231 research outputs found
Molecular epidemiology of antibiotic resistant ESKAPE pathogens isolated from public sector hospitals in uMgungundlovu District, KwaZulu-Natal, South Africa.
Doctor of Philosophy in Medical Microbiology. University of KwaZulu-Natal. Durban, 2017.Multi-drug resistant Enterococcus faecium, staphylococcus aureus, Klebsiella pneumoniae,
Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp termed ESKAPE
pathogens are commonly implicated in difficult-to-treat infectious diseases in developed and
developing countries. The prevalence, risk factors, phenotypic and genotypic profiles including
but not limited to clonal relatedness, genetic diversity, resistance and virulence associated with
ESKAPE bacteria were investigated in carriage and clinical isolates from patients in a rural, district
and an urban tertiary hospital in the public health sector in uMgungundlovu District, Kwazulu-
Natal, South Africa.
The overall carriage of MDR ESKAPE Gram-negative bacteria in both hospitals was 37.21%,
42.31% and 57.14% at admission, after 48 hours and at discharge, respectively. The prevalence of
MDR ESKAPE Gram-negative bacteria in faecal carriage (46%) was higher than clinical samples
(28%) and colonization was mainly associated with referral from the district to the tertiary hospital
with high statistical significance (OR: 14.40, 95% CI 0.98-210.84). blaCTX-M-group-9, blaCTX-M-group-1
and blaSHV were the main resistance genes identified. Similarly, the overall prevalence of faecal
VRE carriage was 53% with patients at the district hospital being more likely to be colonized by
VRE at admission (44%), after 48 hours (64%) and discharge (100%) than those of the tertiary
level. Fifteen (39%) E. faecium and 23 (61%) E. faecalis, were detected and displayed high level
of antibiotic resistance. Extensive genetic diversity of E. faecalis and E. faecium and clonal
dissemination of various lineages were observed across wards and within hospitals. The high
levels of resistance in S. aureus were attributed to the multi-drug resistant efflux pumps mepA,
mexE, AcrB, MATE, qac and qacA. Whole genome analysis revealed that the circulating S. aureus
isolates belonged to the extremely virulent ST121 clone that harboured a total of 18 virulence
genes.
The high prevalence, genetic diversity and virulence of antibiotic-resistant ESKAPE bacteria
elucidated in this study necessitates routine screening and surveillance in communities and
hospitals, stringent infection prevention and control measures and antibiotic stewardship to
monitor epidemiological changes, to contain their spread and inform appropriate antibiotic
treatment options respectively
Practical Application of the Learning Mechanics–Game Mechanics (LM-GM) framework for Serious Games Analysis in Engineering Education
La veterinaria doméstica, ó Método tan económico como fácil de preservar y curar á los animales domésticos y a los vegetales cultivados de la mayor parte de sus enfermedades
Cardiovascular Manifestations and Risk Factors in Patients Hospitalized With Covid-19: A World Heart Federation Global Study
Correction: Management of Cardiovascular Disease Patients With Confirmed or Suspected COVID-19 in Limited Resource Settings.
[This corrects the article DOI: 10.5334/gh.823.]
The World Heart Federation Global Study on COVID-19 and Cardiovascular Disease.
Background: The emergence of novel coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has presented an unprecedented global challenge for the healthcare community. The ability of SARS-CoV-2 to get transmitted during the asymptomatic phase, and its high infectivity have led to the rapid transmission of COVID-19 beyond geographic regions facilitated by international travel, leading to a pandemic. To guide effective control and interventions, primary data is required urgently, globally, including from low- and middle-income countries where documentation of cardiovascular manifestations and risk factors in people hospitalized with COVID-19 is limited. Objectives: This study aims to describe the cardiovascular manifestations and cardiovascular risk factors in patients hospitalized with COVID-19. Methods: We propose to conduct an observational cohort study involving 5000 patients recruited from hospitals in low-, middle- and high-income countries. Eligible adult COVID-19 patients will be recruited from the participating hospitals and followed-up until 30 days post admission. The outcomes will be reported at discharge and includes the need of ICU admission, need of ventilator, death (with cause), major adverse cardiovascular events, neurological outcomes, acute renal failure, and pulmonary outcomes. Conclusion: Given the enormous burden posed by COVID-19 and the associated severe prognostic implication of CVD involvement, this study will provide useful insights on the risk factors for severe disease, clinical presentation, and outcomes of various cardiovascular manifestations in COVID-19 patients particularly from low and middle income countries from where the data remain scant
The enigma of Enaliosuchus, and a reassessment of the Lower Cretaceous fossil record of Metriorhynchidae
Management of Cardiovascular Disease Patients With Confirmed or Suspected COVID-19 in Limited Resource Settings
In this paper, we provide recommendations on the management of cardiovascular disease (CVD) among patients with confirmed or suspected coronavirus disease (COVID-19) to facilitate the decision making of healthcare professionals in low resource settings. The emergence of novel coronavirus disease, also known as Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has presented an unprecedented global challenge for the healthcare community. The ability of SARS-CoV-2 to get transmitted during the asymptomatic phase and its high infectivity have led to the rapid transmission of COVID-19 beyond geographic regions, leading to a pandemic. There is concern that COVID-19 is cardiotropic, and it interacts with the cardiovascular system on multiple levels. Individuals with established CVD are more susceptible to severe COVID-19. Through a consensus approach involving an international group this WHF statement summarizes the links between cardiovascular disease and COVID-19 and present some practical recommendations for the management of hypertension and diabetes, acute coronary syndrome, heart failure, rheumatic heart disease, Chagas disease, and myocardial injury for patients with COVID-19 in low-resource settings. This document is not a clinical guideline and it is not intended to replace national clinical guidelines or recommendations. Given the rapidly growing burden posed by COVID-19 illness and the associated severe prognostic implication of CVD involvement, further research is required to understand the potential mechanisms linking COVID-19 and CVD, clinical presentation, and outcomes of various cardiovascular manifestations in COVID-19 patients
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