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1. Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Africa, Eastern Europe, Latin America, and the Middle East: Findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Victor Daniel Rosenthal, Zhilin Jin, Ziad A. Memish, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Mohammad Abdellatif Daboor, Subhash Kumar Todi, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan, Luisa Fernanda Jiménez Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga Chavarria, Narangarav Davaadagva, Mat Nor Mohd Basri, Katherine Gomez, Daisy Aguilar De Moros, Chian-Wern Tai, Alejandro Sassoe Gonzalez, Lina Alejandra Aguilar Moreno, Kavita Sandhu, Jarosław Janc, Mary Cruz Aleman Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano Medina, Maria Isabel Villegas Mota, Abeer Aly Omar, Wieslawa Duszynska, Souad BelKebir, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Nellie Tumu, May Gamar Elanbya, Reshma Dongol, Vesna Mioljević, Lul Raka, Lourdes Dueñas, Nilton Yhuri Carreazo, Tarek Dendane, Aamer Ikram, Souha S. Kanj, Michael M. Petrov, Asma Bouziri, Nguyen Viet Hung, Vladislav Belskiy, Naheed Elahi, María Marcela Bovera, and Ruijie Yin

Subjects
Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Abstract Objective: Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs. Design: Prospective cohort study. Setting: This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries. Participants: The study included patients admitted to ICUs across 24 years. Results: In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16–1.28; P < .0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07–1.08; P < .0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23–1.31; P < .0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57–15.48; P < .0001); tracheostomy connected to a MV, which was associated with the next-highest risk (aOR, 8.31; 95% CI, 7.21–9.58; P < .0001); endotracheal tube connected to a MV (aOR, 6.76; 95% CI, 6.34–7.21; P < .0001); surgical hospitalization (aOR, 1.23; 95% CI, 1.17–1.29; P < .0001); admission to a public hospital (aOR, 1.59; 95% CI, 1.35-1.86; P < .0001); middle-income country (aOR, 1.22; 95% CI, 15–1.29; P < .0001); admission to an adult-oncology ICU, which was associated with the highest risk (aOR, 4.05; 95% CI, 3.22–5.09; P < .0001), admission to a neurologic ICU, which was associated with the next-highest risk (aOR, 2.48; 95% CI, 1.78–3.45; P < .0001); and admission to a respiratory ICU (aOR, 2.35; 95% CI, 1.79–3.07; P < .0001). Admission to a coronary ICU showed the lowest risk (aOR, 0.63; 95% CI, 0.51–0.77; P < .0001). Conclusions: Some identified VAP RFs are unlikely to change: sex, hospitalization type, ICU type, facility ownership, and country income level. Based on our results, we recommend focusing on strategies to reduce LOS, to reduce the MV utilization ratio, to limit CPAP use and implementing a set of evidence-based VAP prevention recommendations.

Published
2023
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3. Infections in Neurosurgical Intensive Care Patients: A 3-Year Study in a Tertiary Health Care Center, North India

Author

Deepa Chaturvedi, Pragnya P. Jena, Bansidhar Tarai, and Kavita Sandhu

Subjects
infections, neurosurgical intensive care unit, risk factors, lumbar and ventricular drain, glasgow coma score, Anesthesiology, RD78.3-87.3
Abstract

Background In the neurosurgical patient community, infection rate depends on the severity of neurological injuries at the time of presentation, which is measured by the Glasgow coma score (GCS). In addition, associated comorbidities; exposure to invasive devices such as endotracheal tube, central venous catheters, and urinary catheters; and neuroscience-specific devices, such as ventricular/lumbar catheters, increase chances of infection. We share our experience from a dedicated neurosurgical intensive care unit (NSICU) of a super speciality tertiary care hospital in north India. Patients and Methods This is a 3-year retrospective and observational study from January 2014 to December 2016. Total 2,608 patients were admitted to NSICU during this period; 229 patients were included whose cultures were collected after 48 hours of admission and were positive. We have analyzed patient's risk factors, length of stay (LOS), outcome, organism details, and those health care–associated infections (HAI) that fulfilled the CDC (Centers for Disease Control and Prevention) criteria. Results Out of 2,608 patients admitted, 229 were culture positive after 48 hours of admission and 53 developed HAIs (53/2,608 [2.03%]). Male-to-female ratio was 2:1. One hundred three patients had a low GCS (5–8) and 126 had a high GCS (9–15). Average LOS in ICU was 6 days, and mortality was 17.4% (40/229). A total of 57 laboratory-confirmed positive cultures were identified in 53 patients. This included 35 from urine, 15 from blood, 2 from surgical wound, and 1 from respiratory tract. Among the HAI, the rate of ventilator-associated pneumonia (VAP) was 0.22, central line-associated bloodstream infection (CLABSI) 3.43, catheter-associated urinary tract infection (CAUTI) 5.93, and surgical site infection (SSI) 0.9%. Conclusion Neurosurgical patients are particularly vulnerable to infection because of the formidable nature of their illness, frequency of associated trauma, and presence of invasive devices. In our study, lower rate of HAIs was observed because we have a dedicated NSICU, strict infection control practices, an appropriate antimicrobial stewardship program, and early shifting of neurosurgical patients to an appropriately staffed high-dependency unit/ward.

Published
2019
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4. Transcranial Doppler-guided cerebral blood flow augmentation resulting in near complete resolution of cerebral infarct: A case report of intractable intracranial hypertension

Author

Shashi Rao, Binesh Badyal, Kavita Sandhu, and Bipin S. Walia

Subjects
barbiturate coma therapy, cerebral ischaemia, intractable intracranial hypertension, multimodality monitoring, transcranial doppler, traumatic brain injury, Anesthesiology, RD78.3-87.3
Abstract

Intractable intracranial hypertension is a nerve wrecking clinical challenge which is associated with high morbidity and mortality. Barbiturate coma therapy (BCT) is one of the recommended options for such a challenge but is associated with its own set of complications. Multimodality monitoring is a new advent in neurocritical care and provides a new vision to judiciously cater to such challenges. We hereby report a case of successfully treating intractable intracranial hypertension after maximal possible surgical decompression and evidence of well-formed cerebral ischaemic zones with intracranial multimodality monitoring guided BCT. The positive outcome was to the extent of almost complete reversal of cerebral ischaemic zones and return to normal life schedule.

Published
2016
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7. Traumatic frontonasoethmoidal encephalocele

Author

Harjinder S Bhatoe, Sanjay Roy Chowdhury, Ravi Chaturvedi, Kavita Sandhu, R Solanki, and MK Mukherji

Subjects
Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Published
2007

8. Multinational prospective study of incidence and risk factors for central-line–associated bloodstream infections in 728 intensive care units of 41 Asian, African, Eastern European, Latin American, and Middle Eastern countries over 24 years

Author

Victor Daniel Rosenthal, Ruijie Yin, Sheila Nainan Myatra, Ziad A. Memish, Camilla Rodrigues, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Majeda Afeef Al-Ruzzieh, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan, Luisa Fernanda Jiménez Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga Chavarria, Narangarav Davaadagva, Yin Hoong Lai, Katherine Gomez, Daisy Aguilar-de-Moros, Chian-Wern Tai, Alejandro Sassoe Gonzalez, Lina Alejandra Aguilar Moreno, Kavita Sandhu, Jarosław Janc, Mary Cruz Aleman Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano Medina, Maria Isabel Villegas Mota, Abeer Aly Omar, Wieslawa Duszynska, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Nellie Tumu, May Gamar Elanbya, Reshma Dongol, Vesna Mioljević, Lul Raka, Lourdes Dueñas, Nilton Yhuri Carreazo, Tarek Dendane, Aamer Ikram, Tala Kardas, Michael M. Petrov, Asma Bouziri, Nguyen Viet-Hung, Vladislav Belskiy, Naheed Elahi, Estuardo Salgado, and Zhilin Jin

Subjects
Microbiology (medical), Infectious Diseases, Epidemiology
Abstract

Objective: To identify central-line (CL)–associated bloodstream infection (CLABSI) incidence and risk factors in low- and middle-income countries (LMICs). Design: From July 1, 1998, to February 12, 2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms. Setting: The study included 728 ICUs of 286 hospitals in 147 cities in 41 African, Asian, Eastern European, Latin American, and Middle Eastern countries. Patients: In total, 278,241 patients followed during 1,815,043 patient days acquired 3,537 CLABSIs. Methods: For the CLABSI rate, we used CL days as the denominator and the number of CLABSIs as the numerator. Using multiple logistic regression, outcomes are shown as adjusted odds ratios (aORs). Results: The pooled CLABSI rate was 4.82 CLABSIs per 1,000 CL days, which is significantly higher than that reported by the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC NHSN). We analyzed 11 variables, and the following variables were independently and significantly associated with CLABSI: length of stay (LOS), risk increasing 3% daily (aOR, 1.03; 95% CI, 1.03–1.04; P < .0001), number of CL days, risk increasing 4% per CL day (aOR, 1.04; 95% CI, 1.03–1.04; P < .0001), surgical hospitalization (aOR, 1.12; 95% CI, 1.03–1.21; P < .0001), tracheostomy use (aOR, 1.52; 95% CI, 1.23–1.88; P < .0001), hospitalization at a publicly owned facility (aOR, 3.04; 95% CI, 2.31–4.01; P Conclusions: The following CLABSI risk factors are unlikely to change: country income level, facility ownership, hospitalization type, and ICU type. These findings suggest a focus on reducing LOS, CL days, and tracheostomy; using PICC instead of internal-jugular or femoral CL; and implementing evidence-based CLABSI prevention recommendations.

Published
2023

9. Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections

Author

Victor Daniel Rosenthal, Zhilin Jin, Camilla Rodrigues, Sheila Nainan Myatra, Jigeeshu Vasishth Divatia, Sanjay K. Biswas, Anjana Mahesh Shrivastava, Mohit Kharbanda, Bikas Nag, Yatin Mehta, Smita Sarma, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Chin Seng Gan, Michelle Siu Yee Low, Marissa Bt Madzlan Kushairi, Soo Lin Chuah, Qi Yuee Wang, Rajesh Chawla, Aakanksha Chawla Jain, Sudha Kansal, Roseleen Kaur Bali, Rajalakshmi Arjun, Narangarav Davaadagva, Batsuren Bat-Erdene, Tsolmon Begzjav, Mat Nor Mohd Basri, Chian-Wern Tai, Pei-Chuen Lee, Swee-Fong Tang, Kavita Sandhu, Binesh Badyal, Ankush Arora, Deep Sengupta, and Ruijie Yin

Subjects
Microbiology (medical), Infectious Diseases, Epidemiology
Abstract

Objective: To identify risk factors for mortality in intensive care units (ICUs) in Asia. Design: Prospective cohort study. Setting: The study included 317 ICUs of 96 hospitals in 44 cities in 9 countries of Asia: China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam. Participants: Patients aged >18 years admitted to ICUs. Results: In total, 157,667 patients were followed during 957,517 patient days, and 8,157 HAIs occurred. In multiple logistic regression, the following variables were associated with an increased mortality risk: central-line–associated bloodstream infection (CLABSI; aOR, 2.36; P < .0001), ventilator-associated event (VAE; aOR, 1.51; P < .0001), catheter-associated urinary tract infection (CAUTI; aOR, 1.04; P < .0001), and female sex (aOR, 1.06; P < .0001). Older age increased mortality risk by 1% per year (aOR, 1.01; P < .0001). Length of stay (LOS) increased mortality risk by 1% per bed day (aOR, 1.01; P < .0001). Central-line days increased mortality risk by 2% per central-line day (aOR, 1.02; P < .0001). Urinary catheter days increased mortality risk by 4% per urinary catheter day (aOR, 1.04; P < .0001). The highest mortality risks were associated with mechanical ventilation utilization ratio (aOR, 12.48; P < .0001), upper middle-income country (aOR, 1.09; P = .033), surgical hospitalization (aOR, 2.17; P < .0001), pediatric oncology ICU (aOR, 9.90; P < .0001), and adult oncology ICU (aOR, 4.52; P < .0001). Patients at university hospitals had the lowest mortality risk (aOR, 0.61; P < .0001). Conclusions: Some variables associated with an increased mortality risk are unlikely to change, such as age, sex, national economy, hospitalization type, and ICU type. Some other variables can be modified, such as LOS, central-line use, urinary catheter use, and mechanical ventilation as well as and acquisition of CLABSI, VAE, or CAUTI. To reduce mortality risk, we shall focus on strategies to reduce LOS; strategies to reduce central-line, urinary catheter, and mechanical ventilation use; and HAI prevention recommendations.

Published
2022

10. Multinational prospective cohort study over 18 years of the risk factors for ventilator-associated pneumonia in 9 Asian countries: INICC findings

Author

Victor Daniel Rosenthal, Ruijie Yin, Camilla Rodrigues, Sheila Nainan Myatra, Jigeeshu Vasishth Divatia, Sanjay K Biswas, Anjana Mahesh Shrivastava, Mohit Kharbanda, Bikas Nag, Yatin Mehta, Smita Sarma, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Chin Seng Gan, Michelle Siu Yee Low, Marissa Bt Madzlan Kushairi, Soo Lin Chuah, Qi Yuee Wang, Rajesh Chawla, Aakanksha Chawla Jain, Sudha Kansal, Roseleen Kaur Bali, Rajalakshmi Arjun, Narangarav Davaadagva, Batsuren Bat-Erdene, Tsolmon Begzjav, Mat Nor Mohd Basri, Chian-Wern Tai, Pei-Chuen Lee, Swee-Fong Tang, Kavita Sandhu, Binesh Badyal, Ankush Arora, Deep Sengupta, Lili Tao, and Zhilin Jin

Subjects
Infectious Diseases, Epidemiology, Health Policy, Public Health, Environmental and Occupational Health
Abstract

Ventilator associated pneumonia (VAP) rates in Asia are several times above those of US. The objective of this study is to identify VAP risk factors.We conducted a prospective cohort study, between March 27, 2004 and November 2, 2022, in 279 ICUs of 95 hospitals in 44 cities in 9 Asian countries (China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, Vietnam).153,717 patients, followed during 892,996 patient-days, acquired 3,369 VAPs. We analyzed 10 independent variables. Using multiple logistic regression we identified following independent VAP RFs= Age, rising VAP risk 1% per year (aOR=1.01; 95%CI=1.00-1.01, P.0001); male gender (OR=1.17; 95%CI=1.08-1.26, P.0001); length of stay, rising VAP risk 7% daily (aOR=1.07; 95%CI=1.06-1.07, P.0001); mechanical ventilation (MV) device utilization (DU) ratio (OR=1.43; 95%CI=1.36-1.51; p.0001); tracheostomy connected to a MV (OR=11.17; 95%CI=9.55-14.27; p.0001); public (OR=1.84; 95%CI=1.49-2.26, P.0001), and private (OR=1.57; 95%CI=1.29-1.91, P.0001) compared with teaching hospitals; upper-middle income country (OR=1.86; 95%CI=1.63-2.14, P.0001). Regarding ICUs, Medical-Surgical (OR=4.61; 95%CI=3.43-6.17; P.0001), Neurologic (OR=3.76; 95%CI=2.43-5.82; P.0001), Medical (OR=2.78; 95%CI=2.04-3.79; P.0001), and Neuro-Surgical (OR=2.33; 95%CI=1.61-3.92; P.0001) showed the highest risk.Some identified VAP RFs are unlikely to change= age, gender, ICU type, facility ownership, country income level. Based on our results, we recommend limit use of tracheostomy, reducing LOS, reducing the MV/DU ratio, and implementing an evidence-based set of VAP prevention recommendations.

Published
2022

11. The impact of healthcare-associated infections on mortality in ICU: A prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East

Author

Victor Daniel Rosenthal, Ruijie Yin, Yawen Lu, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Mohammad Abdellatif Daboor, Subhash Kumar Todi, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan, Luisa Fernanda Jiménez-Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga-Chavarria, Narangarav Davaadagva, Mat Nor Mohd Basri, Katherine Gomez-Nieto, Daisy Aguilar-de-Moros, Chian-Wern Tai, Alejandro Sassoe-Gonzalez, Lina Alejandra Aguilar-Moreno, Kavita Sandhu, Jarosław Janc, Mary Cruz Aleman-Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano-Medina, Maria Isabel Villegas-Mota, Abeer Aly Omar, Wieslawa Duszynska, Souad BelKebir, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Ziad A. Memish, and Zhilin Jin

Subjects
Infectious Diseases, Epidemiology, Health Policy, Public Health, Environmental and Occupational Health
Abstract

The International Nosocomial Infection Control Consortium has found a high ICU mortality rate. Our aim was to identify all-cause mortality risk factors in ICU-patients.Multinational, multicenter, prospective cohort study at 786 ICUs of 312 hospitals in 147 cities in 37 Latin American, Asian, African, Middle Eastern, and European countries.Between 07/01/1998 and 02/12/2022, 300,827 patients, followed during 2,167,397 patient-days, acquired 21,371 HAIs. Following mortality risk factors were identified in multiple logistic regression: Central line-associated bloodstream infection (aOR:1.84; P.0001); ventilator-associated pneumonia (aOR:1.48; P.0001); catheter-associated urinary tract infection (aOR:1.18;P.0001); medical hospitalization (aOR:1.81; P.0001); length of stay (LOS), risk rises 1% per day (aOR:1.01; P.0001); female gender (aOR:1.09; P.0001); age (aOR:1.012; P.0001); central line-days, risk rises 2% per day (aOR:1.02; P.0001); and mechanical ventilator (MV)-utilization ratio (aOR:10.46; P.0001). Coronary ICU showed the lowest risk for mortality (aOR: 0.34;P.0001).Some identified risk factors are unlikely to change, such as country income-level, facility ownership, hospitalization type, gender, and age. Some can be modified; Central line-associated bloodstream infection, ventilator-associated pneumonia, catheter-associated urinary tract infection, LOS, and MV-utilization. So, to lower the risk of death in ICUs, we recommend focusing on strategies to shorten the LOS, reduce MV-utilization, and use evidence-based recommendations to prevent HAIs.

Published
2022

12. Multinational prospective cohort study of incidence and risk factors for central line-associated bloodstream infections over 18 years in 281 ICUs of 9 Asian countries

Author

Victor Daniel Rosenthal, Ruijie Yin, Camilla Rodrigues, Sheila Nainan Myatra, Jigeeshu Vasishth Divatia, Sanjay K Biswas, Anjana Mahesh Shrivastava, Mohit Kharbanda, Bikas Nag, Yatin Mehta, Smita Sarma, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Chin Seng Gan, Michelle Siu Yee Low, Marissa Bt Madzlan Kushairi, Soo Lin Chuah, Qi Yuee Wang, Rajesh Chawla, Aakanksha Chawla Jain, Sudha Kansal, Roseleen Kaur Bali, Rajalakshmi Arjun, Narangarav Davaadagva, Ider Bat-Erdene, Tsolmon Begzjav, Mat Nor Mohd Basri, Chian-Wern Tai, Pei-Chuen Lee, Swee-Fong Tang, Kavita Sandhu, Binesh Badyal, Ankush Arora, Deep Sengupta, Lili Tao, and Zhilin Jin

Subjects
Nephrology, Surgery
Abstract

Background: Our objective was to identify central line (CL)-associated bloodstream infections (CLABSI) rates and risk factors (RF) in Asia. Methods: From 03/27/2004 to 02/11/2022, we conducted a multinational multicenter prospective cohort study in 281 ICUs of 95 hospitals in 44 cities in 9 Asian countries (China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam). For estimation of CLABSI rate we used CL-days as denominator and number of CLABSI as numerator. To estimate CLABSI RF for we analyzed the data using multiple logistic regression, and outcomes are shown as adjusted odds ratios (aOR). Results: A total of 150,142 patients, hospitalized 853,604 days, acquired 1514 CLABSIs. Pooled CLABSI rate per 1000 CL-days was 5.08; per type of catheter were: femoral: 6.23; temporary hemodialysis: 4.08; jugular: 4.01; arterial: 3.14; PICC: 2.47; subclavian: 2.02. The highest rates were femoral, temporary for hemodialysis, and jugular, and the lowest PICC and subclavian. We analyzed following variables: Gender, age, length of stay (LOS) before CLABSI acquisition, CL-days before CLABSI acquisition, CL-device utilization ratio, CL-type, tracheostomy use, hospitalization type, ICU type, facility ownership and World Bank classifications by income level. Following were independently associated with CLABSI: LOS before CLABSI acquisition, rising risk 4% daily (aOR = 1.04; 95% CI = 1.03–1.04; p Conclusions: The following CLABSI RFs are unlikely to change: country income level, facility-ownership, hospitalization type, and ICU type. Based on these findings it is suggested to focus on reducing LOS, CL-days, and tracheostomy; using subclavian or PICC instead of internal-jugular or femoral; and implementing evidence-based CLABSI prevention recommendations.

Published
2023

13. Infections in Neurosurgical Intensive Care Patients: A 3-Year Study in a Tertiary Health Care Center, North India

Author

Kavita Sandhu, Deepa Chaturvedi, Pragnya P. Jena, and Bansidhar Tarai

Subjects
medicine.medical_specialty, Critical Care and Intensive Care Medicine, law.invention, lcsh:RD78.3-87.3, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, Intensive care, Health care, medicine, Antimicrobial stewardship, Infection control, risk factors, infections, business.industry, Glasgow Coma Scale, Surgical wound, medicine.disease, Intensive care unit, Pneumonia, Anesthesiology and Pain Medicine, glasgow coma score, lcsh:Anesthesiology, Emergency medicine, lumbar and ventricular drain, neurosurgical intensive care unit, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background In the neurosurgical patient community, infection rate depends on the severity of neurological injuries at the time of presentation, which is measured by the Glasgow coma score (GCS). In addition, associated comorbidities; exposure to invasive devices such as endotracheal tube, central venous catheters, and urinary catheters; and neuroscience-specific devices, such as ventricular/lumbar catheters, increase chances of infection. We share our experience from a dedicated neurosurgical intensive care unit (NSICU) of a super speciality tertiary care hospital in north India. Patients and Methods This is a 3-year retrospective and observational study from January 2014 to December 2016. Total 2,608 patients were admitted to NSICU during this period; 229 patients were included whose cultures were collected after 48 hours of admission and were positive. We have analyzed patient's risk factors, length of stay (LOS), outcome, organism details, and those health care–associated infections (HAI) that fulfilled the CDC (Centers for Disease Control and Prevention) criteria. Results Out of 2,608 patients admitted, 229 were culture positive after 48 hours of admission and 53 developed HAIs (53/2,608 [2.03%]). Male-to-female ratio was 2:1. One hundred three patients had a low GCS (5–8) and 126 had a high GCS (9–15). Average LOS in ICU was 6 days, and mortality was 17.4% (40/229). A total of 57 laboratory-confirmed positive cultures were identified in 53 patients. This included 35 from urine, 15 from blood, 2 from surgical wound, and 1 from respiratory tract. Among the HAI, the rate of ventilator-associated pneumonia (VAP) was 0.22, central line-associated bloodstream infection (CLABSI) 3.43, catheter-associated urinary tract infection (CAUTI) 5.93, and surgical site infection (SSI) 0.9%. Conclusion Neurosurgical patients are particularly vulnerable to infection because of the formidable nature of their illness, frequency of associated trauma, and presence of invasive devices. In our study, lower rate of HAIs was observed because we have a dedicated NSICU, strict infection control practices, an appropriate antimicrobial stewardship program, and early shifting of neurosurgical patients to an appropriately staffed high-dependency unit/ward.

Published
2019

14. 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

Author

Vineya Rai, Nguyen Viet Hung, Suhas Nirkhiwale, Nirada Siriyakorn, Prasad Rajhans, Nikhil Modi, Sweta Shah, Josephine Anne Ng, Regina Berba, Vaibhavi R Subhedar, Nadimpalli Gita, Maithili Satish Kavathekar, M Tuvshinbayar, Byambadorj Batkhuu, Chandrika Kambam, Sonali Vadi, Manoj Agarwal, Burhan Jawadwala, Ramachadran Gopinath, Namita Jaggi, Ider Bat-Erdene, Tenzin Zompa, Guxiang Ye, Anup Warrier, Xiuqin Guo, M Bhattacharyya, Rhendra Hardy Mohamad Zaini, Mohit Kharbanda, Supriya Chabukswar, Le Thu Nguyet, D.P. Punia, Chin Seng Gan, Lucy Chai See Lum, Dolatsinh Zala, Andrew Trotter, Audrey Rose D Tapang, Sheila Nainan Myatra, Victor D. Rosenthal, Yatin Mehta, Kavita Sandhu, Subhash Todi, Deepak Singla, Siva Kumar, Samir Sahu, Debkishore Gupta, Nirav Pandya, Aisha Mubarak, Le Thi Anh Thu, Vanajakshi, Bala Ramachandran, Anil Karlekar, S Muralidharan, Purva Mathur, Maria Carmen Sg Buenaflor, Shakti Bedanta Mishra, Camilla Rodrigues, Nagamani Sen, Ami Varaiya, Sujit Kar Purkayasta, Suresh Kumar, Montri Luxsuwong, Nagarajan Ramakrishnan, Aruna Poojary, Asmita Sagar Sakle, Salil Kumar Mohanty, Mayur Patel, Pravin K Nair, Murali Chakravarthy, Sanjeev Singh, Suneeta Sahu, Kimberley M Dayapera, and Arpita Dwivedy

Subjects
medicine.medical_specialty, Asia, Time Factors, 030501 epidemiology, Risk Assessment, law.invention, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, law, Risk Factors, Bloodstream infection, Catheterization, Peripheral, Asian country, medicine, Humans, 030212 general & internal medicine, South east asia, Hospital Mortality, Prospective Studies, Cross Infection, Infection Control, business.industry, Incidence, Bacterial Infections, Length of Stay, Nosocomial infection control, Intensive care unit, Treatment Outcome, Nephrology, Catheter-Related Infections, Emergency medicine, Peripheral venous catheter, Surgery, 0305 other medical science, business, Vascular Access Devices
Abstract

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.

Published
2020

15. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

Author

Víctor Daniel Rosenthal, Hail M. Al-Abdely, Amani Ali El-Kholy, Safa A Aziz AlKhawaja, Hakan Leblebicioglu, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Souha Sami Kanj, Mona Foda Salama, Estuardo Salgado-Yepez, Naheed Elahi, Rayo Morfin Otero, Anucha Apisarnthanarak, Braulio Matias De Carvalho, Bat Erdene Ider, Dale Fisher, Maria Carmen S.G. Buenaflor, Michael M. Petrov, Ana Marcela Quesada-Mora, Farid Zand, Vaidotas Gurskis, Tanja Anguseva, Aamer Ikram, Daisy Aguilar de Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di Silvestre, Katarina Furova, Gloria Y. Ramos-Ortiz, May Osman Gamar Elanbya, Hindra Irawan Satari, Umesh Gupta, Tarek Dendane, Lul Raka, Humberto Guanche-Garcell, Bijie Hu, Denis Padgett, Kushlani Jayatilleke, Najla Ben Jaballah, Eleni Apostolopoulou, Walter Enrique Prudencio Leon, Alejandra Sepulveda-Chavez, Hector Miguel Telechea, Andrew Trotter, Carlos Alvarez-Moreno, Luis Kushner-Davalos, J.E. Desse, D.M. Maurizi, A.M. Montanini, G.J. Chaparro, J.P. Stagnaro, A. Romani, A.C. Bianchi, G. Álvarez, A. Palaoro, M. Bernan, R. Cabrera-Montesino, C. Domínguez, C.G. Rodríguez, C.G. Silva, E. Bogdanowicz, F.O. Riera, G. Benchetrit, I. Perez, J. Vimercati, L.S. Marcos, L. Ramasco, M. Caridi, M.C. Oyola, M.C. Rodríguez, M.L. Spadaro, M.S. Olivieri, P. Saul, P.D. Juarez, R.H. Pérez, P. Botta, D.Q. Quintana, A.M. Ríos, V. Chediack, W. Chilon, Ameena Isa Alsayegh, Fatema Hasan Yaseen, Lateefa Fardan Hani, Saleh Fakher Sowar, Tahira Anwar Magray, E.A. Medeiros, A. Alves De Oliveira, A. Romario-Mendes, C. Fernandes-Valente, C. Santos, D. Escudeiro, D. Azevedo-Ferreira Lima, D. Azevedo-Pereira, E.M. Onzi-Siliprandi, F. Serpa-Maia, F. Aguiar-Leitao, G. Assuncao-Ponte, J. Dos Anjos-Lima, J. Olszewski, K. Harten Pinto Coelho, L.F. Alves De Lima, M. Mendonca, M.L. Maciel-Canuto Amaral, M.T. Tenorio, S. Gerah, M. Andrade-Oliveira-Reis, M. Moreira, M. Ximenes-Rocha Batista, R.S. Campos-Uchoa, R. Rocha-Vasconcelos Carneiro, R. Amaral De Moraes, S.C. Do Nascimento, T. Moreira-Matos, T.M. Lima-De Barros Araujo, T. De Jesus Pinheiro-Bandeira, V.L. Machado-Silva, W.M. Santos Monteiro, E. Hristozova, E.D. Kostadinov, K. Angelova, V.A. Velinova, V.J. Dicheva, X. Guo, G. Ye, R. Li, L. Song, K. Liu, T. Liu, G. Song, C. Wang, X. Yang, H. Yu, Y. Yang, A. Martínez, A.R. Vargas-García, A. Lagares-Guzmán, A.P. González, C. Linares, C. Ávila-Acosta, D. Santofimio, D. Yepes-Gomez, D.A. Marin-Tobar, D.P. Mazo-Elorza, E.G. Chapeta-Parada, G. Camacho-Moreno, G.E. Roncancio-Vill, I.A. Valderrama-Marquez, J.E. Ruiz-Gallardo, J.O. Ospina-Martínez, J. Osorio, J.I. Marín-Uribe, J.C. López, S. Gualtero, J.R. Rojas, K. Gomez-Nieto, L.Y.M. Rincon, L. Meneses-Ovallos, L.M. Canas-Giraldo, L.D. Burgos-Florez, M. Amaral-Almeida Costa, M. Rodriguez, N. Barahona-Guzmán, O. Mancera-Paez, P.A. Rios-Arana, R. Ortega, S.L. Romero-Torres, S.M. Pulido-Leon, S. Valderrama, V.M. Moreno-Mejia, W. Raigoza-Martinez, W. Villamil-Gomez, Y.A. Pardo-Lopez, A. Argüello-Ruiz, A. Solano-Chinchilla, G.A. Muñoz-Gutierrez, I. Calvo-Hernández, L. Maroto-Vargas, M.A. Zuniga, M. Valverde-Hernandez, O. Chavarria-Ugalde, B. Herrera, C. Díaz, M.M. Bovera, C. Cevallos, C. Pelaez, E. Jara, V. Delgado, E.E. Coello-Gordon, F. Picoita, F.M. Guerrero-Toapant, F. Valencia, G. Santacruz, H. Gonzalez, L.N. Pazmino, M.F. Garcia, M. Arboleda, M. Lascano, N. Alquinga, V. Ramírez, Reham H.A. Yousef, Abd El Moniem Moustafa, A. Ahmed, A.M. Elansary, Ahmad Mahmoud Ali, Ahmed Hasanin, Antoine Abdel Messih, Arwa Ramadan, B.A. El Awady, D.M. Hassan, Doaa Abd El Aziz, Hala Hamza, Hala Mounir Agha, Islam Abdullorziz Ghazi, J. ElKholy, May Abdel Fattah, Mervat Elanany, M. Mansour, M.M.A. Haleim, R. Fouda, Rasha Hamed El-Sherif, S. Bekeit, V. Bayani, Y.S. Elkholy, Y.M. Abdelhamid, Zeinab Salah, D.M. Rivera, A. Chawla, A.N. Manked, A. Azim, A. Mubarak, A. Thakur, A.V. Dharan, A. Patil, A. Sasidharan, Anil Kumar Bilolikar, A. Anirban Karmakar, A.M. Mathew, Anuja Kulkarni, Anuradha Agarwal, Anuradha Sriram, A. Dwivedy, Arnab Dasgupta, A. Bhakta, Arul Rose Suganya, A. Poojary, Ashwin Kumar Mani, Asmita Sakle, Babu K. Abraham, Baby Padmini, B. Ramachandran, Banambar Ray, Basanta Kumar Pati, Bhaskar Narayan Chaudhury, Biraj Mohan Mishra, S. Biswas, M. Bri Saibala, Burhan Q. Jawadwala, C. Rodrigues, Chirag Modi, Chirag Patel, D.K. Khanna, Dedeepiya Devaprasad, Deepa Divekar, Deepesh G. Aggarwal, J.V. Divatia, Dolatsinh Zala, Edwin Pathrose, Fazil Abubakar, Felcy Chacko, G.S. Gehlot, Gautam Khanna, H.K. Sale, Indranil Roy, Jayant Shelgaonkar, Jehangir Sorabjee, Jincy Eappen, Justin Mathew, Jyotishka Pal, Karthikeya Varma, Kashmira Limaye Joshi, Kavita Sandhu, R. Kelkar, Lakshmi Ranganathan, L. Pushparaj, Madhav Lavate, Madhavi Latha, Madhupriya Suryawanshi, M. Bhattacharyya, Maithili Kavathekar, Manoj Kumar Agarwal, Mayur Patel, Mehul Shah, M.N. Sivakumar, Mohit Kharbanda, Mrinmoy Bej, Mrunalini Potdar, M. Chakravarthy, M. Karpagam, S.N. Myatra, N. Gita, N.P. Rao, N. Sen, N. Ramakrishnan, N. Jaggi, N. Saini, N.K. Pawar, Nikhil Modi, Nirav Pandya, Nisith Mohanty, Pooja Thakkar, Pradnya Joshi, Prafulla Kumar Sahoo, Pravin Kumar Nair, Priyadarshini Senthil Kumar, Priyanka Patil, Purnima Mukherjee, P. Mathur, Purvi Shah, R. Sukanya, Rajalakshmi Arjun, Rajesh Chawla, Ram Gopalakrishnan, Ramesh Venkataraman, S. Raut, Ravikumar Krupanandan, Reshma Tejam, Richa Misra, Ritesh Debroy, S. Saranya, Sajith Narayanan, Sanghamitra Mishra, Sanjith Saseedharan, Sankar Sengupta, S.K. Patnaik, Saswati Sinha, Seelas Blessymole, Seema Rohra, Senthilkumar Rajagopal, Shanta Mukherjee, Sharmila Sengupta, Sheeba John, Shefali Bhattacharya, null Sijo, Sinchan Bhattacharyya, S. Singh, T. Sohanlal, Sonali Vadi, S.S. Dalal, S.K. Todi, Subodh Kumar, Sudha Kansal, Sudhjan Misra, Sudipta Bhattacharyya, Suhas Nirkhiwale, Sujit Kar Purkayastha, Sujoy Mukherjee, S. Sahu, Sunil Sharma, Suresh Kumar, S. Basu, S. Shetty, S. Shah, T. Singhal, Thara Francis, Thejasvini Anand, V. Venkateshwar, Valsa Thomas, V. Kothari, null Velupandi, Vini Kantroo, Gortap Sitohang, Retno Kadarsih, Anahita Sanaei, Behzad Maghsudi, Golnar Sabetian, Mansoor Masjedi, Masoud Alebouyeh, Somayeh Jahani Sherafat, Yassir Khidir Mohamed, Abdulrahim Al Khamis, Adnan Soliman Alsaadi, Ahmed Abdoh Al-Jarie, Aisha Hassan Mutwalli, A.S.K. Rillorta, Anumol Thomas, Ashraf Kelany, Athena Manao, Dhaffer Moghram Alamri, E.B. Santiago, E.P. Cruzpero, Fahad Ahmed Sawan, Fatima Abdullah Al Qasmah, Haeel Alabdaly, Hajer Am Al-Dossary, Hala Ahmed, Hala Roshdi, Halima Yahia Al-Alkami, Hana Hanafi, Hassan Eisa Ammari, Hatem Mohd Al Hani, Ibrahim A.M. Alzaydani Asiri, Jeffrey Asidera Mendoza, Jomol Philipose, Joy Ola Selga, null Kehkashan, Khalid Mohammed Ghalilah, Leide Shyrine Redito, L. Josph, M. Al-Alawi, Manal Mansour Al-Gethamy, Marjory Madco, M.G. Manuel, M. Girvan, Mervat Aldalaton, M. De Guzman, Modhi Alkhamaly, Mohammad Masfar, Mohammed Ahmed Ali Karrar, Munayfa Musallam Al Azmi, Myrna Lim Quisai, Myrna Misador Torres, N. Al-Abdullah, Nader Ahmed Tawfic, Nashwa Elsayed, Nawal Salah Abdulkhalik, Nehad Abdulshakour Bugis, Neilia Cardinal Ariola, N. Gad, Nesreen Alghosn, Nidal Tashkandi, N. Al Zharani, P.A. De Vera, Radhika Krishnan, Raed Hassan Al Shehri, Rasha Nour Aldeen Jaha, Reny Thomas, Rhea Lynn Cresencia, R. Penuliar, R.V. Lozada, S. Al Qahtani, Sameh Twfik, Sarah Hassan Al Faraj, Sherin El-Sherbiny, Siti Jhulmina B. Alih, Solita Briones, Syed Zahid Bukhari, Tariq Saad Abdulhadi Alotaibi, Uma Gopal, Usha Nair, Wael Abdulrahman Abdulatif, Waleed Mohd Hussain, Wynndale Mae Demotica, G. Spahija, N. Baftiu, A. Gashi, Abeer A. Omar, A.M. Mohamed, F.M. Rebello, Haifaa Hassan Almousa, Naglaa Mahmoud Abdo, S.M. George, Soad Khamis, Suja Thomas, A. Ahmad Zaatari, A. Anwar Al Souheil, H. Ayash, I. Zeid, J. Tannous, N.K. Zahreddine, R. Ahmadieh, T. Mahfouz, T. Kardas, V. Tanzi, Z. Kanafani, Z. Hammoud, A. Dagys, D. Grinkeviciute, R. Kevalas, T. Kondratas, Milena Petrovska, Katja Popovska, Zan Mitrev, Zaneta Bogoevska Miteva, Katerina Jankovska, Snezana Tufekcievska Guroska, Chin Seng Gan, Ainul Auzani Othman, Aliza Mohamad Yusof, Anis Siham Zainal Abidin, Fadzlina Abdul Aziz, Foong Kit Weng, Hasimah Zainol, Kamal Bashar Abu Bakar, Lucy Chai See Lum, Marzida Mansor, Mazuin Kamarul Zaman, Mohamad Fadhil Hadi Jamaluddin, Mohd Shahnaz Hasan, Raha Abdul Rahman, Rhendra Hardy Mohamad Zaini, Rosliza Zhazali, Sasheela Sri La Sri Ponnampala, Soo Lin Chuah, Wan Fadzlina Wan Mohd Shukeri, Wan Nazaruddin Wan Hassan, Wan Nurbayah Wan Yusoff, Wan Rahiza Wan Mat, M.A. Cureno-Diaz, G. Aguirre-Avalos, A. Flores-Alvarado, A. Cerero-Gudino, A. Zamores-Pedroza, B. Cano-Munoz, B.E. Hernandez-Chena, C.C. Carreon-Martinez, H. Coronado-Magana, F. Corona-Jimenez, E. Rodriguez-Noriega, E. Alcala-Martinez, E. Gonzalez-Diaz, F.M. Guerra-Infante, G. Arteaga-Troncoso, G. Martinez-Falcon, G. Leon-Garnica, H.A. Delgado-Aguirre, H.R. Perez-Gomez, I.E. Sosa-Gonzalez, J.A. Galindo-Olmeda, J.J. Ayala-Gaytan, J. Rodriguez-Pacheco, L. Zamorano-Flores, J.A. Lopez-Pulgarin, M.G. Miranda-Novales, M. Ramírez, M. Lopez-Hurtado, M. Lozano, M.E. Gomez, M.E. Sanchez-Castuera, M. Kasten-Monges, M. Gonzalez-Martinez, M. Sanchez-Vargas, M.C. Culebro-Burguet, M.A. Altuzar-Figueroa, J.C. Mijangos-Mendez, O.G. Ramires, O.S. Espinosa, R. De Leon-Escobedo, R. Salas-Flores, R. Ruiz-Rendon, S. Petersen-Morfin, S.A. Aguirre-Diaz, S. Esparza-Ahumada, S. Vega-Gonzalez, V. Gaona-Flores, V.A. Monroy-Colin, Z. Cruz-Rivera, A. Bat-Erdene, Batsaikhan Narankhuu, Batsuren Choijamts, Battsetseg Tuvdennyam, Byambadorj Batkhuu, K.H. Chuluunchimeg, D. Enkhtsetseg, G. Batjargal, G. Bayasgalan, M. Dorj, Naranpurev Mendsaikhan, Otgon Baatar, P. Suvderdene, S. Baigalmaa, T. Khajidmaa, Tsolmon Begzjav, null Tsuyanga, Z. Ariyasuren, A.A. Zeggwagh, K. Berechid, K. Abidi, N. Madani, R. Abouqal, Anjeela Koirala, Rashmi Giri, Samana Sainju, Subhash Prasad Acharya, Abeera Ahmed, Aun Raza, Azra Parveen, Faisal Sultan, Maria Khan, Nadeem Paul, Nargis Daud, Sana Yusuf, Summiya Nizamuddin, E. Garcia-Mayorca, E.G. Castaño, J.L. Moreno-Castillo, J.M. Ballinas-Aquino, L. Lara, M. Vargas, M.I. Rojas-Bonilla, S.J. Ramos, T. Mapp, V. De Iturrado, C.E. La Hoz Vergara, C.F. Linares-Calderon, D. Moreno, E. Ramirez, F.M. Ramírez Wong, G.M. Montenegro-Orrego, H.R. Sandoval-Castillo, J. Pichilingue-Chagray, J. Mueras-Quevedo, K.F. Aibar-Yaranga, L.I. Castillo-Bravo, L.M. Santivanez-Monge, M.J. Mayorga-Espichan, M.L.G. Rosario-Tueros, M.V. Changano-Rodriguez, N.E. Salazar-Ramirez, V.A. Marquez-Mondalgo, Anna Lyn N. Tajanlangit, Arnefelina S. Tamayo, Cristina Mari Jean P. Llames, Ever Labro, Ana P. Dy, J.D. Fortin, L.D. Bergosa, L.G. Salvio, V. Bermudez, M.C. Sg-Buenaflor, M.F. Trajano, M.T. Mendoza, O.P. Javellana, R.R. Maglente, Y. Arreza-Galapia, J.A. Navoa-Ng, A. Kubler, B. Barteczko-Grajek, B. Dragan, M. Zurawska, M. Mikaszewska-Sokolewicz, M. Zielinska, G.Y. Ramos-Ortiz, A. Florin-Rogobete, C. Daliborca Vlad, D. Muntean, D. Sandesc, M. Papurica, M. Licker, Ovidiu Horea Bedreag, R. Popescu, S.D. Grecu, V. Dumitrascu, A. Molkov, D. Galishevskiy, M. Furman, A. Simic, D. Lekic, G. Ristic, J. Eremija, J. Kojovic, L. Nikolic, M. Bjelovic, A. Lesnakova, S. Hlinkova, M.O. Gamar-Elanbya, Namphon Supa, Pornpheth Prasan, Rungratchanee Pimathai, Suthinee Wanitanukool, Suwara Somabutr, N. Ben-Jaballah, A. Borgi, A. Bouziri, A. Dilek, A. Oncul, A. Kaya, Ali Pekcan Demiroz, A. Gunduz, A. Ozgultekin, Asuman Inan, A.N. Yalcin, A. Ramazanoglu, A. Engin, A. Willke, Basak Ceyda Meco, C. Aygun, C. Bulut, C. Uzun, C. Becerik, Cigdem Ataman Hatipoglu, Cigdem Yildirim Guclu, D. Ozdemir, D. Yildizdas, D. Ugurcan, E. Azak, E. Guclu, Esmeray Mutlu Yilmaz, F. Sebnem-Erdinc, F. Sirmatel, F. Ulger, Ferhat Sari, Filiz Kizilates, G. Usluer, G. Ceylan, G. Ersoz, G. Kaya, Gunay Tuncer Ertem, G. Senol, Hasan Agin, Hatice Cabadak, H. Yilmaz, Hulya Sungurtekin, Humeyra Zengin, H. Turgut, I. Ozgunes, I. Devrim, I. Erdem, Inşa Gul Ekiz Işcanlı, M. Mehmet Bakir, M.F. Geyik, M. Oral, M. Meric, M. Cengiz, M. Ozcelik, M. Altindis, M. Sunbul, N. Elaldi, N. Kuyucu, N. Unal, N. Oztoprak, N. Yasar, Nurettin Erben, Nuri Bayram, Oguz Dursun, Oguz Karabay, O. Coskun, Ozden Ozgur Horoz, Ozge Turhan, Ozlem Sarac Sandal, Recep Tekin, Saban Esen, Selvi Yener Erdogan, Serhat Unal, Sevim Karacorlu, Suha Sen, Suzan Sacar, Volkan Yarar, Yeliz Oruc, Yusuf Sahip, Zeynep Kaya, Anamma Philip, Ashraf Elhoufi, Hussain Alrahma, E. Sachez, F. Perez, G.D. Empaire, H. Vidal, L. Montes-Bravo, M.E. Guzman Siritt, N. Orozco, N. Navarrete, Y. Ruiz, Z. Duran-Gil De Anez, Dang Thi Van Trang, Dao Quang Minh, Dao Xuan Co, Dinh Pham Phuong Anh, Le Thi Anh Thu, Le Thi Diem Tuyet, Le Thi Thu Nguyet, Ngo uy Chau, Nguyen Gia Binh, Nguyen Phuc Tien, Nguyen Quoc Anh, Phan Thi Hang, Tran Thi My Hanh, Tran Thi Thuy Hang, Truong Anh Thu, Vo Thi Hong Thoa, Ondokuz Mayıs Üniversitesi, and MERİÇ KOÇ, MELİHA

Subjects
Male, 0301 basic medicine, Pediatrics, Imipenem, Antibiotic resistance, Epidemiology, health care facilities, manpower, and services, Ceftazidime, Global Health, 0302 clinical medicine, Bloodstream infection, Prospective Studies, 030212 general & internal medicine, Child, Aged, 80 and over, Cross Infection, Urinary tract infection, Incidence, Health Policy, Ventilator-associated pneumonia, Middle Aged, Intensive Care Units, Infectious Diseases, Amikacin, Child, Preschool, Limited resources countries, Female, medicine.drug, Adult, medicine.medical_specialty, Adolescent, Health care-associated infection, 030106 microbiology, Catheter-associated urinary tract infection, Developing countries, Young Adult, 03 medical and health sciences, Intensive care, medicine, Humans, Hospital infection, Aged, business.industry, Infant, Newborn, Public Health, Environmental and Occupational Health, Infant, Device use, Nosocomial infection control, medicine.disease, Emergency medicine, Central line-associated bloodstream infections, business
Abstract

Hasan, M. Shahnaz/0000-0002-7493-7416; Abouqal, Redouane/0000-0002-6117-4341; Altindis, Mustafa/0000-0003-0411-9669; Masjedi, Mansoor/0000-0001-6175-9289; Popescu, Roxana/0000-0002-9387-1141; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; Meco, Basak Ceyda/0000-0003-2951-9634; Kumar, Perikala Vijayananda/0000-0001-8315-7000; Zand, Farid/0000-0003-3489-3372; Maghsoudi, Behzad/0000-0002-1279-8799; KAMARUL ZAMAN, MAZUIN/0000-0002-7920-6399; Gan, Chin Seng/0000-0002-6758-4798; Horoz, Ozden Ozgur/0000-0001-7590-650X; Medeiros, Eduardo A/0000-0002-6205-259X; Sabetian, Golnar/0000-0001-8764-2150; UNAL, SERHAT/0000-0003-1184-4711; Gan, Chin Seng/0000-0002-6758-4798; Delia, Muntean/0000-0001-9100-4530; Yalcin, Ata Nevzat/0000-0002-7243-7354; Leblebicioglu, Hakan/0000-0002-6033-8543; Horhat, Florin George/0000-0001-6133-0204; Yousef, Reham H. A./0000-0003-4004-3008; Delgado Aguirre, Hector Alberto/0000-0001-5448-7975; El Kholy, Amani/0000-0002-0645-7664; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Sanaei Dashti, Anahita/0000-0002-2827-3575; KARABAY, OGUZ/0000-0003-1514-1685; Barahona G., Nayide/0000-0003-3559-6900; Stagnaro, Juan Pablo/0000-0003-3836-9957; Alexandru Florin, Rogobete/0000-0003-1286-4431; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Jayatilleke, Kushlani/0000-0002-3931-6630; Unal, Necmettin/0000-0002-9440-7893; Duszynska, Wieslawa/0000-0002-5880-4904; Ngo, Quy Chau/0000-0002-6787-2757; Elmanakhly, Arwa/0000-0001-8557-0536; yildizdas, dincer/0000-0003-0739-5108; Kanj, Souha/0000-0001-6413-3396; Gupta, Umesh/0000-0001-7717-1404 WOS: 000392626300014 PubMed: 27742143 Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DAHAI), we collected prospective data from861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central lineassociated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheterassociated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. VDR; Foundation to Fight against Nosocomial Infections The funding for design, development, maintenance, technical support, data validation, and report generation of the Surveillance Online System, and the activities carried out at International Nosocomial Infection Control Consortium headquarters, were provided by VDR and the Foundation to Fight against Nosocomial Infections.

Published
2016

16. Six-year multicenter study on short-term peripheral venous catheters-related bloodstream infection rates in 204 intensive care units of 57 hospitals in 19 cities of India: International Nosocomial Infection Control Consortium (INICC) findings

Author

D.P. Punia, Mohit Kharbanda, Kavita Sandhu, Siva Kumar, Nagamani Sen, Maithili Satish Kavathekar, Sonali Vadi, Dolatsinh Zala, Samir Sahu, Ramachadran Gopinath, Tenzin Zompa, Manoj Agarwal, Sheila Nainan Myatra, Vaibhavi R Subhedar, Nadimpalli Gita, Burhan Jawadwala, Nikhil Modi, Suhas Nirkhiwale, Mayur Patel, S Muralidharan, Camilla Rodrigues, Sanjeev Singh, Arpita Dwivedy, Aruna Poojary, Sweta Shah, Anup Warrier, Nagarajan Ramakrishnan, Ami Varaiya, Sujit Kar Purkayasta, Suneeta Sahu, Anil Karlekar, M Bhattacharyya, Purva Mathur, Pravin K Nair, Deepak Singla, Aisha Mubarak, Shakti Bedanta Mishra, Asmita Sagar Sakle, Salil Kumar Mohanty, Debkishore Gupta, Murali Chakravarthy, M.R. Vanajakshi, Prasad Rajhans, Suresh Kumar, Namita Jaggi, Bala Ramachandran, Subhash Todi, Yatin Mehta, Nirav Pandya, Victor D. Rosenthal, Chandrika Kambam, and Supriya Chabukswar

Subjects
medicine.medical_specialty, Catheters, Epidemiology, India, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Antibiotic resistance, Intensive care, Sepsis, medicine, Infection control, Humans, 030212 general & internal medicine, Prospective Studies, Cities, 0303 health sciences, Cross Infection, Infection Control, 030306 microbiology, Pseudomonas aeruginosa, business.industry, Health Policy, Incidence (epidemiology), Public Health, Environmental and Occupational Health, Nosocomial infection control, Hospitals, Intensive Care Units, Infectious Diseases, Catheter-Related Infections, Emergency medicine, Peripheral venous catheter, business, Developed country
Abstract

Background Short-term peripheral venous catheters-related bloodstream infections (PVCR-BSIs) rates have not been systematically studied in developing countries, and data on their incidence by number of device-days are not available. Methods Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013 to May 31, 2019 in 204 intensive care units (ICUs), members of the International Nosocomial Infection Control Consortium (INICC), from 57 hospitals in 19 cities of India. We applied US INICC definition criteria and reported methods using the INICC Surveillance Online System. Results We followed 7,513 ICU patients for 296,893 bed-days and 295,795 short term peripheral venous catheter (PVC)-days. We identified 863 PVCR-BSIs, amounting to a rate of 2.91/1,000 PVC-days. Mortality in patients with PVC but without PVCR-BSI was 4.14%, and 11.59% in patients with PVCR-BSI. The length of stay in patients with PVC but without PVCR-BSI was 4.13 days, and 5.9 days in patients with PVCR-BSI. The micro-organism profile showed 68% of gram negative bacteria: Escherichia coli (23%), Klebsiella spp (15%), Pseudomonas aeruginosa (5%), and others. The predominant gram-positive bacteria were Staphylococcus aureus (10%). Conclusions PVCR-BSI rates found in our ICUs were much higher than rates published from industrialized countries. Infection prevention programs must be implemented to reduce the incidence of PVCR-BSIs.

Published
2019

18. Transcranial Doppler-guided cerebral blood flow augmentation resulting in near complete resolution of cerebral infarct: A case report of intractable intracranial hypertension

Author

Binesh Badyal, Shashi Rao, Bipin S Walia, and Kavita Sandhu

Subjects
medicine.medical_specialty, cerebral ischaemia, Traumatic brain injury, Critical Care and Intensive Care Medicine, intractable intracranial hypertension, lcsh:RD78.3-87.3, Surgical decompression, High morbidity, barbiturate coma therapy, medicine, Coma, business.industry, traumatic brain injury, Neurointensive care, medicine.disease, multimodality monitoring, Complete resolution, Transcranial Doppler, Surgery, Anesthesiology and Pain Medicine, Cerebral blood flow, lcsh:Anesthesiology, transcranial doppler, Neurology (clinical), Radiology, medicine.symptom, business
Abstract

Intractable intracranial hypertension is a nerve wrecking clinical challenge which is associated with high morbidity and mortality. Barbiturate coma therapy (BCT) is one of the recommended options for such a challenge but is associated with its own set of complications. Multimodality monitoring is a new advent in neurocritical care and provides a new vision to judiciously cater to such challenges. We hereby report a case of successfully treating intractable intracranial hypertension after maximal possible surgical decompression and evidence of well-formed cerebral ischaemic zones with intracranial multimodality monitoring guided BCT. The positive outcome was to the extent of almost complete reversal of cerebral ischaemic zones and return to normal life schedule.

Published
2016

19. Chemical Eye Injury in a Case of Cervical Spine Surgery

Author

Kavita Sandhu and Sarika Juneja

Subjects
Cervical spine surgery, medicine.medical_specialty, Anesthesiology and Pain Medicine, Spine surgery, Decompression, business.industry, MEDLINE, medicine, Surgery, Neurology (clinical), Chemical eye injury, business
Published
2019

20. Acute Subdural Hematoma Causing Neurogenic Pulmonary Edema Following Lumbar Spine Surgery

Author

Kavita Sandhu, Ashoo Wadehra, Arnab Dasgupta, and Abhijeet Raha

Subjects
Adult, Male, Neurogenic pulmonary edema, medicine.medical_specialty, Dopamine, Dopamine Agents, Pulmonary Edema, Lumbar vertebrae, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Hematoma, Postoperative Complications, Furosemide, medicine, Lumbar spine surgery, Animals, Hematoma, Subdural, Acute, Humans, Diuretics, Lumbar Vertebrae, medicine.diagnostic_test, Morphine, business.industry, Brain, 030208 emergency & critical care medicine, Magnetic resonance imaging, medicine.disease, Pulmonary edema, Magnetic Resonance Imaging, Surgery, Analgesics, Opioid, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Anesthesia, Neurology (clinical), business, Acute subdural hematoma, 030217 neurology & neurosurgery, medicine.drug
Published
2015

21. Secondary brain injury: Prevention and intensive care management

Author

T Prabhakar, Kavita Sandhu, Tvsp Murthy, Parmeet Bhatia, and RL Gogna

Subjects
medicine.medical_specialty, business.industry, Injury prevention, medicine, Intensive care management, Medical emergency, Intensive care medicine, medicine.disease, business
Published
2005

25. Resuscitation of the ischaemic brain

Author

Kavita Sandhu, Tvsp Murthy, and Brig T Prabhakar

Subjects
medicine.medical_specialty, Resuscitation, business.industry, Emergency medicine, medicine, business
Published
2004

26. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

Author

Víctor Daniel Rosenthal, Dennis George Maki, Yatin Mehta, Hakan Leblebicioglu, Ziad Ahmed Memish, Haifaa Hassan Al-Mousa, Hanan Balkhy, Bijie Hu, Carlos Alvarez-Moreno, Eduardo Alexandrino Medeiros, Anucha Apisarnthanarak, Lul Raka, Luis E. Cuellar, Altaf Ahmed, Josephine Anne Navoa-Ng, Amani Ali El-Kholy, Souha Sami Kanj, Ider Bat-Erdene, Wieslawa Duszynska, Nguyen Van Truong, Leonardo N. Pazmino, Lucy Chai See-Lum, Rosalia Fernández-Hidalgo, Gabriela Di-Silvestre, Farid Zand, Sona Hlinkova, Vladislav Belskiy, Hussain Al-Rahma, Marco Tulio Luque-Torres, Nesil Bayraktar, Zan Mitrev, Vaidotas Gurskis, Dale Fisher, Ilham Bulos Abu-Khader, Kamal Berechid, Arnaldo Rodríguez-Sánchez, Florin George Horhat, Osiel Requejo-Pino, Nassya Hadjieva, Nejla Ben-Jaballah, Elías García-Mayorca, Luis Kushner-Dávalos, Srdjan Pasic, Luis E. Pedrozo-Ortiz, Eleni Apostolopoulou, Nepomuceno Mejía, May Osman Gamar-Elanbya, Kushlani Jayatilleke, Miriam de Lourdes-Dueñas, Guadalupe Aguirre-Avalos, Diego Marcelo Maurizi, Adriana Montanini, Maria Laura Spadaro, Lorenzo Santiago Marcos, Priscila Botta, Florencia Maria Jerez, Maria Constanza Chavez, Lucia Ramasco, Maria Isabel Colqui, Maria Silvia Olivieri, Ana Silvia Rearte, Gladys Edith Correa, Paola Deolinda Juarez, Paola Fabiana Gallardo, Miriam Patricia Brito, Gabriel Horacio Mendez, Julia Rosa Valdez, Lorena Paola Cardena, Jose Maria Harystoy, Gustavo Jorge Chaparro, Claudia Gabriela Rodriguez, Rodolfo Toomey, Maria Caridi, Monica Viegas, Marisa Liliana Bernan, Adriana Romani, Claudia Beatriz Dominguez, Luis Kushner Davalos, Rosana Richtmann, Camila Almeida Silva, Tatiane T. Rodrigues, Amaury Mielle Filho, Ernandi Dagoberto Seerig Palme, Aline Besen, Caroline Lazzarini, Caroline Batista Cardoso, Francisco Kennedy Azevedo, Ana Paula Fontes Pinheiro, Aparecida Camacho, Braulio Matias De Carvalho, Maria Jose Monteiro De Assis, Ana Paula Vasconcelos Carneiro, Maria Lilian Maciel Canuto, Keyla Harten Pinto Coelho, Tamiris Moreira, Agamenon Alves Oliveira, Marcela Maria Sousa Colares, Marcia Maria De Paula Bessa, Tereza De Jesus Pinheiro Gomes Bandeira, Renata Amaral De Moraes, Danilo Amâncio Campos, Tânia Mara Lima De Barros Araújo, Maria Tereza Freitas Tenório, Simone Amorim, Manuela Amaral, Julianne Da Luz Lima, Lindalva Pino Da Silva Neta, Caphiane Batista, Fabio Jorge De Lima Silva, Maria C. Ferreira De Souza, Katia Arruda Guimaraes, Julia Marcia Maluf Lopes, Karina M. Nogueira Napoles, Lorena Luiza Silva Neto Avelar, Lilian Aguiar Vieira, Luis Gustavo De Oliveira Cardo, Christianne F.V. Takeda, Glaydson A. Ponte, Fco Eduardo Aguiar Leitão, Ricardo De Souza Kuchenbecker, Rodrigo Pires Dos Santos, Erci Maria Onzi Siliprandi, Luiz Fernando Baqueiro Freitas, Ianick Souto Martins, Daiane Casi, Maria Angela Maretti Da Silva, Sergio Blecher, Margarete Villins, Reinaldo Salomao, Solange Regina Oliveira Castro, Daniela V. Da Silva Escudero, Mariana Andrade Oliveira Reis, Marcelo Mendonca, Valter Furlan, Antonio Claudio do Amaral Baruzzi, Tarquino Eristidesg Sanchez, Marina Moreira, Wania Vasconcelos de Freitas, Leonardo Passos de Souza, Velmira Angelova Velinova, Michael M. Petrov, Dimitar Georgiev Karadimov, Emil D. Kostadinov, Violeta Jivkova Dicheva, Chaohua Wang, Xiuqin Guo, Xihua Geng, Shufang Wang, Jinzhi Zhang, Ling Zhu, Shufang Zhuo, Chunli Guo, Tao Lili, Li Ruisheng, Liu Kun, Xuesong Yang, Li Yimin, Mao Pu, Li Changan, Yiang Shumei, Wu Kangxiong, Lin Meiyi, Guxiang Ye, Xu Ziqin, Suo Yao, Song Liqiang, Luis Marino Cañas Giraldo, Elsa Margarita Trujillo Ramirez, Paola Andrea Rios, Juan Carlos Torres Millan, Edwin Giovanny Chapeta Parada, Andres Eduardo Mindiola Rochel, Andres H. Corchuelo Martinez, Ana Marãa Perez Fernandez, Nayide Barahona Guzman, Alfredo Lagares Guzman, Marena Rodriguez Ferrer, Yazmin Leon Vega, Heidi Johanna Munoz, Germán Camacho Moreno, Sandra Liliana Romero Torres, Herlidia Taboada Hernandez, Ismael A. Valderrama MarquezClaudia Linares, Monica Espinosa Valencia, Lusayda Sanchez Corrales, Sandra Milena Bonilla, Jorge Ivan Marin Uribe, David Yepes Gomez, Javier Ospina Martinez, Luz Dary Burgos Florez, Johanna Osorio, Dagoberto Santofimio, Lorena Matta Cortes, Wilmer Villamil-Gomez, Gabriel Munoz Gutierrez, Adela Arguello Ruiz, Carlos Gonzalez Fuentes, Antonio Solano Chinchilla, Ivar Calvo Hernandez, Olber Chavarria Ugalde, Humberto Guanche Garcell, Clara Morales Perez, Selin Bardak, Sumru Ozkan, Nepomuceno Mejia, Adrian M. Puello Guerrero Glenny Mirabal, Margarita Delgado, Ramona Severino, Eliesel Lacerda, Gilda Tolari, María Marcela Bovera, Diego Barahona Pinto, Pedro Fernández González, Gasdali Santacruz, Nelly Alquinga, Celso Zaruma, Nelson Remache, Diego Morocho, Mario Arboleda, Mario Cadena Zapata, Maria Fernanda Garcia, Fabricio Picoita, Jorge Velez, Marcia Valle, Estuardo Salgado Yepez, Diego Morocho Tutillo, Ricardo Arteaga Mora, Andrea Peña Padilla, Mayra Chango, Karina Cabezas, Shirley Tenorio López, Ana Lucía Bonilla Escudero, Gladys Tatiana Sánchez, Hugo Alberto Gonzalez Flores, Islam Abdullorziz Ghazi, Mohamed Hassan, Ghada A. Ismail, Reham Hamed, Mona Mohiedden Abdel-Halim, May Abd El-Fattah, Doaa Abdel-Aziz, Zeinab Salah Seliem, Rasha Hamed Elsherif, Reham Ali Dewdar, Abeer Ahmed Mohmed, Lamiaa Abdel-Fatteh Ahmed, Lilian De Jesus Machuca, Concepcion Bran De Casares, Prokopis Kithreotis, Maria Daganou, Dimitrios Veldekis, Maria Kartsonaki, Achilleas Gikas, Marco Tulio Luque Torres, Denis Padgett, Doris Maribel Rivera, Namita Jaggi, Camilla Rodrigues, Bhagyesh Shah, Keyur Parikh, Jigar Patel, Riya Thakkar, Murali Chakravarthy, B.N. Gokul, R. Sukanya, Leema Pushparaj, Thejas Vini, Sukanya Rangaswamy, Saroj Kumar Patnaik, Vempati Venkateshwar, Biju John, Shamsher Dalal, Suneeta Sahu, Samir Sahu, Banambar Ray, Sudhiranjan Misra, Nisith Mohanty, Biraj Mohan Mishra, Prafulla Sahoo, Naresh Parmar, Sanghamitra Mishra, Basanta Kumar Pati, Santosh Singh, Bhabani Shankar Pati, Aparajita Panda, Swarna Banergee, Dipankar Padhihari, Soumya Samal, Karthikeya Varma, Velu Pandi Suresh Kumar, Ram Gopalakrishnan, Nagarajan Ramakrishnan, Babu Kuruvilla Abraham, Senthilkumar Rajagopal, Ramesh Venkatraman, Ashwin Kumar Mani, Dedeepiya Devaprasad, Lakshmi Ranganathan, Thara Francis, Kotturathu Mammen Cherain, Bala Ramachandran, Ravikumar Krupanandan, S. Muralidharan, Murali Karpagam, Baby Padmini, S. Saranya, Siva Kumar, Nirav Pandya, Rajesh Kakkar, Tenzin Zompa, Narinder Saini, Srinivas Samavedam, Ganshyam Jagathkar, Suhas Nirkhiwale, G.S. Gehlot, Shefali Bhattacharya, Sanjeev Sood, Suman Singh, Sanjeev Singh, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Susmita Basu, Anuradha Agarwal, Manoj Agarwal, Mohit Kharbanda, Sankar Sengupta, Anirban Karmakar, Debkishore Gupta, Ajoy Krishna Sarkar, Rimita Dey, Chandramouli Bhattacharya, Mammen Chandy, V.R. Ramanan, Aseem Mahajan, Manas Roy, Sanjay Bhattacharya, Saswati Sinha, Indranil Roy, Umesh Gupta, Sujoy Mukherjee, Mrinmoy Bej, Purnima Mukherjee, Sumana Baidya, Afzal Azim, Asmita Sagar Sakle, Jehangir Soli Sorabjee, Mrunalini Subhash Potdar, Vaibhavi R. Subhedar, F.E. Udwadia, Hena Francis, Arpita Dwivedy, Sheena Binu, Suvin Shetty, Pravin Kumar Nair, Devendra K. Khanna, Felcy Chacko, Seelas Blessymole, Preeti Rajeev Mehta, Tanu Singhal, Sweta Shah, Vatsal Kothari, Reshma Naik, Mayur Harshadrai Patel, Deepesh Gokulchand Aggarwal, Burhanuddin Qutbuddin Jawadwala, Niketa Kaul Pawar, Shoeb Nizamuddin Kardekar, Abizer Nuruddin Manked, S.N. Myatra, J.V. Divatia, R. Kelkar, S.K. Biswas, V. Raut, S. Sampat, Alka Thool, Anil Karlekar, Sumi Nandwani, Sudhir Gupta, Sanjay Singhal, Madhu Gupta, Purva Mathur, Subodh Kumar, Kavita Sandhu, Arnab Dasgupta, Abhijeet Raha, Padmalatha Raman, Ashoo Wadhera, Binesh Badyal, Sarika Juneja, Bikas Mishra, Sunil Sharma, Megha Mehrotra, Jayant Shelgaonkar, Vikram Padbidri, Rohini Dhawale, Sheena Mary Sibin, Dileep Mane, Hanamant Kashinath Sale, Mohammad Mukhit Abdul Gaffar Kazi, Supriya Chabukswar, Anju Mathew, Dipti Gaikwad, Amol Harshe, Gita Nadimpalli, Sunil Bhamare, Soniya Thorat, Omnarayan Sarda, Pattabhiramarao Nadimpalli, Angelina Mendonca, Sujata Malik, Asmita Kamble, Nilakshi Kumari, Sohini Arora, Nita Munshi, Deepa Ganesh Divekar, Maithili Satish Kavathekar, Anuja Kedar Kulkarni, Madhupriya Vijay Suryawanshi, Madhavi Latha Bommala, Anil Bilolikar, Kashmira Limaye Joshi, Charulata Pamnani, Harvinder Wasan, Sonali Khamkar, Leena Steephen, Arjun Rajalakshmi, Anzar Thair, Aisha Mubarak, Swathy Sathish, Suresh Kumar, H. Sunil, Sujith Sujith, null Dinesh, Nagamani Sen, Nitin Shinde, Masoud Alebouyeh, Somayeh Jahani-Sherafat, Mohammad Reza Zali, Mohammad Reza Sarbazi, Nahid Mansouri, Elahe Tajeddin, Maryam Razaghi, Simasadat Seyedjavadi, Marjan Rashidan, Mansoor Masjedi, Behzad Maghsudi, Golnar Sabetian, Anahita Sanaei, Atefeh Yousefipour, Abdullah Mufareh Assiri, Elaine Mari Furukawa-Cinquini, Areej Dhafer Alshehri, Alysia Faye Giani, Nadia Lynette Demaisip, Elizabeth Laungayan Cortez, Analen Fabros Cabato, Jerlie Mae Gonzales Celiz, Ibrahim A.M. Al-Zaydani Asiri, Yassir Khidir Mohammed, Mohammed Abdullah Al Raey, Ali Omer Abdul Aziz, Saeed Ali Al Darani, Misbah Rehman Aziz, Roaa Hasan Basri, Duaa Khalil Al-Awadi, Syed Zahid Bukhari, Rosita Gasmin Aromin, Evangelina Balon Ubalde, Apsia Musa Molano, Hessa Abdullah Al Enizy, Celia Flores Baldonado, Fatima Mohammad Al Adwani, Arlu Marie Casuyon Pahilanga, Avigail M. Tan, Sonia Joseph, Deepa Sasidharan Nair, Nabeela Abdullah Al-Abdullah, Grace Sindayen, Annalyn Amor Malificio, Diaa Abdullah Mohammed, Hanan Mesfer Al Ghamdi, Ameurfina Curioso Silo, Marianina Brenda V. Valisto, Nektarios Foteinakis, Sameeh Salem Ghazal, Mercy V. Joseph, Ahmed Hakawi, Antigona Hasani, Ismet Jusufi, Gazmend Spahija, Nehat Baftiu, Agreta Gecaj-Gashi, Nasser Yehia Aly, Mohammad El-Dossoky Noweir, Suga Thomas Varghese, Ruby Jose Ramapurath, Amna Mostafa Mohamed, Sneha Mary George, Anu Kurian, Amani Fouad Sayed, Mona Foda Salama, Abeer Aly Omar, Flavie Maria Rebello, Dennis Malungcot Narciso, Nada Kara Zahreddine, Zeina Kanafani, Tala Kardas, Bassel Molaeb, Lamia Jurdi, Anwar Al Souheil, Mohamad Ftouni, Hasan Ayash, Tahsine Mahfouz, Tomas Kondratas, Dovile Grinkeviciute, Rimantas Kevalas, Greta Gailiene, Algirdas Dagys, Milena Petrovska, Katja Popovska, Zaneta Bogoevska-Miteva, Katerina Jankovska, Snezana Tufekcievska Guroska, Tanja Anguseva, Wan Nurbayah Wan Yusoff, Anis Shiham Zainal Abidin, Chin Seng Gan, Hasimah Zainol, Vineya Rai, Wong Kang Kwong, Mohd Shahnaz Hasan, Sasheela Sri La Sri Ponnampala, Jeyaganesh Veerakumaran, Ojan Assadian, Doan Mai Phuong, Nguyen Gia Binh, Kerinjeet Kaur, Joelene Lim, Lian-Huat Tan, Jegathesan Manikavasagam, Yuet-Meng Cheong, Hilario Coronado Magaña, Julio Cesar Mijangos Méndez, Federico Corona Jiménez, Sergio Esparza-Ahumada, Rayo Morfin-Otero, Eduardo Rodriguez-Noriega, Susana Gutierrez-Martinez, Hector Raul Perez-Gomez, Gerardo León-Garnica, Christian Mendoza-Mujica, Martha Cecilia Culebro Burguet, Jorge Horacio Portillo-Gallo, Fernando Aguilera Almazán, Gaspar Iglesias Miramontes, Maria del Rosario Vázquez Olivas, Lucio Alberto Aguilar Angel, Marisol Sanchez Vargas, Angel Orlando Flores Alvarado, Roberto Carlos Mares Morales, Luis Carlos Fernandez Alvarez, Hector Armando Rincon Leon, Karla Reyna Navarro Fuentes, Yuri Mariela Perez Hernandez, Gabriela Martinez Falcon, Angel Gonzalez Vargas, Marco A. Trujillo Juarez, Antonio Martinez Mulia, Paulina Alma Ulloa Camacho, Martha Y. Martinez-Marroquin, Marco Montell Garcia, Araceli Martinez Martinez, Elena Leon Sanchez, Guadalupe Gomez Flores, Marisela del Rocío González Martínez, Jesús Alfonso Galindo Olmeda, Georgina Olivarez, Enrique Barbachano Rodriguez, María Magdalena Gutierrez Castillo, María Guadalupe Villa González, Isaura Beatriz Sauceda Castañeda, Jaime Martínez Rodriguez, Otgon Baatar, Byambadorj Batkhuu, Kabiri Meryem, Barkat Amina, Rédouane Abouqal, Amine Ali Zeggwagh, Tarek Dendane, Khalid Abidi, Naoufel Madani, Syed Faisal Mahmood, Badaruddin A. Memon, Gul Hassan Bhutto, Nadeem Paul, Azra Parveen, Aun Raza, Amjad Mahboob, Summiya Nizamuddin, Faisal Sultan, Hammad Nazeer, Ashraf Ali Khan, Arifa Hafeez, Lydia Lara, Trudell Mapp, Balkys Alvarez, Magda Ivonne Rojas-Bonilla, Elizabeth Castano, Daisy A. De Moros, Roberto Espinoza Atarama, Maria Elena Calisto Pazos, Alfredo Paucar, Marlene Tasayco Ramos, Jenny Jurado, Dafne Moreno, Marãa E. Cruz Saldarriaga, Eliza Ramirez, Carlos Enrique La Hoz Vergara, Walter Enrique Prudencio Leon, Luis Isidro Castillo Bravo, Katya Fernanda Aibar Yaranga, Janet E. Pichilingue Chagray, Vanessa A. Marquez Mondalgo, Socorro Torres Zegarra, Nazario Silva Astete, Francisco Campos Guevara, Javier Soto Pastrana, Carlos F. Linares Calderon, Manuel Jesus Mayorga Espichan, Luis Martin Santivanez Monge, Maria V. Changano Rodriguez, Zoila Rosa Diaz Tavera, Fernando Martin Ramirez Wong, Selene Manga Chavez, Teodora Atencio-Espinoza, Victoria D. Villanueva, Maria Teresa Blanco-Abuy, Arnefelina S. Tamayo, Lailane D. Bergosa, Cristina Mari Jean P. Llames, Marilou F. Trajano, Suzette A. Bunsay, Jessica C. Amor, Regina Berba, Maria Carmen Sg Buenaflor, Ever Labro, Myrna T. Mendoza, Ofelia P. Javellana, Lilibeth G. Salvio, Rhoda Gay Rayco, Vanessa Bermudez, Andrzej Kubler, Marzena Zielinska, Magdalena Kosmider-Zurawska, Barbara Barteczko-Grajek, Ewa Szewczyk, Barbara Dragan, Malgorzata Anna Mikaszewska-Sokolewicz, Tomasz Lazowski, Elsie Cancel, Monica Sorina Licker, Liliana Alina Dragomirescu, Victor Dumitrascu, Dorel Sandesc, Ovidiu Bedreag, Marius Papurica, Delia Muntean, Igor Kotkov, Vladimir Kretov, Vladimir Shalapuda, Alexander Molkov, Sergey Puzanov, Ivan Utkin, Alexander Tchekulaev, Valentina Tulupova, Ljubica Nikolic, Goran Ristic, Jelena Eremija, Jelena Kojovic, Dragana Lekic, Sladjana Vasiljevic, Anna Lesnakova, Alzbeta Marcekova, Katarina Furova, May Osman Gamar Elanbya, Malik Abdo Ali, Shobhana Kumari Kadankunnel, Suwara Somabutr, Rungratchanee Pimathai, Suthinee Wanitanukool, Montri Luxsuwong, Namphon Supa, Pornpheth Prasan, Visanu Thamlikitkul, Silom Jamulitrat, Nonglak Suwalak, Parichart Phainuphong, Bouziri Asma, Borgi Aida, Bel Hadj Sarra, Khaldi Ammar, Gunay Tuncer Ertem, Cemal Bulut, Cigdem Ataman Hatipoglu, Fatma Sebnem Erdinc, Ali Pekcan Demiroz, Menekse Ozcelik, Basak Ceyda Meco, Mehmet Oral, Necmettin Unal, Cigdem Yildirim Guclu, Tanıl Kendirli, Erdal İnce, Ergin Çiftçi, Ayhan Yaman, Çağlar Ödek, Adem Karbuz, Bilge Aldemir Kocabaş, Nilgün Altın, Salih Cesur, Begum Atasay, Omer Erdeve, Hasan Akduman, Dilek Kahvecioglu, Ufuk Cakir, Duran Yildiz, Atila Kilic, Saadet Arsan, Dilek Arman, Serhat Unal, Yasemin Gelebek, Humeyra Zengin, Suha Sen, Hatice Cabadak, Ayse Erbay, Ata Nevzat Yalcin, Ozge Turhan, Melike Cengiz, Oguz Dursun, Perihan Gunasan, Sehnaz Kaya, Atilla Ramazanoglu, Cemal Ustun, Aliye Yasayacak, Hayrettin Akdeniz, Fatma Sirmatel, Ali Metin Otkun, Suzan Sacar, Alper Sener, Huseyn Turgut, Hulya Sungurtekin, Dogaç Ugurcan, Ceyda Necan, Cansu Yilmaz, Davut Ozdemir, Mehmet Faruk Geyik, Nevin Ince, Ayse Danis, Selvi Yener Erdogan, Nurettin Erben, Gaye Usluer, Ilhan Ozgunes, Cengiz Uzun, Oral Oncul, Levent Gorenek, Hakan Erdem, Orhan Baylan, Asu Ozgultekin, Asuman Inan, Sibel Bolukcu, Gunes Senol, Halil Ozdemir, Zeynel Gokmen, Sonay Incesoy Ozdemir, Ali Kaya, Gulden Ersoz, Necdet Kuyucu, Sevim Karacorlu, Zeynep Kaya, Ertugrul Guclu, Gulsume Kaya, Oguz Karabay, Saban Esen, Canan Aygun, Fatma Ulger, Ahmet Dilek, Hava Yilmaz, Mustafa Sunbul, Aynur Engin, Mehmet Bakir, Nazif Elaldi, Iftihar Koksal, Dincer Yildizdas, Ozden Ozgur Horoz, Ayşe Willke, Meliha Meriç Koç, Emel Azak, Naheed Elahi, Philip Annamma, Ashraf El Houfi, Maria Catalina Pirez Garcia, Hector Vidal, Fernando Perez, Gabriel D. Empaire, Yvis Ruiz, Dulce Hernandez, Dayana Aponte, Evelyn Salinas, Claudia Diaz, María Eugenia Guzmán Siritt, Zenaida Durán Gil De Añez, Luis Montes Bravo, Nelva Orozco, Eugenia Mejías, Nguyen Viet Hung, Nguyen Quoc Anh, Ngo Quy Chau, Truong Anh Thu, Le Thi Diem Tuyet, Dang Thi Van Trang, Vo Thi Hong Thoa, Nguyen Phuc Tien, Le Thi Anh Thu, Phan Thi Hang, Tran Thi My Hanh, Tran Thi Thuy Hang, Dinh Pham Phuong Anh, Ondokuz Mayıs Üniversitesi, KILIÇ, ATİLA, and MERİÇ KOÇ, MELİHA

Subjects
Imipenem, medicine.medical_specialty, Pediatrics, Low income countries, Asia, Epidemiology, Klebsiella pneumoniae, Health care-associated infection, Antibiotic resistance, Catheter-associated urinary tract infection, Ceftazidime, Network, Bloodstream infection, Developing countries, Nosocomial infection, Intensive care, medicine, Ventilator-associated pneumonia, Humans, Hospital infection, Prospective Studies, Urinary tract infection, Cross Infection, Infection Control, biology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, medicine.disease, Nosocomial infection control, biology.organism_classification, Device-associated infection, United States, Europe, Pneumonia, Intensive Care Units, Infectious Diseases, Latin America, Amikacin, Emergency medicine, Africa, Limited resources countries, Central line-associated bloodstream infections, Centers for Disease Control and Prevention, U.S, business, medicine.drug
Abstract

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2014

28. Current concepts of optimal cerebral perfusion pressure in traumatic brain injury

Author

Padmaja Durga, Rajiv Chawla, Hemanshu Prabhakar, Kavita Sandhu, and Hemant Bhagat

Subjects
optimal, ARDS, Traumatic brain injury, Ischemia, Review Article, polycyclic compounds, medicine, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, Cerebral perfusion pressure, evidence, business.industry, traumatic brain injury, musculoskeletal, neural, and ocular physiology, Oxygenation, management protocols, medicine.disease, Oxygen tension, body regions, Clinical trial, Anesthesiology and Pain Medicine, nervous system, Cerebral blood flow, Anesthesia, business, neuromonitoring, psychological phenomena and processes
Abstract

Traumatic brain injury (TBI) consists of varied pathophysiological consequences and alteration of intracranial dynamics, reduction of the cerebral blood flow and oxygenation. In the past decade more emphasis has been directed towards optimizing cerebral perfusion pressure (CPP) in patients who have suffered TBI. Injured brain may show signs of ischemia if CPP remains below 50 mmHg and raising the CPP above 60 mmHg may avoid cerebral oxygen desaturation. Though CPP above 70 mmHg is influential in achieving an improved patient outcome, maintenance of CPP higher than 70 mmHg was associated with greater risk of acute respiratory distress syndrome (ARDS). The target CPP has been laid within 50-70 mmHg. Cerebral blood flow and metabolism are heterogeneous after TBI and with regional temporal differences in the requirement for CPP. Brain monitoring techniques such as jugular venous oximetry, monitoring of brain tissue oxygen tension (PbrO2), and cerebral microdialysis provide complementary and specific information that permits the selection of the optimal CPP. This review highlights the rationale for use CPP directed therapies and neuromonitoring to identify optimal CPP of head injured patients. The article also reviews the evidence provided by various clinical trials regarding optimal CPP and their application in the management of head injured patients.

Published
2014

29. Traumatic frontonasoethmoidal encephalocele

Author

Kavita Sandhu, R Solanki, MK Mukherjee, Sanjay Roy Chowdhury, Ravi Chaturvedi, and Harjinder S Bhatoe

Subjects
medicine.medical_specialty, business.industry, medicine, medicine.disease, business, Surgery, Encephalocele
Published
2007

30. Giant Occipital Encephalocele

Author

Bipin S Walia, Pradeep Bhargava, and Kavita Sandhu

Subjects
medicine.medical_specialty, Occipital encephalocele, business.industry, Meninges, Case Report, General Medicine, Anatomy, medicine.disease, Encephalocele, Surgery, Cerebrospinal fluid, medicine.anatomical_structure, medicine, business
Abstract

Encephalocele is a broad term representing herniation of cranial contents through a congenital defect in the cranium. If only cerebrospinal fluid (CSF) and meninges herniate, it is termed as a meningocele. A meningoencephalocele is herniation of both neural elements and meninges. The incidence of encephalocele is 1 per 5000 live births [1]. Anterior encephaloceles are more common in males while 70% of posterior or occipital encephaloceles occur in females. We present one case of a giant occipital encephalocele to highlight the problems encountered in its management.

Published
2005

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