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  1. Article ; Online: Epidemiology and microbiology of catheter-associated urinary tract infections: A 14-year surveillance study at a tertiary care center in Lebanon.

    Shmoury, Abdel Hadi / Hanna, Wael / Zakhour, Johnny / Zahreddine, Nada Kara / Kanj, Souha S

    Journal of infection and public health

    2024  Volume 17, Issue 5, Page(s) 825–832

    Abstract: Background: Catheter-associated urinary tract infections (CAUTIs) are the most common device-associated healthcare-acquired infections and pose a significant burden on patients and healthcare systems worldwide. However, there is a paucity of data on ... ...

    Abstract Background: Catheter-associated urinary tract infections (CAUTIs) are the most common device-associated healthcare-acquired infections and pose a significant burden on patients and healthcare systems worldwide. However, there is a paucity of data on CAUTI epidemiology and microbiology in the Middle East and North Africa (MENA) region, including Lebanon.
    Methods: This 14-year retrospective cohort study was conducted at a tertiary care center in Lebanon. It analyzed data on all adult patients diagnosed with CAUTI between January 2009 and December 2022 in intensive care units (ICUs) and between June 2011 and December 2022 in regular units. Incidence rates, urinary catheter utilization ratios, and microbiological profiles were collected and analyzed.
    Results: A total of 620 CAUTI cases were identified during the study period. The overall CAUTI rate was 2.4 per 1000 catheter-days, with higher rates in ICUs (3.2 per 1000 catheter-days) compared to regular units (1.4 per 1000 catheter-days). No significant changes in the rates were noted despite implementing many interventions. The most common pathogens were Gram-negative bacteria, with Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae being predominant. Multidrug-resistant organisms represented 48% of all isolates. Enterobacterales were largely extended-spectrum β-lactamase (ESBL) producing, and most Acinetobacter baumannii isolates showed multidrug resistance.
    Conclusions: This study provides important insights into CAUTI epidemiology and microbiology in a tertiary care center in Lebanon, addressing the knowledge gap in this area in the MENA region. Despite implementing prevention measures, CAUTI rates remained stable over the 14-year period. The findings highlight the need for continuous improvement in infection prevention practices, diagnostic stewardship, and antimicrobial stewardship, especially given the rising threat of antimicrobial resistance. These results can serve as a guide for the development of targeted preventive strategies to reduce the burden of CAUTIs, particularly in low- and middle-income countries where antimicrobial resistance is a major issue.
    MeSH term(s) Adult ; Humans ; Catheter-Related Infections/prevention & control ; Tertiary Care Centers ; Retrospective Studies ; Lebanon/epidemiology ; Urinary Tract Infections/microbiology ; Intensive Care Units ; Catheters/adverse effects ; Anti-Infective Agents ; Cross Infection/microbiology
    Chemical Substances Anti-Infective Agents
    Language English
    Publishing date 2024-03-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2467587-8
    ISSN 1876-035X ; 1876-0341
    ISSN (online) 1876-035X
    ISSN 1876-0341
    DOI 10.1016/j.jiph.2024.03.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The experience of an antimicrobial stewardship program and antibiotic consumption and resistance trends during the COVID-19 pandemic at a tertiary care center in Beirut.

    Haddad, Nisrine / Zeenny, Rony M / El Halabi, Celia / Abdallah, Tamara / El Helou, Remie / Zahreddine, Nada Kara / Kanj, Souha S / Rizk, Nesrine A

    Journal of infection and public health

    2023  Volume 17, Issue 2, Page(s) 254–262

    Abstract: Background: Antimicrobial Resistance, a global concern, worsened with the COVID-19 pandemic that caused a surge of critically ill patients, increased antimicrobial consumption, and the spread of infections with multidrug-resistant organisms (MDROs). ... ...

    Abstract Background: Antimicrobial Resistance, a global concern, worsened with the COVID-19 pandemic that caused a surge of critically ill patients, increased antimicrobial consumption, and the spread of infections with multidrug-resistant organisms (MDROs). Antimicrobial Stewardship Programs (ASP) aim to optimize antimicrobial utilization to fight resistance. We aim to describe the ASP experience and to study antimicrobial consumption and MDRO rates among COVID-19 patients at a tertiary care center in Beirut.
    Methods: We compiled the ASP interventions, defined as ASP team recommendations, from January 2019 until December 2021. Data on antimicrobial consumption, expressed as a defined daily dose (DDD) per 100 patient days, was collected per quarter for all antimicrobials and restricted antimicrobials per ASP guidance. Our primary objective was to report on the ASP experience, and the secondary objective was to reflect on the rates of MDROs among hospitalized COVID-19 patients with respiratory or bloodstream bacterial co-infections between March 2020 and September 2021.
    Results: 9922 ASP interventions were documented during this study period, with a noticeable correlation between COVID-19 surges in Lebanon and the number of ASP interventions. Acceptance rates for these recommendations improved over time, with a noticeable decrease in the proportion of interventions related to de-escalation and discontinuation of broad-spectrum antimicrobials. We noted an increase in all antimicrobial consumption after the onset of the pandemic, peaking in Q4 2020 (142.8 DDD of anti-infectives/100 patient days) and Q1 2021 (79.1 DDD of restricted anti-infectives/100 patient days). As expected, MDROs, particularly ESKAPE organisms (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Carbapenem-resistant Enterobacteriaceae) accounted for 24% of isolates obtained from this cohort.
    Conclusion: This study highlights the experience of the ASP as we adapted to the COVID-19 pandemic. The ASP team maintained its operations and continued to monitor antibiotic consumption and provide recommendations to limit antibiotic misuse in an effort to mitigate the impact of the pandemic on antimicrobial resistance.
    MeSH term(s) Humans ; Anti-Bacterial Agents/therapeutic use ; Tertiary Care Centers ; Pandemics ; Antimicrobial Stewardship ; COVID-19 ; Bacterial Infections/drug therapy ; Bacterial Infections/epidemiology ; Enterococcus faecium
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2023-12-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2467587-8
    ISSN 1876-035X ; 1876-0341
    ISSN (online) 1876-035X
    ISSN 1876-0341
    DOI 10.1016/j.jiph.2023.12.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Blood Stream Infections in COVID-19 Patients From a Tertiary Care Center in Lebanon: Causative Pathogens and Rates of Multi-Drug Resistant Organisms.

    Nahhal, Sarah B / Zakhour, Johnny / Shmoury, Abdel Hadi / Sawma, Tedy / Haddad, Sara F / Abdallah, Tamara / Zahreddine, Nada Kara / Tannous, Joseph / Haddad, Nisrine / Rizk, Nesrine / Kanj, Souha S

    Mayo Clinic proceedings. Innovations, quality & outcomes

    2023  Volume 7, Issue 6, Page(s) 556–568

    Abstract: Objective: To report the microbiological profile of the pathogens implicated in blood stream infections (BSI) in hospitalized coronavirus disease 2019 (COVID-19) patients and to examine the risk factors associated with multidrug-resistant organisms ( ... ...

    Abstract Objective: To report the microbiological profile of the pathogens implicated in blood stream infections (BSI) in hospitalized coronavirus disease 2019 (COVID-19) patients and to examine the risk factors associated with multidrug-resistant organisms (MDROs) causing BSI.
    Patients and methods: Between March 2020 and September 2021, 1647 patients were hospitalized with COVID-19 at the American University of Beirut. From 85 patients, 299 positive blood cultures were reported to the Infection Control and Prevention Program. The BSI was defined as 1 positive blood culture for bacterial or fungal pathogens. The following organisms were considered MDROs: methicillin-resistant
    Results: We identified 99 true positive BSI events. Gram-negative bacteria accounted for 38.4 %, followed by Gram-positive bacteria (37.4%), and fungi (24.2%). The most isolated species were
    Conclusion: Rigorous infection prevention and control measures and antimicrobial stewardship are important to prevent antimicrobial resistance progression, especially in low-resource settings.
    Language English
    Publishing date 2023-11-24
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2542-4548
    ISSN (online) 2542-4548
    DOI 10.1016/j.mayocpiqo.2023.10.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: COVID-19 Infections and Predictors of Sickness Related Absences Among Healthcare Workers: The Experience of a Tertiary Care Center With the COVID-19 Pandemic.

    Sakr, Carine J / Fakih, Lina / Melhem, Nada M / Fakhreddine, Mohammad / Musharrafieh, Umayya / Banna, Hanin / Doudakian, Rita / Zahreddine, Nada Kara / Tannous, Joseph / Kanj, Souha S / Slade, Martin / Redlich, Carrie A / Rahme, Diana

    Journal of occupational and environmental medicine

    2023  Volume 65, Issue 7, Page(s) 590–594

    Abstract: Background: Little has been published on predictors of prolonged sick leaves during the COVID-19 pandemic. This study aims to determine the rate of COVID-19 infections among healthcare workers (HCWs) and to identify the predictors of longer sick leave ... ...

    Abstract Background: Little has been published on predictors of prolonged sick leaves during the COVID-19 pandemic. This study aims to determine the rate of COVID-19 infections among healthcare workers (HCWs) and to identify the predictors of longer sick leave days.
    Methods: We identified predictors of longer sick leave using linear regression analysis in a cross-sectional study design.
    Results: Thirty-three percent of the total workforce contracted COVID-19. On average, HCWs took 12.5 sick leave days after COVID-19 infection. The regression analysis revealed that older employees, nurses, and those who caught COVID-19 earlier in the pandemic were more likely to take longer sick leave.
    Conclusions: Age, job position, and month of infection predicted sick leave duration among HCWs in our sample. Results imply that transmission was most likely community-based. Public health interventions should consider these factors when planning for future pandemics.
    MeSH term(s) Humans ; COVID-19/epidemiology ; Pandemics ; Tertiary Care Centers ; Cross-Sectional Studies ; Health Personnel ; Sick Leave
    Language English
    Publishing date 2023-04-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1223932-x
    ISSN 1536-5948 ; 1076-2752
    ISSN (online) 1536-5948
    ISSN 1076-2752
    DOI 10.1097/JOM.0000000000002857
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: COVID-19 and

    Allaw, Fatima / Haddad, Sara F / Habib, Nabih / Moukarzel, Pamela / Naji, Nour Sabiha / Kanafani, Zeina A / Ibrahim, Ahmad / Zahreddine, Nada Kara / Spernovasilis, Nikolaos / Poulakou, Garyphallia / Kanj, Souha S

    Microorganisms

    2022  Volume 10, Issue 5

    Abstract: Many healthcare centers around the world have reported the surge of Candida auris (C. auris) outbreaks during the COVID-19 pandemic, especially among intensive care unit (ICU) patients. This is a retrospective study conducted at the American University ... ...

    Abstract Many healthcare centers around the world have reported the surge of Candida auris (C. auris) outbreaks during the COVID-19 pandemic, especially among intensive care unit (ICU) patients. This is a retrospective study conducted at the American University of Beirut Medical Center (AUBMC) between 1 October 2020 and 15 June 2021, to identify risk factors for acquiring C. auris in patients with severe COVID-19 infection and to evaluate the impact of C. auris on mortality in patients admitted to the ICU during that period. Twenty-four non-COVID-19 (COV−) patients were admitted to ICUs at AUBMC during that period and acquired C. auris (C. auris+/COV−). Thirty-two patients admitted with severe COVID-19 (COV+) acquired C. auris (C. auris+/COV+), and 130 patients had severe COVID-19 without C. auris (C. auris−/COV+). Bivariable analysis between the groups of (C. auris+/COV+) and (C. auris−/COV+) showed that higher quick sequential organ failure assessment (qSOFA) score (p < 0.001), prolonged length of stay (LOS) (p = 0.02), and the presence of a urinary catheter (p = 0.015) or of a central venous catheter (CVC) (p = 0.01) were associated with positive culture for C. auris in patients with severe COVID-19. The multivariable analysis showed that prolonged LOS (p = 0.008) and a high qSOFA score (p < 0.001) were the only risk factors independently associated with positive culture for C. auris. Increased LOS (p = 0.02), high “Candida score” (p = 0.01), and septic shock (p < 0.001) were associated with increased mortality within 30 days of positive culture for C. auris. Antifungal therapy for at least 7 days (p = 0.03) appeared to decrease mortality within 30 days of positive culture for C. auris. Only septic shock was associated with increased mortality in patients with C. auris (p = 0.006) in the multivariable analysis. C. auris is an emerging pathogen that constitutes a threat to the healthcare sector.
    Language English
    Publishing date 2022-05-11
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720891-6
    ISSN 2076-2607
    ISSN 2076-2607
    DOI 10.3390/microorganisms10051011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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