Asociación entre el crecimiento bacteriano de la flora intestinal y la presión arterial de hombres adultos mayores hipertensos después de cinco semanas de consumo de Soya (Glicine máx)

Objetivo: Determinar la asociación entre el crecimiento bacteriano de la flora intestinal y la presión arterial de hombres adultos mayores hipertensos después de cinco semanas de consumo de Soya (Glicine máx).Materiales y métodos: estudio cuasi-experimental para evaluar la asociación entre cambios en la presión arterial y el crecimiento bacteriano en 24 hombres hipertensos con edades entre 61 y 82 años residentes en “Las Malvinas”, suroccidente de Barranquilla, quienes adicionaron a la dieta habitual “Leche de soya” de grano entero sin lactosa (18 g. de proteína de soya por día) durante 6 semanas. En el análisis microbiológico de las heces fecales se determinaron los géneros y la cantidad de bacterias mediante técnicas tradicionales. Se midió la presión arterial al inicio y final del tratamiento.Resultados: Los recuentos de bacterias aeróbicas al inicio fueron 10⁵ a 10⁹ y al final, 10⁶ a 10⁹ UFC/gramo de muestra; en bacterias anaeróbicas se encontraron los recuentos más altos: 10⁵ a 10⁹ antes y 10⁶ a 1010 UFC/g, al final. Después del tratamiento con soya la presión sistólica disminuyó en 37.5% de los participantes, la diastólica en 16.67%, la media en 45.83% y la de pulso en 45.83%; sin embargo, no hubo significancia estadística en ningún caso. El coeficiente de correlación de Pearson entre presión arterial y crecimiento bacteriano fue ̵ 0.14.Conclusiones: se observó una asociación débil e inversa entre el incremento de la microbiota intestinal y la disminución de la presión arterial

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Asociación entre el crecimiento bacteriano de la flora intestinal y la presión arterial de hombres adultos mayores hipertensos después de cinco semanas de consumo de Soya (Glicine máx)

Objetivo: Determinar la asociación entre el crecimiento bacteriano de la flora intestinal y la presión arterial de hombres adultos mayores hipertensos después de cinco semanas de consumo de Soya (Glicine máx).Materiales y métodos: estudio cuasi-experimental para evaluar la asociación entre cambios en la presión arterial y el crecimiento bacteriano en 24 hombres hipertensos con edades entre 61 y 82 años residentes en “Las Malvinas”, suroccidente de Barranquilla, quienes adicionaron a la dieta habitual “Leche de soya” de grano entero sin lactosa (18 g. de proteína de soya por día) durante 6 semanas. En el análisis microbiológico de las heces fecales se determinaron los géneros y la cantidad de bacterias mediante técnicas tradicionales. Se midió la presión arterial al inicio y final del tratamiento.Resultados: Los recuentos de bacterias aeróbicas al inicio fueron 10⁵ a 10⁹ y al final, 10⁶ a 10⁹ UFC/gramo de muestra; en bacterias anaeróbicas se encontraron los recuentos más altos: 10⁵ a 10⁹ antes y 10⁶ a 1010 UFC/g, al final. Después del tratamiento con soya la presión sistólica disminuyó en 37.5% de los participantes, la diastólica en 16.67%, la media en 45.83% y la de pulso en 45.83%; sin embargo, no hubo significancia estadística en ningún caso. El coeficiente de correlación de Pearson entre presión arterial y crecimiento bacteriano fue ̵ 0.14.Conclusiones: se observó una asociación débil e inversa entre el incremento de la microbiota intestinal y la disminución de la presión arterial

Findings of the International Nosocomial Infection Control Consortium (INICC), Part II: Impact of a Multidimensional Strategy to Reduce Ventilator-Associated Pneumonia in Neonatal Intensive Care Units in 10 Developing Countries

Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454WOS: 000304998300009PubMed: 22669232DESIGN. Before-after prospective surveillance study to assess the efficacy of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control program to reduce the rate of occurrence of ventilator-associated pneumonia (VAP). SETTING. Neonatal intensive care units (NICUs) of INICC member hospitals from 15 cities in the following 10 developing countries: Argentina, Colombia, El Salvador, India, Mexico, Morocco, Peru, Philippines, Tunisia, and Turkey. PATIENTS. NICU inpatients. METHODS. VAP rates were determined during a first period of active surveillance without the implementation of the multidimensional approach (phase 1) to be then compared with VAP rates after implementation of the INICC multidimensional infection control program (phase 2), which included the following practices: a bundle of infection control interventions, education, outcome surveillance, process surveillance, feedback on VAP rates, and performance feedback on infection control practices. This study was conducted by infection control professionals who applied National Health Safety Network (NHSN) definitions for healthcare-associated infections and INICC surveillance methodology. RESULTS. During phase 1, we recorded 3,153 mechanical ventilation (MV)-days, and during phase 2, after the implementation of the bundle of interventions, we recorded 15,981 MV-days. The VAP rate was 17.8 cases per 1,000 MV-days during phase 1 and 12.0 cases per 1,000 MV-days during phase 2 (relative risk, 0.67 [95% confidence interval, 0.50-0.91]; P = .001), indicating a 33% reduction in VAP rate. CONCLUSIONS. Our results demonstrate that an implementation of the INICC multidimensional infection control program was associated with a significant reduction in VAP rate in NICUs in developing countries. Infect Control Hosp Epidemiol 2012;33(7):704-710Foundation to Fight against Nosocomial InfectionsFinancial support. The funding for the activities performed at INICC headquarters were provided by V.D.R. and the Foundation to Fight against Nosocomial Infections

Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a Multidimensional Infection Control Approach on Catheter-Associated Urinary Tract Infection Rates in Pediatric Intensive Care Units of 6 Developing Countries

DESIGN. A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates. SETTING. Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey. PATIENTS. PICU inpatients. METHODS. We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented. RESULTS. During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UCdays in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21-1.0]), indicating a rate reduction of 57%. CONCLUSIONS. Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries. Infect Control Hosp Epidemiol 2012;33(7):696-70

Time-dependent analysis of extra length of stay and mortality due to ventilator-associated pneumonia in intensive-care units of ten limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC)

Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69 248 admissions followed for 283 069 days in ICUs from 10 countries. Data were arranged according to the multi-state format. Extra LoS and increased risk of death were estimated independently in each country, and their results were combined using a random-effects meta-analysis. VAP prolonged LoS by an average of 2.03 days (95% CI 1.52-2.54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity

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

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