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Background: Tuberculosis (TB) has become a public health problem among elderly in developing countries with the gradual increase in life expectancy. Aim/Objective: This study aimed to analyze the prognosis factors and chronological trends of TB in elderly in Southern Tunisia. Methods: A retrospective study was conducted. All TB patients aged ≥60 years, recorded in the Center of TB Control between 1995 and 2016, were included. Chronological trends of TB were analyzed by calculating the correlation coefficient of Spearman (Rho). Multivariate analysis was done by binary logistic regression (Adjusted Odds ratio (AOR); CI; p) to determine the independent risk factors associated with unsuccessful outcome in elderly. A p value <0.05 was considered as statistically significant. Results: Overall, 512 new elderly TB cases were notified between 1995 and 2016, with an average of 23.3 new cases/year. The mean TB incidence rate for elderly was 2.31/100,000 population/year. The case-fatality rate of 8.6%. Multivariate analysis showed that factors independently associated with unsuccessful outcome among elderly patients were age between 80 and 89 (AOR = 4.5; [95% CI: 2, 10.2]; p < 0.001), male gender (AOR = 2.2; [95% CI: 1.1, 4.4]; p = 0.026) and neuro-meningeal involvement (AOR = 4.6; [95% CI: 1.4, 14.8]; p = 0.011). The incidence of TB in elderly patients increased significantly from 0.95/100,000 population in 1995 to 2.17/100,000 population in 2016 (Rho = 0.48; p = 0.024). Discussion: A better understanding of TB features in elderly and its chronological trends overtime would facilitate to put in place, in the national TB control program, strategies geared towards this group of people. [ABSTRACT FROM AUTHOR]

Background: The high prevalence of carbapenem-resistant Klebsiella imposes optimizing antibiotic consumption. We aimed to evaluate the impact of antibiotic stewardship program on carbapenem consumption and the Klebsiella resistance. Method: We retrospectively evaluated critically ill patients with isolated Klebsiella species from Elaraby hospital, Egypt during the period from April 2017 to January 2019. We collected data related to carbapenems consumption and Klebsiella clinical isolates with their antimicrobial susceptibility. Based on susceptibility, Klebsiella isolates were classified into sensitive, extended spectrum beta-lactamase (ESBL) producer, and carbapenem-resistant Klebsiella (CRK), respectively. Our primary outcome was the change in carbapenems consumption after implementing the program, while the secondary outcomes were the changes in the incidence of CRK. Results: The study included 205 patients with isolated Klebsiella species during the study period. The antibiotic stewardship program started in March 2018. Out of the 205 patients, 61 patients (29.8%) represented the pre-intervention sample, and 144 patients (70.2%) represented the post-intervention sample. Applying the antibiotic stewardship program was associated with a significant decrease in the carbapenems consumption from 38.9 to 26.6 defined daily dose/1000 patient-days (p = 0.02). The incidence of CRK was decreased from 85.25% of total Klebsiella isolates to 48.6% (p < 0.001). Klebsiella species were more likely to be in a lower category of resistance after applying the program with an odds ratio of 6.3 (2.88–13.73) using ordinal logistic regression. Conclusion: Applying the antibiotic stewardship program could reduce the unnecessary carbapenems use in the ICU with a subsequent decrease in the emergence of the Klebsiella- resistant strains. [ABSTRACT FROM AUTHOR]

Hand hygiene is the single most important measure in reducing the spread of infection. The aim of this study was to assess the uptake of fake tan in nursing students and evaluate the impact of wearing fake tan on hand hygiene training lotion removal during handwashing with soap and water. Of the 217 participants recruited, 21% wore fake tan. Statistical analysis revealed no significant difference between fake tan and non-fake tan wearers. Consequentially, no guidelines regarding the wearing of fake tan in clinical practice are currently required. [ABSTRACT FROM AUTHOR]