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《Journal of infection and chemotherapy》2022,28(11):1578-1581
IntroductionLong-term care hospitals (LTCHs) are at a high risk for the inflow and spread of antimicrobial resistance (AMR) pathogens. However, owing to limited laboratory resources, little is known about the extent to which AMR organisms are endemic.MethodsWe performed active surveillance for carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in newly admitted patients at Marugame Medical Center, a nearly 200-bedded LTCH located in Kagawa, Japan. From August to December 2021, we tested stool samples from patients wearing diapers and confirmed the genetic variants using specific PCR assays. We also collected clinical variables and compared them between AMR carriers and non-carriers.ResultsStool samples were collected from 75 patients, with a median age of 84 years. CRE strain was not detected, but 37 strains of ESBL-E were isolated from 32 patients (42.7%). During the study period, 4.9% of in-hospital patients (37 per 756 patients) were identified to be ESBL-E carriers in the routine microbiological processing, suggesting that active surveillance detected approximately 9-fold more ESBL-E carriers. The blaCTX-M-9 group was the most common (38.5%), followed by the blaTEM (26.9%). The clinical backgrounds of the ESBL-E non-carriers and carriers were not significantly different.ConclusionOur active screening demonstrated that nearly half of the patients hospitalized or transferred to a Japanese LTCH were colonized with ESBL-E. We highlight the enforcement of universal basic infection prevention techniques at LTCHs where patients carrying AMR pathogens gather. 相似文献
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Marc Evans MD Susanne Engberg MD Mads Faurby MSc João Diogo Da Rocha Fernandes MSc Pollyanna Hudson MSc William Polonsky PhD 《Diabetes, obesity & metabolism》2022,24(3):377-390
We designed a systematic literature review to identify available evidence on adherence to and persistence with antidiabetic medication in people with type 2 diabetes (T2D). Electronic screening and congress searches identified real-world noninterventional studies (published between 2010 and October 2020) reporting estimates of adherence to and persistence with antidiabetic medication in adults with T2D, and associations with glycaemic control, microvascular and/or macrovascular complications, hospitalizations and healthcare costs. Ninety-two relevant studies were identified, the majority of which were retrospective and reported US data. The proportions of patients considered adherent (median [range] 51.2% [9.4%-84.3%]) or persistent (median [range] 47.7% [16.9%-94.0%]) varied widely across studies. Multiple studies reported an association between greater adherence/persistence and greater reductions in glycated haemoglobin levels. Better adherence/persistence was associated with fewer microvascular and/or macrovascular outcomes, although there was little consistency across studies in terms of which outcomes were improved. More adherent and more persistent patients were typically less likely to be hospitalized or to have emergency department visits/admissions and spent fewer days in hospital annually than less adherent/persistent patients. Greater adherence and persistence were generally associated with lower hospitalization costs, higher pharmacy costs and lower or budget-neutral total healthcare costs compared with lower adherence/persistence. In conclusion, better adherence and persistence in people with T2D is associated with lower rates of microvascular and/or macrovascular outcomes and inpatient hospitalization, and lower or budget-neutral total healthcare expenditure. Education and treatment strategies to address suboptimal adherence and persistence are needed to improve clinical and economic outcomes. 相似文献
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幽门螺杆菌(HP)是革兰阴性微需氧的螺旋样杆菌,主要通过口-口途径在人-人之间感染传播。HP的发现加深了人类对慢性感染、炎症和癌症之间关系的认识。其特定的螺旋形体型、鞭毛及动力、尿素酶和黏附素活性,以及细胞毒素基因A(cagA)、空泡细胞毒素基因A(vacA)等是影响HP感染研究较多的相关致病因素。HP感染在胃癌的发生、发展中可能具有重要作用,但尚未确切证实HP感染是导致胃癌的主因。文章概述了HP感染相关致病因素的研究进展。 相似文献
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《Drug discovery today》2022,27(1):223-233
Approaches based on animal and two-dimensional (2D) cell culture models cannot ensure reliable results in modeling novel pathogens or in drug testing in the short term; therefore, there is rising interest in platforms such as organoids. To develop a toolbox that can be used successfully to overcome current issues in modeling various infections, it is essential to provide a framework of recent achievements in applying organoids. Organoids have been used to study viruses, bacteria, and protists that cause, for example, respiratory, gastrointestinal, and liver diseases. Their future as models of infection will be associated with improvements in system complexity, including abilities to model tissue structure, a dynamic microenvironment, and coinfection.Teaser.Organoids are a flexible tool for modelling viral, bacterial and protist infections. They can provide fast and reliable information on the biology of pathogens and in drug screening, and thus have become essential in combatting emerging infectious diseases. 相似文献
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目的 系统评价儿童耐碳青霉烯类肠杆菌定植或感染的危险因素。 方法 计算机检索PubMed、Web of Science、中国知网、万方、中国生物医学文献数据库,获得各数据库自建库至2021年5月31日关于儿童耐碳青霉烯类肠杆菌定植或感染危险因素的相关文献,采用RevMan 5.3软件进行Meta分析。 结果 共纳入13篇文献,累计1 501例样本。Meta分析结果显示下列变量是儿童耐碳青霉烯类肠杆菌定植或感染的危险因素(P <0.05):留置胃管(OR =4.91)、气管插管(OR =5.03)、中心静脉置管(OR =3.75)、留置导尿管(OR =4.11)、机械通气(OR =3.09)、重症监护室住院史(OR =2.39)、外科手术史(OR =3.22)、第三代头孢菌素使用史(OR =2.62)、碳青霉烯类抗生素使用史(OR =3.82)、糖肽类抗生素使用史(OR =3.48)、β-内酰胺酶抑制剂抗生素使用史(OR =2.87)、抗真菌药使用史(OR =2.48)、氨基糖苷类抗生素使用史(OR =2.54)、生后1 min Apgar评分≤7分(OR =2.10)。 结论 侵入性操作、重症监护室住院史、碳青霉烯类抗生素等抗生素使用史、生后1 min Apgar评分≤7分是儿童CRE定植或感染的危险因素。 相似文献