Patients as Patches: Ecology and Epidemiology in Healthcare Environments

2016 ◽  
Vol 37 (12) ◽  
pp. 1507-1512 ◽  
Author(s):  
Eric T. Lofgren ◽  
Andrea M. Egizi ◽  
Nina H. Fefferman
Keyword(s):  
Built Environment ◽  
Infectious Diseases ◽  
Ecosystem Management ◽  
Healthcare Associated Infections ◽  
Complex Interactions ◽  
Microbial Ecosystems ◽  
Infection Surveillance ◽  
Healthcare Environments ◽  
Healthcare Associated ◽  
And Control

The modern healthcare system involves complex interactions among microbes, patients, providers, and the built environment. It represents a unique and challenging setting for control of the emergence and spread of infectious diseases. We examine an extension of the perspectives and methods from ecology (and especially urban ecology) to address these unique issues, and we outline 3 examples: (1) viewing patients as individual microbial ecosystems; (2) the altered ecology of infectious diseases specifically within hospitals; and (3) ecosystem management perspectives for infection surveillance and control. In each of these cases, we explore the accuracy and relevance of analogies to existing urban ecological perspectives, and we demonstrate a few of the potential direct uses of this perspective for altering research into the control of healthcare-associated infections.Infect Control Hosp Epidemiol. 2016;1507–1512

Surveillance for Healthcare associated Infections in Indian NICUs: Researchable Issues

2009 ◽  
Vol 23 (4) ◽  
pp. 331-336
Author(s):  
Ashwani Kumar ◽  
Praveen Kumar
Keyword(s):  
Developed Countries ◽  
Control Measures ◽  
Surveillance Systems ◽  
Healthcare Associated Infections ◽  
Infection Control Measures ◽  
Infection Surveillance ◽  
Healthcare Associated ◽  
Symptoms And Signs ◽  
Local Research ◽  
Underlying Risk

Systematic surveillance is the first and integral step of all infection control measures, especially in intensive care settings. Surveillance systems started evolving in developed countries nearly 40 years ago. With experience and wisdom gained, the surveillance methods have improved and become more standardized. It is now clearly recognized that all patients are not at equal risk. For fair comparisons over time within an unit and in between units, the denominator must take the underlying risk into account. Infection surveillance in the NICU presents a number of unique challenges regarding definitions and differing symptoms and signs in the neonate. Although the importance of surveillance is being increasingly recognized in our country and the methods of developed countries are being adopted, there are numerous issues which need local research. This is in view of the limited manpower and financial resources and different profile of organisms and their epidemiology.

Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study

2021 ◽  
pp. 175717742110358
Author(s):  
Sailesh Kumar Shrestha ◽  
Swarup Shrestha ◽  
Sisham Ingnam
Keyword(s):  
Prevention And Control ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Healthcare Associated ◽  
And Control

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

scholarly journals Hybrid Simulation for Modeling Healthcare-associated Infections: Promising But Challenging

2020 ◽  
Author(s):  
Le Khanh Ngan Nguyen ◽  
Itamar Megiddo ◽  
Susan Howick
Keyword(s):  
Hybrid Simulation ◽  
Public Health Problem ◽  
Simulation Models ◽  
Hybrid Models ◽  
Major Public Health Problem ◽  
Healthcare Associated Infections ◽  
Simulation Performance ◽  
Systems Simulation ◽  
Healthcare Associated ◽  
And Control

Abstract Healthcare-associated infections (HAIs) are a major public health problem as they pose a serious risk for patients and providers, increasing morbidity, mortality, and length of stay, as well as costs to patients and the health system. Prevention and control of HAIs has, therefore, become a priority for most healthcare systems. Systems simulation models have provided insights into the dynamics of HAIs and help to evaluate the effect of infection control interventions. However, as each systems simulation modeling method has strengths and limitations, combining these methods in hybrid models can offer a better tool to gain complementary views on, and deeper insights into HAIs. Hybrid models can, therefore, assist decision-making at different levels of management, and provide a balance between simulation performance and result accuracy. This report discusses these benefits in more depth but also highlights some challenges associated with the use of hybrid simulation models for modeling HAIs.

scholarly journals Strengthening infection prevention and control and systematic surveillance of healthcare associated infections in India

BMJ ◽  
2017 ◽  
pp. j3768 ◽  
Author(s):  
Soumya Swaminathan ◽  
Jagdish Prasad ◽  
Akshay C Dhariwal ◽  
Randeep Guleria ◽  
Mahesh C Misra ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
And Control

scholarly journals The prevalence of and risk factors for healthcare-associated infections in Slovenia: results of the second national survey

2016 ◽  
Vol 55 (4) ◽  
pp. 239-247 ◽  
Author(s):  
Irena Klavs ◽  
Jana Kolman ◽  
Tatjana Lejko Zupanc ◽  
Božena Kotnik Kevorkijan ◽  
Aleš Korošec ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Prevention And Control ◽  
Acute Care Hospitals ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Tract Infections ◽  
Healthcare Associated ◽  
And Control

Abstract Introduction In the second Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute-care hospitals, we estimated the prevalence of all types of HAIs and identified risk factors. Methods Patients from acute-care hospitals were enrolled into a one-day cross-sectional study in October 2011. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors. Results Among 5628 patients, 3.8% had at least one HAI and additional 2.6% were still being treated for HAIs on the day of the survey; the prevalence of HAIs was 6.4%. The prevalence of urinary tract infections was the highest (1.4%), followed by pneumoniae (1.3%) and surgical site infections (1.2%). In intensive care units (ICUs), the prevalence of patients with at least one HAI was 35.7%. Risk factors for HAIs included central vascular catheter (adjusted odds ratio (aOR) 4.0; 95% confidence intervals (CI): 2.9-5.7), peripheral vascular catheter (aOR 2.0; 95% CI: 1.5-2.6), intubation (aOR 2.3; 95% CI: 1.4-3.5) and rapidly fatal underlying condition (aOR 2.1; 95% CI: 1.4-3.3). Conclusions The prevalence of HAIs in Slovenian acute-care hospitals in 2011 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.

scholarly journals Burden of Healthcare-Associated Infections in Italy: Disability-Adjusted Life Years

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Bordino ◽  
C Vicentini ◽  
A D'Ambrosio ◽  
F Quattrocolo ◽  
C M Zotti
Keyword(s):  
Prevention And Control ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Significant Burden ◽  
Tract Infections ◽  
Healthcare Associated ◽  
And Control

Abstract Background Healthcare-Associated Infections (HAIs) significantly increase adverse clinical outcomes and healthcare costs. In 2016 Italy participated in the second European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey (PPS) of HAIs and antimicrobial use in acute care hospitals. The aim of this study was to estimate the burden of the 5 most common HAIs in Italy, by evaluating incidence, attributable deaths, Years of Life Lost (YLL), Years Lived with Disability (YLD) and Disability-Adjusted Life-Years (DALYs). Methods National PPS data were used to establish sex- and age-specific incidence of Healthcare-associated Pneumonia (HAP), HA Urinary tract infections (HA UTI), HA Bloodstream Infections (HA BSI) excluding neonatal BSI, Surgical Site Infections (SSI), HA Clostridium Difficile infections (HA CDI). Patients' life expectancy was adjusted according to the severity of underlying conditions using the McCabe score. Following the methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project, an adapted version of the disease models of the BCoDE toolkit was used. Results An overall yearly incidence of 643434 new cases of HAI in Italy was estimated. The aggregate burden of the 5 HAIs was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL), corresponding to 702.53 DALYs per 100000 total population. HA BSI and HAP had the highest burden with respectively 253868.22? and 126038.26 DALYs. The population strata with the highest burden were the ones with McCabe Score 1 for every considered HAI. The age groups with the highest burden were 70-74 for male and 45-49 for female patients. In total, 56% of DALYs were attributable to men and 44% to women. Conclusions This nation-wide study found a significant burden of disease due to HAIs in Italy. Results of this study could be used to guide policy-makers in the implementation of measures aiming to reduce the impact of HAIs. Key messages This study estimated the burden of 5 HAIs in Italy was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL according to 2016 PPS data. Considering the significant burden of HAIs found in this study, infection prevention and control measures should be a Public Health priority in Italy.

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