The Effects of Daily 2% CHG Cloth Bathing on Catheter-Related Bloodstream Infection Rates in a Surgical Intensive Care Unit

AbstractObjectives:To determine the risk factors for acquisition of nosocomial primary bloodstream infections (BSIs), including the effect of nursing-staff levels, in surgical intensive care unit (SICU) patients.Design:A nested case-control study.Setting:A 20-bed SICU in a 1,000-bed inner-city public hospital.Patients:28 patients with BSI (case-patients) were compared to 99 randomly selected patients (controls) hospitalized ≥3 days in the same unit.Results:Case- and control-patients were similar in age, severity of illness, and type of central venous catheter (CVC) used. Case-patients were significantly more likely than controls to be hospitalized during a 5-month period that had lower regular-nurse-to-patient and higher pool-nurse-to-patient ratios than during an 8-month reference period; to be in the SICU for a longer period of time; to be mechanically ventilated longer; to receive more antimicrobials and total parenteral nutrition; to have more CVC days; or to die. Case-patients had significantly lower regular-nurse-to-patient and higher pool-nurse-to-patient ratios for the 3 days before BSI than controls. In multivariate analyses, admission during a period of higher pool-nurse-to-patient ratio (odds ratio [OR]=3.8), total parenteral nutrition (OR=1.3), and CVC days (OR=1.1) remained independent BSI risk factors.Conclusions:Our data suggest that, in addition to other factors, nurse staffing composition (ie, pool-nurse-to-patient ratio) may be related to primary BSI risk. Patterns in intensive care unit nurse staffing should be monitored to assess their impact on nosocomial infection rates. This may be particularly important in an era of cost containment and healthcare reform.

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Device-associated infection rates with microbiological profile and antibiogram pattern from an adult medical-surgical intensive care unit of a tertiary care hospital

Indian Journal of Medical Specialities ◽

10.1016/j.injms.2016.12.001 ◽

2017 ◽

Vol 8 (1) ◽

pp. 25-30

Author(s):

Bineeta Kashyap ◽

Shilpi Gupta ◽

Nisha Goyal ◽

Yogesh Sarin

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Surgical Intensive Care Unit ◽

Care Hospital ◽

Infection Rates ◽

Surgical Intensive Care ◽

Microbiological Profile ◽

Device Associated Infection

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Surveillance in a Surgical Intensive Care Unit: Patient and Environment

Infection Control ◽

10.1017/s0195941700053698 ◽

1981 ◽

Vol 2 (1) ◽

pp. 21-25

Author(s):

Maryanne B. McGuckin ◽

Steven G. Kelsen

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Nosocomial Infection ◽

Respiratory Tract ◽

Significant Relationship ◽

Close Correlation ◽

Surgical Intensive Care Unit ◽

Airborne Bacteria ◽

Infection Rates ◽

Surgical Intensive Care

AbstractMicrobiologic surveillance of both the patients and the ambient environment of a surgical intensive care unit allowed us to relate the incidence of nosocomial respiratory tract infection to levels of airborne bacteria. Over the study period respiratory tract nosocomial infection rates varied from 0.7% to 17.0%, and nonrespiratory infection rates varied from 1.0% to 25.0%. Airborne bacteria counts during that time varied from 1.0 ± 0.8 S.E. CFU/ft3to 96.0 ± 6.8 S.E. CFU/ft3. There was a reasonably close correlation between airborne bacteria levels and the incidence of nosocomial pneumonia (r=0.81, p<0.05). Furthermore, there was a close correlation between a specific organism nosocomial infection rate and the number of colonies of that organism present in the air (r=0.88, p<0.05). In contrast, there was no significant relationship between airborne bacteria counts and nonrespiratory attack rates (r=0.60, p<0.05). If the bacteria traveled from the air to the patients, there appear to be at least three possible explanations for this significant relationship: (1) direct inoculation of the airway by the airborne bacteria; (2) inoculation of the airway by direct contact, which is related to the degree of “cleanliness” of the environment; and (3) an increased incidence of contaminated respiratory equipment and airway inoculation because of high counts of airborne bacteria. It is also possible that high bacterial air counts represent contamination of the air from patients with respiratory infections. Regardless of the pathway(s), surveillance of the ambient environment may prove to be a useful epidemiologic tool in the study and control of nosocomial respiratory tract infections in certain high-risk patient care areas.

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