Other specific DSP article suggested by Editorial Board
Comparison of Pediatric Risk of Mortality-III, Phoenix Sepsis, and pediatric Sequential Organ Failure Assessment scores for predicting septic shock in Vietnamese children with sepsis
Authors: Khai Quang Tran
Abstract
Background: Early recognition of septic shock is crucial for improving outcomes in children with sepsis. This study aimed to compare the predictive performance of the Pediatric Risk of Mortality-III (PRISM-III), Phoenix Sepsis Score (PSS), and pediatric Sequential Organ Failure Assessment (pSOFA) scores for septic shock in Vietnamese children.
Methods: A cross-sectional study was conducted on 86 children aged 2-months to 15-years with sepsis (including 23 with septic shock) admitted to a pediatric intensive care unit. Septic shock classification was performed independently and single ‒ blinded to score calculations to minimize assessment bias. The PSS and pSOFA were calculated using the worst parameters within the first 6-hours, and PRISM-III within the first 24 hours of admission. Discriminatory ability was assessed by the Area Under the Receiver Operating Characteristic Curve (AUROC). Multivariable logistic regression and calibration analyses were performed. Calibration results should be interpreted cautiously due to the small sample size.
Results: The PSS showed the highest AUROC (0.867, 95 % CI: 0.777–0.931), followed by PRISM-III (0.826, 95 % CI: 0.729–0.899) and pSOFA (0.791, 95 % CI: 0.690–0.871); pairwise comparisons were not statistically significant. The PSS demonstrated the highest sensitivity (95.7 %) and negative predictive value (97.6 %), while PRISM-III had the highest specificity (90.5 %) and positive predictive value (70.0 %). In multivariable analysis, both PSS (Odds Ratio, OR = 2.78) and PRISM-III (OR = 1.23) were independent predictors of septic shock.
Conclusions: The PSS and PRISM-III provide complementary value. A two-step approach using the sensitive PSS for initial screening and the specific PRISM III for confirmation may enhance early septic shock recognition in resource-limited settings.”
Other specific DSP article suggested by Editorial Board
Differences in clinical outcomes according to duration of antibiotic therapy following successful ERCP in patients with acute cholangitis: A retrospective cohort study in Colombia
Authors: Juan Pablo García-Marmolejo
Background: Acute cholangitis is a significant cause of mortality and morbidity, particularly in elderly patients and those with comorbidities. However, the optimal duration of antibiotic therapy following biliary drainage remains unclear. This study aimed to evaluate clinical outcomes based on the duration of antibiotic therapy after successful biliary drainage in adults with acute cholangitis.
Methods: We conducted a retrospective cohort study of patients treated for acute cholangitis at a university hospital in Colombia between 2014 and 2022. Short-course antibiotic therapy was defined as ≤4 days after successful post-ERCP drainage. The primary outcome was a composite of in-hospital mortality, ICU admission, or hospital readmission within 30 days of discharge. Univariate and multivariate logistic regression analyses were performed to examine the association between antibiotic duration and the primary outcome.
Results: All in all, 317 patients were included. Escherichia coli was the most frequently isolated microorganism, with 54 % manifesting full antimicrobial susceptibility. Fifty-nine patients received short-course therapy, while 258 received long-course therapy. There were no significant differences in the primary outcome between the groups (p = 1). However, longer hospital stays were observed in the long-course group (p < 0.001). Tokyo III severity (OR 32.07; 95 % CI 11.84–113.16; p < 0.001) and carbapenem resistance (OR 4.07; 95 % CI 1.02–16.96; p = 0.04) were identified as independent risk factors for the composite outcome.
Conclusions: Shorter antibiotic courses following ERCP drainage may be a viable option for patients with acute cholangitis. Further randomized controlled trials and pragmatic studies are necessary to confirm these findings.”
Other specific DSP article suggested by Editorial Board
Risk factors for deep vein thrombosis during peripherally inserted central catheter-related infections: A retrospective study
Authors: Paul Petitgas
Abstract
Background: Peripherally inserted central catheters (PICCs) are associated with complications including deep vein thrombosis (DVT) and infections. However, the risk factors for developing DVT specifically during PICC-related infections remain poorly understood.
Methods: We conducted a retrospective observational study in a tertiary-care hospital in Reunion Island, examining adult patients with PICC-related infections between January 2021 and March 2022. Venous Doppler ultrasound results, microbiological data, and clinical variables were analyzed. Univariate analysis was performed to identify factors associated with PICC-related DVT.
Results: Among 63 patients with PICC-related infections, 40 underwent Doppler ultrasound examinations, with 12 (19 %) diagnosed with PICC-DVT. Infections with Staphylococcus aureus (P = 0.05) and local signs (P = 0.04) were significantly associated with PICC-DVT. Enterobacterales were the predominant pathogens (42.5 %). The incidence rate of PICC-DVT was 5.0/1000 catheter-days in patients with PICC-related infections.
Conclusions: Staphylococcus aureus infection and local signs are associated with PICC-DVT. Our findings suggest that these factors should be considered when managing patients with PICC-related infections. Prospective studies are needed to develop clinical prediction tools to identify which patients would benefit most from Doppler ultrasound.
Other specific DSP article suggested by Editorial Board
Bioaerosol assessment of indoor air in hospital wards for isolation of Nocardia species from a tertiary care hospital in Iranshahr, Iran
Authors: Zahed Ahmadi
Abstract
Background: Bioaerosols can be a critical role in the transmission of hospital-acquired infections. Nocardia species are opportunistic pathogens that primarily affect immunocompromised patients, accounting for approximately 1–2% of all hospital-acquired bacterial infections in this population. To date, there are no comprehensive studies examining the presence of Nocardia in hospital indoor air. This study aimed to assess the species diversity of the Nocardia genus in different hospital indoor environments at Khatam Hospital, Iranshahr, Iran.
Methods: Particle concentration in various hospital wards was measured using the direct reading method. Bioaerosol sampling followed NIOSH methods 0800 and 0801, using Sauton’s medium plates. Each Petri dish was incubated in an inverted position for three weeks at both 25 °C and 37 °C in parallel. Nocardia isolates were identified through phenotypic tests, including growth in lysozyme broth and substrate degradation assays (tyrosine, xanthine, and hypoxanthine), followed by molecular confirmation.
Results: The orthopedic ward exhibited the highest particle concentration among all wards. Fourteen Nocardia isolates were recovered: four from the emergency department, four from infectious diseases, and three from surgery, two from hemodialysis, and one from orthopedics. The identified species included N. cyriacigeorgica, N. asteroides, N. otitidiscaviarum, N. wallacei, N. kroppenstedtii, N. farcinica, and N. nova.
Conclusion:
This study represents one of the earliest documented investigations, detecting clinically relevant Nocardia species in hospital indoor air. Although the direct link between airborne Nocardia and hospital-acquired infections remains to be proven, the detection of pathogenic species in patient-care environments underscores a potential risk to vulnerable individuals.