Monitoring of High-Risk Areas: Intensive Care Units

2013 ◽  
pp. 123-126
Author(s):  
B. K. Rao
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Intensive Care Units ◽  
Risk Areas

scholarly journals Good practice issues in psychiatric intensive-care units

1999 ◽  
Vol 23 (7) ◽  
pp. 397-400 ◽  
Author(s):  
Stephen Pereira ◽  
M. Dominic Beer ◽  
Carol Paton
Keyword(s):  
Intensive Care ◽  
Clinical Practice ◽  
High Risk ◽  
Intensive Care Units ◽  
Clinical Care ◽  
Good Practice ◽  
Clinical Implications ◽  
Clinical Leadership ◽  
Risk Areas ◽  
Areas Of Concern

Aims and methodTo survey some aspects of care relevant to good practice in psychiatric intensive-care units.ResultsA number of areas of concern were identified, including care issues for informal and female patients, a lack of uniform clinical leadership and a paucity of policies/guidelines for high-risk areas of clinical practice.Clinical implicationsIn an attempt to provide a service for the most disturbed patients from widely varying sources, psychiatric intensive-care units are at risk of compromising the ability to provide good-quality clinical care.

scholarly journals High-Risk International Clones of Carbapenem-Nonsusceptible Pseudomonas aeruginosa Endemic to Indonesian Intensive Care Units: Impact of a Multifaceted Infection Control Intervention Analyzed at the Genomic Level

mBio ◽  
2019 ◽  
Vol 10 (6) ◽  
Author(s):  
Andreu Coello Pelegrin ◽  
Yulia Rosa Saharman ◽  
Aurélien Griffon ◽  
Mattia Palmieri ◽  
Caroline Mirande ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
High Risk ◽  
Infection Control ◽  
Intensive Care Units ◽  
Clinical Data ◽  
Prevention Measures ◽  
Content Type ◽  
Control Intervention ◽  
The Impact

ABSTRACT Infection control effectiveness evaluations require detailed epidemiological and microbiological data. We analyzed the genomic profiles of carbapenem-nonsusceptible Pseudomonas aeruginosa (CNPA) strains collected from two intensive care units (ICUs) in the national referral hospital in Jakarta, Indonesia, where a multifaceted infection control intervention was applied. We used clinical data combined with whole-genome sequencing (WGS) of systematically collected CNPA to infer the transmission dynamics of CNPA strains and to characterize their resistome. We found that the number of CNPA transmissions and acquisitions by patients was highly variable over time but that, overall, the rates were not significantly reduced by the intervention. Environmental sources were involved in these transmissions and acquisitions. Four high-risk international CNPA clones (ST235, ST823, ST375, and ST446) dominated, but the distribution of these clones changed significantly after the intervention was implemented. Using resistome analysis, carbapenem resistance was explained by the presence of various carbapenemase-encoding genes (blaGES-5, blaVIM-2-8, and blaIMP-1-7-43) and by mutations within the porin OprD. Our results reveal for the first time the dynamics of P. aeruginosa antimicrobial resistance (AMR) profiles in Indonesia and additionally show the utility of WGS in combination with clinical data to evaluate the impact of an infection control intervention. (This study has been registered at www.trialregister.nl under registration no. NTR5541). IMPORTANCE In low-to-middle-income countries such as Indonesia, work in intensive care units (ICUs) can be hampered by lack of resources. Conducting large epidemiological studies in such settings using genomic tools is rather challenging. Still, we were able to systematically study the transmissions of carbapenem-nonsusceptible strains of P. aeruginosa (CNPA) within and between ICUs, before and after an infection control intervention. Our data show the importance of the broad dissemination of the internationally recognized CNPA clones, the relevance of environmental reservoirs, and the mixed effects of the implemented intervention; it led to a profound change in the clonal make-up of CNPA, but it did not reduce the patients’ risk of CNPA acquisitions. Thus, CNPA epidemiology in Indonesian ICUs is part of a global expansion of multiple CNPA clones that remains difficult to control by infection prevention measures.

scholarly journals Bacterial but no SARS-CoV-2 contamination after terminal disinfection of tertiary care intensive care units treating COVID-19 patients

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Daniel A. Hofmaenner ◽  
◽  
Pedro David Wendel Garcia ◽  
Branko Duvnjak ◽  
Bhavya Chakrakodi ◽  
...  
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Ribonucleic Acid ◽  
Bacterial Contamination ◽  
Tertiary Care ◽  
Invasive Ventilation ◽  
Gram Negative ◽  
Skin Flora

Abstract Background In intensive care units (ICUs) treating patients with Coronavirus disease 2019 (COVID-19) invasive ventilation poses a high risk for aerosol and droplet formation. Surface contamination of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) or bacteria can result in nosocomial transmission. Methods Two tertiary care COVID-19 intensive care units treating 53 patients for 870 patient days were sampled after terminal cleaning and preparation for regular use to treat non-COVID-19 patients. Results A total of 176 swabs were sampled of defined locations covering both ICUs. No SARS-CoV-2 ribonucleic acid (RNA) was detected. Gram-negative bacterial contamination was mainly linked to sinks and siphons. Skin flora was isolated from most swabbed areas and Enterococcus faecium was detected on two keyboards. Conclusions After basic cleaning with standard disinfection measures no remaining SARS-CoV-2 RNA was detected. Bacterial contamination was low and mainly localised in sinks and siphons.

Improving Influenza Immunization Rates Among Healthcare Workers Caring for High-Risk Pediatric Patients

2004 ◽  
Vol 25 (11) ◽  
pp. 912-917 ◽  
Author(s):  
Kristina A. Bryant ◽  
Beth Stover ◽  
Linda Cain ◽  
Gail L. Levine ◽  
Jane Siegel ◽  
...  
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Infection Control ◽  
Intensive Care Units ◽  
Healthcare Workers ◽  
Neonatal Intensive Care ◽  
Pediatric Intensive Care ◽  
Vaccination Rates ◽  
Influenza Immunization ◽  
Immunization Rates

AbstractObjective:To assess influenza vaccination rates of healthcare workers (HCWs) in neonatal intensive care units (NICUs), pediatric intensive care units (PICUs), and oncology units in Pediatric Prevention Network (PPN) hospitals.Participants:Infection control practitioners and HCWs in NICUs, PICUs, and oncology units.Methods:In November 2000, posters, electronic copies of a slide presentation, and an influenza fact sheet were distributed to 32 of 76 PPN hospitals. In January 2001, a survey was distributed to PPN hospital participants to obtain information about the immunization campaigns. On February 7, 2001, a survey of influenza immunization was conducted among HCWs in NICU, PICU, and oncology units at participating hospitals.Results:Infection control practitioners from 19 (25%) of the 76 PPN hospitals completed the surveys. The median influenza immunization rate was 43% (range, 12% to 63%), with 7 hospitals exceeding 50%. HCWs (n = 1,123) at 15 PPN hospitals completed a survey; 53% of HCWs reported receiving influenza immunization. Immunization rates varied by work site: 52% in NICUs and PICUs compared with 60% in oncology units. Mobile carts and PPN educational fact cards were associated with higher rates among these subpopulations (P < .001) (361 [63%] of 575 vs 236 [44%] of 541 for mobile carts; 378 [60%] of 633 vs 219 [45%] of 483 for fact cards).Conclusion:Despite delayed distribution of influenza vaccine during the 2000–2001 season, immunization rates at 7 hospitals and among HCWs in high-risk units exceeded the National Association of Children's Hospitals and Related Institutions goal of 50%.

scholarly journals Klebsiella pneumoniae acquisition in ICUs: patient-based and laboratory-based surveillance

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Barchitta ◽  
A Maugeri ◽  
C La Mastra ◽  
MC La Rosa ◽  
L Sessa ◽  
...  
Keyword(s):  
Public Health ◽  
Intensive Care ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Intensive Care Units ◽  
Multidrug Resistant ◽  
Trauma Patients ◽  
Healthcare Associated Infections ◽  
Global Threat ◽  
Healthcare Associated

Abstract Klebsiella pneumoniae - and especially multidrug-resistant K. pneumoniae - represents a global threat for Public Health, due to its high dissemination in Intensive Care Units (ICUs) and its association with mortality. Here, we investigated the molecular epidemiology of multidrug-resistant K. pneumoniae strains in ICUs from Catania, Italy. We used data and samples from the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project, which has been surveying the epidemiology and the risk of Healthcare-associated infections (HAIs) in Italian ICUs. The SPIN-UTI network adopted the ECDC protocols for patient-based HAI surveillance. In a sample of ICUs the patient-based surveillance was integrated with a laboratory-based surveillance of MDR K. pneumoniae isolates. K. pneumoniae isolates were genotyped by multilocus sequence typing (MLST), and patterns of K. pneumoniae acquisition (i.e. carriage, colonization and infection) were identified using standard definitions. Our analysis included 155 patients who stayed in two ICUs for a total of 2254 days, from October 2016 to March 2017. Trauma patients were more likely to be infected with K. pneumoniae than other patients (OR = 5.9; 95%CI=2.4-14.8; p = 0.004). A total of 109 K. pneumoniae strains were isolated from different sites of 39 patients, which in turn were defined as 45.2% colonization, 25.8% infection, and 29% carriage. 79.3% K. pneumoniae isolates resistant to carbapenems and 100% resistant to penicillins and cephalosporins. The MLST identified two major clonal groups: the ST395 and the ST37, which represented respectively the 65.6% and the 21.3% of typed isolates. Surveillance of colonization and infection by high-risk clones might help in implementing appropriate strategies, which are crucial to reduce the spread of K. pneumoniae in ICUs. *Study Group AOU 'Policlinico-Vittorio Emanuele', Catania, Italy: Patrizia Bellocchi, Giacomo Castiglione, Alida Imbriani, Marinella Astuto, Giuseppa La Camera, Agata Sciacca Key messages Multidrug-resistant K. pneumoniae still represents a threat for Public Health in Italy and globally, due to its high dissemination in intensive care units. Surveillance of colonization and infection by high-risk clones might help in reducing the spread of Klebsiella pneumoniae.

scholarly journals Construction of an instrument for the prognostic evaluation of elderly persons in intensive care units

2017 ◽  
Vol 20 (3) ◽  
pp. 319-329
Author(s):  
Ivanilda Lacerda Pedrosa ◽  
Djacyr Magna Cabral Freire ◽  
Rodolfo Herberto Schneider
Keyword(s):  
Intensive Care ◽  
High Risk ◽  
Data Collection ◽  
Elderly Patients ◽  
Intensive Care Units ◽  
Total Sample ◽  
Cutoff Score ◽  
Elderly Persons ◽  
Prognostic Evaluation ◽  
Risk Of Death

Abstract Objective: To create an instrument for the prognostic evaluation of elderly patients hospitalized in an intensive care unit. Methods: A cohort study, with prospective data collection, which included elderly persons aged 60 years or older, was carried out in the city of João Pessoa, in the state of Paraíba, Brazil. Data collection was performed using an instrument created from a pilot study and the Katz Index. Poisson’s regression was used for data analysis. This technique estimates relative risk, retaining variables with p≤0.10 in the instrument, and ensures biological plausibility. The classification of risk of death was performed using quartile analysis, confirmed by the Receiver Operator Characteristic (ROC) curve. Results: 205 elderly patients with an average age of 74.6 years and a 59% risk of mortality, were included. Of the total sample and based on the scores, 16.6% of elderly persons had a low risk of developing death, 23.9% were at moderate risk, 40% had a high risk, and 19.5% exhibited a very high risk of death. The positive predictive value of the instrument was 77% and the negative value was 67.5%, with a concordance index of 0.78. The cutoff score of the instrument was 9 points or over. The sensitivity was 77.7% and the specificity was 66.7%. Conclusions: The instrument developed may be useful in the identification of elderly people with risk factors who require increased care. The instrument described can therefore be applied in Brazilian intensive care units.

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