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1.
Antimicrob Resist Infect Control ; 12(1): 104, 2023 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-37726843

RESUMO

OBJECTIVE: To determine the overall and procedure-specific incidence of surgical site infections (SSI) caused by Staphylococcus aureus (S. aureus) as well as risk factors for such across all surgical disciplines in Europe. METHODS: This is a retrospective cohort of patients with surgical procedures performed at 14 European centres in 2016, with a nested case-control analysis. S. aureus SSI were identified by a semi-automated crossmatching bacteriological and electronic health record data. Within each surgical procedure, cases and controls were matched using optimal propensity score matching. RESULTS: A total of 764 of 178 902 patients had S. aureus SSI (0.4%), with 86.0% of these caused by methicillin susceptible and 14% by resistant pathogens. Mean S. aureus SSI incidence was similar for all surgical specialties, while varying by procedure. CONCLUSIONS: This large procedure-independent study of S. aureus SSI proves a low overall infection rate of 0.4% in this cohort. It provides proof of principle for a semi-automated approach to utilize big data in epidemiological studies of healthcare-associated infections. Trials registration The study was registered at clinicaltrials.gov under NCT03353532 (11/2017).


Assuntos
Infecções Estafilocócicas , Infecção da Ferida Cirúrgica , Humanos , Infecção da Ferida Cirúrgica/epidemiologia , Estudos Retrospectivos , Staphylococcus aureus , Infecções Estafilocócicas/epidemiologia , Europa (Continente)/epidemiologia
2.
Expert Rev Anti Infect Ther ; 17(4): 295-305, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30922129

RESUMO

BACKGROUND: Candida auris is an emerging, multidrug-resistant yeast causing hospital outbreaks. This study describes the first 24 months of the ongoing C. auris outbreak in our hospital and analyzes predisposing factors to C. auris candidemia/colonization. RESEARCH DESIGN AND METHODS: A 12-month prospective, case-controlled study was performed including a total of 228 patients (114 colonized/candidemia and 114 controls). Data from the first 79 candidemia episodes and 738 environmental samples were also analyzed. Definitive C. auris identification was performed by ITS sequencing. Antifungal susceptibility was carried out by EUCAST methodology. RESULTS: Polytrauma (32%), cardiovascular disease (25%), and cancer (17%) were the most common underlying condition in colonized/candidemia patients. Indwelling CVC (odds ratio {OR}, 13.48), parenteral nutrition (OR, 3.49), and mechanical ventilation (OR, 2.43) remained significant predictors of C. auris colonization/candidemia. C. auris was most often isolated on sphygmomanometer cuffs (25%) patient tables (10.2%), keyboards (10.2%), and infusion pumps (8.2%). All isolates were fully resistant to fluconazole (MICs >64 mg/L) and had significantly reduced susceptibility to voriconazole (GM, 1.8 mg/L). CONCLUSIONS: Predictor conditions to C. auris colonization/candidemia are similar to other Candida species. C. auris colonizes multiple patient's environment surfaces. All isolates are resistant to fluconazole and had significant reduced susceptibility to voriconazole.


Assuntos
Antifúngicos/administração & dosagem , Candida/isolamento & purificação , Candidemia/tratamento farmacológico , Surtos de Doenças , Adulto , Idoso , Antifúngicos/farmacologia , Candidemia/microbiologia , Estudos de Casos e Controles , Estado Terminal , Farmacorresistência Viral , Feminino , Fluconazol/farmacologia , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Voriconazol/farmacologia
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