scholarly journals Epidemiology of Methicillin-SusceptibleStaphylococcus aureusin a Neonatology Ward

2015 ◽  
Vol 36 (11) ◽  
pp. 1305-1312 ◽  
Author(s):  
Yvonne Achermann ◽  
Kati Seidl ◽  
Stefan P. Kuster ◽  
Nadja Leimer ◽  
Nina Durisch ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Sequence Type ◽  
University Hospital ◽  
Infection Rates ◽  
Group Iii ◽  
Infection Surveillance ◽  
Hospital Acquired ◽  
Neonatal Ward ◽  
Mssa Infection ◽  
Hospital Transmission

OBJECTIVEIn-hospital transmission of methicillin-susceptibleStaphylococcus aureus(MSSA) among neonates remains enigmatic. We describe the epidemiology of MSSA colonization and infection in a 30-bed neonatal ward.DESIGNMultimodal outbreak investigationSETTINGA public 800-bed tertiary care university hospital in SwitzerlandMETHODSInvestigations in 2012–2013, triggered by a MSSA infection cluster, included prospective MSSA infection surveillance, microbiologic screening of neonates and environment, onsite observations, and a prospective cohort study. MSSA isolates were characterized by pulsed-field gel electrophoresis (PFGE) and selected isolates were examined for multilocus sequence type (MLST) and virulence factors.RESULTSAmong 726 in 2012, 30 (4.1%) patients suffered from MSSA infections including 8 (1.1%) with bacteremia. Among 655 admissions in 2013, 13 (2.0%) suffered from MSSA infections including 2 (0.3%) with bacteremia. Among 177 neonates screened forS. aureuscarriage, overall 77 (44%) tested positive. A predominant PFGE-1-ST30 strain was identified in 6 of 30 infected neonates (20%) and 30 of 77 colonized neonates (39%). This persistent clone waspvl-negative,tst-positive and belonged toagrgroup III. We found no environmental point source. MSSA carriage was associated with central vascular catheter use but not with a particular midwife, nurse, physician, or isolette. Observed healthcare worker behavior may have propagated transmission via hands and fomites. Despite multimodal interventions, clonal transmission and colonization continued and another clone, PFGE-6-ST5, became predominant.CONCLUSIONSHospital-acquired MSSA clones represent a high proportion of MSSA colonization but not MSSA infections in neonate inpatients. In contrast to persisting MSSA, transmission infection rates decreased concurrently with interventions. It remains to be established whether eradication of hospital-acquired MSSA strains would reduce infection rates further.Infect. Control Hosp. Epidemiol.2015;36(11):1305–1312

A Decade of Prevalence Surveys in a Tertiary-Care Center: Trends in Nosocomial Infection Rates, Device Utilization, and Patient Acuity

1999 ◽  
Vol 20 (8) ◽  
pp. 543-548 ◽  
Author(s):  
Jeffrey W. Weinstein ◽  
Dorothy Mazon ◽  
Elizabeth Pantelick ◽  
Patricia Reagan-Cirincione ◽  
Louise M. Dembry ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Bloodstream Infection ◽  
Acute Care ◽  
Nosocomial Infections ◽  
Tertiary Care ◽  
Infection Rates ◽  
Nosocomial Bloodstream Infection ◽  
Abnormal Laboratory ◽  
Infection Surveillance ◽  
The Mean

AbstractObjective:To evaluate the usefulness of repeated prevalence surveys to determine trends in the rates of nosocomial infections and to detect changes in risk factors (eg, use of invasive devices) associated with nosocomial infections.Patients And Methods:Ten annual prevalence surveys were conducted by trained infection control practitioners between 1985 and 1995 for acute-care patients on the medical, surgical, pediatric, and obstetric-gynecologic services at a 900-bed, tertiary-care, teaching hospital with 750 acute-care beds. The same methods of chart review and concurrent reporting from nursing, the microbiology and clinical laboratory, and the pharmacy were used each year to collect data on the prevalence of nosocomial infections, invasive-device utilization, and abnormal laboratory indicators. Although data were collected on a single day, a period-prevalence study approach was used, because charts were reviewed for any infection data occurring within the 7 days prior to the survey.Results:The hospital census for acute-care patients, as measured by the prevalence surveys, declined sharply over the 10 years, from 673 to 575 patients (P=.02). However, the medical service census increased from 150 to 188 patients (P=.01). During the same period, there was a significant decrease in the mean length of stay, from 7.3 to 6.0 days (P=.01), and a concomitant increase in the mean diagnosis-related-group case-mix index, from 1.03 to 1.24 (P=.001). Overall, nosocomial infection rates remained unchanged over the study period (mean of 9.85 infections per 100 patients), but rates of nosocomial bloodstream infection increased from 0.0% in 1985 to 2.3% in 1995 (P=.05). Nosocomial infection rates were significantly higher on the medical and surgical services than on other services (P<.001). Utilization rates increased significantly for Foley catheters (9.0% to 16.0%, P=.002) and ventilators (5.0% to 8.0%, P=.05).Conclusions:Despite apparent increases in the severity of illness of our patients, overall rates of nosocomial infection remained stable during a decade of study. Rates of nosocomial bloodstream infection increased, in parallel with National Nosocomial Infection Surveillance System data. We found repeated prevalence surveys to be useful in following trends and rates of infection, device utilization, and abnormal laboratory values among patients at our institution. Such methodologies can be valuable and low-cost components of a comprehensive infection surveillance, prevention, and control program and other potential quality-improvement initiatives, because they enable better annual planning of departmental strategies to meet hospital needs

scholarly journals Epidemiology, clinical relevance and prognosis of staphylococci in hospital-acquired postoperative intra-abdominal infections: an observational study in intensive care unit

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kévin Boussion ◽  
Nathalie Zappella ◽  
Nathalie Grall ◽  
Lara Ribeiro-Parenti ◽  
Grégory Papin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
University Hospital ◽  
Coagulase Negative Staphylococci ◽  
One Year ◽  
Abdominal Infections ◽  
Hospital Acquired

AbstractThe pathogenic role of staphylococci in hospital-acquired postoperative intra-abdominal infections (HAIs) has never been evaluated. In a tertiary care university hospital, we assessed the clinical characteristics and outcomes of patients admitted to the intensive care unit for HAIs according to the presence of staphylococci (S-HAI) or their absence (nS-HAI) in peritoneal cultures. Patients with S-HAIs were compared to nS-HAIs patients. Overall, 380 patients were analyzed, including 87 (23%) S-HAI patients [29 Staphylococcus aureus (Sa-HAIs) and 58 coagulase-negative staphylococci (CoNS-HAIs)]. The clinical characteristics did not differ between the S-HAI and nS-HAI patients. Adequacy of empirical anti-infective therapy was achieved less frequently in the staphylococci group (54 vs 72%, respectively, p < 0.01). The 90-day (primary endpoint) and one-year mortality rates did not differ between these groups. The S-HAI patients had decreased rates of postoperative complication (p < 0.05). The adjusted analysis of the clinical outcomes reported a decreased frequency of surgical complications in the staphylococci group (OR 0.43, 95% CI [0.20–0.93], p = 0.03). While the trends toward decreased morbidity criteria were observed in S-HAI patients, the clinical outcomes were not different between the CoNS-HAI and Sa-HAI patients. In summary, our data are not substantial enough to conclude that staphylococci exhibit no pathogenicity in HAIs.

scholarly journals Exploration of epidemiologic profile and strategic prevention framework for surgical site infection rates in a tertiary care hospital of Bhopal city

2018 ◽  
Vol 5 (2) ◽  
pp. 784
Author(s):  
Vidit Goyal ◽  
Rituja Kaushal
Keyword(s):  
Surgical Site Infection ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Care Hospital ◽  
Site Infection ◽  
Infection Rates ◽  
Routine Surveillance ◽  
Epidemiologic Profile ◽  
Hospital Acquired

Background: Post-operative surgical site infections are deadlock for any successful surgery. This exigency triggers draining of extra resources for management of the quagmire. Methods: This prospective direct surveillance study based on incidence design was undertaken to gauge and estimate the nature of propensity of various surgical site infections in a tertiary care hospital over a period of twelve months. Results: Calculated cumulative SSI rate for the year 2016 was found to be 4.32%. Conclusions: It was concluded that a multidisciplinary approach integrating periodic training sessions on infection control, checklists based routine surveillance & following some benchmark etc. are the linchpin in controlling hospital acquired infections including surgical site infection rates in any clinical setting.

The epidemiology of, and risk factors for, mortality from severe sepsis and septic shock in a tertiary-care university hospital setting

2009 ◽  
Vol 137 (9) ◽  
pp. 1333-1341 ◽  
Author(s):  
B. KHWANNIMIT ◽  
R. BHURAYANONTACHAI
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Hospital Mortality ◽  
Tertiary Care ◽  
Hospital Setting ◽  
University Hospital ◽  
Apache Ii Score ◽  
Sepsis And Septic Shock ◽  
Hospital Acquired

SUMMARYThis study investigated the clinical characteristics of, and outcomes and risk factors for hospital mortality of 390 patients admitted with severe sepsis or septic shock in an intensive care unit (ICU). Prospectively collected data from patients collected between 1 July 2004 and 30 June 2006 were analysed. Overall hospital mortality was 49·7% and comorbidities were found in 40·3% of patients, the most common of which was haematological malignancy. The respiratory tract was the most common site of infection (50%). Hospital-acquired infections accounted for 55·6% of patients with Gram-negative bacteria predominant (68%). Multivariate analysis showed that acute respiratory distress syndrome, pulmonary artery catheter placement, comorbidities, hospital-acquired infection, APACHE II score and maximum LOD score, were independent risk factors for hospital mortality. In conclusion, severe sepsis and septic shock are common causes of ICU admission. Patients with risk factors for increased mortality should be carefully monitored and aggressive treatment administered.

Prevalence of Hospital-Acquired Infections During Successive Surveillance Surveys Conducted at a University Hospital in The Netherlands

2007 ◽  
Vol 28 (4) ◽  
pp. 459-465 ◽  
Author(s):  
T. E. M. Hopmans ◽  
H. E. M. Blok ◽  
A. Troelstra ◽  
M. J. M. Bonten
Keyword(s):  
University Hospital ◽  
Infection Rates ◽  
Total Cost ◽  
Surgical Department ◽  
Hospital Acquired Infections ◽  
Orthopedic Procedure ◽  
High Prevalence ◽  
Cheap Method ◽  
Control And Prevention ◽  
Hospital Acquired

Objective.To monitor hospital-wide trends in the prevalence of hospital-acquired infections (HAIs) in order to identify areas where the risk of infection is increasing.Methods.Successive surveillance surveys were conducted twice yearly, from November 2001 until May 2004, to determine the prevalence of HAIs at 2 Dutch hospitals, using Centers for Disease Control and Prevention criteria.Results.In all, 340 HAIs were observed in 295 (11.1%) of 2,661 patients surveyed. The overall prevalence per survey varied from 10.2% to 15.6%, with no significant differences between successive surveys. In the surgical department, the prevalence of HAIs increased from 10.8 cases per 100 surgeries in November 2001 to 20.4 cases per 100 surgeries in May 2002. Further analysis revealed a high prevalence of surgical site infection among patients who had an orthopedic procedure performed. In the neurology-neurosurgery department, the prevalence increased from 13.0 cases per 100 patients in May 2002 to 26.6 cases per 100 patients in May 2003 and involved several types of infection. Further analysis retrieved exceptionally high incidences of infections associated with cerebrospinal fluid drainage. Specific infection control interventions were developed and implemented in both departments. The total cost of the surveys was estimated to be €9,100 per year.Conclusion.Successive performance of surveillance surveys is a simple and cheap method to monitor the prevalence of infection throughout the hospital and appeared instrumental in identifying 2 departments with increased infection rates.

scholarly journals Frequency of Thrombocytopenia in Neonates Following Phototherapy in Neonatology Unit of Tertiary Care Hospital

2021 ◽  
pp. 252-257
Author(s):  
Hina Naqvi ◽  
Shazia Memon ◽  
Mushtaque Ali Shah ◽  
Muhammad Nadeem Chohan ◽  
Numra Shaikh ◽  
...  
Keyword(s):  
Platelet Count ◽  
Complete Blood Count ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Total Serum ◽  
Care Hospital ◽  
Baseline Platelet Count ◽  
Paediatric Department ◽  
Neonatal Ward

Aim: To determine the frequency of thrombocytopenia and its severity in relation to level of indirect hyperbilirubinemia in neonates following phototherapy at tertiary care hospital. Study Design: Descriptive study Place and duration:  This study was conducted at Paediatric department (neonatal ward), Liaquat University Hospital, Hyderabad, from 1st August 2020 till 31st Jan 2021 Methodology: All neonates who fulfilled the inclusion criteria presented at pediatric department (neonatal ward), Liaquat University Hospital Hyderabad were included in the study. After written consent, brief history was taken from the mother or family member and complete blood count (CBC) was sent to check the baseline platelet count along with total serum bilirubin, it was repeated after 48 hours of phototherapy. Results: Out of 231 neonates 70 (30.3%) developed thrombocytopenia after phototherapy. In our study 117 neonates (50.6%) were males & 114 neonates (49.4%) were females with the mean age of 5.9307+1.6640 days. The thrombocytopenia was seen in 70 neonates (30.3%) and type of severity was mild, moderate & severe in 52(22.5%), 13(5.6%) & 5(2.2%) respectively. Conclusion: There was a decline in mean platelet count after phototherapy but it was not statistically significant. The treating doctor should also keep in mind, other causes of thrombocytopenia when the patient is receiving phototherapy.

scholarly journals Extensively drug-resistant Acinetobacter baumannii isolated in a university hospital: Role of inter-hospital transmission

2016 ◽  
Vol 10 (01) ◽  
pp. 96-99 ◽  
Author(s):  
Gonzalo Rivera ◽  
Juan Bulnes ◽  
Claudia Castillo ◽  
Maria Cristina Ajenjo ◽  
Patricia Garcia ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Median Time ◽  
Positive Culture ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Clinical Ward ◽  
Hospital Acquired ◽  
Hospital Transmission

Introduction: Acinetobacter baumannii causes severe infections that primarily affect intensive care unit (ICU) patients. It has a high prevalence of multidrug resistance, including carbapenems, and a high potential for intra-hospital and inter-hospital transmission. The aim of this study was to determine the origin of extensively drug-resistant (XDR) A. baumannii isolates in our hospital during 2009. Methodology: This was an observational retrospective study. Isolates of A. baumannii were obtained from patients hospitalized during 2009. XDR isolates were defined using criteria published by Magiorakos et al.. The isolates were classified as community acquired, hospital acquired, and inter-hospital transmission. Results: A total of 48 isolates of A. baumannii were isolated during 2009, corresponding to 34 patients. Of these, 18 (53%) were susceptible, 6 (18%) were multidrug resistant (MDR), and 10 (29%) were XDR. Of the 10 XDR isolates, 9 were isolated from patients transferred from other hospitals. The median time of hospitalization in origin hospitals was 17 days, while the median time of hospitalization in the study hospital, previous to isolation of A. baumannii, was 1 day. A total of 6 out of 10 patients had a positive culture taken on the day of admission. None of the patients shared a clinical ward or time during hospitalization. Genotypic characterization demonstrated the existence of two clones (A and B) which were geographically associated with patients transferred from two different regions of the country. Conclusions: During 2009, all XDR A. baumannii isolates were recovered from patients coming from other hospitals, indicative of inter-hospital transmission.

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