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1. A Landscaping Assessment and Call‐to‐Action to Improve Access to Novel Reserve Antibiotics in 14 Low‐ and Middle‐Income Countries

Author

Fabrizio Motta, Summiya Nizamuddin, Ejaz Khan, Tracie Muraya, Silvio Vega, Joseph Fadare, Shaffi F. Koya, Maria Virginia Villegas, Faisal Sultan, Tara Lumley, Rahul Dwivedi, Lauren Jankelowitz, and Jennifer Cohn more...

Subjects
access, antimicrobial resistance, low‐ and middle‐income country (LMIC), Reserve antibiotics, Public aspects of medicine, RA1-1270
Abstract

ABSTRACT Background Antimicrobial resistance (AMR) presents a significant global mortality burden which particularly affects the low‐ and middle‐income countries (LMICs). Enhancing diagnostics to identify drug‐resistant infections and improving appropriate access to novel Reserve antibiotics in LMICs can address AMR‐related morbidity, mortality and healthcare costs. This article characterizes the AMR landscape across 14 LMICs and describes an introductory pathway for novel Reserve antibiotics. Methods This mixed‐method study was completed in 14 LMICs in Africa, the Americas, Asia and Europe through a combination of qualitative interviews with physicians and public health experts (PHEs), and a quantitative survey of physicians, supported by an assessment of secondary materials relating to antibiotic introduction and AMR burden. Results A total of 54 physicians and 17 PHEs were interviewed, and 209 physicians participated in the survey. Top unmet needs across public and private settings were as follows: access to new antibiotics to better manage drug‐resistant infections; affordability; adequate safety profile for prescribed antibiotics. Access to diagnostics and antibiotic susceptibility testing was noted as a barrier, with large tertiary and private centres experiencing better access. Implementation of antibiotic stewardship programmes was variable and limited by insufficient funding, shortage of infectious disease physicians, poor AMR education and lack of restrictions to limit antibiotic use. Antibiotic access varies by sector, centre type, location and strength of individual state procurement systems. In particular, private sector facilities have better access to Reserve products. In most countries, most Reserve antibiotics included in WHO's Essential Medicines List (EML) were not included in national EMLs or not registered in countries. Conclusion This study has helped to identify common barriers and pathways to Reserve antibiotic access, irrespective of the level of preparedness of countries. The data offer insights into possible solutions to improve access and highlight opportunities to strengthen access pathways and expedite access, for example, by identifying priority antibiotics based on national public health need. A six‐step introductory pathway for novel Reserve antibiotics is described. more...

Published
2024
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3. Decoding the historical tale: COVID-19 impact on haematological malignancy patients—EPICOVIDEHA insights from 2020 to 2022Research in context

Author

Jon Salmanton-García, Francesco Marchesi, Francesca Farina, Barbora Weinbergerová, Federico Itri, Julio Dávila-Valls, Sonia Martín-Pérez, Andreas Glenthøj, Ditte Stampe Hersby, Maria Gomes da Silva, Raquel Nunes Rodrigues, Alberto López-García, Raúl Córdoba, Yavuz M. Bilgin, Iker Falces-Romero, Shaimaa El-Ashwah, Ziad Emarah, Caroline Besson, Milena Kohn, Jaap Van Doesum, Emanuele Ammatuna, Monia Marchetti, Jorge Labrador, Giovanni Paolo Maria Zambrotta, Luisa Verga, Ozren Jaksic, Marcio Nucci, Klára Piukovics, Alba Cabirta-Touzón, Moraima Jiménez, Elena Arellano, Ildefonso Espigado, Ola Blennow, Anna Nordlander, Stef Meers, Jens van Praet, Tommaso Francesco Aiello, Carolina Garcia-Vidal, Nicola Fracchiolla, Mariarita Sciumè, Guldane Cengiz Seval, Pavel Žák, Caterina Buquicchio, Carlo Tascini, Stefanie K. Gräfe, Martin Schönlein, Tatjana Adžić-Vukičević, Valentina Bonuomo, Chiara Cattaneo, Summiya Nizamuddin, Martin Čerňan, Gaëtan Plantefeve, Romane Prin, Tomas Szotkovski, Graham P. Collins, Michelina Dargenio, Verena Petzer, Dominik Wolf, Natasha Čolović, Lucia Prezioso, Toni Valković, Francesco Passamonti, Gustavo-Adolfo Méndez, Uluhan Sili, Antonio Vena, Martina Bavastro, Alessandro Limongelli, Rafael F. Duarte, Marie-Pierre Ledoux, Milche Cvetanoski, Zlate Stojanoski, Marina Machado, Josip Batinić, Gabriele Magliano, Monika M. Biernat, Nikola Pantić, Christian Bjørn Poulsen, Annarosa Cuccaro, Maria Ilaria Del Principe, Austin Kulasekararaj, Irati Ormazabal-Vélez, Alessandro Busca, Fatih Demirkan, Marriyam Ijaz, Nikolai Klimko, Igor Stoma, Sofya Khostelidi, Noemí Fernández, Ali S. Omrani, Rui Bergantim, Nick De Jonge, Guillemette Fouquet, Milan Navrátil, Ghaith Abu-Zeinah, Michail Samarkos, Johan Maertens, Cristina De Ramón, Anna Guidetti, Ferenc Magyari, Tomás José González-López, Tobias Lahmer, Olimpia Finizio, Natasha Ali, László Imre Pinczés, Esperanza Lavilla-Rubira, Alessandra Romano, Maria Merelli, Mario Delia, Maria Calbacho, Joseph Meletiadis, Darko Antić, José-Ángel Hernández-Rivas, Joyce Marques de Almeida, Murtadha Al-Khabori, Martin Hoenigl, Maria Chiara Tisi, Nina Khanna, Aleksandra Barać, Noha Eisa, Roberta Di Blasi, Raphaël Liévin, Carolina Miranda-Castillo, Nathan C. Bahr, Sylvain Lamure, Mario Virgilio Papa, Ayel Yahya, Avinash Aujayeb, Jan Novák, Nurettin Erben, María Fernández-Galán, José-María Ribera-Santa Susana, Ikhwan Rinaldi, Rita Fazzi, Monica Piedimonte, Rémy Duléry, Yung Gonzaga, Andrés Soto-Silva, Giuseppe Sapienza, Alexandra Serris, Ľuboš Drgoňa, Ana Groh, Laura Serrano, Eleni Gavriilaki, Athanasios Tragiannidis, Juergen Prattes, Nicola Coppola, Vladimir Otašević, Miloš Mladenović, Mirjana Mitrović, Bojana Mišković, Pavel Jindra, Sofia Zompi, Maria Vittoria Sacchi, Carolin Krekeler, Maria Stefania Infante, Daniel García-Bordallo, Gökçe Melis Çolak, Jiří Mayer, Marietta Nygaard, Michaela Hanáková, Zdeněk Ráčil, Matteo Bonanni, Philipp Koehler, Laman Rahimli, Oliver A. Cornely, Livio Pagano, Francisco Javier Martín-Vallejo, Przemyslaw Zdziarski, Hossein Zarrinfer, Jana Wittig, Sein Win, Vivien Wai-Man, Benjamín Víšek, Donald C. Vinh, Maria Vehreschild, Gina Varricchio, Panagiotis Tsirigotis, Ana Torres-Tienza, Alina Daniela Tanase, Agostino Tafuri, Maria Stamouli, Jiří Sramek, Carole Soussain, Ayten Shirinova, Jörg Schubert, Enrico Schalk, Mohammad Reza Salehi, Modar Saleh, Giorgio Rosati, Elisa Roldán, Florian Reizine, Mayara Rêgo, Isabel Regalado-Artamendi, Marina Popova, Fernando Pinto, Laure Philippe, Hans Martin Orth, Hans-Beier Ommen, Aleš Obr, Lucía Núñez-Martín-Buitrago, Nicolas Noël, Julia Neuhann, Gianpaolo Nadali, Julia A. Nacov, Ana M. Munhoz Alburquerque, Maria Enza Mitra, Malgorzata Mikulska, Sibylle Mellinghoff, Ben Mechtel, Juan-Alberto Martín-González, Sandra Malak, Jorge Loureiro-Amigo, Lisset Lorenzo De La Peña, Giulia Liberti, Marianne Landau, Ira Lacej, Martin Kolditz, Chi Shan Kho, Reham Abdelaziz Khedr, Meinolf Karthaus, Linda Katharina Karlsson, María-Josefa Jiménez-Lorenzo, Macarena Izuzquiza, Baerbel Hoell-Neugebauer, Raoul Herbrecht, Christopher H. Heath, Fabio Guolo, Jan Grothe, Antonio Giordano, Sergey Gerasymchuk, Ramón García-Sanz, Nicole García-Poutón, Vaneuza Araújo Moreira Funke, Monica Fung, Charlotte Flasshove, Luana Fianchi, Jenna Essame, Matthias Egger, Bernard Drenou, Giulia Dragonetti, Maximilian Desole, Roberta Della Pepa, Bénédicte Deau Fischer, Elizabeth De Kort, Erik De Cabo, François Danion, Etienne Daguindau, Tania Cushion, Louise Cremer, Marianna Criscuolo, Gregorio Cordini, Antonella Cingolani, Fabio Ciceri, Fazle Rabbi Chowdhury, Ekaterina Chelysheva, Adrien Chauchet, Louis Yi Ann Chai, M. Mansour Ceesay, Elena Busch, Mathias Brehon, Davimar M.M. Borducchi, Stephen Booth, Serge Bologna, Caroline Berg Venemyr, Rebeca Bailén-Almorox, Anastasia Antoniadou, Amalia N. Anastasopoulou, and Fevzi Altuntaş more...

Subjects
Vaccination, ICU, COVID-19, Haematological malignancy, Immunosuppression, Medicine (General), R5-920
Abstract

Summary: Background: The COVID-19 pandemic heightened risks for individuals with hematological malignancies due to compromised immune systems, leading to more severe outcomes and increased mortality. While interventions like vaccines, targeted antivirals, and monoclonal antibodies have been effective for the general population, their benefits for these patients may not be as pronounced. Methods: The EPICOVIDEHA registry (National Clinical Trials Identifier, NCT04733729) gathers COVID-19 data from hematological malignancy patients since the pandemic's start worldwide. It spans various global locations, allowing comprehensive analysis over the first three years (2020–2022). Findings: The EPICOVIDEHA registry collected data from January 2020 to December 2022, involving 8767 COVID-19 cases in hematological malignancy patients from 152 centers across 41 countries, with 42% being female. Over this period, there was a significant reduction in critical infections and an overall decrease in mortality from 29% to 4%. However, hospitalization, particularly in the ICU, remained associated with higher mortality rates. Factors contributing to increased mortality included age, multiple comorbidities, active malignancy at COVID-19 onset, pulmonary symptoms, and hospitalization. On the positive side, vaccination with one to two doses or three or more doses, as well as encountering COVID-19 in 2022, were associated with improved survival. Interpretation: Patients with hematological malignancies still face elevated risks, despite reductions in critical infections and overall mortality rates over time. Hospitalization, especially in ICUs, remains a significant concern. The study underscores the importance of vaccination and the timing of COVID-19 exposure in 2022 for enhanced survival in this patient group. Ongoing monitoring and targeted interventions are essential to support this vulnerable population, emphasizing the critical role of timely diagnosis and prompt treatment in preventing severe COVID-19 cases. Funding: Not applicable. more...

Published
2024
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4. Dexamethasone treatment for COVID-19 is related to increased mortality in hematologic malignancy patients: results from the EPICOVIDEHA Registry

Author

Tommaso Francesco Aiello, Jon Salmanton-Garcia, Francesco Marchesi, Barbora Weinbergerova, Andreas Glenthoj, Jens Van Praet, Francesca Farina, Julio Davila-Valls, Sonia Martin-Perez, Shaimaa El-Ashwah, Martin Schonlein, Iker Falces-Romero, Jorge Labrador, Uluhan Sili, Caterina Buquicchio, Antonio Vena, Gaetan Plantefeve, Verena Petzer, Monika M. Biernat, Tobias Lahmer, Ildefonso Espigado, Jaap Van Doesum, Ola Blennow, Klara Piukovics, Carlo Tascini, Michail Samarkos, Yavuz M. Bilgin, Luana Fianchi, Federico Itri, Toni Valković, Nicola S. Fracchiolla, Michelina Dargenio, Moraima Jimenez, Ferenc Magyari, Alberto Lopez-Garcia, Lucia Prezioso, Natasha Čolović, Evgenii Shumilov, Ghaith Abu-Zeinah, Carolin Krekeler, Esperanza Lavilla-Rubira, Mario Virgilio Papa, Tomas Jose Gonzalez-Lopez, Laszlo Imre Pinczes, Fatih Demirkan, Natasha Ali, Caroline Besson, Guillemette Fouquet, Alessandra Romano, Jose-Angel Hernandez-Rivas, Maria Ilaria Del Principe, Avinash Aujayeb, Maria Merelli, Sylvain Lamure, Joyce Marques De Almeida, Maria Gomes Da Silva, Noha Eisa, Joseph Meletiadis, Ikhwan Rinaldi, Olimpia Finizio, Ozren Jaksic, Mario Delia, Summiya Nizamuddin, Monia Marchetti, Marriyam Ijaz, Marina Machado, Rebeca Bailen-Almorox, Martin Čerňan, Nicola Coppola, Eleni Gavriilaki, Chiara Cattaneo, Ana Groh, Zlate Stojanoski, Nurettin Erben, Nicola Pantic, Gustavo-Adolfo Mendez, Roberta Di Blasi, Stef Meers, Cristina De Ramon, Nathan C. Bahr, Ziad Emarah, Gina Varricchio, Milche Cvetanoski, Ramon Garcia-Sanz, Mirjana Mitrovic, Raphael Lievin, Michaela Hanakova, Zdeněk Račil, Maria Vehreschild, Athanasios Tragiannidis, Raquel Nunes Rodrigues, Daniel Garcia-Bordallo, Raul Cordoba, Alba Cabirta, Anna Nordlander, Emanuele Ammatuna, Elena Arellano, Dominik Wolf, Romane Prin, Alessandro Limongelli, Martina Bavastro, Gokce Melis Colak, Stefanie Grafe, Ditte Stampe Hersby, Laman Rahimli, Oliver A. Cornely, Carolina Garcia-Vidal, Livio Pagano, and EPICOVIDEHA study group more...

Subjects
Diseases of the blood and blood-forming organs, RC633-647.5
Published
2024
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5. Case of Carbapenem-Resistant Salmonella Typhi Infection, Pakistan, 2022

Author

Summiya Nizamuddin, Ejaz Ahmed Khan, Marie Anne Chattaway, and Gauri Godbole

Subjects
Salmonella Typhi, Salmonella enteria serovar Typhi, therapy, diagnosis, antimicrobial resistance, carbapenem resistance, Medicine, Infectious and parasitic diseases, RC109-216
Abstract

Salmonella Typhi infection in a patient in Pakistan initially responded to standard treatment but failed to respond to subsequent treatment. The first strain was susceptible to carbapenems and azithromycin; subsequent strains harbored the NDM-5 gene. Treatment with a combination of intravenous meropenem and colistin was successful. Carbapenem-resistant Salmonella Typhi emergence will hinder treatment. more...

Published
2023
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6. Bacteremia in Pediatric Oncology Patients; A Single-Center Experience

Author

Zunaira Shaukat, Rabia Wali, Saadiya Javed Khan, Summiya Nizamuddin, Romena Qazi, Kainat Memon, and Najma Shaheen

Subjects
Antimicrobial Stewardship, Bacteremia, Escherichia coli, Febrile neutropenia, Mucositis, Medicine, Medicine (General), R5-920
Abstract

Objective: To study organisms causing bacteremia and their outcome in cancer children with febrile neutropenia (FN) admitted at our centre. Study Design: Retrospective longitudinal study. Place and duration of study: Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore, from Feb to Dec 2017. Methodology: All pediatric oncology patients with febrile neutropenia admitted to the inpatient department were included. Data fields included age, diagnoses, demographics, organism types, time to positivity, multi-drug resistance, antibiotics, and outcome. Results: A total of 391 episodes of febrile neutropenia were documented among 86 patients. The mean age was 4.7±2.7 years. Twelve (14.0%) patients had intensive care admission, and 9(10.5%) of them died. Fifty-four (63.0%) children had primary diagnoses of haematological malignancies. Sixty-five percent had mucositis, central catheter, or both as risk factors. Thirty-nine isolates were cultured in 391 febrile-neutropenic episodes. Escherichia coli was the most frequently isolated organism in 16(41.0%) cultures, followed by Pseudomonas and Streptococcus pneumoniae in 4(10.3%) each. Poly-microbial isolates were seen in 6(15.4%) cultures. Multi-drug resistance was found in 12(30.8%) isolates. Thirty-four (87.0%) patients with positive cultures received appropriate antibiotics. Majority organisms were sensitive to Piperacillin/Tazobactam (14,35.9%) followed by Meropenem (10, 25.6%) and Colistin (6, 15.4%). Conclusions: Rapid identification of organisms from positive blood cultures combined with antimicrobial stewardship can have improved antibiotic treatment and outcomes. more...

Published
2022
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7. Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance in Neisseria gonorrhoeae from Pakistan (1992–2009)

Author

Kauser Jabeen, Summiya Nizamuddin, Seema Irfan, Erum Khan, Faisal Malik, and Afia Zafar

Subjects
Arctic medicine. Tropical medicine, RC955-962
Abstract

Emergence and spread of drug resistant Neisseria gonorrhoeae is global concern. We evaluated trends of antimicrobial resistance in Neisseria gonorrhoeae over years 1992–2009 in Pakistan. Resistance rates were compared between years (2007–2009) and (1992–2006). Antimicrobial susceptibility testing was performed and interpreted according to Clinical Laboratory Standards Institute (CLSI) criteria using the disk diffusion methodology against penicillin, ceftriaxone, tetracycline and ofloxacin. Additional antibiotics tested in 100 strains isolated during 2007–2009, included cefotaxime, cefoxitin, cefuroxime, cefipime, ceftazidime, ceftizoxime, cefixime, cefpodoxime, spectinomycin and azithromycin. Neisseria gonorrhoeae ATCC 49226 was used as control. Chi-square for trend analysis was conducted to assess resistance trend over the study period. During study period significant increase in combined resistance to penicillin, tetracycline and ofloxacin was observed (P value more...

Published
2011
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8. Reporting of Azithromycin Activity against Clinical Isolates of Extensively Drug-Resistant Salmonella enterica Serovar Typhi

Author

Kokab Jabeen, Sidrah Saleem, Summiya Nizamuddin, Faiqa Arshad, Shah Jahan, Faisal Hasnain, Waleed Tariq, Muhammad Junaid Tahir, Zohaib Yousaf, and Muhammad Sohaib Asghar

Subjects
Infectious Diseases, Virology, Parasitology
Abstract

This study aimed to evaluate the minimum inhibitory concentration (MIC) of azithromycin (AZM) in clinical isolates of extensively drug-resistant (XDR) Salmonella Typhi (i.e., resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporin) using the E-test versus the broth microdilution method (BMD). From January to June 2021, a retrospective cross-sectional study was carried out in Lahore, Pakistan. Antimicrobial susceptibility was performed initially by the Kirby-Bauer disk diffusion method for 150 XDR Salmonella enterica serovar Typhi isolates, and MICs of all the recommended antibiotics were determined by the VITEK 2 (BioMérieux) fully automated system using Clinical Laboratory Standard Institute (CLSI) 2021 guidelines. The E-test method was used to determine AZM MICs. These MICs were compared with the BMD, which is the method recommended by the CLSI but not adopted in routine laboratory reporting. Of 150 isolates, 10 (6.6%) were resistant by disk diffusion. Eight (5.3%) of these had high MICs against AZM by the E-test. Only three isolates (2%) were resistant by E-test, having an MIC of 32 μg/mL. All eight isolates had a high MIC by BMD with different MIC distributions, but only one was resistant, having an MIC of 32 μg/mL by BMD. The sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic accuracy of the E-test method versus BMD were 98.65%,100%, 99.3%, 33.3%, and 98.6%, respectively. Similarly, the concordance rate was 98.6%, negative percent agreement was 100%, and positive percent agreement was 33%. The BMD is the most reliable approach for reporting AZM sensitivity in XDR S. Typhi compared with the E-test and disk diffusion methods. Potentially, AZM resistance in XDR S. Typhi is around the corner. Sensitivity patterns should be reported with MIC values, and if possible, higher values should be screened for the presence of any potential resistance genes. Antibiotic stewardship should be strictly implemented. more...

Published
2023
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9. Identification of Multiple Variant Extensively Drug-Resistant Typhoid Infections across Pakistan

Author

Rashid Kamal, Carly Ching, Muhammad H. Zaman, Faisal Sultan, Salma Abbas, Ezza Khan, Shaper Mirza, and Summiya Nizamuddin

Subjects
Infectious Diseases, Virology, Parasitology
Abstract

Typhoid fever, caused by Salmonella enterica serovar Typhi (S. Typhi), is a life-threatening bacterial infection. Recently, an outbreak of a new sublineage of extensively drug resistant (XDR) S. Typhi emerged in Pakistan in the province of Sindh. This sublineage had both a composite multidrug resistance transposon integrated on the chromosome and an acquired IncY plasmid carrying the extended spectrum beta-lactamase, blaCTX-M-15, which conferred resistance to third-generation cephalosporins. We observed previously that XDR typhoid had spread beyond the originating southern Sindh Province. Thus, we sought to determine the genetic diversity of 58 ceftriaxone-resistant S. Typhi clinical isolates by whole genome sequencing collected across Pakistan from November 2018 to December 2020 to provide insights into the molecular epidemiology of the evolving outbreak. We identify multiple novel genomic integrations of the extended spectrum beta-lactamase gene into the chromosome in S. Typhi, revealing the existence of various XDR typhoid variants circulating in the country. Notably, the integration of the IncY plasmid bearing antibiotic resistance genes may allow for subsequent plasmid acquisition by these variants, potentially leading to further plasmid-borne multidrug resistance. Our results can inform containment initiatives, help track associated outcomes and international spread, and help determine how widespread the risk is. more...

Published
2023
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10. Country data on AMR in Pakistan in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicine and clinical outcome

Author

Didem, Torumkuney, Bushra, Jamil, Summiya, Nizamuddin, James, van Hasselt, Uzma, Pirzada, and Rendani, Manenzhe

Subjects
Community-Acquired Infections, Pharmacology, Microbiology (medical), Infectious Diseases, Acute Disease, COVID-19, Humans, Pakistan, Pharmacology (medical), Respiratory Tract Infections, Health Services Accessibility, Anti-Bacterial Agents
Abstract

BackgroundAntimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action.ObjectivesTo review the current situation with respect to AMR in Pakistan and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize any further rises in AMR and improve patient outcomes.MethodsNational AMR initiatives, antibiotic use and prescribing in Pakistan, and availability of susceptibility data, in particular for the key community-acquired respiratory tract infection (CA-RTI) pathogens (Streptococcus pneumoniae and Haemophilus influenzae) were identified. National and international antibiotic prescribing guidelines for specific CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, plus local antibiotic availability. Insights from a local clinician and clinical microbiologist were sought to contextualize this information.ConclusionsPakistan is active in developing initiatives to address AMR such as compiling a National Action Plan. However, antibiotic consumption is high and although there is legislation in place prohibiting over-the-counter purchase of antibiotics, this is still possible. Healthcare professionals use local and international antibiotic prescribing guidelines for CA-RTIs when managing patients. As highlighted by the clinical microbiologist’s expert comments, surveillance of AMR in locally prevalent microorganisms is lacking. A more standardized inclusive approach in developing local guidelines, using up-to-date local surveillance data of isolates from community-acquired infections, could make management guideline use more locally relevant for clinicians. This would pave the way for a higher level of appropriate antibiotic prescribing and improved adherence. This would, in turn, potentially limit AMR development and improve clinical outcomes for patients. more...

Published
2022
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13. Antibacterial Activity of Manuka Honey Against Azithromycin Resistant Extensively Drug Resistant Salmonella Typhi Clinical Isolates: In-Vitro Study

Author

Kokab Jabeen, Sidrah Saleem, Faiqa Arshad, null Zill-e-Huma, Shah Jahan, and Summiya Nizamuddin

Subjects
food and beverages, bacterial infections and mycoses
Abstract

Typhoid fever is a significant health problem in developing countries like Pakistan. Salmonella Typhi the causative agent of typhoid has developed resistant to almost all recommended antibiotics. Emergence of resistance to third generation cephalosporins has further complicated the situation and such strains are called as extensively drug resistant (XDR) Salmonella Typhi. Currently only available options are azithromycin and cabapenems. Recently few reports of azithromycin resistance have emerged from countries like Pakistan, India, Bangladesh and Nepal. As azithromycin is the only oral option available to treat XDR Typhoid, development of resistance may change treatment strategy altogether from out patient management to hospitalization of every patient. This may increase the burden on already weak health care system of countries like Pakistan. So there is dire need to look for the alternative treatment options. Manuka honey is well known for its therapeutic potential against wide range of bacteria including Salmonella Typhimurium. In this study 3 azithromycin resistant isolates were isolated and identified using disc diffusion, E-test and broth micro dilution methods and antibacterial activity, MIC and MBC of manuka honey was performed by agar well diffusion assay and broth micro dilution assay respectively. Manuka honey manifested significant antibacterial activity against all test isolates with zone of inhibition ranging from 7.3mm to 7.5mm, MIC and MBC values were between 10 to 15% v/v Here, we conclude that Manuka honey possess potent antibacterial activity and might be used as an alternative treatment option against azithromycin resistant XDR Typhid. However, further clinical trials are mandatory to validate our initial findings. more...

Published
2022
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14. Vaccine hesitancy and refusal among parents: An international ID-IRI survey

Author

Yakup Cag, Mohammad Emad Al Madadha, Handan Ankarali, Yasemin Cag, Kubra Demir Onder, Aysegul Seremet-Keskin, Filiz Kizilates, Rok Čivljak, Ghaydaa Shehata, Handan Alay, Sevil Alkan-Ceviker, Fatma Yilmaz-Karadag, Meliha Cagla-Sonmezer, Manar Ezzelarab Ramadan, Dumitru Irina Magdelena, Ljiljana Betica Radic, Jurica Arapovic, Fatma Kesmez-Can, Nagwa Mostafa El-Sayed, Oladapo Babatunde Campbell, Gulden Eser-Karlidag, Reham Khedr, Mehmet Emirhan Isik, Michael Mihailov Petrov, Roxana Cernat, Umran Erturk, Yesim Uygun-Kizmaz, Eva Huljev, Fatma Amer, Mehmet Resat Ceylan, Andrea Marino, Gulnur Kul, Tuba Damar-Cakirca, Yara Mohsen Khalaf, Arzu Cennet Isik, Olumuyiwa Elijah Ariyo, Ismail Necati Hakyemez, Rezaul Karim Ripon, Abdorrahim Afkhamzadeh, Emine Kubra Dindar-Demiray, Osasona Oluwadamilola Gideon, Maya Belitova, Mustafa Altindis, Rehab El-Sokkary, Recep Tekin, Mohammed Ahmed Garout, Joanna Zajkowska, Farhan Fazal, Muhammed Bekcibasi, Mirsada Hukic, Summiya Nizamuddin, Serkan Surme, Ricardo Fernandez, Amani El-Kholy, Nasim Akhtar, Saadia Ijaz, Andrea Cortegiani, Meliha Meric-Koc, Hakan Hasman, Agah Victor Maduka, Jehan Ali ElKholy, Sema Sari, Mumtaz Ali Khan, Yasemin Akin, Sukran Kose, Hakan Erdem, MERİÇ KOÇ, MELİHA, Cag, Yakup, Al Madadha, Mohammad Emad, Ankarali, Handan, Cag, Yasemin, Demir Onder, Kubra, Seremet-Keskin, Aysegul, Kizilates, Filiz, Čivljak, Rok, Shehata, Ghaydaa, Alay, Handan, Alkan-Ceviker, Sevil, Yilmaz-Karadag, Fatma, Cagla-Sonmezer, Meliha, Ezzelarab Ramadan, Manar, Magdelena, Dumitru Irina, Radic, Ljiljana Betica, Arapovic, Jurica, Kesmez-Can, Fatma, El-Sayed, Nagwa Mostafa, Campbell, Oladapo Babatunde, Eser-Karlidag, Gulden, Khedr, Reham, Isik, Mehmet Emirhan, Petrov, Michael Mihailov, Cernat, Roxana, Erturk, Umran, Uygun-Kizmaz, Yesim, Huljev, Eva, Amer, Fatma, Ceylan, Mehmet Resat, Marino, Andrea, Kul, Gulnur, Damar-Cakirca, Tuba, Khalaf, Yara Mohsen, Isik, Arzu Cennet, Ariyo, Olumuyiwa Elijah, Hakyemez, Ismail Necati, Ripon, Rezaul Karim, Afkhamzadeh, Abdorrahim, Dindar-Demiray, Emine Kubra, Gideon, Osasona Oluwadamilola, Belitova, Maya, Altindis, Mustafa, El-Sokkary, Rehab, Tekin, Recep, Garout, Mohammed Ahmed, Zajkowska, Joanna, Fazal, Farhan, Bekcibasi, Muhammed, Hukic, Mirsada, Nizamuddin, Summiya, Surme, Serkan, Fernandez, Ricardo, El-Kholy, Amani, Akhtar, Nasim, Ijaz, Saadia, Cortegiani, Andrea, Meric-Koc, Meliha, Hasman, Hakan, Maduka, Agah Victor, ElKholy, Jehan Ali, Sari, Sema, Khan, Mumtaz Ali, Akin, Yasemin, Kose, Sukran, and Erdem, Hakan more...

Subjects
Male, Parents, Health Knowledge, Attitudes, Practice, An international ID-IRI survey-, JOURNAL OF INFECTION IN DEVELOPING COUNTRIES, cilt.16, sa.6, ss.1081-1088, 2022 [Cag Y., Al Madadha M. E. , ANKARALI H., ÇAĞ Y., Onder K. D. , Seremet-Keskin A., Kizilates F., Civljak R., Shehata G., ALAY H., et al., -Vaccine hesitancy and refusal among parents], Vaccination, General Medicine, Patient Acceptance of Health Care, Microbiology, Communicable Diseases, parent, Infectious Diseases, Cross-Sectional Studies, Virology, Surveys and Questionnaires, vaccine refusal, Humans, Parasitology, Female, Vaccination Hesitancy, Child, Vaccine hesitancy
Abstract

Introduction:Although vaccines are the safest and most effective means to prevent and control infectious diseases, the increasing rate of vaccine hesitancy and refusal (VHR) has become a worldwide concern. We aimed to find opinions of parents on vaccinating their children and contribute to available literature in order to support the fight against vaccine refusal by investigating the reasons for VHR on a global scale.Methodology:In this international cross-sectional multicenter study conducted by the Infectious Diseases International Research Initiative (ID-IRI), a questionnaire consisting of 20 questions was used to determine parents' attitudes towards vaccination of their children.Results:Four thousand and twenty-nine (4,029) parents were included in the study and 2,863 (78.1%) were females. The overall VHR rate of the parents was found to be 13.7%. Nineteen-point three percent (19.3%) of the parents did not fully comply with the vaccination programs. The VHR rate was higher in high-income (HI) countries. Our study has shown that parents with disabled children and immunocompromised children, with low education levels, and those who use social media networks as sources of information for childhood immunizations had higher VHR rates (p < 0.05 for all).Conclusions:Seemingly all factors leading to VHR are related to training of the community and the sources of training. Thus, it is necessary to develop strategies at a global level and provide reliable knowledge to combat VHR.Keywords:Vaccine hesitancy; parents; vaccine refusal.Copyright (c) 2022 Yakup Cag, Mohammad Emad al Madadha, Handan Ankarali, Yasemin Cag, Kubra Demir Onder, Aysegul Seremet-Keskin, Filiz Kizilates, Rok Civljak, Ghaydaa Shehata, Handan Alay, Sevil Alkan-Ceviker, Fatma Yilmaz-Karadag, Meliha Cagla-Sonmezer, Manar Ezzelarab Ramadan, Dumitru Irina Magdelena, Ljiljana Betica Radic, Jurica Arapovic, Fatma Kesmez-Can, Nagwa Mostafa El-Sayed, Oladapo Babatunde Campbell, Gulden Eser-Karlidag, Reham Khedr, Mehmet Emirhan Isik, Michael Mihailov Petrov, Roxana Cernat, Umran Erturk, Yesim Uygun-Kizmaz, Eva Huljev, Fatma Amer, Mehmet Resat Ceylan, Andrea Marino, Gulnur Kul, Tuba Damar-Cakirca, Yara Mohsen Khalaf, Arzu Cennet Isik, Olumuyiwa Elijah Ariyo, Ismail Necati Hakyemez, Rezaul Karim Ripon, Abdorrahim Afkhamzadeh, Emine Kubra Dindar-Demiray, Osasona Oluwadamilola Gideon, Maya Belitova, Mustafa Altindis, Rehab El-Sokkary, Recep Tekin, Mohammed Ahmed Garout, Joanna Zajkowska, Farhan Fazal, Muhammed Bekcibasi, Mirsada Hukic, Summiya Nizamuddin, Serkan Surme, Ricardo Fernandez, Amani El-Kholy, Nasim Akhtar, Saadia Ijaz, Andrea Cortegiani, Meliha Meric-Koc, Hakan Hasman, Agah Victor Maduka, Jehan Ali ElKholy, Sema Sari, Mumtaz Ali Khan, Yasemin Akin, Sukran Kose, Hakan Erdem. more...

Published
2022

15. Continued Outbreak of Ceftriaxone-Resistant Salmonella enterica Serotype Typhi across Pakistan and Assessment of Knowledge and Practices among Healthcare Workers

Author

Muhammad H. Zaman, Faisal Sultan, Carly Ching, Summiya Nizamuddin, and Rashid Kamal

Subjects
Serotype, Health Knowledge, Attitudes, Practice, Health Personnel, Population, Salmonella typhi, Serogroup, Typhoid fever, Disease Outbreaks, Virology, Environmental health, Drug Resistance, Multiple, Bacterial, Health care, medicine, Prevalence, Humans, Blood culture, Pakistan, Typhoid Fever, education, education.field_of_study, medicine.diagnostic_test, business.industry, Ceftriaxone, Outbreak, Infant, Salmonella enterica, Articles, medicine.disease, bacterial infections and mycoses, Anti-Bacterial Agents, Vaccination, Infectious Diseases, Child, Preschool, Parasitology, business
Abstract

Pakistan is experiencing the first known outbreak of extensively drug-resistant (XDR) Salmonella enterica serotype Typhi (resistant to third-generation cephalosporins). The outbreak originated in Hyderabad in 2016 and spread throughout the Sindh Province. Whereas focus has remained on Sindh, the burden of XDR typhoid in Punjab, the most populous province, and the rest of the country is understudied. Using laboratory data from Shaukat Khanum Memorial Cancer Hospital and Research Centre in Lahore (Punjab Province) and its network of more than 100 collection centers across the country, we determined the frequency of blood culture–confirmed XDR typhoid cases from 2017 to 2019. We observed an increase in XDR typhoid cases in Punjab, with the percent of ceftriaxone resistance among Salmonella Typhi cases increasing from no cases in 2017, to 30% in 2018, and to 50% in 2019, with children bearing the largest burden. We also observed spread of XDR typhoid to the two other provinces in Pakistan. To assess prevailing knowledge and practices on XDR typhoid, we surveyed 321 frontline healthcare workers. Survey results suggested that inappropriate diagnostic tests and antibiotic practices may lead to underdiagnosis of XDR typhoid cases, and potentially drive resistance development and spread. Of those surveyed, only 43.6% had heard of XDR typhoid. Currently, serological tests are more routinely used over blood culture tests even though blood culture is imperative for a definitive diagnosis of typhoid fever. We recommend stronger liaisons between healthcare providers and diagnostic laboratories, and increased promotion of typhoid vaccination among healthcare workers and the general population. more...

Published
2021

16. Antimicrobial resistance trends from a hospital and diagnostic facility in Lahore, Pakistan: A five-year retrospective analysis (2014-2018)

Author

Farah Rasheed, Muhammad H. Zaman, Faisal Sultan, R J Seager, Carly Ching, Summiya Nizamuddin, and Felix Litvak

Subjects
Afghan, Antibiotic resistance, business.industry, Environmental health, Incidence (epidemiology), Retrospective analysis, Psychological intervention, Outbreak, Medicine, Disease, Antimicrobial, business
Abstract

ObjectiveObserving antimicrobial resistance (AMR) trends is critical to identify emerging pathogens and potential disease outbreaks. Determining these trends also allows for policy evaluations and development of interventions. We performed a retrospective analysis of microbiological testing results from a hospital and diagnostic facility in Lahore, Pakistan that represents country-wide sampling. Within this analysis, data was disaggregated by nationality, as it has been suggested that migration increases the burden of AMR. We sought to determine any trends in AMR among populations, which are often at-risk, while contributing to AMR surveillance in Pakistan, which currently does not have a national surveillance network.MethodsRetrospective analysis of antimicrobial susceptibility records from 2014 to 2018 from Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKMCH&RC) in Lahore, Pakistan was performed. All positive microbiological cultures from patients was analyzed to assess antibiotic resistance rates of the most common bacterial isolates and incidence of ESKAPE pathogens and emerging outbreaks among adults and children.ResultsFor all years, data for a total of 12,702 and 78,130 bacterial and fungal isolates from children and adults, respectively, with Pakistani nationality were analyzed. For all years, data for 597 and 2470 bacterial and fungal isolates for children and adults, respectively, with Afghan nationality were analyzed. AMR rates largely did not vary between populations, but rather followed similar trends. AMR rates also largely agreed with the World Health Organization Global Antimicrobial Surveillance System results for Pakistan.ConclusionPakistan requires increased AMR surveillance to identify emerging resistance infections and outbreaks. more...

Published
2019
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17. 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 more...

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. more...

Published
2016
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18. Risk factors and clinical outcomes for vancomycin-resistant enterococcus bacteraemia in hospitalised cancer patients in Pakistan: A case-control study

Author

Nasim, Akhtar, Faisal, Sultan, Summiya, Nizamuddin, and Waleed, Zafar

Subjects
Adult, Male, Bacteremia, Vancomycin Resistance, Microbial Sensitivity Tests, Length of Stay, Anti-Bacterial Agents, Risk Factors, Vancomycin, Case-Control Studies, Data Interpretation, Statistical, Neoplasms, Humans, Female, Pakistan, Child, Enterococcus, Gram-Positive Bacterial Infections
Abstract

To compare the risk factors and outcomes of vancomycin-resistant enterococcus with vancomycin-sensitive enterococcus bacteraemia among hospitalised cancer patients.The retrospective, case-control study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data of cancer patients whose blood culture grew either vancomycin-sensitive or vancomycin-resistant enterococcus from January 2012 to December 2014. Multivariable logistic regression analyses were used to determine the factors associated with the development of vancomycin-resistant enterococcus bacteraemia and 12-week mortality. Stata 11 was used for data analysis.Of the 138 cases, 111(80%) were selected, of which 46(41.44%) were of vancomycin-resistant and 65(58.55%) were of vancomycin-sensitive enterococcus. Length of hospital stay prior to bacteraemia (adjusted odds ratio 1.18; 95% confidence interval 1.08-1.28) and use of vancomycin 30 days before the onset of bacteraemia (adjusted odds ratio 9.4; 95% confidence interval 1.70-52.19) were significant risk factors for the development of vancomycin-resistant enterococcus bacteraemia. The overall 12-week mortality rate was 29(63%) for patients with vancomycin-resistant bacteraemia and 28(43.1%) for vancomycin-sensitive enterococcus bacteraemia patients. Risk factors for mortality included the presence of shock at the time of the onset of bacteraemia (adjusted odds ratio 32.91; 95% confidence interval 3.02-358.81).The length of hospital stay and prior exposure to vancomycin were significant risk factors for the occurrence of vancomycin-resistant enterococcus bacteraemia. more...

Published
2016

19. Bacteraemia caused by Escherichia coli in cancer patients at a specialist center in Pakistan

Author

Azra, Parveen, Faisal, Sultan, Aun, Raza, Waleed, Zafar, Summiya, Nizamuddin, Amjad, Mahboob, Saliha, Saleem, and Syed Hammad, Nazeer

Subjects
Adult, Male, Adolescent, Bacteremia, Cancer Care Facilities, Middle Aged, Young Adult, Risk Factors, Neoplasms, Drug Resistance, Bacterial, Escherichia coli, Humans, Female, Pakistan, Child, Escherichia coli Infections, Aged, Retrospective Studies
Abstract

To analyse the antimicrobial susceptibility patterns of Escherichia coli bacteraemia among cancer patients, and to assess the risk factors and outcomes of multidrug-resistant Escherichia coli bacteraemia.The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, and comprised medical records of patients with Escherichia coli bacteraemia presenting between December 2012 and November 2013. Multivariable logistic regression analyses were used to determine the factors associated with the development and 30-day mortality of multidrug-resistant Escherichia coli bacteraemia.Out of 1603 episodes of bacteraemia, 227(35.6%) were caused by E.coli, of which 98(43.2%) were multidrug-resistant. In multivariable analysis, age less than 18 years (adjusted odds ratio 3.92; 95% confidence interval 1.43-10.68), presence of central venous catheter (adjusted odds ratio 2.12; 95% confidence interval 1.04-4.33) and exposure to piperacillin/tazobactam within 90 days prior to infection (adjusted odds ratio 2.37; 95% confidence interval 1.15-4.86) were identified as independent risk factors for acquisition of multidrug-resistant Escherichia coli bacteraemia. The overall 30 day mortality rate was 35.2% (80/227). Risk factors for mortality were intensive care unit admission (adjusted odds ratio 3.95; 95% confidence interval 1.79-8.71) and profound neutropenia (adjusted odds ratio 4.03; 95% confidence interval 1.55-10.49).Bloodstream infections with multidrug-resistant Escherichia coli were common in cancer patients. However it was not a predictor of mortality. more...

Published
2015

20. 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 more...

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. more...

Published
2014

21. Evaluation of prevalence of low and high level mupirocin resistance in methicillin resistant Staphylococcus aureus isolates at a tertiary care hospital

Author

Summiya, Nizamuddin, Seema, Irfan, and Afia, Zafar

Subjects
Methicillin-Resistant Staphylococcus aureus, Mupirocin, Drug Resistance, Bacterial, Prevalence, Humans, Pakistan, Microbial Sensitivity Tests, Staphylococcal Infections, Hospitals, Teaching, Anti-Bacterial Agents
Abstract

To evaluate the trend of mupirocin resistance in MRSA, isolated at the Clinical Microbiology Laboratory of a tertiary care hospital.A total of 200 MRSA strains recovered over a 2 year period from various body sites were tested using the 5 and 200 microg discs of mupirocin to detect its resistance.High level and low level mupirocin resistance were detected in zero and 1% of MRSA strains, respectively. Resistance to other non beta lactam antibiotics was also high. No MRSA strains were found to be resistant to vancomycin and tegicycline.Mupirocin resistance was found to be very low among local clinical isolates of MRSA. Its judicious use to decolonize nasal carriers should be promoted among hospitalized patients to avoid further transmission and infections due to prevalent endemic MRSA strains in any health care setting. Concomitantly, regular surveillance and effective infection control initiatives are desirable to reduce the incidence of health care associated infections due to MRSA and also of mupirocin resistance. more...

Published
2011

22. Evaluation of predominant Neisseria gonorrhoeae strain types and its correlation with fluoroquinolone resistance in Pakistan

Author

Summiya, Nizamuddin, Kauser, Jabeen, and Afia, Zafar

Subjects
Gonorrhea, Drug Resistance, Bacterial, Prevalence, Animals, Humans, Pakistan, Microbial Sensitivity Tests, Serotyping, Neisseria gonorrhoeae, Anti-Bacterial Agents, Bacterial Typing Techniques, Fluoroquinolones
Abstract

To study the predominant Neisseria gonorrhoeae strain types in Pakistan and to evaluate their correlation with fluoroquinolone resistance.A total of 314 strains were collected from 2007-2009. Of these 112 strains were randomly selected for serotyping via the coagglutination technique. Fluoroquinolone susceptibility was checked through the E-test method. Chi square was performed to assess the correlation between the strain type and fluoroquinolone resistance pattern.N. gonorrhoeae isolates were typed in two serogroups and 28 serovars. Serogroup WI comprised 40% (n = 45) whereas WII/WIII was 60% (n = 67). Most commonly isolated serovar belonged to serogroup WI namely Aorst (10%). The other predominant circulating serovars of the serogroup WI were Aost (9%) and Ast (8%) and Bsy (8%), Bopyt (5%) and Bprt (4.5%) in the serogroup WII/III. Fluoroquinolone resistance was 98%, with an MIC of 2 microg/mL in 47%, 4 microg/mL in 36% and32 microg/mL in 12% of the isolates. On inferential analysis no significant correlation was observed between fluoroquinolone resistance and any particular serovars.A diverse population of N. gonorrhoeae serovars suggesting influx of a variety of gonococcal strains with high fluoroquinolone resistance was identified. This resistance was not associated with any particular serovars, so we speculated inappropriate use of fluoroquinolones in the community to be a major cause. Injudicious fluoroquinolone use in the community should be strongly discouraged to curtail increase in antimicrobial resistance. Furthermore, continuous surveillance of prevalent serovars will be critical to assess genetic alterations of endemic and imported strains to design effective disease control measures. more...

Published
2011