This deeply insightful ethnography explores the healing power of caring and intimacy in a small, closely bonded Apostolic congregation during Botswana's HIV/AIDS pandemic.Death in a Church of ...Lifepaints a vivid picture of how members of the Baitshepi Church make strenuous efforts to sustain loving relationships amid widespread illness and death. Over the course of long-term fieldwork, Frederick Klaits discovered Baitshepi's distinctly maternal ethos and the "spiritual" kinship embodied in the church's nurturing fellowship practice. Klaits shows that for Baitshepi members, Christian faith is a form of moral passion that counters practices of divination and witchcraft with redemptive hymn singing, prayer, and the use of therapeutic substances. An online audio annex makes available examples of the church members' preaching and song.
As atrocity has become characteristic of modern history, testimonial writing has become a major twentieth-century genre. Untimely Interventions relates testimonial writing, or witnessing, to the ...cultural situation of aftermath, exploring ways in which a culture can be haunted by its own history.
Ross Chambers argues that culture produces itself as civilized by denying the forms of collective violence and other traumatic experience that it cannot control. In the context of such denial, personal accounts of collective disaster can function as a form of counter-denial. By investigating a range of writing on AIDS, the First World War, and the Holocaust, Chambers shows how such writing produces a rhetorical effect of haunting, as it seeks to describe the reality of those experiences culture renders unspeakable.
Ross Chambers is Professor of Romance Languages at the University of Michigan. His other books includeFacing It: AIDS Diaries and the Death of the Author.
Background/Objectives
We investigated whether behavioral precautions adopted during Coronavirus disease (COVID‐19) pandemic also influenced the spreading and multidrug resistance (MDR) of ESKAPEEc ...(Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii AB, Pseudomonas aeruginosa, Enterobacter spp and Escherichia Coli, EC) among Intensive Care Unit (ICU) patients.
Subjects/Methods
We performed a single‐center retrospective study in adult patients admitted to our COVID‐19‐free surgical ICU. Only patients staying in ICU for more than 48 hours were included. The ESKAPEEc infections recorded during the COVID‐19 period (June 1, 2020 ‐ February 28, 2021) and in the corresponding pre‐pandemic period (June 1, 2019 ‐ February 28, 2020) were compared. An interrupted time series analysis was performed to rule out possible confounders.
Results
Overall, 173 patients in the COVID‐19 period and 132 in the pre‐COVID‐19 period were investigated. The ESKAPEEc infections were documented in 23 (13.3%) and 35 (26.5%) patients in the pandemic and the pre‐pandemic periods, respectively (p = 0.005). Demographics, diagnosis, comorbidities, type of surgery, Simplified Acute Physiology Score II, length of mechanical ventilation, hospital and ICU length of stay, ICU death rate, and 28‐day hospital mortality were similar in the two groups. In comparison with the pre‐pandemic period, no AB was recorded during COVID‐19 period, (p = 0.017), while extended‐spectrum beta‐lactamase‐producing EC infections significantly decreased (p = 0.017). Overall, the ESKAPEEc isolates during pandemic less frequently exhibited multidrug‐resistant (p = 0.014).
Conclusions
These findings suggest that a robust adherence to hygiene measures together with human contact restrictions in a COVID‐19 free ICU might also restrain the transmission of ESKAPEEc pathogens.
This book enters into the many worlds of expression brought forth across Africa by the ravaging presence of HIV/AIDS. Africans and non-Africans, physicians and social scientists, journalists and ...documentarians share here a common and essential interest in understanding creative expression in crushing and uncertain times. Chapters investigate and engage the social networks, power relationships, and cultural structures that enable the arts to convey messages of hope and healing, and of knowledge and good counsel to the wider community. And from Africa to the wider world, the text here brings intimate, inspiring portraits of the performers, artists, communities, and organizations that have shared here their insights and the sense they have made of their lives and actions from deep within this devastating epidemic. Covering the wide expanse of the African continent, the chapters include explorations of, for example, the use of music to cope with AIDS; the relationship between music, HIV/AIDS, and social change; visual approaches to HIV literacy; radio and television as tools for “edutainment”; several individual artists’ confrontations with HIV/AIDS; various performance groups’ response to the epidemic; combating HIV/AIDS with local cultural performance; and more. Source material, such as song lyrics and interviews, weaves throughout the collection, which is a nuanced and profoundly affective portrayal of the intricate relationship between HIV/AIDS and the arts in Africa.
Highlights • Burn depth/agent increases risk of developing an infection. • Infections found folliculitis, burn wound, urinary tract, pneumonia, CVC and bloodstream. • Microorganism includes P. ...aeruginosa , Acinetobacter , E. coli , S. aureus and Klebsiella. • Burn wounds get infected by Acinetobacter and P. aeruginosa. • Infection by gram positive bacteria can be treated with Oxacilin or 1st generation cephalosporin.
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most successful modern pathogens. The same organism that lives as a commensal and is transmitted in both health-care and community ...settings is also a leading cause of bacteraemia, endocarditis, skin and soft tissue infections, bone and joint infections and hospital-acquired infections. Genetically diverse, the epidemiology of MRSA is primarily characterized by the serial emergence of epidemic strains. Although its incidence has recently declined in some regions, MRSA still poses a formidable clinical threat, with persistently high morbidity and mortality. Successful treatment remains challenging and requires the evaluation of both novel antimicrobials and adjunctive aspects of care, such as infectious disease consultation, echocardiography and source control. In this Review, we provide an overview of basic and clinical MRSA research and summarize the expansive body of literature on the epidemiology, transmission, genetic diversity, evolution, surveillance and treatment of MRSA.
Device-associated health care-associated infections (DA-HAIs) in intensive care unit (ICU) patients constitute a major therapeutic issue complicating the regular hospitalisation process and having ...influence on patients' condition, length of hospitalisation, mortality and therapy cost.
The study involved all patients treated > 48 h at ICU of the Medical University Teaching Hospital (Poland) from 1.01.2015 to 31.12.2017. The study showed the surveillance and prevention of DA-HAIs on International Nosocomial Infection Control Consortium (INICC) Surveillance Online System (ISOS) 3 online platform according to methodology of the INICC multidimensional approach (IMA).
During study period 252 HAIs were found in 1353 (549F/804M) patients and 14,700 patient-days of hospitalisation. The crude infections rate and incidence density of DA-HAIs was 18.69% and 17.49 ± 2.56 /1000 patient-days. Incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI) and catheter-associated urinary tract infection (CA-UTI) per 1000 device-days were 12.63 ± 1.49, 1.83 ± 0.65 and 6.5 ± 1.2, respectively. VAP(137) constituted 54.4% of HAIs, whereas CA-UTI(91) 36%, CLA-BSI(24) 9.6%.The most common pathogens in VAP and CA-UTI was multidrug-resistant (MDR) Acinetobacter baumannii (57 and 31%), and methicillin-resistant Staphylococcus epidermidis (MRSE) in CLA-BSI (45%). MDR Gram negative bacteria (GNB) 159 were responsible for 63.09% of HAIs. The length of hospitalisation of patients with a single DA-HAI at ICU was 21(14-33) days, while without infections it was 6.0 (3-11) days; p = 0.0001. The mortality rates in the hospital-acquired infection group and no infection group were 26.1% vs 26.9%; p = 0.838; OR 0.9633;95% CI (0.6733-1.3782). Extra cost of therapy caused by one ICU acquired HAI was US$ 11,475/Euro 10,035. Hand hygiene standards compliance rate was 64.7%, while VAP, CLA-BSI bundles compliance ranges were 96.2-76.8 and 29-100, respectively.
DA-HAIs was diagnosed at nearly 1/5 of patients. They were more frequent than in European Centre Disease Control report (except for CLA-BSI), more frequent than the USA CDC report, yet less frequent than in limited-resource countries (except for CA-UTI). They prolonged the hospitalisation period at ICU and generated substantial additional costs of treatment with no influence on mortality. The Acinetobacter baumannii MDR infections were the most problematic therapeutic issue. DA-HAIs preventive methods compliance rate needs improvement.
Objective. To estimate the proportion of healthcare-associated
infections (HAIs) in US hospitals that are “reasonably preventable,”
along with their related mortality and costs.
Methods. To estimate ...preventability of catheter-associated
bloodstream infections (CABSIs), catheter-associated urinary tract
infections (CAUTIs), surgical site infections (SSIs), and ventilator-associated
pneumonia (VAP), we used a federally sponsored systematic review of
interventions to reduce HAIs. Ranges of preventability included the
lowest and highest risk reductions reported by US studies of “moderate”
to “good” quality published in the last 10 years. We used
the most recently published national data to determine the annual
incidence of HAIs and associated mortality. To estimate incremental
cost of HAIs, we performed a systematic review, which included costs
from studies in general US patient populations. To calculate ranges
for the annual number of preventable infections and deaths and annual
costs, we multiplied our infection, mortality, and cost figures with
our ranges of preventability for each HAI.
Results. As many as 65%–70% of cases of CABSI and CAUTI
and 55% of cases of VAP and SSI may be preventable with current evidence-based
strategies. CAUTI may be the most preventable HAI. CABSI has the highest
number of preventable deaths, followed by VAP. CABSI also has the
highest cost impact; costs due to preventable cases of VAP, CAUTI,
and SSI are likely less.
Conclusions. Our findings suggest that 100% prevention of
HAIs may not be attainable with current evidence-based prevention
strategies; however, comprehensive implementation of such strategies
could prevent hundreds of thousands of HAIs and save tens of thousands
of lives and billions of dollars.
Objective. We compared differences in the hospital charges, length of hospital stay, and mortality between patients with healthcare- and community-associated bloodstream infections, urinary tract ...infections, and pneumonia due to antimicrobial-resistant versus -susceptible bacterial strains. Methods. A retrospective analysis of an electronic database compiled from laboratory, pharmacy, surgery, financial, and patient location and device utilization sources was undertaken on 5699 inpatients who developed healthcare-or community-associated infections between 2006 and 2008 from 4 hospitals (1 community, 1 pediatric, 2 tertiary/quaternary care) in Manhattan. The main outcome measures were hospital charges, length of stay, and mortality among patients with antimicrobial-resistant and -susceptible infections caused by Staphylococcus aureus, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. Results. Controlling for multiple confounders using linear regression and nearest neighbor matching based on propensity score estimates, resistant healthcare- and community-associated infections, when compared with susceptible strains of the same organism, were associated with significantly higher charges ($15 626; confidence interval CI, $4339–$26 913 and $25 573; CI, $9331–$41 816, respectively) and longer hospital stays for community-associated infections (3.3; CI, 1.5–5.4). Patients with resistant healthcare-associated infections also had a significantly higher death rate (0.04; CI, 0.01–0.08). Conclusions. With careful matching of patients infected with the same organism, antimicrobial resistance was associated with higher charges, length of stay, and death rates. The difference in estimates after accounting for censoring for death highlight divergent social and hospital incentives in reducing patient risk for antimicrobial resistant infections.
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