Scientific research, within the framework of a circular and sustainable economy, has increasingly focused on wild plants and agricultural by-products as valuable sources of bioactive compounds for innovative applications. In this study, the plant species selected for extract preparation and evaluation of their dyeing properties included Isatis tinctoria L., Castanea sativa, Juglans regia L., Rumex crispus L., Arbutus unedo L., and Punica granatum L. Each extract was analyzed to assess its dyeing performance on cotton and other cellulosic fabrics. Cellulose pads dyed with peels of P. granatum extract (PPGE) proved to be versatile and effective, showing potential for use in extending the shelf life of various fruits such as strawberries, apples, cherries, and persimmons. The optimum dyeing condition for cellulose and cotton fabrics was found to be 6% w/v dye. These findings support the development of natural, multifunctional materials suitable for food packaging applications aimed at preserving fresh produce, as well as for sustainable textile dyeing.
Abstract Background Vascular access device (VAD) placement is an increasingly performed procedure linked to hospital-acquired bloodstream infections. VADs comprise peripheral venous catheters (mid-tight, mini-midline, midline), centrally (CICC, FICC), and peripherally (PICC) inserted central venous catheters. CRBSI and CABSI definitions are often improperly used, and data beyond ICU settings are scarce. This study investigates risk factors and the prevalence and incidence of CABSI and CRBSI episodes in non-ICU wards.Table 1.Characteristics and outcomes of the study populationImmunosuppression: active onco-hematological, rheumatological disorder, solid organ transplant, hematopoietic stem-cell transplantation, or recent (<1 year) treatment, with chemotherapy or prolonged immunosuppressive treatment of any of these conditions.PiCC: Peripherally inserted Central venous Catheter, CiCC: Centrally inserted Central venous Catheter, FiCC: Femorally inserted Central venous Catheter Methods This retrospective, observational study (January 2021- December 2023) was conducted in Luigi Sacco Hospital, Milan. Clinical and demographic data of hospitalized non-ICU patients undergone VAD placement were retrieved from medical records. Continuous variables were described with median and interquartile [IQR], and categorical variables with counts and percentiles. A multivariable logistic regression accounting for patients’ and VADs’ characteristics was performed.Figure 1.Microbiological data of CABSI (top) and CRBSI (bottom) episodesMSSA: Methicillin-sensible S.aureus, MRSA: Methicillin-resistant S.aureus, MSSE: Methicillin-sensible S.epidermidis, MRSE: Methicillin-resistant S.epidermidis, Enterobacterales WT: sensible to III gen. cefalosporins, CP: carbapenemase-producing, VRE: Vancomycin-resistant Enterococci, CoNS: Coagulase-negative Staphylococci Results A total of 1999 VAD placements were included, patients’ characteristics and outcomes are outlined in Table 1. Peripheral devices were 66.4%, and 54 CRBSI and 86 CABSI events were identified, according to international guidelines. CABSI and CRBSI displayed prevalence rates of 0.049 and 0.033, and incidences of 1.85 and 1.16 episodes per 1000 catheter days respectively. Parenteral nutrition was the only factor associated with CABSI and CRBSI events (p< 0.0001). Coagulase-negative Staphylococci (CoNS) were isolated in 37.0% of CABSI, and 31.9% of CRBSI episodes, most frequently S.epidermidis (16%), followed by E.fecium, and E.fecalis, resistant to first-line agents in 59.2%, 35.3%, and 18.8% of cases respectively. Candida spp. was isolated in 12.4% of cases, and polymicrobial etiology was 17.9%. Pathogens’ prevalence and susceptibility profiles are depicted in Figure 1. Conclusion We observed low CRBSI and CABSI incidences in non-ICU wards. CoNs were most prevalent, and parenteral nutrition was associated with VAD-related infections, as already described. Despite the non-ICU setting, Candida, drug-resistant GNB, and polymicrobial infection rates were alarming, stressing the importance of correct VAD management in non-ICU wards to prevent difficult-to-treat infections. Disclosures All Authors: No reported disclosures
Abstract Background While risk factors for COVID-19 hospitalization are well characterized, only a few studies investigated those associated with hospital re-admission after SARS-CoV-2 re-infections, since most are focused-on re-admission because of all-causes. Our aim was to identify co-morbidities and other risk factors associated with a second COVID-19 hospitalization. Study flowchart and timeline Methods Administrative database from the Lombardy Welfare Directorate was used to detect patients hospitalized for COVID-19 for a first time between 1st Feb 2020 to 31st Aug 2021. Information on demographic variables, hospital records and drug prescriptions were collected. The population comprised the re-hospitalized individuals, who were readmitted for COVID-19 at least 3 months after their initial hospital admission, likely because of a different SARS-CoV-2 infection and the non-re-hospitalized subjects. Follow-up observation lasted until the re-hospitalization, death or the end of study period. Adjusted hazard ratio (CI, 95%) was performed to assess the association between risk factors and re-hospitalization with a competing risk analysis. Multivariable analysis with competing risk, where death after 3 months is the competing risk for re-hospitalization due to COVID-19. Results From a total of 98,369 patients hospitalized for COVID-19, 25,776 (26.2%) died within three months and 610 (0.6%) were re-hospitalized for a likely new SARS-CoV-2 infection (Figure 1). Re-hospitalized patients were mostly male (61.3%) and were 72.2 years on average. The strongest risks for re-hospitalization in patients with a new episode of COVID-19 were kidney and liver diseases. However, a significant association for this risk was also observed for age, males, immune suppression, cerebro-vascular and cardio-vascular diseases, lung disease, diabetes, and some medications (Table 1). Conclusion We demonstrated that vulnerability due to multimorbidity and chronic conditions, such as kidney and liver disfunction, may diminish the ability to withstand physiological challenges, elevating the risk of re-hospitalization. The fact that the elderly, immune suppressed individuals, or those with chronic conditions may survive an initial hospitalization does not safeguard them from further admissions. We emphasized the importance of targeted interventions and heightened clinical vigilance for these high-risk patient populations. Disclosures All Authors: No reported disclosures
Abstract Background Functional decline (decrement in physical/cognitive functioning that causes inability to engage in daily activities) is common following acute hospitalization in elderly patients and is associated with hospital readmission, institutionalization, and mortality. We sought to determine rate of institutionalization after COVID-19 hospitalization and to characterize functional decline of patients institutionalized after COVID-19. Characteristics of COVID-19 and pre-COVID-19 hospitalized patients Methods We conducted a retrospective cohort study using health administrative database from Lombardy Welfare Directorate. We included patients 44 years-old and older who were discharged from a Lombardy hospital with a diagnosis of COVID-19 between Feb 1st, 2020 and Jun, 30th, 2022 (COVID cohort) compared with patients discharged from the same sites with any diagnosis from Jan, 1st 2018 until Dec 31st, 2018 (pre-COVID cohort). Our primary outcome was institutionalization during the 6-month period following hospital discharge. We also compared functional decline parameters at institutionalization in the two cohorts. Trend of institutionalization during the COVID-19 pandemic waves Results Our study included 141651 patients hospitalized for COVID-19 and 251459 individuals acutely hospitalized before COVID-19 pandemic (pre-COVID-cohort) for any diagnosis (Table 1). Among them, 3835 (2.7%) and 7976 (3.2%) were institutionalized during the following 6-months, respectively. Rates of institutionalization in the COVID-cohort increased over time during the observation period (Table 2). At institutionalization, patients hospitalized for COVID-19 were younger (median 83.6 years vs 84.9 years, p >0.0001), and more frequently female (37.8% vs 32.3%, p< 0.0001). Moreover, they had more frequently pressure sores (20.5% vs 16.3%, p< 0.0001) and urinary catheter (27% vs 19.8%, p< 0.0001) and fewer assistive devices (p< 0.0001) as compared to the pre-COVID cohort (Table 3). Characteristics of institutionalized patients following acute COVID-19-realated hospitalizations vs non-COVID-19 acute hospitalization Conclusion Hospitalization for COVID-19 was followed by institutionalization at the same rate as acute hospitalization for all-cause in the pre-COVID period. However, functional decline, pressure sores, urinary catheter, incontinence, and use of assistive devices following COVID-19 hospitalization in the elderly population should be closely monitored. Disclosures All Authors: No reported disclosures
Abstract Background Intensive care unit (ICU) acquired bloodstream infections (BSIs) are an important cause of morbidity and mortality. The use of invasive devices, such as endovascular catheters is associated with greater risk of developing such infections. Our study focuses on the epidemiology of ICU-acquired catheter-related BSIs (CR-BSIs) in Italy from 2014 to 2022.Table 1.Characteristics of ICU admitted patients from 2014 to 2022.LOS, length of stay; SD, standard deviation; CVC, central venous catheter; BSI, bloodstream infection; CR-BSI, catheter-related bloodstream infection. With intensive care treatment need we mean the number and percentage of patients who were admitted to ICU for intensive care treatment, therefore excluding those admitted for post-surgical monitoring or invasive procedure execution. Methods We retrieved data from the PROSAFE project, a prospective, observational, multicentric study involving 135 Italian ICUs. Clinical data were continuously collected by physicians from January 2014 to December 2022. CR-BSIs episodes were defined in accordance with the National Healthcare Safety Network. Multi-drug resistant Gram-negative bacteria (MDR-GNB) were defined as resistant to at least one carbapenem. Continuous variables were summarized with mean and standard deviation, while categorical data were presented as counts and percentages.Figure 1.Percentage of species isolated from blood cultures of patients with ICU-acquired catheter-related bloodstream infection from 2014 to 2022.S. aureus, Staphylococcus aureus; CoNS, Coagulase negative Staphylococci; GPB, Gram positive bacteria, GNB; Gram negative bacteria. Other GPB include Streptococci and Enterococci. Results A total of 271654 patients were included in our study (Table 1). The number of episodes of CR-BSIs was 3361. The in-ICU mortality of patients with CR-BSIs was 28.5%. The incidence of CR-BSIs slightly increased through the years (1.1% in 2014 vs 1.9% in 2022), peaking in 2020-2021. Regarding the microbiology, most bacteria were Gram positive (GP), representing around half of the involved pathogens (Figure 1). CR-BSIs due to coagulase-negative staphylococci (CoNS) increased over the years (from 28.9% in 2014 to 41.2% in 2022), particularly since the COVID-19 pandemic. More than a third of CR-BSIs were caused by GNB, 22.7% of which were MDR. The most common pathogen was Klebsiella pneumoniae, which represented 13.4% of all CR-BSIs. An overall decrease of MDR-GNB was noted (Figure 2). CR-fungemias represented almost 9% of all CR-BSIs, with a peak at 12% in 2020.Figure 2.Percentage of resistant pathogens isolated from blood cultures of patients with ICU-acquired catheter-related bloodstream infection from 2014 to 2022. Resistant pathogens were defined as resistant to methicillin for Staphylococcus aureus, resistant to vancomycin for Enterococci and resistant to at least one carbapenem for Gram-negative rods. CR-BSI, catheter-related bloodstream infection; MRSA, methicillin-resistant Staphylococcus aureus, E. faecium, Enterococcus faecium; E. faecalis, Enterococcus faecalis; K. pneumoniae, Klebsiella pneumoniae; E. coli, Escherichia coli; P. aeruginosa, Pseudomonas aeruginosa; A. baumannii, Acinetobacter baumannii. Conclusion Our study highlights the significant burden of CR-BSIs in Italian ICUs. Despite efforts to mitigate these infections, the incidence of CR-BSIs has shown a concerning upward trend, particularly driven by the rise in CoNS infections, notably since the onset of the COVID-19 pandemic. These findings underscore the ongoing challenge of combating CR-BSIs and emphasize the importance of continued surveillance and targeted interventions to mitigate their impact on patient outcomes in ICUs. Disclosures All Authors: No reported disclosures
