Meeting the Needs of Family Members of Trauma Patients in the Emergency Department.

BACKGROUND: While the needs of family members have previously been studied, the needs of families of trauma patients have received less attention. OBJECTIVE: This study aims to assess the needs of family members of trauma patients in the emergency department. METHODS: This cross-sectional survey study was conducted over 4 months (February-May 2022) with family members of trauma patients admitted to the emergency department of a state hospital in Istanbul, Turkey. The validated Critical Care Family Needs Inventory - Emergency Department survey was administered face-to-face to a convenience sample of consenting family members. RESULTS: A total of 248 family members participated, representing 84 patients. The mean age of the participants was 33 (8.18) years, with a gender distribution of 50% women. On average, 76.5% of the family members' needs were met. The most important needs reported as mean (SD) were as follows: communication, 3.52 (0.68); participation in care, 3.52 (0.68); comfort, 3.36 (0.65); and support needs, 3.21 (0.72). These needs were met to varying degrees: communication 85%, participation in care 81.2%, comfort 75.4%, and support needs 65.2%. CONCLUSION: The study findings indicate that the needs of family members of emergency department trauma patients are not fully met. Families report needing communication the most and comfort the least.

Bacteriophage cocktail as a promising bio-enhancer for methanogenic activities in anaerobic membrane bioreactors.

This study aimed to explore the effect of a bacteriophage cocktail, pyophage, on the treatment of wastewater containing antibiotics in an anaerobic membrane bioreactor (AnMBR). During the operational period, performance of the AnMBR was monitored through the changes in chemical oxygen demand (COD), antibiotic removal, transmembrane pressure, and biogas production. Microbial community structure and composition, as well as the occurrence of antibiotic resistance genes were analyzed through shotgun metagenomics analysis. When exposed to pyophage, COD removal efficiency was enhanced up to 96%, whereas membrane fouling was delayed by 25%. Average biogas production was doubled from 224.2 mL/d in control with antibiotics to 447.3 mL/d when exposed to pyophage cocktail with considerable alterations to the archaeal and bacterial community structures. Most notably, the methanogenic community shifted from dominance of Methanothermobacter to Methanoculleus, along with syntrophic bacteria. The results provide insight into the synergistic effects of phage-bacteria and methanogenic communities and illustrate the potential of bacteriophages as bio-enhancers.

Pyophage cocktail for the biocontrol of membrane fouling and its effect in aerobic microbial biofilm community during the treatment of antibiotics.

Membrane bioreactor systems face an inevitable challenge that is biofouling, which not only hinders the operation of the system, but also poses an environmental and medical concern caused by the increased antibiotic resistance in bacterial biofilms. This study investigates the disruption of membrane fouling using bacteriophage cocktail (Pyophage) in an aerobic membrane bioreactor for treatment of wastewater containing high non-lethal concentration of erythromycin, tetracycline and sulfamethoxazole, while also considering the effect of the cocktail on performance. The results indicate that Pyophage cocktail contributes significantly to the decrease (45%) in transmembrane pressure while also suppressing biofilm-producing bacteria compared to the control reactors. It also reconstructed biodegradation mechanism of antibiotics especially increasing the relative abundance of gram-negative bacteria by enhancement the removal rate of erythromycin and sulfamethoxazole from the aerobic system to 99%.

Investigation of PhiKZ phage therapy against Pseudomonas aeruginosa in mouse pneumonia model

Background/aim: The aim of this study was to investigate the effects of PhiKZ phage therapy and meropenem alone or combined treatments in a pneumonia mouse model induced by the Pseudomonas aeruginosa PAO1 strain. The cross-talk between lungs and kidneys was also determined. Materials and methods: The systemic, lung-specific, and kidney-specific inflammation levels and the bacterial load in lung tissue and biochemical parameters were investigated after PhiKZ phage therapy and meropenem alone or combined treatments in a pneumonia mouse model induced by the P. aeruginosa PAO1 strain. The cross-talk between lungs and kidneys was also determined by measuring plasma levels of glycocalyx components. Results: The greatest reduction in lung bacterial load was obtained with the combined use of the PhiKZ phage and meropenem. The C-reactive protein level in the patient group was significantly higher than in the treatment groups and decreased after treatment. Serum interleukin IL-6 levels were statistically significantly higher than in the phage serum and phage + meropenem groups. Pulmonary infection can trigger proinflammatory cytokines such as IL-6, TNF-α, and IL-1ß. Increased cytokines trigger insulin resistance in the liver. Lung infection triggers liver inflammation because there is communication between the lungs and liver. Conclusion: Elevated proinflammatory cytokines due to infection were decreased because of the reduced burden of bacterial load after treatment. This study might have proved communication between lungs and kidneys related to proinflammatory cytokines.