15 research outputs found
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The potential impact of the COVID-19 pandemic on global antimicrobial and biocide resistance : an AMR Insights global perspective
The COVID-19 pandemic presents a serious public health challenge in all countries. However, repercussions of
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on future global health
are still being investigated, including the pandemic’s potential effect on the emergence and spread of global
antimicrobial resistance (AMR). Critically ill COVID-19 patients may develop severe complications, which may
predispose patients to infection with nosocomial bacterial and/or fungal pathogens, requiring the extensive
use of antibiotics. However, antibiotics may also be inappropriately used in milder cases of COVID-19
infection. Further, concerns such as increased biocide use, antimicrobial stewardship/infection control, AMR
awareness, the need for diagnostics (including rapid and point-of-care diagnostics) and the usefulness of
vaccination could all be components shaping the influence of the COVID-19 pandemic. In this publication, the
authors present a brief overview of the COVID-19 pandemic and associated issues that could influence
the pandemic’s effect on global AMR.This study was supported by internal funding.https://academic.oup.com/jacamram2022School of Health Systems and Public Health (SHSPH
Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia
BACKGROUND: Community-acquired pneumonia (CAP) severity scores can identify patients at low risk for mortality who may be suitable for ambulatory care. Here, we follow the clinical course of hospitalized patients with CAP due to 2009 H1N1 influenza. OBJECTIVE: To evaluate the role of CAP severity scores as predictors of mortality. METHODS: This was a secondary data analysis of patients hospitalized with CAP due to 2009 H1N1 influenza confirmed by reverse transcriptase polymerase chain reaction enrolled in the CAPO (Community-Acquired Pneumonia Organization) international cohort study. CAP severity scores PSI (Pneumonia Severity Index), CURB-65 (confusion, urea, respiratory rate, blood pressure, age 65 65 years) and CRB-65 (confusion, respiratory rate, blood pressure, age 65 65 years) were calculated. Actual and predicted mortality rates were compared. A total of 37 predictor variables were evaluated to define those associated with mortality. RESULTS: Data from 250 patients with CAP due to 2009 H1N1 influenza were analyzed. Patients with low predicted mortality rates (0-1.5%) had actual mortality rates ranging from 2.6% to 17.5%. Obesity and wheezing were the only novel variables associated with mortality. CONCLUSIONS: The decision to hospitalize a patient with CAP due to 2009 H1N1 influenza should not be based on current CAP severity scores, as they underestimate mortality rates in a significant number of patients. Patients with obesity or wheezing should be considered at an increased risk for mortality