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Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies

Background: Whether Candida interacts to enhance the invasive potential of Acinetobacter and Pseudomonas bacteria cannot be resolved within individual studies. There are several anti-septic, antibiotic, anti-fungal, and non-decontamination-based interventions to prevent ICU acquired infection. These...

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Autor principal: Hurley, James C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712580/
https://www.ncbi.nlm.nih.gov/pubmed/33121074
http://dx.doi.org/10.3390/jof6040252
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author Hurley, James C.
author_facet Hurley, James C.
author_sort Hurley, James C.
collection PubMed
description Background: Whether Candida interacts to enhance the invasive potential of Acinetobacter and Pseudomonas bacteria cannot be resolved within individual studies. There are several anti-septic, antibiotic, anti-fungal, and non-decontamination-based interventions to prevent ICU acquired infection. These effective prevention interventions would be expected to variably impact Candida colonization. The collective observations within control and intervention groups from numerous ICU infection prevention studies simulates a multi-centre natural experiment with which to evaluate Candida, Acinetobacter and Pseudomonas interaction (CAPI). Methods: Eight Candidate-generalized structural equation models (GSEM), with Candida, Pseudomonas and Acinetobacter colonization as latent variables, were confronted with blood culture and respiratory tract isolate data derived from >400 groups derived from 286 infection prevention studies. Results: Introducing an interaction term between Candida colonization and each of Pseudomonas and Acinetobacter colonization improved model fit in each case. The size of the coefficients (and 95% confidence intervals) for these interaction terms in the optimal Pseudomonas (+0.33; 0.22 to 0.45) and Acinetobacter models (+0.32; 0.01 to 0.5) were similar to each other and similar in magnitude, but contrary in direction, to the coefficient for exposure to topical antibiotic prophylaxis (TAP) on Pseudomonas colonization (−0.45; −0.71 to −0.2). The coefficient for exposure to topical antibiotic prophylaxis on Acinetobacter colonization was not significant. Conclusions: GSEM modelling of published ICU infection prevention data supports the CAPI concept. The CAPI model could account for some paradoxically high Acinetobacter and Pseudomonas infection incidences, most apparent among the concurrent control groups of TAP studies.
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spelling pubmed-77125802020-12-04 Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies Hurley, James C. J Fungi (Basel) Article Background: Whether Candida interacts to enhance the invasive potential of Acinetobacter and Pseudomonas bacteria cannot be resolved within individual studies. There are several anti-septic, antibiotic, anti-fungal, and non-decontamination-based interventions to prevent ICU acquired infection. These effective prevention interventions would be expected to variably impact Candida colonization. The collective observations within control and intervention groups from numerous ICU infection prevention studies simulates a multi-centre natural experiment with which to evaluate Candida, Acinetobacter and Pseudomonas interaction (CAPI). Methods: Eight Candidate-generalized structural equation models (GSEM), with Candida, Pseudomonas and Acinetobacter colonization as latent variables, were confronted with blood culture and respiratory tract isolate data derived from >400 groups derived from 286 infection prevention studies. Results: Introducing an interaction term between Candida colonization and each of Pseudomonas and Acinetobacter colonization improved model fit in each case. The size of the coefficients (and 95% confidence intervals) for these interaction terms in the optimal Pseudomonas (+0.33; 0.22 to 0.45) and Acinetobacter models (+0.32; 0.01 to 0.5) were similar to each other and similar in magnitude, but contrary in direction, to the coefficient for exposure to topical antibiotic prophylaxis (TAP) on Pseudomonas colonization (−0.45; −0.71 to −0.2). The coefficient for exposure to topical antibiotic prophylaxis on Acinetobacter colonization was not significant. Conclusions: GSEM modelling of published ICU infection prevention data supports the CAPI concept. The CAPI model could account for some paradoxically high Acinetobacter and Pseudomonas infection incidences, most apparent among the concurrent control groups of TAP studies. MDPI 2020-10-27 /pmc/articles/PMC7712580/ /pubmed/33121074 http://dx.doi.org/10.3390/jof6040252 Text en © 2020 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hurley, James C.
Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies
title Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies
title_full Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies
title_fullStr Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies
title_full_unstemmed Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies
title_short Candida–Acinetobacter–Pseudomonas Interaction Modelled within 286 ICU Infection Prevention Studies
title_sort candida–acinetobacter–pseudomonas interaction modelled within 286 icu infection prevention studies
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712580/
https://www.ncbi.nlm.nih.gov/pubmed/33121074
http://dx.doi.org/10.3390/jof6040252
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