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The Challenges in Hospital Acquired Infections
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The Challenges in Hospital Acquired Infections

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (15 December 2022) | Viewed by 5248

Special Issue Editor

Dr. Marco Bongiovanni

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Guest Editor
Department of Infectious Diseases, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland
Interests: antimicrobial stewardship; HIV infection; COVID-19 infection
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hospital-acquired infections (HAIs) are one of the most important emerging healthcare problems. The growing number of conditions that lead to the hospitalization of individuals presenting with increasingly severe clinical conditions and immunosuppression, in addition to the increased resistance to antimicrobial agents, indicates the importance of HAI in public health management. Furthermore, HAIs can result in a prolonged hospital stay, long-term disability, increased resistance of microorganisms to antimicrobial agents, increased risk of mortality, and a massive additional financial burden for the health system and for patients and their families 

This Special Issue will publish up-to-date data on novel perspectives in the management of HAIs, proposing strategies for better optimizing clinical and therapeutic approaches.

Dr. Marco Bongiovanni
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hospital infections
  • antimicrobial stewardship
  • optimizing antibiotic treatment
  • multi-drug-resistant bacteria

Published Papers (3 papers)

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Research

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15 pages, 33860 KiB  
Article
Long-Term Follow-Up after Mycobacterium Chimaera Infection Following Cardiac Surgery: Single-Center Experience
by Thibault Schaeffer, Sabine Kuster, Luca Koechlin, Nina Khanna, Friedrich S. Eckstein and Oliver Reuthebuch
J. Clin. Med. 2023, 12(3), 948; https://doi.org/10.3390/jcm12030948 - 26 Jan 2023
Cited by 1 | Viewed by 1455
Abstract
Background: Disseminated Mycobacterium chimaera (M. chimaera) infection following cardiac surgery has been associated with a high mortality. The long-term impact of surgery and the appropriate surgical approach are still matters of debate. Methods: From 2015 to 2019, seven patients with M. [...] Read more.
Background: Disseminated Mycobacterium chimaera (M. chimaera) infection following cardiac surgery has been associated with a high mortality. The long-term impact of surgery and the appropriate surgical approach are still matters of debate. Methods: From 2015 to 2019, seven patients with M. chimaera infection following cardiac surgery were isolated. Results: The median incubation time was 30 months (IQR 18–38). Echocardiography was unremarkable in three patients (43%). We decided to redo cardiac surgery in all patients and explanted all previously implanted prosthetic material. All explant cultures yielded M. chimaera. One patient (14%) died in-hospital seven months after the redo surgery. After a median follow-up of 59.6 months (IQR 39.1–69.6), we observed three infection relapses among the survivors (43%), presumably due to concomitant extracardiac infection and recurrent cardiac implant infection. Conclusions: M. chimaera infection following cardiac surgery is associated with a delayed and unspecific clinical presentation. Echocardiogaphy has a limited sensitivity for prosthetic valve infection with M. chimaera, and negative findings should not preclude the surgical decision. The extraction of all previously implanted material is crucial to achieving the source control, as the re-implantation of prosthetic material as well as uncontrolled extracardiac infection at the time of the redo cardiac surgery appear to be key factors for persisting/relapsing infection. Full article
(This article belongs to the Special Issue The Challenges in Hospital Acquired Infections)
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11 pages, 1417 KiB  
Article
Clinical Outcomes and Prolonged SARS-CoV-2 Viral Shedding in ICU Patients with Severe COVID-19 Infection and Nosocomial Bacterial Pneumonia: A Retrospective Cohort Study
by Chuan-Yen Sun, Jia-Yih Feng, Jhong-Ru Huang, Hisao-Chin Shen, Yuh-Min Chen, Wei-Chih Chen and Kuang-Yao Yang
J. Clin. Med. 2022, 11(22), 6796; https://doi.org/10.3390/jcm11226796 - 17 Nov 2022
Cited by 7 | Viewed by 1478
Abstract
Objectives: This study explored the clinical outcomes and association of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding in patients with severe coronavirus disease 2019 (COVID-19) infection who developed nosocomial pneumonia. Methods: This was a retrospective study conducted in a medical center [...] Read more.
Objectives: This study explored the clinical outcomes and association of prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shedding in patients with severe coronavirus disease 2019 (COVID-19) infection who developed nosocomial pneumonia. Methods: This was a retrospective study conducted in a medical center in Taiwan. From May to September 2021, patients from four intensive care units were enrolled after SARS-CoV-2 was confirmed through quantitative polymerase chain reaction and all cases were compatible with the definitions of severe COVID-19 infection. Baseline characteristics, disease severity, clinical outcomes, and times of viral shedding were recorded. Results: A total of 72 patients were diagnosed as having severe COVID-19 infection and 30 developed nosocomial pneumonia, comprising hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). The patients with severe COVID-19 infection and concomitant HAP/VAP had longer intensive care unit (ICU) stays and fewer ventilator-free days at Day 28. An independent risk factor for nosocomial pneumonia was a greater SOFA score at admission. Furthermore, the patients with severe COVID-19 infection who developed HAP/VAP had a significantly longer duration of SARS-CoV-2 shedding (19.50 days vs. 15.00 days, p = 0.006). Conclusions: Patients with severe COVID-19 infection who developed nosocomial pneumonia had longer SARS-CoV-2 shedding days, more complications, and worse outcomes. Full article
(This article belongs to the Special Issue The Challenges in Hospital Acquired Infections)
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Review

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12 pages, 591 KiB  
Review
Pseudomonas aeruginosa Bloodstream Infections in SARS-CoV-2 Infected Patients: A Systematic Review
by Marco Bongiovanni and Beatrice Barda
J. Clin. Med. 2023, 12(6), 2252; https://doi.org/10.3390/jcm12062252 - 14 Mar 2023
Cited by 10 | Viewed by 1725
Abstract
Bacterial co-infections increase the severity of respiratory viral infections and are frequent causes of mortality in COVID-19 infected subjects. During the COVID-19 period, especially at the beginning of the pandemic, an inappropriate use of broad-spectrum antibiotic treatments has been frequently described, mainly due [...] Read more.
Bacterial co-infections increase the severity of respiratory viral infections and are frequent causes of mortality in COVID-19 infected subjects. During the COVID-19 period, especially at the beginning of the pandemic, an inappropriate use of broad-spectrum antibiotic treatments has been frequently described, mainly due to prolonged hospitalization, especially in intensive care unit departments, and the use of immune-suppressive treatments as steroids. This misuse has finally led to the occurrence of infections by multi-drug resistant (MDR) bacteria in hospitalized COVID-19 patients. Although different reports assessed the prevalence of Gram-negative infections in COVID-19 infected patients, scarce data are currently available on bloodstream infections caused by Pseudomonas aeruginosa in hospitalized COVID-19 patients. The aim of our systematic review is to describe data on this specific population and to discuss the possible implications that these co-infections could have in the management of COVID-19 pandemics in the future. We systematically analysed the current literature to find all the relevant articles that describe the occurrence of P. aeruginosa bloodstream infections in COVID-19 patients. We found 40 papers that described in detail P. aeruginosa HAIs-BSI in COVID-19 patients, including 756,067 patients overall. The occurrence of severe infections due to MDR bacteria had a significant impact in the management of hospitalized patients with COVID-19 infections, leading to a prolonged time of hospitalization and to a consequent increase in mortality. In the near future, the increased burden of MDR bacteria due to the COVID-19 pandemic might partially be reduced by maintaining the preventive measures of infection control implemented during the acute phase of the COVID-19 pandemic. Finally, we discuss how the COVID-19 pandemic changed the role of antimicrobial stewardship in healthcare settings, according to the isolation of MDR bacteria and how to restore on a large scale the optimization of antibiotic strategies in COVID-19 patients. Full article
(This article belongs to the Special Issue The Challenges in Hospital Acquired Infections)
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