scholarly journals Comparing Hospital Healthcare-Associated Infection Incidence During Pre-COVID-19 Pandemic and Pandemic Eras

2021 ◽  
Vol 1 (S1) ◽  
pp. s45-s46
Author(s):  
Andrea Parriott ◽  
N. Neely Kazerouni ◽  
Erin Epson
Keyword(s):  
Antimicrobial Resistance ◽  
Bloodstream Infection ◽  
Incomplete Data ◽  
Central Line ◽  
Incidence Rates ◽  
Healthcare Associated Infection ◽  
California Department ◽  
Crude Incidence ◽  
Infection Incidence ◽  
Healthcare Associated

Background: Diversion of resources from infection prevention activities, personal protective equipment supply shortages, conservation (extended use and reuse) or overuse with multiple gown and glove layers, and antimicrobial prescribing changes during the COVID-19 pandemic might increase healthcare-associated infection (HAI) incidence and antimicrobial resistance. We compared the incidences of Clostridioides difficile infection (CDI), methicillin-resistant Staphyloccocus aureus bloodstream infection (MRSA BSI), and vancomycin-resistant enterococci bloodstream infection (VRE BSI) reported by California hospitals during the COVID-19 pandemic with incidence data collected prior to the pandemic. Methods: Using data reported by hospitals to the California Department of Health via the NHSN, we compared incidences in the second and third quarters of 2020 (pandemic) to the second and third quarters of 2019 (before the pandemic). For CDI and MRSA BSI, we compared the standardized infection ratios (SIRs, based on the 2015 national baseline), and we calculated the P values. No adjustment model is available for VRE BSI; thus, we measured incidence via crude incidence rates (infections per 100,000 patient days). We calculated incidence rate ratio (IRR) with 95% CI for VRE BSI. To examine the possible effect of missing data during the pandemic, we performed a sensitivity analysis by excluding all facilities that had incomplete data reporting at any time during either analysis period. Results: Incidence measures and numbers of facilities contributing data in prepandemic and pandemic periods are shown in Table 1. There were no statistically significant changes in SIRs at P = .05 for either MRSA BSI or CDI between the prepandemic and pandemic periods (MRSA BSI P = .17; CDI P = .08). Crude VRE BSI incidence increased during the pandemic compared to the prepandemic period (IRR, 1.40; 95% CI, 1.16–1.70). Excluding facilities with incomplete data had minimal effect. Conclusions: We found insufficient evidence that MRSA BSI or CDI incidence changed in California hospitals during the pandemic relative to the prepandemic period; however, there was a significant increase in the crude incidence of VRE BSI. Next, we will include interrupted time series analyses to assess departure from long-term trends, including a risk-adjusted model for VRE BSI. Additionally, we will evaluate for changes in central-line–associated bloodstream infection incidence and antimicrobial resistance among HAI pathogens.Funding: NoDisclosures: None

scholarly journals Surveillance Length and Validity of Benchmarks for Central Line-Associated Bloodstream Infection Incidence Rates in Intensive Care Units

PLoS ONE ◽  
2012 ◽  
Vol 7 (5) ◽  
pp. e36582 ◽  
Author(s):  
Patricia S. Fontela ◽  
Caroline Quach ◽  
David Buckeridge ◽  
Madukhar Pai ◽  
Robert W. Platt
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Incidence Rates ◽  
Infection Incidence

scholarly journals Indirect Versus Direct Standardization Methods for Reporting Healthcare-Associated Infections: An Analysis of Central Line–Associated Bloodstream Infections in Maryland

2017 ◽  
Vol 38 (8) ◽  
pp. 989-992 ◽  
Author(s):  
Lyndsay M. O’Hara ◽  
Max Masnick ◽  
Surbhi Leekha ◽  
Sarah S. Jackson ◽  
Natalia Blanco ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Acute Care ◽  
Bloodstream Infections ◽  
Acute Care Hospitals ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated ◽  
Direct Standardization ◽  
Standardization Methods

Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line–associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 methods generate different hospital rankings with payment implications.Infect Control Hosp Epidemiol 2017;38:989–992

Distribution of Central Line-Associated Bloodstream Infections Determined From Washington State’s Annual Reporting Validation Program, 2009–2013

2016 ◽  
Vol 38 (4) ◽  
pp. 489-492
Author(s):  
Jason M. Lempp ◽  
M. Jeanne Cummings ◽  
David W. Birnbaum
Keyword(s):  
Bloodstream Infection ◽  
Healthcare Quality ◽  
Bloodstream Infections ◽  
Central Line ◽  
Infect Control Hosp ◽  
Public Healthcare ◽  
Healthcare Associated Infection ◽  
Reporting Accuracy ◽  
Annual Reporting ◽  
Healthcare Associated

Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State’s validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure that hospital reporting accuracy is maintained. This paper details findings and costs from our experience.Infect Control Hosp Epidemiol 2017;38:489–492

scholarly journals Characteristics of Healthcare-Associated Infections Contributing to Unexpected In-Hospital Deaths

2010 ◽  
Vol 31 (8) ◽  
pp. 864-866 ◽  
Author(s):  
Daniel J. Morgan ◽  
Lucia L. Lomotan ◽  
Kathleen Agnes ◽  
Linda McGrail ◽  
Mary-Claire Roghmann
Keyword(s):  
Bloodstream Infection ◽  
Medical Records ◽  
Central Line ◽  
Multidrug Resistant ◽  
Healthcare Associated Infections ◽  
Bacterial Isolates ◽  
Healthcare Associated Infection ◽  
Hospital Deaths ◽  
Healthcare Associated

We reviewed the medical records of all the patients who died in our hospital during the period from 2004 through 2008 to determine the contribution of healthcare-associated infections to mortality. Of the 179 unexpected in-hospital deaths during that period, 55 (31%) were related to 69 healthcare-associated infections. The most common healthcare-associated infection was central line-associated bloodstream infection, and the most common organisms identified were members of the Enterobacteriaceae family. Overall, 45% of bacterial isolates were multidrug resistant.

scholarly journals Estimating central line–associated bloodstream infection incidence rates by sampling of denominator data: A prospective, multicenter evaluation

2015 ◽  
Vol 43 (8) ◽  
pp. 853-856 ◽  
Author(s):  
Nicola D. Thompson ◽  
Jonathan R. Edwards ◽  
Wendy Bamberg ◽  
Zintars G. Beldavs ◽  
Ghinwa Dumyati ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Central Line ◽  
Incidence Rates ◽  
Infection Incidence

The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Catheter-Associated Bloodstream Infections

2010 ◽  
Vol 31 (S1) ◽  
pp. S27-S31 ◽  
Author(s):  
Kristina A. Bryant ◽  
Danielle M. Zerr ◽  
W. Charles Huskins ◽  
Aaron M. Milstone
Keyword(s):  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Morbidity And Mortality ◽  
Prevention Strategies ◽  
Healthcare Associated Infection ◽  
Research Topics ◽  
The Past ◽  
Healthcare Associated ◽  
Current Practices

Central line–associated bloodstream infections cause morbidity and mortality in children. We explore the evidence for prevention of central line–associated bloodstream infections in children, assess current practices, and propose research topics to improve prevention strategies.

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

MedPharmRes ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 17-21
Author(s):  
Lam Nguyen-Ho ◽  
Duong Hoang-Thai ◽  
Vu Le-Thuong ◽  
Ngoc Tran-Van
Keyword(s):  
Risk Factor ◽  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
Community Acquired Pneumonia ◽  
Resistant Organism ◽  
Healthcare Associated Infection ◽  
Female Ratio ◽  
High Prevalence ◽  
Need To Evaluate ◽  
Healthcare Associated

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR. Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included. Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia. Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

scholarly journals Impact of Medicare’s Hospital-Acquired Condition Policy on Infections in Safety Net and Non–Safety Net Hospitals

2015 ◽  
Vol 36 (6) ◽  
pp. 649-655 ◽  
Author(s):  
Louise Elaine Vaz ◽  
Kenneth P. Kleinman ◽  
Alison Tse Kawai ◽  
Robert Jin ◽  
William J. Kassler ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Financial Incentives ◽  
Safety Net ◽  
The United States ◽  
Central Line ◽  
Unintended Consequences ◽  
Infection Rates ◽  
Healthcare Associated Infection ◽  
Hospital Acquired Conditions ◽  
Hospital Acquired

BACKGROUNDPolicymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals.OBJECTIVETo determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non–safety net hospitals.DESIGNInterrupted time-series design.SETTING AND PARTICIPANTSNonfederal acute care hospitals that reported central line–associated bloodstream infection and ventilator-associated pneumonia rates to the Centers for Disease Control and Prevention’s National Health Safety Network from July 1, 2007, through December 31, 2013.RESULTSWe did not observe changes in the slope of targeted infection rates in the postpolicy period compared with the prepolicy period for either safety net (postpolicy vs prepolicy ratio, 0.96 [95% CI, 0.84–1.09]) or non–safety net (0.99 [0.90–1.10]) hospitals. Controlling for prepolicy secular trends, we did not detect differences in an immediate change at the time of the policy between safety net and non–safety net hospitals (P for 2-way interaction, .87).CONCLUSIONSThe Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy did not have an impact, either positive or negative, on already declining rates of central line–associated bloodstream infection in safety net or non–safety net hospitals. Continued evaluations of the broad impact of payment policies on safety net hospitals will remain important as the use of financial incentives and penalties continues to expand in the United States.Infect Control Hosp Epidemiol 2015;00(0): 1–7

Predicting Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infection Incidence Rates using Canadian Nosocomial Infection Surveillance Program (CNISP)

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Jona Gjevori ◽  
Kahina Abdesselam
Keyword(s):  
Public Health ◽  
Staphylococcus Aureus ◽  
Nosocomial Infection ◽  
Bloodstream Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Surveillance Program ◽  
Methicillin Resistant ◽  
Infection Surveillance ◽  
Healthcare Associated

Methicillin-Resistant Staphylococcus aureus (MRSA) is among the most prevalent nosocomial pathogens globally, causing significant morbidity, mortality, and healthcare costs. MRSA bloodstream infection (BSI) incidence rates in Canadian hospitals have significantly risen by almost 60% and have a mortality of over 20% upon Intensive Care Unit admission. MRSA is believed to be spread through healthcare workers; thus, high hand hygiene compliancy in addition to environmental cleaning are the cornerstone countermeasures to disrupting its transmission. The Public Health Agency of Canada (PHAC), in collaboration with the Canadian Nosocomial Infection Surveillance Program (CNISP), conducts national, sentinel surveillance on healthcare-associated infections like MRSA. As a Student Epidemiologist, I developed a research proposal detailing two study objectives: 1) develop a regression model to predict all incident MRSA BSI rates among acute-care hospitals in Canada using CNISP MRSA BSI incident cases from 2000 to 2019, and 2) create a compartmental (Susceptible-Infected-Recovered-Deceased) model to determine the impact of various Infection Prevention and Control (IPC) measures on the risk of healthcare-associated MRSA BSI transmission specifically. This study hopes to demonstrate that proper IPC compliance is associated with lower incident MRSA BSI rates with the goal being to produce a manuscript draft by 2021. MRSA poses a serious threat to patient safety globally and is becoming a growing national public health concern in Canada; determining which IPC strategy is most effective at disrupting MRSA transmission is essential to reducing incidence and mortality rates.

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