Infection Control & Hospital Epidemiology, 2020
Background:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates h... more Background:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.Methods:Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.Results:We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but witho...
International Journal of Research in Medical Sciences, 2019
Background: In most developing countries, the renal replacement therapy (RRT) in ICU is not perfo... more Background: In most developing countries, the renal replacement therapy (RRT) in ICU is not performed locally. We designed this study to assess the intermittent hemodialysis (IHD) offsite intakes on survival in critically ill patients admitted with renal failure.Methods: We prospectively analyzed all patients admitted to medical ICU with Acute Renal Failure (AKF) or Chronic Renal Failure (CKF) from February 2011 to September 2013. Patients were divided into two groups: those that received IHD in Hemodialysis Unit (IHD+) and those who did not (IHD-). Every patient IHD+ was matched to a patient IHD - using propensity score.Results: 202 patients were included: 151 with ARF and 51 with CRF. 116 patients were matched (age: 48±18 years; 46F/70M; median serum creatinine: 51mg/l; IQR: 32-90 mg/l). The total number of dialysis sessions was 112 for 58 patients (1.8±1.4 session/patient). The median delay to initiate IHD was 5.5h (IQR: 2-8h) and median duration of transportation was 10 min (IQR...
Elderly patients are increasingly enrolled in dialysis programs and present a series of special c... more Elderly patients are increasingly enrolled in dialysis programs and present a series of special characteristics due to their high morbidity and mortality. Objective:To describe the characteristics of incident dialysis patients aged >75 years, their comorbidities and their admissions, with a view to determining the factors that influence their course and mortality. Patients and Methods: The study included all patients aged >75 years who started dialysis in our center since January 2000. The mean duration of follow-up was 3.3 ± 2.2 years. Data were collected on incident comorbidity, admissions and their causes. A total of 139 patients were included, with a mean age of 78.6 ± 2.6 years (67.6% males, 33.8% diabetic and 7.9% on peritoneal dialysis). Three groups were established according to age: 75–79, 80–85 and >85 years. The most frequent comorbidities were chronic obstructive pulmonary disease (25.9%), ischemic heart disease (25.2%), heart failure (25.9%), neoplasms (23.7%),...
Acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. We report an un... more Acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. We report an uncommon case of advanced pneumococcal meningitis complicated by acute lumbar epidural abscess in an adult. A 35-year-old man was admitted to the medical intensive care unit with pneumococcal meningitis. On the eighth day of hospitalization, he presented a cauda equine syndrome with flaccid paraplegia, saddle anesthesia, and bladder and bowel dysfunction. Magnetic resonance imaging (MRI) of the spine demonstrated a suppurative collection at L2-L3. Surgical decompression was performed, and antibiotherapy was followed for eight weeks. Clinical improvement was progressive over eight months. New onset neurologic deficits in a patient with pneumococcal meningitis should raise suspicion of acute epidural abscess.
Journal of Occupational Medicine and Toxicology, 2013
Introduction Sleep deprivation among training physicians is of growing concern; training physicia... more Introduction Sleep deprivation among training physicians is of growing concern; training physicians are susceptible due to their prolonged work hours and rotating work schedules. The aim of this study was to determine the prevalence of self-perceived sleepiness in emergency training physicians, and to establish a relationship between self-perceived sleepiness, and quality of life. Methods Prospective survey in Ibn Sina University hospital Center in Morocco from January to April 2011 was conducted. Questionnaires pertaining to socio-demographic, general, and sleep characteristics were completed by training physician who ensured emergency service during the month preceding the survey. They completed the Epworth sleepiness scale (ESS) which assessed the self-perceived sleepiness, and the EuroQol-5 dimensions (EQ-5D) scale which assessed the general quality of life. Results Total 81 subjects (49 men and 32 women) were enrolled with mean age of 26.1 ± 3.4 years. No sleepiness was found i...
Infection Control & Hospital Epidemiology, 2020
Background:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates h... more Background:Short-term peripheral venous catheter–related bloodstream infection (PVCR-BSI) rates have not been systematically studied in resource-limited countries, and data on their incidence by number of device days are not available.Methods:Prospective, surveillance study on PVCR-BSI conducted from September 1, 2013, to May 31, 2019, in 727 intensive care units (ICUs), by members of the International Nosocomial Infection Control Consortium (INICC), from 268 hospitals in 141 cities of 42 countries of Africa, the Americas, Eastern Mediterranean, Europe, South East Asia, and Western Pacific regions. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System.Results:We followed 149,609 ICU patients for 731,135 bed days and 743,508 short-term peripheral venous catheter (PVC) days. We identified 1,789 PVCR-BSIs for an overall rate of 2.41 per 1,000 PVC days. Mortality in patients with PVC but witho...
International Journal of Research in Medical Sciences, 2019
Background: In most developing countries, the renal replacement therapy (RRT) in ICU is not perfo... more Background: In most developing countries, the renal replacement therapy (RRT) in ICU is not performed locally. We designed this study to assess the intermittent hemodialysis (IHD) offsite intakes on survival in critically ill patients admitted with renal failure.Methods: We prospectively analyzed all patients admitted to medical ICU with Acute Renal Failure (AKF) or Chronic Renal Failure (CKF) from February 2011 to September 2013. Patients were divided into two groups: those that received IHD in Hemodialysis Unit (IHD+) and those who did not (IHD-). Every patient IHD+ was matched to a patient IHD - using propensity score.Results: 202 patients were included: 151 with ARF and 51 with CRF. 116 patients were matched (age: 48±18 years; 46F/70M; median serum creatinine: 51mg/l; IQR: 32-90 mg/l). The total number of dialysis sessions was 112 for 58 patients (1.8±1.4 session/patient). The median delay to initiate IHD was 5.5h (IQR: 2-8h) and median duration of transportation was 10 min (IQR...
Elderly patients are increasingly enrolled in dialysis programs and present a series of special c... more Elderly patients are increasingly enrolled in dialysis programs and present a series of special characteristics due to their high morbidity and mortality. Objective:To describe the characteristics of incident dialysis patients aged >75 years, their comorbidities and their admissions, with a view to determining the factors that influence their course and mortality. Patients and Methods: The study included all patients aged >75 years who started dialysis in our center since January 2000. The mean duration of follow-up was 3.3 ± 2.2 years. Data were collected on incident comorbidity, admissions and their causes. A total of 139 patients were included, with a mean age of 78.6 ± 2.6 years (67.6% males, 33.8% diabetic and 7.9% on peritoneal dialysis). Three groups were established according to age: 75–79, 80–85 and >85 years. The most frequent comorbidities were chronic obstructive pulmonary disease (25.9%), ischemic heart disease (25.2%), heart failure (25.9%), neoplasms (23.7%),...
Acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. We report an un... more Acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. We report an uncommon case of advanced pneumococcal meningitis complicated by acute lumbar epidural abscess in an adult. A 35-year-old man was admitted to the medical intensive care unit with pneumococcal meningitis. On the eighth day of hospitalization, he presented a cauda equine syndrome with flaccid paraplegia, saddle anesthesia, and bladder and bowel dysfunction. Magnetic resonance imaging (MRI) of the spine demonstrated a suppurative collection at L2-L3. Surgical decompression was performed, and antibiotherapy was followed for eight weeks. Clinical improvement was progressive over eight months. New onset neurologic deficits in a patient with pneumococcal meningitis should raise suspicion of acute epidural abscess.
Journal of Occupational Medicine and Toxicology, 2013
Introduction Sleep deprivation among training physicians is of growing concern; training physicia... more Introduction Sleep deprivation among training physicians is of growing concern; training physicians are susceptible due to their prolonged work hours and rotating work schedules. The aim of this study was to determine the prevalence of self-perceived sleepiness in emergency training physicians, and to establish a relationship between self-perceived sleepiness, and quality of life. Methods Prospective survey in Ibn Sina University hospital Center in Morocco from January to April 2011 was conducted. Questionnaires pertaining to socio-demographic, general, and sleep characteristics were completed by training physician who ensured emergency service during the month preceding the survey. They completed the Epworth sleepiness scale (ESS) which assessed the self-perceived sleepiness, and the EuroQol-5 dimensions (EQ-5D) scale which assessed the general quality of life. Results Total 81 subjects (49 men and 32 women) were enrolled with mean age of 26.1 ± 3.4 years. No sleepiness was found i...
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