Mortality Risk Factors with Nosocomial Staphylococcus aureus Infections in Intensive Care Units: Results from the German Nosocomial Infection Surveillance System (KISS)

Infection ◽  
2005 ◽  
Vol 33 (2) ◽  
pp. 50-55 ◽  
Author(s):  
P. Gastmeier ◽  
D. Sohr ◽  
C. Geffers ◽  
M. Behnke ◽  
F. Daschner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Mortality Risk ◽  
Surveillance System ◽  
Infection Surveillance

Reproducibility of the Surveillance Effect to Decrease Nosocomial Infection Rates

2009 ◽  
Vol 30 (10) ◽  
pp. 993-999 ◽  
Author(s):  
P. Gastmeier ◽  
F. Schwab ◽  
D. Sohr ◽  
M. Behnke ◽  
C. Geffers
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Knee Prosthesis ◽  
Venous Catheter ◽  
Infection Rates ◽  
Relative Risks ◽  
Infection Surveillance ◽  
Reduction Effect

Objective.To investigate whether the reduction effect due to participation in a nosocomial infection surveillance system for laboratory-confirmed central venous catheter (CVC)-associated primary bloodstream infection (BSI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI) is reproducible for different time periods, independent of confounding factors that might occur during a specific time period.Methods.Data from the German national nosocomial infection surveillance system from the period January 1997 through June 2008 were used. CVC-associated BSI data and SSI data were analyzed for 3 starting periods, and VAP data were analyzed for 2 starting periods. Monthly infection rates were calculated for the following 36 months, and relative risks comparing the first and third surveillance years of each period were calculated.Results.A total of 2,399 CVC-associated BSI cases from 267 intensive care units, 3,637 VAP cases from 150 intensive care units, and 829 SSIs following 3 different procedures from 113 departments were analyzed. A significant reduction in VAP was shown for both starting periods investigated (overall relative risk [RR], 0.80 [95% CI, 0.74-0.86]). A significant reduction in CVC-associated BSI was demonstrated for 2 of 3 starting periods (overall RR, 0.83 [95% CI, 0.75-0.91]). A significant reduction in SSI was found for 2 starting periods for knee prosthesis insertion (overall RR, 0.56 [95% CI, 0.38-0.82]), for all of the 3 starting periods for cesarean delivery (overall RR, 0.75 [95% CI, 0.61-0.93]), and for none of the 3 starting periods for endoscopically performed cholecystectomy (overall RR, 0.89 [95% CI, 0.62-1.27]).Conclusions.The surveillance effect, manifest as a significant reduction of nosocomial infection rates between the first and third years of participation in a surveillance system, was observed independently from the calendar year in which the surveillance activities started.

Reducing Central Venous Catheter–Associated Primary Bloodstream Infections in Intensive Care Units Is Possible: Data From The German Nosocomial Infection Surveillance System

2003 ◽  
Vol 24 (7) ◽  
pp. 501-505 ◽  
Author(s):  
Irina Zuschneid ◽  
Frank Schwab ◽  
Christine Geffers ◽  
Henning Rüden ◽  
Petra Gastmeier
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Relative Reduction ◽  
Central Venous ◽  
Infection Surveillance

AbstractBackground And Objective:The German Nosocomial Infection Surveillance System (KISS) began in 1997 as a nationwide surveillance project for voluntary registration of nosocomial infections in intensive care units (ICUs). This study investigates trends in the rates of central venous catheter (CVC)–associated primary bloodstream infections (BSIs) in ICUs since participation in KISS.Methods:Eighty-four ICUs that had participated in KISS for at least 24 months were considered for more detailed analysis. Monthly rates of primary BSI for the 84 ICUs were pooled for the 24 months. The best model for describing the curve of reduction was sought. Additionally, incidence densities were compared using the z test.Results:For the 212 ICUs participating, a relative 25.7% decrease (from 2.1 to 1.6 primary BSIs per 1,000 CVC-days) was observed from January 1997 to June 2001. The 84 ICUs that participated in KISS for a minimum of 24 months accumulated 552,359 patient-days and 404,897 CVC-days during their 24 months. A linear regression model was selected to explain the curve of primary BSI reduction in the 84 ICUs. It showed a decrease from 2.1 to 1.5 primary BSIs per 1,000 CVC-days, meaning an overall relative reduction of 28.6% during the 2-year observation period. These results were significant (Student's t test for the monthly reduction coefficient; P = .04). The reduction of primary BSIs was shown for both clinical sepsis and laboratory-confirmed, CVC-associated primary BSIs.Conclusion:Performing surveillance with KISS was associated with a reduction of the rates of CVC-associated primary BSIs in ICU patients (Infect Control Hosp Epidemiol 2003;24:501-505).

scholarly journals Determining the clinical significance of co-colonization of vancomycin-resistant enterococci and methicillin-resistant Staphylococcus aureus in the intestinal tracts of patients in intensive care units: a case–control study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Young Kyung Yoon ◽  
Min Jung Lee ◽  
Yongguk Ju ◽  
Sung Eun Lee ◽  
Kyung Sook Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Case Control ◽  
Methicillin Resistant ◽  
Vancomycin Resistant ◽  
Control Study

Abstract Background The emergence of vancomycin-resistant Staphylococcus aureus (VRSA) has become a global concern for public health. The proximity of vancomycin-resistant enterococcus (VRE) and methicillin-resistant S. aureus (MRSA) is considered to be one of the foremost risk factors for the development of VRSA. This study aimed to determine the incidence, risk factors, and clinical outcomes of intestinal co-colonization with VRE and MRSA. Methods A case–control study was conducted in 52-bed intensive care units (ICUs) of a university-affiliated hospital from September 2012 to October 2017. Active surveillance using rectal cultures for VRE were conducted at ICU admission and on a weekly basis. Weekly surveillance cultures for detection of rectal MRSA were also conducted in patients with VRE carriage. Patients with intestinal co-colonization of VRE and MRSA were compared with randomly selected control patients with VRE colonization alone (1:1). Vancomycin minimum inhibitory concentrations (MICs) for MRSA isolates were determined by the Etest. Results Of the 4679 consecutive patients, 195 cases and 924 controls were detected. The median monthly incidence and duration of intestinal co-colonization with VRE and MRSA were 2.3/1000 patient-days and 7 days, respectively. The frequency of both MRSA infections and mortality attributable to MRSA were higher in the case group than in the control group: 56.9% vs. 44.1% (P = 0.011) and 8.2% vs. 1.0% (P = 0.002), respectively. Independent risk factors for intestinal co-colonization were enteral tube feeding (odds ratio [OR], 2.09; 95% confidence interval [CI] 1.32–3.32), metabolic diseases (OR, 1.75; 95% CI 1.05–2.93), male gender (OR, 1.62; 95% CI 1.06–2.50), and Charlson comorbidity index < 3 (OR, 3.61; 95% CI 1.88–6.94). All MRSA isolates from case patients were susceptible to vancomycin (MIC ≤ 2 mg/L). Conclusions Our study indicates that intestinal co-colonization of VRE and MRSA occurs commonly among patients in the ICU with MRSA endemicity, which might be associated with poor clinical outcomes.

Comparison of different methodological approaches to identify risk factors of nosocomial infection in intensive care units

2001 ◽  
Vol 27 (8) ◽  
pp. 1254-1262 ◽  
Author(s):  
Jokin de Irala-Estévez ◽  
Diego Martínez-Concha ◽  
Carmen Díaz-Molina ◽  
Josefa Masa-Calles ◽  
Amparo Serrano del Castillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Methodological Approaches
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