• hospital-acquired infections
• hospitalized
• low- and middle-income countries
• meta-analysis
• prevalence

• hospital-acquired infections
• hospital-acquired pneumonia
• nosocomial infections
• nosocomial pathogen
• ventilator-associated pneumonia

• COVID-19
• Hospital acquired infection
• Infection prevention and control
• Prevalence

• Humans
• Pandemics
• Tertiary Care Centers
• Methicillin-Resistant Staphylococcus aureus
• Malaysia/epidemiology
• Retrospective Studies
• COVID-19/epidemiology
• Cross Infection/microbiology
• Catheter-Related Infections/microbiology
• Pneumonia, Ventilator-Associated/epidemiology

• epidemiology
• incidence
• predictors
• surgical wound infections
• surveillance

• 22UQU4290073DSR10 Umm al-Qura University

• Haemophilus influenzae
• Staphylococcus aureus
• Streptococcus pneumoniae
• antimicrobial resistance
• penicillin resistance
• penicillin-binding proteins
• β-lactamase

• AMR-conferring genes
• Minimum inhibitory concentration
• Molecular epidemiology
• Multidrug-resistant organisms
• Nosocomial infections
• Risk factors analysis

• Acinetobacter baumannii
• Adolescent
• Adult
• Anti-Bacterial Agents/pharmacology
• Bacterial Proteins/genetics
• Cross Infection/epidemiology
• Cross Infection/microbiology
• DNA Gyrase/genetics
• Drug Resistance, Multiple, Bacterial/genetics
• Enterococcus faecium
• Escherichia coli
• Female
• Genotype
• Humans
• Klebsiella pneumoniae
• Malaysia
• Male
• Microbial Sensitivity Tests
• Middle Aged
• Phenotype
• Pseudomonas aeruginosa
• Risk Factors
• Staphylococcus aureus
• Tertiary Care Centers
• Young Adult
• beta-Lactamases/genetics

• 26398D0016 FIC NIH HHS
• United States of America Naval Medical Research Unit No. TWO (NAMRU-2)
• Armed Forces Health Surveillance Division, Global Emerging Infections Surveillance

• Point prevalence surveys
• healthcare associated infections
• hospital
• infection presentation and control

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bacteria/classification
• Bacteria/isolation & purification
• Bacterial Infections/epidemiology
• Bacterial Infections/microbiology
• Child
• Child, Preschool
• Cross Infection/epidemiology
• Female
• Fungi/classification
• Fungi/isolation & purification
• Global Health
• Hospitals
• Humans
• Infant
• Infant, Newborn
• Male
• Middle Aged
• Mycoses/epidemiology
• Mycoses/microbiology
• Prevalence
• Respiratory Tract Infections/epidemiology
• Respiratory Tract Infections/microbiology
• Sepsis/epidemiology
• Sepsis/microbiology
• Urinary Tract Infections/epidemiology
• Urinary Tract Infections/microbiology
• Young Adult

To assess antimicrobial prescribing in a Northern Ireland hospital (Antrim Area Hospital (AAH)) and compare them with those of a hospital in Jordan (Specialty Hospital).

Using the Global-PPS approach, the present study surveyed patients admitted to the hospital in 2015, the prescribed antibiotics, and a set of quality control indicators related to antibiotics.

Ultimately, 444 and 112 inpatients in the AAH and the Specialty Hospital, respectively, were surveyed. For the medical group, 165 inpatients were prescribed 239 antibiotics in the AAH, while 44 patients in the Specialty Hospital were prescribed 65 antibiotics. In relation to the surgical group, 34 inpatients treated for infection were prescribed 66 antibiotics in the AAH, while 41 patients in the Specialty Hospital treated for infection were prescribed 56 antibiotics. For the medical patients, the most frequently prescribed antibiotics in the AAH were a combination of penicillins (18.8%) and penicillins with extended spectrum (18.8%). For the surgical patients, the most frequently prescribed antibiotics in the AAH were imidazole derivatives (24.2%). For the medical and surgical patients in the Specialty Hospital, the most frequently prescribed antibiotics were third-generation cephalosporins (26.2 and 37.5%, respectively). In medical patients, compliance to guidelines was 92.2% in the Specialty Hospital compared to 72.0% in the AAH (p < 0.001). In surgical patients, compliance to guidelines was 92.7% in the Specialty Hospital compared to 81.8% in the AAH (p = 0.012).

The present study highlighted differences in the utilisation of antimicrobials between two hospitals in two distinct regions and benchmarked antibiotic prescriptions across two hospitals.

• Antimicrobial surveillance
• Antimicrobials
• Global point prevalence survey
• Jordan
• Northern Ireland
• Point prevalence survey

• Developing countries
• Hospital acquired infections
• Limited resources

This study aimed to investigate the prevalence of healthcare-associated infection (HAI) in the China-Japan Friendship Hospital, a tertiary level hospital in Beijing, China.

We defined HAI using the criteria established by the Ministry of Health of the People’s Republic of China. Three cross-sectional surveys were conducted from 2012 to 2014. Inpatients who had been hospitalized for at least 48 h were surveyed. Information on HAI prevalence, isolated pathogens and use of antibiotics were collected. Logistic regression models were used to assess the associations between HAI and potential risk factors.

During three cross-sectional surveys, a total number of 4,029 patients were included (1,233 patients in 2012, 1,220 patients in 2013 and 1,576 patients in 2014). The overall prevalence of patients with HAI was 3.6 % (95 % confidence interval (CI) 3.1 %–4.2 %). Respiratory tract infections were the most common type (64.7 %) of HAIs, followed by urinary tract infections (12.6 %) and bloodstream infections (5.4 %). HAI occurrences were significantly associated with male sex (odds ratio (OR) = 2.25, 95 % CI 1.53-3.32), age over 85 years (OR = 4.74, 95 % CI 2.54–8.83), hospitalization in the intensive care units (ICUs) (OR = 2.42, 95 % CI 1.31–4.49), indwelling urinary catheter (OR = 4.21, 95 % CI 2.46–7.20) and mechanical ventilation (OR = 2.31, 95 % CI 1.30–4.09). Gram-negative bacteria were found to be the most isolated pathogens (67.1 %), with gram-positive bacteria and fungi accounted for 20.3 % and 10.5 %, respectively. Antibiotics were administered to 34.3 % of the included patients over the study period.

The overall HAI prevalence in our hospital is similar to previous studies that were conducted in other areas of China, and the respiratory tract infection should be the priority in HAI reduction control within China. We should focus HAI reduction efforts on patients with advanced age, hospitalization in the ICU and indwelling devices.

• China
• Healthcare-associated infection
• Prevalence

Antibiotic resistance as one of the most serious health threats worldwide leading to a high rate of morbidity and mortality. The aim of present study was to examine the prevalence of nosocomial infections (NIs) and pattern of antibiotic resistance in teaching hospitals in Iran

This cross-sectional descriptive study was conducted in a period of one year in three teaching hospitals and all patients with suspected NIs symptoms were chooses. Among these patients who showed antibiotic resistance were included in the study. The samples for clinical test in laboratory were obtained with using standard methods and aseptic technique by trained personnel. Antibiotic susceptibility testing was performed by Kirby-Bauer’s disk diffusion method on Muller-Hinton agar (Hi Media, Mumbai, India) in accordance with the standards of the Clinical Laboratory Standards Institute.

During one year study, 561 patients with nosocomial infections were recognized and among them 340 patients (60.6%) showed some level of antibiotic resistance. The most common cause of NIs in present study was Acinetobacter and the most type of infection was respiratory system infections (52.7%). The highest resistance rate was against Ciprofloxacin (61.8%) followed by Imipenem (50.3%).

Rate of NIs and antibiotics resistance is high in Iranian hospital. So Iranian health ministry should provide guideline and suitable programs for prevention of NIs and antibiotic therapy in hospitals.

28 new pyrrolidine types of compounds as analogues for natural polyhydroxy alkaloids of codonopsinine were evaluated for their anti-MRSA activity using MIC and MBC value determination assay against a panel of S. aureus isolates. One pyrrolidine compound, MFM 501, exhibited good inhibitory activity with MIC value of 15.6 to 31.3 μg/mL against 55 S. aureus isolates (43 MRSA and 12 MSSA isolates). The active compound also displayed MBC values between 250 and 500 μg/mL against 58 S. aureus isolates (45 MRSA and 13 MSSA isolates) implying that MFM 501 has a bacteriostatic rather than bactericidal effect against both MRSA and MSSA isolates. In addition, MFM 501 showed no apparent cytotoxicity activity towards three normal cell lines (WRL-68, Vero, and 3T3) with IC₅₀ values of >625 µg/mL. Selectivity index (SI) of MFM 501 gave a value of >10 suggesting that MFM 501 is significant and suitable for further in vivo investigations. These results suggested that synthetically derived intermediate compounds based on natural products may play an important role in the discovery of new anti-infective agents against MRSA.

• copper oxide
• epa registered
• antimicrobial surface
• environmental bioburden

• Bacteria/drug effects
• Composite Resins
• Copper/pharmacology
• Cross Infection/prevention & control
• Disinfectants/pharmacology
• Disinfection/methods
• Environmental Microbiology
• Hospitals
• Humans
• Microbial Viability/drug effects
• Surface Properties

• Central line associated-BSI
• ICUs
• nosocomial blood stream infections
• secondary bacteremia
• trauma

The abuse of antimicrobials is a serious concern in China. Several measures have been taken to improve the rational use of antimicrobials, including the establishment of a national surveillance network for antimicrobial use. This study describes the dynamic changes in antimicrobial use in China between 2001 and 2010, with the scope of identifying targets to improve the prescription of antimicrobials.

Five point prevalence surveys were performed in hospitals across mainland China in 2001, 2003, 2005, 2008, and 2010. All inpatients who were admitted for at least 24 hours were included in the study. Details regarding antimicrobial use by these patients and the collection of samples for bacterial culture from inpatients administered therapeutic antimicrobials were recorded.

The surveys encompassed tertiary hospitals from all 31 provinces of mainland China. Antimicrobial use prevalence decreased from 54.79% in 2001 to 46.63% in 2010. While this decline was observed in most hospital departments, antimicrobial use remained stable or increased in others. Antimicrobial use prevalence was relatively high in the Pediatrics departments and general intensive care units, whereas it was lower in the Obstetrics (Neonatal group) departments in each survey. The proportion of patients administered a single antimicrobial increased from 60.78% in 2001 to 70.16% in 2010, while the proportion of administration of two or more antimicrobials declined. The bacterial culture rate increased from 25.22% in 2003 to 34.71% in 2010. Antimicrobial use prevalence (47.96% vs 46.16%), bacterial culture rate (36.40% vs 34.19%), and the proportion of administration of a single antimicrobial (71.41% vs 67.33%) were higher in teaching hospitals than in nonteaching hospitals in 2010.

Although measures for enhancing the rational use of antimicrobials have been effective, further improvements are required. The findings from this study can promote such improvements.

• Anti-Infective Agents/pharmacology
• Anti-Infective Agents/therapeutic use
• Bacteria/drug effects
• Bacteria/growth & development
• China/epidemiology
• Drug Therapy, Combination
• Hospitals/statistics & numerical data
• Hospitals, Teaching/statistics & numerical data
• Humans
• Practice Patterns, Physicians'/statistics & numerical data
• Prevalence

• Health care-associated infections
• Infant

• Bacterial Infections/epidemiology
• Bacterial Infections/microbiology
• Bacterial Infections/prevention & control
• China/epidemiology
• Female
• Humans
• Infant, Newborn
• Infection Control/methods
• Intensive Care Units, Neonatal
• Male
• Mycoses/epidemiology
• Mycoses/microbiology
• Mycoses/prevention & control
• Pneumonia, Ventilator-Associated/epidemiology
• Pneumonia, Ventilator-Associated/microbiology
• Pneumonia, Ventilator-Associated/prevention & control
• Prevalence
• Survival Analysis

The purpose of this study was to investigate the actual conditions of nosocomial infection control in Kathmandu City, Nepal as a basis for the possible contribution to its improvement. The survey was conducted at 17 hospitals and the methods included a questionnaire, site visits and interviews. Nine hospitals had manuals on nosocomial infection control, and seven had an infection control committee (ICC). The number of hospitals that met the required amount of personal protective equipment preparation was as follows: gowns (13), gloves (13), surgical masks (12). Six hospitals had carried out in-service training over the past one year, but seven hospitals responded that no staff had been trained. Eight hospitals were conducting surveillance based on the results of bacteriological testing. The major problems included inadequate management of ICC, insufficient training opportunities for hospital staff, and lack of essential equipment. Moreover, increasing bacterial resistance to antibiotics was recognized as a growing issue. In comparison with the results conducted in 2003 targeting five governmental hospitals, a steady improvement was observed, but further improvements are needed in terms of the provision of high quality medical care. Particularly, dissemination of appropriate manuals, enhancement of basic techniques, and strengthening of the infection control system should be given priority.

• Fact finding survey
• Kathmandu
• Nepal
• nosocomial infection control

Antibacterial activity of honey is mainly dependent on a combination of its peroxide activity and non-peroxide components. This study aims to investigate antibacterial activity of five varieties of Malaysian honey (three monofloral; acacia, gelam and pineapple, and two polyfloral; kelulut and tualang) against Staphylococcus aureus, Bacillus cereus, Escherichia coli, and Pseudomonas aeruginosa.

Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) were performed for semi-quantitative evaluation. Agar well diffusion assay was used to investigate peroxide and non-peroxide activities of honey.

The results showed that gelam honey possessed lowest MIC value against S. aureus with 5% (w/v) MIC and MBC of 6.25% (w/v). Highest MIC values were shown by pineapple honey against E. coli and P. aeruginosa as well as acacia honey against E. coli with 25% (w/v) MIC and 50% (w/v) MBC values. Agar inhibition assay showed kelulut honey to possess highest total antibacterial activity against S. aureus with 26.49 equivalent phenol concentrations (EPC) and non-peroxide activity of 25.74 EPC. Lowest antibacterial activity was observed in acacia honey against E. coli with total activity of 7.85 EPC and non-peroxide activity of 7.59 EPC. There were no significant differences (p > 0.05) between the total antibacterial activities and non-peroxide activities of Malaysian honey. The intraspecific correlation between MIC and EPC of E. coli (r = -0.8559) was high while that between MIC and EPC of P. aeruginosa was observed to be moderate (r = -0.6469). S. aureus recorded a smaller correlation towards the opposite direction (r = 0.5045). In contrast, B.cereus showed a very low intraspecific correlation between MIC and EPC (r = -0.1482).

Malaysian honey, namely gelam, kelulut and tualang, have high antibacterial potency derived from total and non-peroxide activities, which implies that both peroxide and other constituents are mutually important as contributing factors to the antibacterial property of honey.

16S rRNA methylase-producing Gram-negative bacteria are highly resistant to all clinically important aminoglycosides. We analyzed clinical strains of 16S rRNA methylase-producing Acinetobactor baumannii and Pseudomonas aeruginosa obtained from clinical isolates in medical settings in Vietnam.

From 2008 to 2011, 101 clinical strains of A. baumannii and 15 of P. aeruginosa were isolated from patients in intensive care units (ICUs) in two medical settings in Vietnam. Antimicrobial susceptibilities were determined using the microdilution method and epidemiological analysis was performed by pulsed-field gel electrophoresis and MLST. Genes encoding the 16S rRNA methylases, OXAs and CTX-Ms were analyzed by PCR and sequence analysis.

16S rRNA methylase-producing Gram-negative pathogens were detected in two hospitals in Vietnam. Of the 101 clinical isolates of A. baumannii and the 15 of P. aeruginosa isolated from two ICUs in these hospitals, 72 (71.3%) were highly resistant to amikacin, arbekacin and gentamicin, with MICs greater than 1,024 mg/L. The 16S rRNA methylases ArmA and RmtB were produced by 61 and 9 isolates of A. baumannii, respectively, and RmtB was produced by 2 isolates of P. aeruginosa. Moreover, 52 of the A. baumannii isolates producing 16S rRNA methylases harbored both blaOXA-23-like and blaOXA-51-like genes. Most A. baumannii isolates producing 16S rRNA methylase obtained in hospital A in Hanoi were ST91 and ST231, whereas most from hospital B in Ho Chi Minh City were ST136, ST195, and ST254.

The two P. aeruginosa isolates harboring rmtB showed different patterns on PFGE, one each corresponding to ST217 and ST313.

Gram-negative bacteria producing the 16S rRNA methylases ArmA and RmtB are emerging in medical settings in Vietnam. A. baumannii isolates in northern and southern regions of Vietnam may be of different lineages.

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents/therapeutic use
• Child
• Child, Preschool
• Cross-Sectional Studies
• Drug Utilization/statistics & numerical data
• Female
• Hospitals, General
• Humans
• Inappropriate Prescribing/statistics & numerical data
• Male
• Middle Aged
• Vietnam
• Young Adult

Approximately 7 million people worldwide acquire a healthcare associated infection each year. Despite aggressive monitoring, hand washing campaigns and other infection control measures, nosocomial infections (NI) rates, especially those caused by antibiotic resistant pathogens, are unacceptably high worldwide. Additional ways to fight these infections need to be developed. A potential overlooked and neglected source of nosocomial pathogens are those found in non-intrusive soft and hard surfaces located in clinical settings. Soft surfaces, such as patient pyjamas and beddings, can be an excellent substrate for bacterial and fungal growth under appropriate temperature and humidity conditions as those present between patients and the bed. Bed making in hospitals releases large quantities of microorganisms into the air, which contaminate the immediate and non-immediate surroundings. Microbes can survive on hard surfaces, such as metal trays, bed rails and door knobs, for very prolonged periods of time. Thus soft and hard surfaces that are in direct or indirect contact with the patients can serve as a source of nosocomial pathogens. Recently it has been demonstrated that copper surfaces and copper oxide containing textiles have potent intrinsic biocidal properties. This manuscript reviews the recent laboratory and clinical studies, which demonstrate that biocidal surfaces made of copper or containing copper can reduce the microbiological burden and the NI rates.

• Nosocomial infections
• Health acquired infections
• Copper
• Copper oxide
• Biocides
• Surfaces
• Microbiological burden

• Cost of Illness
• Cross Infection/epidemiology
• Developing Countries/statistics & numerical data
• Endemic Diseases
• Humans

• Aged
• Cross Infection/epidemiology
• Cross Infection/microbiology
• Female
• Humans
• Male
• Middle Aged
• Prevalence
• Serbia/epidemiology

Nosocomial infection control is crucial for improving the quality of medical care. It is also indispensable for implementing effective control measures for severe acute respiratory syndrome (SARS) and the possible occurrence of a human influenza pandemic. The present authors, in collaboration with Vietnamese hospital staff, performed a fact-finding survey of nosocomial infection control in hospitals in northern Vietnam and compared the results with those of a survey conducted 4 years previously. Remarkable improvement was recognized in this period, although there were considerable differences between the central hospitals in Hanoi and local hospitals. In the local hospitals, basic techniques and the systems for infection control were regarded as insufficient, and it is necessary to improve these techniques and systems under the guidance of hospitals in the central area. Based on the results of the survey, programs were prepared and training courses were organized in local hospitals. Evaluation conducted after the training courses showed a high degree of satisfaction among the trainees. The results of the survey and the training courses conducted during the study period are expected to contribute to the improvement of nosocomial infection control in remote areas of Vietnam

• Aged
• Cross Infection/epidemiology
• Female
• Hospitals, University
• Humans
• Male
• Middle Aged
• Prevalence
• Risk Factors
• Serbia

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Cross Infection/epidemiology
• Female
• Hospitals, University/statistics & numerical data
• Humans
• Intensive Care Units/statistics & numerical data
• Male
• Middle Aged
• Morocco/epidemiology
• Odds Ratio
• Prevalence
• Risk Factors
• Surgical Wound Infection/epidemiology
• Urinary Catheterization/adverse effects
• Urinary Catheterization/statistics & numerical data

Hospital infection prevalence surveys were performed in our 1400-bed University medical centre in Hong Kong from 1985 to 1988. We investigated the rates of four major hospital-acquired infections (HAIs) (pneumonia, symptomatic urinary tract infection, surgical site infection and laboratory-confirmed bloodstream infection) in order to identify current distribution and any changes after 15 years. A one-day point prevalence study was performed on 7 September 2005. All inpatients were surveyed for HAIs, community-acquired infections (CAIs), risk factors, pathogenic isolates and antibiotics prescribed. Infections were diagnosed according to Centers for Disease Control and Prevention (CDC) criteria. In total, 1021 patients were surveyed; of these, 41 had 42 HAIs (4% prevalence) and 389 (38%) were receiving antibiotics. The commonest HAI was pneumonia (1.4%) followed by bloodstream infection (0.9%) and symptomatic urinary tract infection (0.8%). The prevalence of postoperative surgical site infection was 5.6%. The nosocomial prevalence rate was highest in the Intensive Care Unit, followed by the Pediatric and Neonatal Intensive Care Units, Children's Cancer Centre/Bone Marrow Transplant Unit and Orthopaedics with Traumatology. Meticillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa were the commonest pathogens. The rates are significantly lower than previously and reflect the increased resources for infection control made available following the outbreak of severe acute respiratory syndrome (SARS).

• Adult
• Anti-Bacterial Agents/therapeutic use
• Bacteremia/drug therapy
• Bacteremia/etiology
• Catheterization/adverse effects
• Cross Infection/drug therapy
• Cross Infection/epidemiology
• Cross Infection/etiology
• Female
• Hong Kong/epidemiology
• Hospital Units/statistics & numerical data
• Hospitals, University
• Humans
• Length of Stay
• Male
• Middle Aged
• Pneumonia/drug therapy
• Pneumonia/epidemiology
• Prevalence
• Risk Factors
• Surgical Wound Infection/drug therapy
• Surgical Wound Infection/epidemiology
• Urinary Tract Infections/drug therapy
• Urinary Tract Infections/etiology