Displaying publications 1 - 20 of 23 in total

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  1. Lubbe, A., Khatib, A., Yuliana, N.D., Jinap, S., Verpoorte, R.
    MyJurnal
    The whole plant extract of plant Sceletium tortuosum, plant native to South Africa, has been known
    traditionally to have mood enhancing and stimulant properties. These properties have been confirmed before by proving serotonin-uptake inhibition activity. A further confirmation by using CB1 receptor binding assay has been performed in this study. The unfermented alkaloid extract was proved to posses a higher activity to bind CB1 receptor compared to that of the fermented one. GC-MS analysis confirmed that unfermented alkoloid extract contain more alkaloids than the fermented one. The ethanol extract was also more active than the fermented one, suggesting that non-alkaloid compounds in this extract could posses this activity. An additional test to check wether this extract can improve cognitive function and memory was performed by acetylcholinesterase inhibitory assay. Both fermented and unfermented alkaloid extracts could inhibit acetylcholinesterase with IC50 being 0.303 mg/ml and 0.330 mg/ml, respectively. However, the major alkaloid in the extract, mesembrine, did not show inhibition of the enzyme. A TLC based test proved that other alkaloids in the extract were responsible to the activity.
  2. Yuliana ND, Tuarita MZ, Khatib A, Laila F, Sukarno S
    Food Sci Biotechnol, 2020 Jun;29(6):825-835.
    PMID: 32523792 DOI: 10.1007/s10068-019-00725-2
    GC-MS metabolomics was used to discriminate the phytochemicals profile of Indonesian white, red, and black rice brans, and Japanese white rice brans. This technique was used for the first time to identify compounds in rice brans having cytotoxic activity against WiDr colon cancer cells. Orthogonal Projection to the Latent Structure (OPLS) analysis showed that protocatechuic acid (PA) was a discriminating factor found in black rice brans which strongly correlated with its cytotoxicity (IC50 8.53 ± 0.26 µM). Real time-PCR data demonstrated that PA cytotoxicity at different concentrations (1, 5, 10, 25 and 50 µg/mL) was mediated through different pathways. Bcl-2 expression was downregulated at all tested concentrations indicating apoptosis stimulation. At 1-10 ppm concentration, PA activated both intrinsic and extrinsic apoptosis pathways since the expression of p53, Bax, caspase-8, and caspase-9 were upregulated. At a higher dose (25 and 50 µg/mL), PA possibly involved in pyroptosis-mediated pro-inflammatory cell death by upregulating the expression of caspase-1 and caspase-7.
  3. Windarsih A, Bakar NKA, Rohman A, Yuliana ND, Dachriyanus D
    Anim Biosci, 2024 Jan 14.
    PMID: 38228131 DOI: 10.5713/ab.23.0238
    OBJECTIVE: The adulteration of raw beef (BMr) with dog meat (DMr) and pork (PMr) becomes a serious problem because it is associated with halal status, quality, and safety of meats. This research aimed to develop an effective authentication method to detect non-halal meats (dog meat and pork) in beef using metabolomics approach.

    METHODS: Liquid chromatography-high resolution mass spectrometry (LC-HRMS) using untargeted approach combined with chemometrics was applied for analysis non-halal meats in BMr.

    RESULTS: The untargeted metabolomics approach successfully identified various metabolites in BMr DMr, PMr, and their mixtures. The discrimination and classification between authentic BMr and those adulterated with DMr and PMr were successfully determined using partial least square-discriminant analysis (PLS-DA) with high accuracy. All BMr samples containing non-halal meats could be differentiated from authentic BMr. A number of discriminating metabolites with potential as biomarkers to discriminate BMr in the mixtures with DMr and PMr could be identified from the analysis of variable importance for projection (VIP) value. Partial least square (PLS) and orthogonal PLS (OPLS) regression using discriminating metabolites showed high accuracy (R2 > 0.990) and high precision (both RMSEC and RMSEE < 5%) in predicting the concentration of DMr and PMr present in beef indicating that the discriminating metabolites were good predictors. The developed untargeted LC-HRMS metabolomics and chemometrics successfully identified non-halal meats adulteration (DMr and PMr) in beef with high sensitivity up to 0.1% (w/w).

    CONCLUSION: A combination of LC-HRMS untargeted metabolomic and chemometrics promises to be an effective analytical technique for halal authenticity testing of meats. This method could be further standardized and proposed as a method for halal authentication of meats.

  4. Nishata Royan Rajendran Royan, Abu Bakar Sulong, Nor Yuliana Yuhana, Mohd Hafizuddin Ab Ghani, Sahrim Ahmad
    Sains Malaysiana, 2017;46:1749-1756.
    Kaedah tindak balas permukaan (RSM) telah digunakan untuk mengoptimumkan penyediaan biokomposit rHDPE berpenguat sekam padi sebagai pengisi. Sekam padi adalah sisa pertanian yang mempunyai ciri-ciri kayu dan digunakan secara pesat dalam bidang komposit kayu plastik. Kesan parameter suhu, tekanan serta masa proses tekanan panas ke atas kekuatan tegangan telah dikaji. Reka bentuk Box Bechken telah digunakan untuk menentukan parameter optimum biokomposit yang mempunyai kekuatan tegangan yang tinggi. Model tertib kedua telah dibangunkan untuk meramalkan kekuatan tegangan berdasarkan reka bentuk komposit. Didapati bahawa komposit sesuai digunakan apabila model regresi kuadratik dengan pekali penentu bilang (R2) yang tinggi. Keadaan proses menekan yang optimum dicapai pada suhu 180°C, tekanan 1000 psi dan masa 9 min dengan pekali penentu berbilang mencapai 97%. Di bawah keadaan yang optimum ini, komposit yang mengandungi 10, 20, 30, 40 dan 50% gentian RH telah disediakan. Kekuatan tegangan dan modulus tegangan biokomposit menunjukkan peningkatan apabila kandungan gentian RH ditambah.
  5. Esa R, Hashim NA, Ayob Y, Yusof ZY
    BMC Oral Health, 2015 Mar 10;15:28.
    PMID: 25886943 DOI: 10.1186/s12903-015-0013-y
    BACKGROUND: To evaluate the psychometric properties of the faces version of the Modified Child Dental Anxiety Scale (MCDASf) Malay version in 5-6 and 9-12 year-old children.
    METHODS: The MCDASf was cross culturally adapted from English into Malay. The Malay version was tested for reliability and validity in 3 studies. In the Study 1, to determine test-retest reliability of MCDASf scale, 166 preschool children aged 5-6 years were asked to rank orders five cartoons faces depicting emotions from 'very happy' to 'very sad' faces on two separate occasions 3 weeks apart. A total of 87 other 5-6 year-old children completed the Malay-MCDASf on two separate occasions 3 weeks apart to determine test-retest reliability for Study 2. In study 3, 239 schoolchildren aged 9-12 years completed the Malay-MCDASf and the Malay-Dental Subscale of the Children Fear Survey Schedule (CFSS-DS) at the same sitting to determine the criterion and construct validity.
    RESULTS: In study 1, Kendall W test showed a high degree of concordance in ranking the cartoon faces picture cards on each of the 2 occasions (time 1, W = 0.955 and time 2, W = 0.954). The Malay-MCDASf demonstrated moderate test-retest reliability (Intraclass correlation coefficient = 0.63, p <0.001) and acceptable internal consistency for all the 6 items (Cronbach's alpha = 0.77) and 8 items (Cronbach's alpha = 0.73). The highest MCDASf scores were observed for the items 'injection in the gum' and 'tooth taken out' for both age groups. The MCDASf significantly correlated with the CFSS-DS (Pearson r = 0.67, p < 0.001).
    CONCLUSIONS: These psychometric findings support for the inclusion of a cartoon faces rating scale to assess child dental anxiety and the Malay-MCDASf is a reliable and valid measure of dental anxiety in 5-12 year-old children.
  6. Ghaemi F, Amiri A, Bajuri MY, Yuhana NY, Ferrara M
    Sustain Cities Soc, 2021 Sep;72:103046.
    PMID: 34055576 DOI: 10.1016/j.scs.2021.103046
    In 2019, a novel type of coronavirus emerged in China called SARS-COV-2, known COVID-19, threatens global health and possesses negative impact on people's quality of life, leading to an urgent need for its diagnosis and remedy. On the other hand, the presence of hazardous infectious waste led to the increase of the risk of transmitting the virus by individuals and by hospitals during the COVID-19 pandemic. Hence, in this review, we survey previous researches on nanomaterials that can be effective for guiding strategies to deal with the current COVID-19 pandemic and also decrease the hazardous infectious waste in the environment. We highlight the contribution of nanomaterials that possess potential to therapy, prevention, detect targeted virus proteins and also can be useful for large population screening, for the development of environmental sensors and filters. Besides, we investigate the possibilities of employing the nanomaterials in antiviral research and treatment development, examining the role of nanomaterials in antiviral- drug design, including the importance of nanomaterials in drug delivery and vaccination, and for the production of medical equipment. Nanomaterials-based technologies not only contribute to the ongoing SARS- CoV-2 research efforts but can also provide platforms and tools for the understanding, protection, detection and treatment of future viral diseases.
  7. Tarjo T, Anggono A, Yuliana R, Prasetyono P, Syarif M, Alkirom Wildan M, et al.
    Heliyon, 2022 Dec;8(12):e11907.
    PMID: 36471844 DOI: 10.1016/j.heliyon.2022.e11907
    The purpose of this research is to determine if financial fraud can lessen the direct impact of Corporate Social Responsibility (CSR) on firm value. Proxies of the CSR are fourth-generation of the Initiative Global Reporting, religiosity, Philanthropy, Voluntary Environmental Disclosure Index, and ISO 26000. The company's value proxy is Price Book Value and Profit Margin. At the same time, the proxy of financial fraud is the F-Score model. This researcher researches mining companies engaged in Indonesia and Malaysia's oil and gas sectors. This study uses a fixed effect model based on the Hausman diagnostic test statistics. This research reveals evidence that financial fraud can reduce the impact of CSR on a firm's value.
  8. Windarsih A, Riswanto FDO, Bakar NKA, Yuliana ND, Dachriyanus, Rohman A
    Molecules, 2022 Nov 29;27(23).
    PMID: 36500423 DOI: 10.3390/molecules27238325
    Adulteration of high-quality meat products using lower-priced meats, such as pork, is a crucial issue that could harm consumers. The consumption of pork is strictly forbidden in certain religions, such as Islam and Judaism. Therefore, the objective of this research was to develop untargeted metabolomics using liquid chromatography-high resolution mass spectrometry (LC-HRMS) combined with chemometrics for analysis of pork in beef meatballs for halal authentication. We investigated the use of non-targeted LC-HRMS as a method to detect such food adulteration. As a proof of concept using six technical replicates of pooled samples from beef and pork meat, we could show that metabolomics using LC-HRMS could be used for high-throughput screening of metabolites in meatballs made from beef and pork. Chemometrics of principal component analysis (PCA) was successfully used to differentiate beef meatballs and pork meatball samples. Partial least square-discriminant analysis (PLS-DA) clearly discriminated between halal and non-halal beef meatball samples with 100% accuracy. Orthogonal projection to latent structures-discriminant analysis (OPLS-DA) perfectly discriminated and classified meatballs made from beef, pork, and a mixture of beef-pork with a good level of fitness (R2X = 0.88, R2Y = 0.71) and good predictivity (Q2 = 0.55). Partial least square (PLS) and orthogonal PLS (OPLS) were successfully applied to predict the concentration of pork present in beef meatballs with high accuracy (R2 = 0.99) and high precision. Thirty-five potential metabolite markers were identified through VIP (variable important for projections) analysis. Metabolites of 1-(1Z-hexadecenyl)-sn-glycero-3-phosphocholine, acetyl-l-carnitine, dl-carnitine, anserine, hypoxanthine, linoleic acid, and prolylleucine had important roles for predicting pork in beef meatballs through S-line plot analysis. It can be concluded that a combination of untargeted metabolomics using LC-HRMS and chemometrics is promising to be developed as a standard analytical method for halal authentication of highly processed meat products.
  9. Windarsih A, Bakar NKA, Dachriyanus, Yuliana ND, Riswanto FDO, Rohman A
    Molecules, 2023 Aug 09;28(16).
    PMID: 37630216 DOI: 10.3390/molecules28165964
    Beef sausage (BS) is one of the most favored meat products due to its nutrition and good taste. However, for economic purposes, BS is often adulterated with pork by unethical players. Pork consumption is strictly prohibited for religions including Islam and Judaism. Therefore, advanced detection methods are highly required to warrant the halal authenticity of BS. This research aimed to develop a liquid chromatography-high-resolution mass spectrometry (LC-HRMS) method to determine the halal authenticity of BS using an untargeted metabolomics approach. LC-HRMS was capable of detecting various metabolites in BS and BS containing pork. The presence of pork in BS could be differentiated using principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) with high accuracy. PLS-DA perfectly classified authentic BS and BS containing pork in all concentration levels of pork with R2X = (0.821), R2Y(= 0.984), and Q2 = (0.795). The level of pork in BS was successfully predicted through partial least squares (PLS) and orthogonal PLS (OPLS) chemometrics. Both models gave high R2 (>0.99) actual and predicted values as well as few errors, indicating good accuracy and precision. Identification of discriminating metabolites' potential as biomarker candidates through variable importance for projections (VIP) value revealed metabolites of 2-arachidonyl-sn-glycero-3-phosphoethanolamine, 3-hydroxyoctanoylcarnitine, 8Z,11Z,14Z-eicosatrienoic acid, D-(+)-galactose, oleamide, 3-hydroxyhexadecanoylcarnitine, arachidonic acid, and α-eleostearic acid as good indicators to detect pork. It can be concluded that LC-HRMS metabolomics combined with PCA, PLS-DA, PLS, and OPLS was successfully used to detect pork adulteration in beef sausages. The results imply that LC-HRMS untargeted metabolomics in combination with chemometrics is a promising alternative as an analytical technique to detect pork in sausage products. Further analysis of larger samples is required to warrant the reproducibility.
  10. Zuhri UM, Yuliana ND, Fadilah F, Erlina L, Purwaningsih EH, Khatib A
    J Ethnopharmacol, 2024 Jan 30;319(Pt 3):117296.
    PMID: 37820996 DOI: 10.1016/j.jep.2023.117296
    ETHNOPHARMACOLOGICAL RELEVANCE: Tinospora crispa (L.) Hook. f. & Thomson stem (TCS) has long been used as folk medicine for the treatment of diabetes mellitus. Previous study revealed that TCS possesses multi-ingredients and multi-targets characteristic potential as insulin sensitizer activity. However, its mechanisms of action and molecular targets are still obscure.

    AIM OF THE STUDY: In the present study, we investigated the effects of TCS against insulin resistance in muscle cells through integrating in vitro experiment and identifying its active biomarker using metabolomics and in molecular docking validation.

    MATERIALS AND METHODS: We used centrifugal partition chromatography (CPC) to isolate 33 fractions from methanolic extract of TCS, and then used UHPLC-Orbitrap-HRMS to identify the detectable metabolites in each fraction. We assessed the insulin sensitization activity of each fraction using enzyme-linked immunosorbent assay (ELISA), and then used confocal immunocytochemistry microscopy to measure the translocation of glucose transporter 4 (GLUT4) to the cell membrane. The identified active metabolites were further simulated for its molecular docking interaction using Autodock Tools.

    RESULTS: The polar fractions of TCS significantly increased insulin sensitivity, as measured by the inhibition of phosphorylated insulin receptor substrate-1 (pIRS1) at serine-312 residue (ser312) also the increasing number of translocated GLUT4 and glycogen content. We identified 58 metabolites of TCS, including glycosides, flavonoids, alkaloids, coumarins, and nucleotides groups. The metabolomics and molecular docking simulations showed the presence of minor metabolites consisting of tinoscorside D, higenamine, and tinoscorside A as the active compounds.

    CONCLUSIONS: Our findings suggest that TCS is a promising new treatment for insulin resistance and the identification of the active metabolites in TCS could lead to the development of new drugs therapies for diabetes that target these pathways.

  11. Nyoo Putro J, Soetaredjo FE, Santoso SP, Irawaty W, Yuliana M, Wijaya CJ, et al.
    Int J Biol Macromol, 2024 Feb;257(Pt 1):128502.
    PMID: 38040139 DOI: 10.1016/j.ijbiomac.2023.128502
    As a natural raw material to replace synthetic chemicals, cellulose and its derivatives are the most popular choices in the pharmaceutical industry. For drug delivery applications, cellulose is usually used as a cellulose nanocrystal (CNC). CNC-based hydrogels are widely utilized for drug delivery because drug molecules can be encapsulated in their pore-like structures. This study aims to develop CNC hydrogels for the delivery of doripenem antibiotics. CNC was obtained from jackfruit peel extraction, and alginate was used as a network polymer to produce hydrogels. Ionotropic gelation was used in the synthesis of CNC-alginate hydrogel composites. The maximum adsorption of doripenem by CNC was 65.7 mg/g, while the maximum adsorption by CNC-alginate was 98.4 mg/g. One of the most challenging aspects of drug delivery is predicting drug release from a solid matrix using simple and complex mathematical equations. The sigmoidal equation could represent the doripenem release from CNC, while the Ritger-Peppas equation could describe the doripenem release from CNC-Alginate. The biocompatibility testing of CNC and CNC-alginate against a 7F2 cell line indicates that both materials were non-toxic.
  12. Lunardi VB, Soetaredjo FE, Putro JN, Santoso SP, Yuliana M, Sunarso J, et al.
    Polymers (Basel), 2021 Jun 23;13(13).
    PMID: 34201884 DOI: 10.3390/polym13132052
    The 'Back-to-nature' concept has currently been adopted intensively in various industries, especially the pharmaceutical industry. In the past few decades, the overuse of synthetic chemicals has caused severe damage to the environment and ecosystem. One class of natural materials developed to substitute artificial chemicals in the pharmaceutical industries is the natural polymers, including cellulose and its derivatives. The development of nanocelluloses as nanocarriers in drug delivery systems has reached an advanced stage. Cellulose nanofiber (CNF), nanocrystal cellulose (NCC), and bacterial nanocellulose (BC) are the most common nanocellulose used as nanocarriers in drug delivery systems. Modification and functionalization using various processes and chemicals have been carried out to increase the adsorption and drug delivery performance of nanocellulose. Nanocellulose may be attached to the drug by physical interaction or chemical functionalization for covalent drug binding. Current development of nanocarrier formulations such as surfactant nanocellulose, ultra-lightweight porous materials, hydrogel, polyelectrolytes, and inorganic hybridizations has advanced to enable the construction of stimuli-responsive and specific recognition characteristics. Thus, an opportunity has emerged to develop a new generation of nanocellulose-based carriers that can modulate the drug conveyance for diverse drug characteristics. This review provides insights into selecting appropriate nanocellulose-based hybrid materials and the available modification routes to achieve satisfactory carrier performance and briefly discusses the essential criteria to achieve high-quality nanocellulose.
  13. Begum S, Yuhana NY, Md Saleh N, Kamarudin NHN, Sulong AB
    Carbohydr Polym, 2021 May 01;259:117613.
    PMID: 33673980 DOI: 10.1016/j.carbpol.2021.117613
    A large amount of wastewater is typically discharged into water bodies and has extremely harmful effects to aquatic environments. The removal of heavy metals from water bodies is necessary for the safe consumption of water and human activities. The demand for seafood has considerably increased, and millions of tons of crustacean waste are discarded every year. These waste products are rich in a natural biopolymer known as chitin. The deacetylated form of chitin, chitosan, has attracted attention as an adsorbent. It is a biocompatible and biodegradable polymer that can be modified and converted to various derivatives. This review paper focuses on relevant literature on strategies for chemically modifying the biopolymer and its use in the removal of heavy metals from water and wastewater. The different aspects of chitosan-based derivatives and their preparation and application are elucidated. A list of chitosan-based composites, along with their adsorptivity and experimental conditions, are compiled.
  14. Rajendran Royan NR, Sulong AB, Yuhana NY, Chen RS, Ab Ghani MH, Ahmad S
    PLoS One, 2018;13(5):e0197345.
    PMID: 29847568 DOI: 10.1371/journal.pone.0197345
    The use of rice husks (RH) to reinforce polymers in biocomposites are increasing tremendously. However, the incompatibility between the hydrophilic RH fibers and the hydrophobic thermoplastic matrices leads to unsatisfactory biocomposites. Surface modification of the fiber surface was carried out to improve the adhesion between fiber and matrix. In this study, the effect of surface modification of RH via alkali, acid and ultraviolet-ozonolysis (UV/O3) treatments on the properties of composites recycled high density polyethylene (rHDPE) composites was investigated. The untreated and treated RH were characterized by Fourier Transform Infrared (FTIR) and Scanning Electron Microscope (SEM). The composites containing 30 wt% of RH (treated and untreated) were then prepared via extrusion and followed by compression molding. As compared to untreated RH, all surface treated RH exhibited rougher surface and showed improved adhesion with rHDPE matrix. Tensile strength of UV/O3-treated RH composites showed an optimum result at 18.37 MPa which improved about 5% in comparison to the composites filled with untreated RH. UV/O3 treatment promotes shorter processing time and lesser raw material waste during treatment process where this is beneficial for commercialization in the future developments of wood plastic composites (WPCs). Therefore, UV/O3 treatment can be served as an alternative new method to modify RH surface in order to improve the adhesion between hydrophilic RH fibre and hydrophobic rHDPE polymer matrix.
  15. Fatmawati S, Yuliana, Purnomo AS, Abu Bakar MF
    Heliyon, 2020 Jul;6(7):e04396.
    PMID: 32685725 DOI: 10.1016/j.heliyon.2020.e04396
    Cassia alata or locally known as Ketepeng Cina (Indonesia) and Gelenggang (Malaysia) has been used as a traditional medicine to treat various diseases, especially skin diseases. In addition, C. alata has been reported to have potential anti allergic, anti inflammatory, antioxidant, anticancer, antidiabetic, and antifungal. Metabolite compounds that have been isolated from C. alata include flavones, flavonols, flavonoids glycosides, alatinon, alanonal and β-sitosterol-β-D-glucoside. The compounds have been isolated mainly from the leaves. Further identification is needed to discover the secondary metabolites from other parts of the plant such as seed, flower and bark which are reported to have potent antibacterial and antifungal activity. Therefore, this article highlights the secondary metabolites and biological activity of this plant which has been shown to have pharmacological properties against selected diseases.
  16. Rosenthal VD, Yin R, Lu Y, Rodrigues C, Myatra SN, Kharbanda M, et al.
    Am J Infect Control, 2023 Jun;51(6):675-682.
    PMID: 36075294 DOI: 10.1016/j.ajic.2022.08.024
    BACKGROUND: The International Nosocomial Infection Control Consortium has found a high ICU mortality rate. Our aim was to identify all-cause mortality risk factors in ICU-patients.

    METHODS: Multinational, multicenter, prospective cohort study at 786 ICUs of 312 hospitals in 147 cities in 37 Latin American, Asian, African, Middle Eastern, and European countries.

    RESULTS: Between 07/01/1998 and 02/12/2022, 300,827 patients, followed during 2,167,397 patient-days, acquired 21,371 HAIs. Following mortality risk factors were identified in multiple logistic regression: Central line-associated bloodstream infection (aOR:1.84; P

  17. Rosenthal VD, Jin Z, Brown EC, Dongol R, De Moros DA, Alarcon-Rua J, et al.
    Am J Infect Control, 2023 Dec 26.
    PMID: 38154739 DOI: 10.1016/j.ajic.2023.12.010
    BACKGROUND: Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden.

    METHODS: We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates. These variables were measured at baseline and during the intervention, specifically during the second month, third month, 4 to 16 months, and 17 to 29 months. Comparisons were conducted using a two-sample t test. To explore the exposure-outcome relationship, we used a generalized linear mixed model with a Poisson distribution to model the number of CLABSIs.

    RESULTS: During 1,837,750 patient-days, 283,087 patients, used 1,218,882 CL-days. CLABSI per 1,000 CL-days rates decreased from 15.34 at the baseline period to 7.97 in the 2nd month (relative risk (RR) = 0.52; 95% confidence interval [CI] = 0.48-0.56; P 

  18. Rosenthal VD, Jin Z, Memish ZA, Rodrigues C, Myatra SN, Kharbanda M, et al.
    PMID: 36714281 DOI: 10.1017/ash.2022.339
    OBJECTIVE: Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs.

    DESIGN: Prospective cohort study.

    SETTING: This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries.

    PARTICIPANTS: The study included patients admitted to ICUs across 24 years.

    RESULTS: In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16-1.28; P < .0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07-1.08; P < .0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23-1.31; P < .0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57-15.48; P < .0001); tracheostomy connected to a MV, which was associated with the next-highest risk (aOR, 8.31; 95% CI, 7.21-9.58; P < .0001); endotracheal tube connected to a MV (aOR, 6.76; 95% CI, 6.34-7.21; P < .0001); surgical hospitalization (aOR, 1.23; 95% CI, 1.17-1.29; P < .0001); admission to a public hospital (aOR, 1.59; 95% CI, 1.35-1.86; P < .0001); middle-income country (aOR, 1.22; 95% CI, 15-1.29; P < .0001); admission to an adult-oncology ICU, which was associated with the highest risk (aOR, 4.05; 95% CI, 3.22-5.09; P < .0001), admission to a neurologic ICU, which was associated with the next-highest risk (aOR, 2.48; 95% CI, 1.78-3.45; P < .0001); and admission to a respiratory ICU (aOR, 2.35; 95% CI, 1.79-3.07; P < .0001). Admission to a coronary ICU showed the lowest risk (aOR, 0.63; 95% CI, 0.51-0.77; P < .0001).

    CONCLUSIONS: Some identified VAP RFs are unlikely to change: sex, hospitalization type, ICU type, facility ownership, and country income level. Based on our results, we recommend focusing on strategies to reduce LOS, to reduce the MV utilization ratio, to limit CPAP use and implementing a set of evidence-based VAP prevention recommendations.

  19. Rosenthal VD, Yin R, Nercelles P, Rivera-Molina SE, Jyoti S, Dongol R, et al.
    Am J Infect Control, 2024 Jan 06.
    PMID: 38185380 DOI: 10.1016/j.ajic.2023.12.019
    BACKGROUND: Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East.

    METHODS: Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI).

    RESULTS: We gathered data from 204,770 patients, 1,480,620 patient days, 936,976 central line (CL)-days, 637,850 mechanical ventilators (MV)-days, and 1,005,589 urinary catheter (UC)-days. Our results showed 4,270 CL-associated bloodstream infections, 7,635 ventilator-associated pneumonia, and 3,005 UC-associated urinary tract infections. The combined rates of DA-HAIs were 7.28%, and 10.07 DA-HAIs per 1,000 patient days. CL-associated bloodstream infections occurred at 4.55 per 1,000 CL-days, ventilator-associated pneumonias at 11.96 per 1,000 MV-days, and UC-associated urinary tract infections at 2.91 per 1,000 UC days. In terms of resistance, Pseudomonas aeruginosa showed 50.73% resistance to imipenem, 44.99% to ceftazidime, 37.95% to ciprofloxacin, and 34.05% to amikacin. Meanwhile, Klebsiella spp had resistance rates of 48.29% to imipenem, 72.03% to ceftazidime, 61.78% to ciprofloxacin, and 40.32% to amikacin. Coagulase-negative Staphylococci and Staphylococcus aureus displayed oxacillin resistance in 81.33% and 53.83% of cases, respectively.

    CONCLUSIONS: The high rates of DA-HAI and bacterial resistance emphasize the ongoing need for continued efforts to control them.

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