan S","Mehta Y","Rai V","Hung NV","Luxsuwong M","Tapang ARD","Guo X","Trotter A","Kharbanda M","Rodrigues C","Dwivedy A","Shah S","Poojary A","Todi SK","Chabukswar S","Bhattacharyya M","Ramachandran B","Ramakrishnan N","Purkayasta SK","Sakle AS","Kumar S","Warrier AR","Kavathekar MS","Sahu S","Mubarak A","Modi N","Jaggi N","Gita N","Mishra SB","Sahu S","Jawadwala B","Zala D","Zompa T","Mathur P","Nirkhiwale S","Vadi S","Singh S","Agarwal M","Sen N","Karlekar A","Punia DP","Kumar S","Gopinath R","Nair PK","Gan CS","Chakravarthy M","Sandhu K","Kambam C","Mohanty SK","Varaiya A","Pandya N","Subhedar VR","Vanajakshi MR","Singla D","Tuvshinbayar M","Patel M","Ye G","Lum LCS","Zaini RHM","Batkhuu B","Dayapera KM","Nguyet LT","Berba R","Buenaflor MCS","Ng JA","Siriyakorn N","Thu LTA
BACKGROUND:Short-term peripheral venous catheter-associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter-associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available. METHODS:Prospective, surveillance study on peripheral venous catheter-associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. RESULTS:We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter-associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter-associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter-associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: Escherichia coli (22.9%), Klebsiella spp (10.7%), Pseudomonas aeruginosa (5.3%), Enterobacter spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were Staphylococcus aureus (11.4%). CONCLUSIONS:Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter-associated bloodstream infections.
背景: 在亚洲国家，短期外周静脉导管相关血流感染率尚未得到系统研究，并且没有关于外周静脉导管相关血流感染发生率的数据。 方法: 2013年9月1日至20 19年5月31日，来自东南亚地区8个国家32个城市78家医院的262个重症监护病房 (国际医院感染控制联盟成员) 进行了外周静脉导管相关血流感染的前瞻性监测研究: 中国，印度，马来西亚、蒙古、尼泊尔、菲律宾、泰国和越南。在这项研究中，我们应用了CDC NHSN的定义和标准、INICC的方法学和名为INICC监控在线系统的软件。 结果: 我们对83,295名重症监护病房患者进行了369,371床日和376,492外周静脉导管日的随访。我们确定了999例外周静脉导管相关性血流感染，总发生率为2.65/1000外周静脉导管日。有外周静脉导管但无外周静脉导管相关血流感染患者的死亡率为4.53%，外周静脉导管相关血流感染患者为12.21%。在有外周静脉导管但无外周静脉导管相关性血流感染的患者中，平均住院时间分别为4.40天和7.11天。微生物谱显示67.1% 为革兰氏阴性菌: 大肠埃希菌 (22.9%)，克雷伯菌属 (10.7%)，铜绿假单胞菌 (5.3%)，肠杆菌属。4.5%)，其他 (23.7%)。革兰阳性菌以金黄色葡萄球菌为主 (11.4%)。 结论: 必须实施感染预防计划以降低外周静脉导管相关血流感染的发生率。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.