Web-based surveillance system for the trends, risks and preventions of hospital-acquired multidrug resistant organisms (MDRO) infections

Healthcare-associated infections caused by multidrug-resistant organisms are associated with prolonged medical care, worse outcome and costly therapies. In Hungary, hospital-acquired infections (HAIs) due to epidemiologically important multidrug-resistant organisms are notifiable by law since 2004. Overall, 6,845 case-patients (59.8% men; median age: 65 years) were notified in Hungary from 2005 to 2010. One third of case-patients died in hospital. The overall incidence of infections increased from 5.4 in 2005 to 14.7 per 100,000 patient-days in 2010. Meticillin-resistant Staphylococcus aureus (MRSA) was the most frequently reported pathogen (52.2%), but while its incidence seemed to stabilise after 2007, notifications of multidrug-resistant Gram-negative organisms have significantly increased from 2005 to 2010. Surgical wound and bloodstream were the most frequently reported sites of infection. Although MRSA incidence has seemingly reached a plateau in recent years, actions aiming at reducing the burden of HAIs with special focus on Gram-negative multidrug-resistant organisms are needed in Hungary. Continuing promotion of antimicrobial stewardship, infection control methodologies, reinforced HAI surveillance among healthcare and infection control practitioners, and engagement of stakeholders, hospital managers and public health authorities to facilitate the implementation of existing guidelines and protocols are essential.

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Incidence of Hospital Acquired Multidrug Resistant Organisms in a Tertiary Care Facility

Journal of Infectious Diseases and Epidemiology ◽

10.23937/2474-3658/1510004 ◽

2015 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Kamran Baig

Keyword(s):

Tertiary Care ◽

Care Facility ◽

Multidrug Resistant ◽

Tertiary Care Facility ◽

Multidrug Resistant Organisms ◽

Hospital Acquired

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1149. Environmental Disinfection With Photocatalyst as an Adjunctive Measure to Control Multidrug-Resistant Organisms Transmission: A Prospective Cohort Study in High Incidence Setting

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.982 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S345-S346

Author(s):

Min Hyung Kim ◽

Su Jin Jeong ◽

Seong Gyu Lee ◽

Ki Sook Kim ◽

Yoon Ji Heo ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Multidrug Resistant ◽

Acquisition Rate ◽

Antimicrobial Coating ◽

High Incidence ◽

Multidrug Resistant Organisms ◽

Hospital Acquired Pneumonia ◽

Hospital Acquired

Abstract Background Hand hygiene and isolation precaution are often difficult to sustain, requiring additional measure to control multidrug-resistant organisms (MDRO) transmission. It was suggested that continuously antimicrobial surfaces could offer superior control of surface bioburden.Thus, we sought to decide the efficacy of photocatalyst antimicrobial coating in reducing MDRO acquisition in high incidence setting. Methods At an institute where used to have high incidence rate of methicillin-resistant Staphylococcus aureus (MRSA), we performed prospective cohort study involving patients hospitalized in medical intensive care unit. Five months of preintervention (where routine infection control measures were maintained) data were compared with 5 months of postintervention (after titanium dioxide-based photocatalyst were coated on high touch surfaces) data. The acquisition rate of MDROs and the rates of hospital acquired blood stream infection (BSI), pneumonia, urinary tract infection (UTI), and Clostridium difficile-associated disease (CDAD) were compared using Cox proportional hazards regression analysis. Results A total of 621 patients were included. There was significant decrease in MRSA acquisition rate after photocatalyst antimicrobial coating. (hazard ratio, 0.37; 95% CI, 0.14–0.99; P = 0.04.) However, acquisition rates of vancomycin-resistant Enterococcus spp. and multidrug-resistant Acinetobacter baunmannii had not significantly decreased. The hazard of acquiring hospital acquired pneumonia during intervention period compared with baseline period was 0.46 (95% CI, 0.23–0.94; P = 0.03). There were not significant reduction in hospital acquired BSI, UTI, and CDAD, after photocatalyst antimicrobial coating. Conclusion MRSA acquisition rate and hospital acquired pneumonia were significantly reduced after photocatalyst antimicrobial coating. This study provides evidence that photocatalyst antimicrobial disinfection can be an adjunctive measure to control MRSA acquisition in high incidence setting. Disclosures All authors: No reported disclosures.

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Hospital-Acquired Pneumonia in a Multipurpose Intensive Care Unit: One-Year Prospective Study

Acta Médica Portuguesa ◽

10.20344/amp.11607 ◽

2019 ◽

Vol 32 (12) ◽

pp. 746

Author(s):

Rui Dias Costa ◽

João Pedro Baptista ◽

Ricardo Freitas ◽

Paulo Jorge Martins

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Mortality Rate ◽

Intensive Care Unit Mortality ◽

Bacterial Flora ◽

Multidrug Resistant ◽

Multidrug Resistant Organisms ◽

Hospital Acquired Pneumonia ◽

One Year ◽

Hospital Acquired

Introduction: Hospital-acquired pneumonia continues to be a frequent complication in the intensive care unit and an important cause of admission in the intensive care unit. The aim of our study was to evaluate the demography, incidence, risk factors, causative bacterial pathogens and outcome of all episodes of Hospital-acquired pneumonia in our unit.Material and Methods: Prospective observational study, at a tertiary university hospital during one year (2014) including all the cases of hospital-acquired pneumonia in the intensive care unit.Results: Sixty patients were identified with pneumonia. Thirty-five (58.3%) had an intensive care unit acquired pneumonia, corresponding to 6.9 cases/1000 intubation-days. Antibiotic treatment in the previous 30 days was present in 75% of the cases. The incidence of Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii was 26.2%, 20.0% and 9.2%, respectively. Patients with late-onset hospital-acquired pneumonia (≥ 7 days) showed higher frequency of non-fermenting Gram-negative bacilli isolates, and methicillin-resistant S. aureus. Combination therapy was performed in 67.0%, and de-escalation in 18.3%. The mortality rate was 18.3%. The adjusted odds ratio for intensive care unit mortality in the group of patients with non-intensive care unit acquired pneumonia was 5.2 (95% CI of 1.02 – 22.10; p = 0.046).Discussion: The knowledge of local bacterial flora and resistance patterns is of crucial importance and strongly recommended. This evidence increases the probability of success of empiric antibiotic therapy.Conclusion: S. aureus was the predominant causative agent of nosocomial pneumonia. The most frequent risk factor identified for infection with multidrug-resistant organisms was previous treatment with antibiotics. Multidrug-resistant organisms were present in 45% of documented hospital-acquired pneumonias. In admitted patients with non-intensive care unit acquired pneumonia, the intensive care unit mortality rate was nearly five times higher compared to intensive care unit acquired pneumonia.

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