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1.
Nutrients ; 14(2)2022 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-35057424

RESUMEN

Elucidating the mechanisms of bacterial translocation is crucial for the prevention and treatment of neonatal sepsis. In the present study, we aimed to evaluate the potential of lactoferrin to inhibit the development of late-onset blood infection in neonates. Our investigation evaluates the role of key stress factors leading to the translocation of intestinal bacteria into the bloodstream and, consequently, the development of life-threatening sepsis. Three stress factors, namely weaning, intraperitoneal administration of Gram-positive cocci and oral intake of Gram-negative rods, were found to act synergistically. We developed a novel model of rat pups sepsis induced by bacterial translocation and observed the inhibition of this process by supplementation of various forms of lactoferrin: iron-depleted (apolactoferrin), iron-saturated (hololactoferrin) and manganese-saturated lactoferrin. Additionally, lactoferrin saturated with manganese significantly increases the Lactobacillus bacterial population, which contributes to the fortification of the intestinal barrier and inhibits the translocation phenomenon. The acquired knowledge can be used to limit the development of sepsis in newborns in hospital neonatal intensive care units.


Asunto(s)
Traslocación Bacteriana/efectos de los fármacos , Escherichia coli , Microbioma Gastrointestinal/efectos de los fármacos , Lactoferrina/administración & dosificación , Sepsis Neonatal/prevención & control , Staphylococcus haemolyticus , Animales , Animales Recién Nacidos , Apoproteínas/administración & dosificación , Infecciones de Transmisión Sanguínea/microbiología , Infecciones de Transmisión Sanguínea/prevención & control , Temperatura Corporal , Peso Corporal , Infección Hospitalaria/prevención & control , Modelos Animales de Enfermedad , Esquema de Medicación , Escherichia coli/efectos de los fármacos , Escherichia coli/fisiología , Microbioma Gastrointestinal/fisiología , Humanos , Recién Nacido , Masculino , Manganeso/administración & dosificación , Sepsis Neonatal/diagnóstico , Sepsis Neonatal/microbiología , Permeabilidad , Distribución Aleatoria , Ratas , Ratas Wistar , Staphylococcus haemolyticus/efectos de los fármacos , Staphylococcus haemolyticus/fisiología , Destete
2.
Int J Infect Dis ; 103: 81-87, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33227513

RESUMEN

OBJECTIVE: To explore the applicability of metagenomic next-generation sequencing (mNGS) technology for the detection of blood pathogens in intensive care unit patients. METHODS: The clinical data of 63 critically ill patients who could not be diagnosed with blood culture (BC) and who underwent mNGS blood sample testing were retrospectively analyzed. The diagnostic efficacy of mNGS was compared with that of traditional detection methods; the distribution of the pathogens identified by mNGS was analyzed; and the differences in laboratory tests, comorbidities, treatment, and prognosis between the mNGS-positive and mNGS-negative groups were compared. RESULTS: The positive rate of mNGS was 41.3% (26/63), and 16 patients were found to have mixed infections. However, the positive rate of BCs performed simultaneously with mNGS was only 7.9% (5/63). The results of univariate analysis showed that the average length of intensive care unit stay (ß, -8.689 [95% CI, -16.176, -1.202]; P = 0.026) and the time from onset to sequencing (ß, -5.816 [95% CI,-9.936, -1.696]; P = 0.007) of the mNGS-positive group were significantly shorter than those of the mNGS-negative group. More patients in the positive group were adjusted for anti-infective treatment after mNGS (OR, 3.789 [95% CI,1.176, 12.211]; P < 0.001). CONCLUSIONS: Detection of blood pathogens by mNGS has good applicability for critically ill patients who cannot be diagnosed by BC in the early stages of infection, and mNGS should be performed as early as possible to obtain higher pathogen detection rates.


Asunto(s)
Infecciones de Transmisión Sanguínea/microbiología , Patógenos Transmitidos por la Sangre/aislamiento & purificación , Secuenciación de Nucleótidos de Alto Rendimiento , Metagenómica , Adulto , Anciano , Cultivo de Sangre , Coinfección/microbiología , Enfermedad Crítica , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
3.
Rev Esp Anestesiol Reanim (Engl Ed) ; 67(5): 227-236, 2020 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-32216956

RESUMEN

INTRODUCTION: Catheter-associated infections are the main cause of nosocomial bacteremia. The main objective of this study was to demonstrate a possible decrease in CLABSI rates in perioperative environment after the implementation of a bundle of measures. Secondary objective was to determine which factors were associated with an increased risk of CLABSI, after the implementation of the bundle. METHODS: Insertion bundle consisted of: subclavian vein as access of choice, disinfection with alcoholic 2% chlorhexidine, central-line full body drapes, sterile ultrasound probe-cable covers and insertion check-list. Cumulative Incidence (CI) and Incidence Density Rate (IR) of CLABSIs were compared before and after the intervention. Associations between patient or CVC characteristic and CLABSI were summarized with odds ratios and 95% confidence interval, obtained from multiple logistic regression, adjusting for age, sex, comorbidities and days with CVC. RESULTS: Before implementing the bundle, from January to November 2016, CI of CLABSI was 5.05% and IR was 5.17 ‰. In the same period of 2018, CI of CLABSI was 2.28% and IR was 2.27 ‰, which means a reduction of 54.8% in CI (P=.072) and of 56% in IR (P=.068) In multivariable analyses, replacement of CVC was associated with a higher risk of CLABSI (OR 11.01, 95%CI 2.03-59.60, P=.005), as well as 2 or more catheterizations (OR 10.05, 95%CI 1.77-57.16, P=.009), and parenteral nutrition (OR 23.37, 95%CI 4.37-124.91, P<.001). CONCLUSIONS: CLABSI rates decreased after the implementation of the insertion bundle. CVC replacement, 2 or more catheterizations and parenteral nutrition were associated with CLABSI after bundle implementation.


Asunto(s)
Bacteriemia/prevención & control , Infecciones de Transmisión Sanguínea/prevención & control , Infecciones Relacionadas con Catéteres/prevención & control , Catéteres Venosos Centrales/efectos adversos , Infección Hospitalaria/prevención & control , Factores de Edad , Anciano , Bacteriemia/epidemiología , Bacteriemia/microbiología , Infecciones de Transmisión Sanguínea/epidemiología , Infecciones de Transmisión Sanguínea/microbiología , Infecciones Relacionadas con Catéteres/epidemiología , Infecciones Relacionadas con Catéteres/microbiología , Cateterismo/efectos adversos , Cateterismo/métodos , Cateterismo/estadística & datos numéricos , Lista de Verificación , Clorhexidina , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Desinfectantes , Desinfección/métodos , Femenino , Humanos , Incidencia , Masculino , Análisis Multivariante , Nutrición Parenteral/efectos adversos , Periodo Perioperatorio/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Entrenamiento Simulado , Vena Subclavia , Ultrasonografía/instrumentación
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