Acinetobacter baumannii in ICU patients: A prospective study highlighting their incidence, antibiotic sensitivity pattern and impact on ICU stay and mortality

Background: Acinetobacter baumannii (A. baumannii) was considered as a leading cause of nosocomial respiratory infection and bacteremia in many hospitals all over the world. However, there was still a debates whether colonization and/ or infection with A. baumannii, increase morbidity and mortality independently of the effect of other risk factors. Aim of the study: 1. To detect the incidence & mortality rate of the acinetobacter among ICU patient. 2. To compare between colonization and infection by A. baumannii in mortality and outcome. 3. To find the rate of nosocomial respiratory infections from acinetobacter baumannii. Patients and methods: A prospective study was carried out at Al-Adwani General Hospital in Al Taif region, KSA in the ICU department from April 2014 to March 2015. In this study (1280) patients were enrolled after informed consent. only 40 case positive culture of A. baumannii were evaluated. We classified the positive cases into 2 groups. Group (1): Patients who developed nosocomial infection (18 patients). Group (2): Patients who developed colonization from all studied cases (22 patients). All patients were under strict infection control practice and take the antibiotic treatment. Results: Nosocomial respiratory tract infections were the commonest (79.5%), followed by urinary tract infections (14.1%) in relation to other nosocomial infection. Acinetobacter infection was statistically significant among all the infections (P < 0.05). The mortality from acinetobacter infection group (1) was 50% and from colonization group (2) was 13.6% with overall mortality 30%. The antibiotics such as tigecyclin and colistin showed high curability and high sensitivity rate (p < 0.01). The mortality rate, comorbidities, ICU stays (days) after acinetobacter, CRP and WBCs were the significant predictors for group (1) patients. Conclusion: Acinetobacter baumannii is not so far as a cause of nosocomial respiratory infection with subsequent long ICU stays and high mortality. Emerging A. baumannii resistant strains is considered a real threat in ICU

Clinical significance of serum surfactant protein D in patients with rheumatoid arthritis-associated interstitial lung diseases

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects approximately 1% of the population, and pulmonary involvement is common. The most common pulmonary manifestation is interstitial lung disease (ILD) which leads to pulmonary fibrosis. ILD is the only complication of RA reported to be increasing in prevalence and it has been shown to account for around 6% of all RA deaths. Surfactant proteins (SP-A, SP-B, SP-C and SP-D) play various important roles in the lung. Serum SP-D levels reflected the disease activity of pulmonary fibrosis. Aim of the study: To determine the clinical significance of surfactant protein D (SP-D), a useful marker for evaluating interstitial lung diseases and specifically in rheumatoid arthritis associated interstitial lung disease patients. Patients and methods: Our patients were classified into 3 groups (Group 1: 18 patients had rheumatoid arthritis ILD; Group 2: 12 patients had rheumatoid arthritis without interstitial pulmonary disease; Group 3: 10 patients had idiopathic pulmonary fibrosis with no rheumatoid arthritis) and 20 healthy control subjects. Serum SP-D levels were assayed using a specific enzyme-linked immunosorbent assay for all studied groups. Results: A highly significant difference was found between patients’ groups and the control group regarding disease duration, serum aCCP, SP-D, serum CRP and RF being higher in patients’ group (p < 0.01). However FVC was significantly lower in patients’ groups compared to the control group (p < 0.05). Assessment of the diagnostic performance of SP-D assay revealed that the best cutoff for discriminating rheumatoid patients with interstitial lung disease from those without interstitial lung disease was 219 ng/mL. At this value, SP-D had a diagnostic sensitivity of 94.2%, specificity 90%, negative predictive value 90%, positive predictive value 94.2% and efficiency 95%. Conclusion: The serum SP-D level may be a useful marker for ILD especially in patients with rheumatoid arthritis

The impact of music therapy on anxiety and pregnancy rate among infertile women undergoing assisted reproductive technologies: a systematic review and meta-analysis

Objective: We aimed to perform a systematic review and meta-analysis to evaluate the effect of music therapy on anxiety and pregnancy rates among infertile women undergoing to perform assisted reproductive technologies (ART). Methods: Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021. We included randomized controlled trials (RCTs) that compared music therapy (intervention group) to no music intervention (control group). Our primary outcomes were anxiety score using the State-Trait Anxiety Inventory (STAI) tool and pain score utilizing the Visual Analog Scale (VAS). Our secondary outcomes were the overall satisfaction score and clinical pregnancy rate. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. The overall quality of evidence was assessed through GRADEpro GDT software. Results: Seven RCTs with a total number of 793 patients were included in our study. Music therapy significantly reduced the anxiety score compared to control group (MD= −3.09, 95% CI [−5.57, −0.61], p = 0.01). Moreover, pain score was significantly improved after music treatment (MD= −2.93, 95% CI [−3.86, −2.00], p > 0.001). A significant improvement in the overall satisfaction score was found among music therapy group (MD= 1.51, 95% CI [0.40, 2.61], p = 0.008). Although more women in music therapy group experienced an increase in the clinical pregnancy rate in comparison with control group, the result was not statistically significant (RR= 1.08, 95% CI [0.94, 1.26], p = 0.28). The GRADEpro GDT tool showed a moderate quality of evidence for the evaluated outcomes. Conclusions: There is evidence of moderate quality that music therapy improves anxiety, pain, and satisfaction scores among infertile women undergoing ART. Moreover, it increases the clinical pregnancy rate but without statistical significance. More trials with a larger sample size are needed to investigate the influence of music therapy on the clinical outcomes of ART

Effect of gamma irradiation and/or certain entomopathogenic fungi on the larval Mortality of Galleria mellonella L

Abstract The present investigation was carried out to study the effect of LC50 of the entomopathogenic fungi (EPF), Paecilomyces lilacinus and Beauveria bassiana, on larval mortality of the greater wax moth (GWM), Galleria mellonella L., under laboratory conditions and also to study the effect of different doses of gamma irradiation (70, 100, 125, and 150 Gy), separately or combined with the LC50 of the isolates of the EPF, B. bassiana, and P. lilacinus, on the second-instar larvae of G. mellonella larval mortality. The combined treatment of gamma irradiation and EPF increased the larval mortality rates than that at each treatment alone. The highest percentage of larval mortality was 78 and 84%, with 125 Gy + B. bassiana in the case of F1 male and F1 female, respectively. According to the obtained results, the gamma irradiation increased the pathogenicity of the fungi against the tested larvae. The combination between the two control tools may provide satisfactory control of the insect-pest, especially, in the storage