scholarly journals Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric

2015 ◽  
Vol 36 (12) ◽  
pp. 1379-1384 ◽  
Author(s):  
Minn M. Soe ◽  
Carolyn V. Gould ◽  
Daniel Pollock ◽  
Jonathan Edwards
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Healthcare Associated Infections ◽  
Healthcare Facilities ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Infection Reduction ◽  
Tract Infections ◽  
Healthcare Associated

OBJECTIVETo develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved.SETTINGAcute care hospitals that report HAI data to the Centers for Disease Control and Prevention’s National Healthcare Safety Network.METHODSThe cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order.RESULTSOf 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal.CONCLUSIONThe CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal.Infect. Control Hosp. Epidemiol. 2015;36(12):1379–1384

Infections in Australian Aged-Care Facilities: Evaluating the Impact of Revised McGeer Criteria for Surveillance of Urinary Tract Infections

2016 ◽  
Vol 37 (5) ◽  
pp. 610-612 ◽  
Author(s):  
Noleen J. Bennett ◽  
Sandra A. Johnson ◽  
Michael J. Richards ◽  
Mary A. Smith ◽  
Leon J. Worth
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Aged Care ◽  
Infect Control Hosp ◽  
Healthcare Associated Infections ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Our survey of 112 Australian aged-care facilities demonstrated the prevalence of healthcare-associated infections to be 2.9%. Urinary tract infections (UTIs) defined by McGeer criteria comprised 35% of all clinically defined UTIs. To estimate the infection burden in these facilities where microbiologic testing is not routine, modified surveillance criteria for UTIs are necessary.Infect Control Hosp Epidemiol 2016;37:610–612

scholarly journals Catheter-Associated Urinary Tract Infections in Adults: Diagnosis, Treatment, and Prevention

2019 ◽  
Vol 15 (9) ◽  
pp. 552-556 ◽  
Author(s):  
Karen Clarke ◽  
Casey L Hall ◽  
Zanthia Wiley ◽  
Sheri Chernetsky Tejedor ◽  
James S Kim ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Patient Outcomes ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Financial Impact ◽  
Healthcare Associated Infections ◽  
Incentive Program ◽  
Treatment And Prevention ◽  
Tract Infections ◽  
Healthcare Associated

Urinary tract infections (UTIs) are among the most common healthcare-associated infections, and 70%-80% are catheter-associated urinary tract infections (CAUTIs). About 25% of hospitalized patients have an indwelling urinary catheter placed during their hospital stay, and therefore, are at risk for CAUTIs which have been associated with worse patient outcomes. Additionally, hospitals face a significant financial impact since the Centers for Medicare and Medicaid Services incentive program penalizes hospitals with higher than expected CAUTIs. Hospitalists care for many patients with indwelling urinary catheters and should be aware of and engage in processes that reduce the rate of CAUTIs. This article will discuss the diagnosis, treatment, and prevention of CAUTIs in adults.

scholarly journals Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017

2019 ◽  
Vol 41 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Sheila Abner ◽  
Jonathan R. Edwards ◽  
Alexander J. Kallen ◽  
Maria Karlsson ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Healthcare Associated Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Location Type

AbstractObjective:Describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) that occurred during 2015–2017 and were reported to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN).Methods:Data from central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and surgical site infections (SSIs) were reported from acute-care hospitals, long-term acute-care hospitals, and inpatient rehabilitation facilities. This analysis included device-associated HAIs reported from adult location types, and SSIs among patients ≥18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated for each HAI type, location type, surgical category, and surgical wound closure technique.Results:Overall, 5,626 facilities performed adult HAI surveillance during this period, most of which were general acute-care hospitals with <200 beds. Escherichia coli (18%), Staphylococcus aureus (12%), and Klebsiella spp (9%) were the 3 most frequently reported pathogens. Pathogens varied by HAI and location type, with oncology units having a distinct pathogen distribution compared to other settings. The %NS for most pathogens was significantly higher among device-associated HAIs than SSIs. In addition, pathogens from long-term acute-care hospitals had a significantly higher %NS than those from general hospital wards.Conclusions:This report provides an updated national summary of pathogen distributions and antimicrobial resistance among select HAIs and pathogens, stratified by several factors. These data underscore the importance of tracking antimicrobial resistance, particularly in vulnerable populations such as long-term acute-care hospitals and intensive care units.

scholarly journals Antimicrobial-resistant pathogens associated with pediatric healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017

2019 ◽  
Vol 41 (1) ◽  
pp. 19-30 ◽  
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Sheila Abner ◽  
Andrea L. Benin ◽  
Jonathan R. Edwards ◽  
Alexander J. Kallen ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Pediatric Patients ◽  
Healthcare Associated Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Location Type ◽  
Pediatric Healthcare

AbstractObjective:To describe common pathogens and antimicrobial resistance patterns for healthcare-associated infections (HAIs) among pediatric patients that occurred in 2015–2017 and were reported to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN).Methods:Antimicrobial resistance data were analyzed for pathogens implicated in central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated pneumonias (VAPs), and surgical site infections (SSIs). This analysis was restricted to device-associated HAIs reported from pediatric patient care locations and SSIs among patients <18 years old. Percentages of pathogens with nonsusceptibility (%NS) to selected antimicrobials were calculated by HAI type, location type, and surgical category.Results:Overall, 2,545 facilities performed surveillance of pediatric HAIs in the NHSN during this period. Staphylococcus aureus (15%), Escherichia coli (12%), and coagulase-negative staphylococci (12%) were the 3 most commonly reported pathogens associated with pediatric HAIs. Pathogens and the %NS varied by HAI type, location type, and/or surgical category. Among CLABSIs, the %NS was generally lowest in neonatal intensive care units and highest in pediatric oncology units. Staphylococcus spp were particularly common among orthopedic, neurosurgical, and cardiac SSIs; however, E. coli was more common in abdominal SSIs. Overall, antimicrobial nonsusceptibility was less prevalent in pediatric HAIs than in adult HAIs.Conclusion:This report provides an updated national summary of pathogen distributions and antimicrobial resistance patterns among pediatric HAIs. These data highlight the need for continued antimicrobial resistance tracking among pediatric patients and should encourage the pediatric healthcare community to use such data when establishing policies for infection prevention and antimicrobial stewardship.

scholarly journals Pathogen Distribution and Antimicrobial Resistance Among Pediatric Healthcare-Associated Infections Reported to the National Healthcare Safety Network, 2011–2014

2017 ◽  
Vol 39 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Jason G. Lake ◽  
Lindsey M. Weiner ◽  
Aaron M. Milstone ◽  
Lisa Saiman ◽  
Shelley S. Magill ◽  
...  
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Intensive Care Units ◽  
Healthcare Associated Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Resistance Data

OBJECTIVETo describe pathogen distribution and antimicrobial resistance patterns for healthcare-associated infections (HAIs) reported to the National Healthcare Safety Network (NHSN) from pediatric locations during 2011–2014.METHODSDevice-associated infection data were analyzed for central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI). Pooled mean percentage resistance was calculated for a variety of pathogen-antimicrobial resistance pattern combinations and was stratified by location for device-associated infections (neonatal intensive care units [NICUs], pediatric intensive care units [PICUs], pediatric oncology and pediatric wards) and by surgery type for SSIs.RESULTSFrom 2011 to 2014, 1,003 hospitals reported 20,390 pediatric HAIs and 22,323 associated pathogens to the NHSN. Among all HAIs, the following pathogens accounted for more than 60% of those reported: Staphylococcus aureus (17%), coagulase-negative staphylococci (17%), Escherichia coli (11%), Klebsiella pneumoniae and/or oxytoca (9%), and Enterococcus faecalis (8%). Among device-associated infections, resistance was generally lower in NICUs than in other locations. For several pathogens, resistance was greater in pediatric wards than in PICUs. The proportion of organisms resistant to carbapenems was low overall but reached approximately 20% for Pseudomonas aeruginosa from CLABSIs and CAUTIs in some locations. Among SSIs, antimicrobial resistance patterns were similar across surgical procedure types for most pathogens.CONCLUSIONThis report is the first pediatric-specific description of antimicrobial resistance data reported to the NHSN. Reporting of pediatric-specific HAIs and antimicrobial resistance data will help identify priority targets for infection control and antimicrobial stewardship activities in facilities that provide care for children.Infect Control Hosp Epidemiol 2018;39:1–11

Association of National Healthcare Safety Network–Defined Catheter-Associated Urinary Tract Infections With Alternate Sources of Fever

2015 ◽  
Vol 36 (10) ◽  
pp. 1236-1238 ◽  
Author(s):  
Surbhi Leekha ◽  
Michael Anne Preas ◽  
Joan Hebden
Keyword(s):  
Urinary Tract ◽  
Annual Meeting ◽  
Urinary Tract Infections ◽  
Infect Control Hosp ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Epidemiology

Presented in part: 20th Annual Meeting of the Society for Healthcare Epidemiology of America; Dallas, Texas; April 1–4, 2011.Infect Control Hosp Epidemiol 2015;36(10):1236–1238

Strategies to Prevent Catheter-Associated Urinary Tract Infections in Acute Care Hospitals

2008 ◽  
Vol 29 (S1) ◽  
pp. S41-S50 ◽  
Author(s):  
Evelyn Lo ◽  
Lindsay Nicolle ◽  
David Classen ◽  
Kathleen M. Arias ◽  
Kelly Podgorny ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Acute Care ◽  
Urinary Catheter ◽  
Acute Care Hospitals ◽  
Urethral Catheter ◽  
Healthcare Associated Infections ◽  
Tract Infections ◽  
Healthcare Associated

Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their catheter-associated urinary tract infection (CAUTI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.1. Burden of CAUTIsa. Urinary tract infection is the most common hospital-acquired infection; 80% of these infections are attributable to an indwelling urethral catheter.b. Twelve to sixteen percent of hospital inpatients will have a urinary catheter at some time during their hospital stay.c. The daily risk of acquisition of urinary infection varies from 3% to 7% when an indwelling urethral catheter remains in situ.2. Outcomes associated with CAUTIa. Urinary tract infection is the most important adverse outcome of urinary catheter use. Bacteremia and sepsis may occur in a small proportion of infected patients.b. Morbidity attributable to any single episode of catheterization is limited, but the high frequency of catheter use in hospitalized patients means that the cumulative burden of CAUTI is substantial.c. Catheter use is also associated with negative outcomes other than infection, including nonbacterial urethral inflammation, urethral strictures, and mechanical trauma.

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