3 research outputs found
The Effect of Acid Hydrolysis Parameters on the Properties of Nanocellulose Extracted from Almond Shells
The effects of acid hydrolysis parameters (acid type, acid concentration, reaction time, and temperature) on the properties of nanocellulose (NC) extracted from almond shells were investigated. The highest percentage yield of NC obtained from each type of acid was 71.8% using 25% w/v sulfuric acid at 50°C for 60 min, followed by 71.1% with 50% w/v perchloric acid at 35°C for 15 min, and finally 67% with 50% w/v methane sulfonic acid at 25°C for 10 min. The hydrolysis treatment using sulfuric and perchloric acids greatly affect the NC particle size and length. The extracted NCs show different thermal degradation profiles due to the difference in the crystallinity index and types of acid used. Hydrolysis with strong acids (sulfuric and perchloric acids) produce NC with lower crystallinity due to the degradation of both amorphous and crystalline regions in the cellulose. Furthermore, BET analysis revealed the NCs from the hydrolysis using sulfuric acid possesses the highest surface area, desorption/adsorption pore diameter, desorption, and adsorption cumulative pore volume compared to other acids
Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study
Purpose
In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials.
Methods
We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021.
Results
2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28.
Conclusions
HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes