6 research outputs found
Prevalence of Pathogenic Vibrio SPP and Molecular Characterisation of Selected Vibrio Cholerae Serovars Isolated from Seafood in Malaysia
The global resurgence of cholera is an important public health challenge as the number
of countries affected by this infection continues to increase. Cholera continues to be a
major health challenge in Malaysia. To adequately control the infection requires a
thorough understanding of its modes of transmission and implementing a
comprehensive programme which takes into account not only the health aspect but
also social, economic, behavioral and political dimension as well. The food-borne
cholera and other pathogenic vibrios have not been thoroughly investigated in food in
Malaysia. This study demonstrated the presence of toxigenic and non-toxigenic Vibrio
cholerae 01, Vibrio cholerae 0139, Vibrio cholerae non-0l/0139 and other vibrios
pathogenic to mankind, which were isolated from seafood marketed from wet-markets
and supermarkets from different locations in Malaysia from July 1998 to June 1999.
In this prevalence study, a total of 768 seafood samples were examined for the
presence of pathogenic Vibrio species. A total of 431 of 768 (56.1%) seafood samples were contaminated with Vibrios. The frequencies of Vibrio contamination in seafood
were: shrimp (Panaeus indicus) 58.6%, squids (Logio sp.) 44%, squids (Sepia sp. )
60%, cockles (Anadara granosa) 82%, blue crabs (Callinectes sapiduy) 62%,
Shellfish (Lithophaga ma/accana) 48% and peel mussels (Perna viridis) 24%. V.
damsela and V. alginolyticus was the most frequently isolated species, followed by V.
meschnikovii, V. jluvalis, V. parahaemolyticus, V. vulnijicus, V. cholerae and V.
mimicus. Of the 433 shrimp samples examined, 35.5% (254/433) were found to be
positive for Vibrio, which yielded 791 isolates of Vibrios. Thus, 68.2 (58/85), 62.2
(28/45), 88 (22/25), 96 (24/25), 25 (5/20) and 100% (48/48) of the samples obtained
from Selayang, Kajang, Bangi in Selangor; Seremban in Negri Sembi Ian; Penang
(North Peninsula Malaysia); and Kuching in Sarawak (on Borneo island) yielded 158,
74, 62, 68, 14, and 231 isolates of Vibrios, respectively. Examination of 185 shrimp
samples from Serdang wet market in Selangor over a nine-month period gave a
contamination rate of 37.2% with incidence for the months ranged from 15 to 40%
Characterization of Vibrio vulnificus isolated from cockles (Anadara granosa): antimicrobial resistance, plasmid profiles and random amplification of polymorphic DNA analysis
Antibiotic susceptibility, plasmid profiles and random amplification of polymorphic DNA (RAPD) were used to study strains of Vibrio vulnificus isolated from cockles (Anadara granosa). Thirty-six isolates were analyzed. The prevalent biotypes were 1 (72.2% of the isolates) and 2 (27.8%). Among these, 21 strains of biotype 1 and two strains of biotype 2 contained plasmid DNA bands ranging in size from 1.4 to 9.7 MDa. Thirty-one (83.3%) were found to be resistant to one or more of the antimicrobial agents tested, however no specific correlation between antimicrobial resistance patterns and a single biotype was found. In addition, no particular plasmid profile was predictive of a particular pattern of antibiotic susceptibility. Two primers produced polymorphisms in all strains tested, producing bands ranging from 0.25 to 2.7 kb, indicating a high variability among both biotype 1 and biotype 2 of the V. vulnificus strains investigated. RAPD identity across biotypes was also observed among Vibrio vulnificus strains
The impact of frailty on survival in elderly intensive care patients with COVID-19: the COVIP study
Auteurs : COVIP study groupInternational audienceBackground The COVID-19 pandemic has led highly developed healthcare systems to the brink of collapse due to the large numbers of patients being admitted into hospitals. One of the potential prognostic indicators in patients with COVID-19 is frailty. The degree of frailty could be used to assist both the triage into intensive care, and decisions regarding treatment limitations. Our study sought to determine the interaction of frailty and age in elderly COVID-19 ICU patients. Methods A prospective multicentre study of COVID-19 patients ≥ 70 years admitted to intensive care in 138 ICUs from 28 countries was conducted. The primary endpoint was 30-day mortality. Frailty was assessed using the clinical frailty scale. Additionally, comorbidities, management strategies and treatment limitations were recorded. Results The study included 1346 patients (28% female) with a median age of 75 years (IQR 72–78, range 70–96), 16.3% were older than 80 years, and 21% of the patients were frail. The overall survival at 30 days was 59% (95% CI 56–62), with 66% (63–69) in fit, 53% (47–61) in vulnerable and 41% (35–47) in frail patients ( p < 0.001). In frail patients, there was no difference in 30-day survival between different age categories. Frailty was linked to an increased use of treatment limitations and less use of mechanical ventilation. In a model controlling for age, disease severity, sex, treatment limitations and comorbidities, frailty was independently associated with lower survival. Conclusion Frailty provides relevant prognostic information in elderly COVID-19 patients in addition to age and comorbidities. Trial registration Clinicaltrials.gov: NCT04321265 , registered 19 March 2020
Health-related quality of life in older patients surviving ICU treatment for COVID-19: results from an international observational study of patients older than 70 years
International audienceBackground health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected. Objective to quantify HRQoL in order to identify areas of interventions. Design prospective observation study. Setting admissions to European ICUs between March 2020 and February 2021. Subjects patients aged 70 years or older admitted with COVID-19 disease. Methods collected determinants include SOFA-score, Clinical Frailty Scale (CFS), number and timing of ICU procedures and limitation of care, Katz Activities of Daily Living (ADL) dependence score. HRQoL was assessed at 3 months after ICU admission with the Euro-QoL-5D-5L questionnaire. An outcome of ≥4 on any of Euro-QoL-5D-5L domains was considered unfavourable. Results in total 3,140 patients from 14 European countries were included in this study. Three months after inclusion, 1,224 patients (39.0%) were alive and the EQ-5D-5L from was obtained. The CFS was associated with an increased odds ratio for an unfavourable HRQoL outcome after 3 months; OR 1.15 (95% confidence interval (CI): 0.71–1.87) for CFS 2 to OR 4.33 (95% CI: 1.57–11.9) for CFS ≧ 7. The Katz ADL was not statistically significantly associated with HRQoL after 3 months. Conclusions in critically ill old intensive care patients suffering from COVID-19, the CFS is associated with the subjectively perceived quality of life. The CFS on admission can be used to inform patients and relatives on the risk of an unfavourable qualitative outcome if such patients survive
Age and frailty are independently associated with increased COVID-19 mortality and increased care needs in survivors: results of an international multi-centre study
Introduction: Increased mortality has been demonstrated in older adults with coronavirus disease 2019 (COVID-19), but the effect of frailty has been unclear.
Methods: This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS) and delirium on risk of increased care requirements on discharge, adjusting for the same variables.
Results: Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, interquartile range [IQR] 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 versus 18–49: hazard ratio [HR] 3.57, confidence interval [CI] 2.54–5.02), frailty (CFS 8 versus 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease and cancer, but not delirium. Age, frailty (CFS 7 versus 1–3: odds ratio 7.00, CI 5.27–9.32), delirium, dementia and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9.
Conclusion: Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.</p