Browsing by Author "Ismail N."

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    It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey
    (2022-12-01) Sartelli M.; Labricciosa F.M.; Coccolini F.; Coimbra R.; Abu-Zidan F.M.; Ansaloni L.; Al-Hasan M.N.; Ansari S.; Barie P.S.; Caínzos M.A.; Ceresoli M.; Chiarugi M.; Claridge J.A.; Cicuttin E.; Dellinger E.P.; Fry D.E.; Guirao X.; Hardcastle T.C.; Hecker A.; Leppäniemi A.K.; Litvin A.; Marwah S.; Maseda E.; Mazuski J.E.; Memish Z.A.; Kirkpatrick A.W.; Pagani L.; Podda M.; Rasa H.K.; Sakakushev B.E.; Sawyer R.G.; Tumietto F.; Xiao Y.; Aboubreeg W.F.; Adamou H.; Akhmeteli L.; Akin E.; Alberio M.G.; Alconchel F.; Magagi I.A.; Araúz A.B.; Argenio G.; Atanasov B.C.; Atici S.D.; Awad S.S.; Baili E.; Bains L.; Bala M.; Baraket O.; Baral S.; Belskii V.A.; Benboubker M.; Ben-Ishay O.; Bordoni P.; Boumédiène A.; Brisinda G.; Cavazzuti L.; Chandy S.J.; Chiarello M.M.; Cillara N.; Clarizia G.; Cocuz M.E.; Cocuz I.G.; Conti L.; Coppola R.; Cui Y.; Czepiel J.; D’Acapito F.; Damaskos D.; Das K.; De Simone B.; Delibegovic S.; Demetrashvili Z.; Detanac D.S.; Dhingra S.; Di Bella S.; Dimitrov E.N.; Dogjani A.; D’Oria M.; Dumitru I.M.; Elmangory M.M.; Enciu O.; Fantoni M.; Filipescu D.; Fleres F.; Foghetti D.; Fransvea P.; Gachabayov M.; Galeiras R.; Gattuso G.; Ghannam W.M.; Ghisetti V.; Giraudo G.; Gonfa K.B.; Gonullu E.; Hamad Y.T.E.Y.; Hecker M.; Isik A.; Ismail N.; Ismail A.; Mahidol University
    Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion: Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.
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    The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: a genotypic analysis
    (2022-04-01) Walker T.M.; Miotto P.; Köser C.U.; Fowler P.W.; Knaggs J.; Iqbal Z.; Hunt M.; Chindelevitch L.; Farhat M.R.; Cirillo D.M.; Comas I.; Posey J.; Omar S.V.; Peto T.E.A.; Suresh A.; Uplekar S.; Laurent S.; Colman R.E.; Nathanson C.M.; Zignol M.; Walker A.S.; Crook D.W.; Ismail N.; Rodwell T.C.; Barilar I.; Battaglia S.; Borroni E.; Brandao A.P.; Brankin A.; Cabibbe A.M.; Carter J.; Chetty D.; Claxton P.; Clifton D.A.; Cohen T.; Coronel J.; Dreyer V.; Earle S.G.; Escuyer V.; Ferrazoli L.; Gao G.F.; Gardy J.; Gharbia S.; Ghisi K.T.; Ghodousi A.; Cruz A.L.G.; Grazian C.; Groenheit R.; Guthrie J.L.; He W.; Hoffmann H.; Hoosdally S.J.; Jarrett L.; Joseph L.; Jou R.; Kambli P.; Khot R.; Koch A.; Kohl T.A.; Kohlerschmidt D.; Kouchaki S.; Lachapelle A.S.; Lalvani A.; Grandjean L.; Lapierre S.G.; Laurenson I.F.; Letcher B.; Lin W.H.; Liu C.; Liu D.; Malone K.M.; Mandal A.; Masjö M.; Matias D.; Meintjes G.; Mendes F.F.; Merker M.; Mihalic M.; Millard J.; Mistry N.; Moore D.A.J.; Musser K.A.; Ngcamu D.; Hoang N.N.; Niemann S.; Nilgiriwala K.S.; Nimmo C.; O'Donnell M.; Okozi N.; Oliveira R.S.; Paton N.I.; Pinhata J.M.W.; Plesnik S.; Puyen Z.M.; Rabodoarivelo M.S.; Rakotosamimanana N.; Rancoita P.M.V.; Rathod P.; Robinson E.R.; Rodger G.; Walker T.M.; Mahidol University
    Background: Molecular diagnostics are considered the most promising route to achievement of rapid, universal drug susceptibility testing for Mycobacterium tuberculosis complex (MTBC). We aimed to generate a WHO-endorsed catalogue of mutations to serve as a global standard for interpreting molecular information for drug resistance prediction. Methods: In this systematic analysis, we used a candidate gene approach to identify mutations associated with resistance or consistent with susceptibility for 13 WHO-endorsed antituberculosis drugs. We collected existing worldwide MTBC whole-genome sequencing data and phenotypic data from academic groups and consortia, reference laboratories, public health organisations, and published literature. We categorised phenotypes as follows: methods and critical concentrations currently endorsed by WHO (category 1); critical concentrations previously endorsed by WHO for those methods (category 2); methods or critical concentrations not currently endorsed by WHO (category 3). For each mutation, we used a contingency table of binary phenotypes and presence or absence of the mutation to compute positive predictive value, and we used Fisher's exact tests to generate odds ratios and Benjamini-Hochberg corrected p values. Mutations were graded as associated with resistance if present in at least five isolates, if the odds ratio was more than 1 with a statistically significant corrected p value, and if the lower bound of the 95% CI on the positive predictive value for phenotypic resistance was greater than 25%. A series of expert rules were applied for final confidence grading of each mutation. Findings: We analysed 41 137 MTBC isolates with phenotypic and whole-genome sequencing data from 45 countries. 38 215 MTBC isolates passed quality control steps and were included in the final analysis. 15 667 associations were computed for 13 211 unique mutations linked to one or more drugs. 1149 (7·3%) of 15 667 mutations were classified as associated with phenotypic resistance and 107 (0·7%) were deemed consistent with susceptibility. For rifampicin, isoniazid, ethambutol, fluoroquinolones, and streptomycin, the mutations' pooled sensitivity was more than 80%. Specificity was over 95% for all drugs except ethionamide (91·4%), moxifloxacin (91·6%) and ethambutol (93·3%). Only two resistance mutations were identified for bedaquiline, delamanid, clofazimine, and linezolid as prevalence of phenotypic resistance was low for these drugs. Interpretation: We present the first WHO-endorsed catalogue of molecular targets for MTBC drug susceptibility testing, which is intended to provide a global standard for resistance interpretation. The existence of this catalogue should encourage the implementation of molecular diagnostics by national tuberculosis programmes. Funding: Unitaid, Wellcome Trust, UK Medical Research Council, and Bill and Melinda Gates Foundation.