scholarly journals The Impact of COVID-19 Response on Central Line Associated Bloodstream Infections and Blood Culture Contamination Rates at a Tertiary Care Center in Greater Detroit Area

2020 ◽  
pp. 1-15
Author(s):  
Jennifer LeRose ◽  
Avnish Sandhu ◽  
Jordan Polistico ◽  
Joe Ellsworth ◽  
Mara Cranis ◽  
...  
Keyword(s):  
Blood Culture ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Central Line ◽  
Tertiary Care Center ◽  
Blood Stream Infections ◽  
Detroit Area ◽  
The Impact

Abstract A comparative retrospective study to quantify the impact of Coronavirus Disease 2019 (COVID-19) on patient safety. We found a statistically significant increase in central line-associated blood stream infections and blood culture contamination rates during the pandemic. Increased length of stay and mortality was also observed during COVID-19.

Insertion site inflammation was associated with central-line–associated bloodstream infections at a tertiary-care center, 2015–2018

2020 ◽  
pp. 1-3
Author(s):  
Takaaki Kobayashi ◽  
Gosia S. Clore ◽  
Mary E. Kukla ◽  
Mohammed Alzunitan ◽  
Jeffrey Kritzman ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Insertion Site ◽  
Bloodstream Infections ◽  
Central Line ◽  
Tertiary Care Center ◽  
Central Line Insertion ◽  
Line Insertion ◽  
Automated Surveillance ◽  
Site Evaluation

Abstract There are currently no guidelines for central-line insertion site evaluation. Our study revealed an association between insertion site inflammation (ISI) and the development of central-line–associated bloodstream infections (CLABSIs). Automated surveillance for ISI is feasible and could help prevent CLABSI.

A Cluster of Central Line–Associated Bloodstream Infections Due to Rapidly Growing Nontuberculous Mycobacteria in Patients with Hematologic Disorders at a Japanese Tertiary Care Center: An Outbreak Investigation and Review of the Literature

2015 ◽  
Vol 36 (1) ◽  
pp. 76-80 ◽  
Author(s):  
Yasuaki Tagashira ◽  
Yasuji Kozai ◽  
Hitomi Yamasa ◽  
Masako Sakurada ◽  
Tetsuya Kashiyama ◽  
...  
Keyword(s):  
Water Supply ◽  
Bloodstream Infection ◽  
Nontuberculous Mycobacteria ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Catheter Removal ◽  
Tertiary Care Center ◽  
Oncology Ward

BACKGROUNDRapidly growing nontuberculous mycobacteria (RGM) are considered rare pathogens, causing central line–associated bloodstream infection. We identified an outbreak of central line–associated bloodstream infection due to RGM at a hematology-oncology ward during a 5-month period.DESIGNOutbreak investigation and literature review.SETTINGA Japanese tertiary care center.PATIENTSAdults who were hospitalized at the hematology-oncology ward from October 15, 2011, through February 17, 2012.RESULTSA total of 5 patients with a bloodstream infection due to RGM (4 cases ofMycobacterium mucogenicumand 1 case ofMycobacterium canariasenseinfection) were identified; of these, 3 patients had acute myeloid leukemia, 1 had acute lymphocytic leukemia, and 1 had aplastic anemia. Four of the 5 patients received cord blood transplantation prior to developing the bloodstream infection. All central venous catheters in patients with a bloodstream infection were removed. These patients promptly defervesced after catheter removal and their care was successfully managed without antimicrobial therapy. Surveillance cultures from the environment and water detectedM. mucogenicumandM. canariasensein the water supply of the hematology-oncology ward. The isolates from the bloodstream infection and water sources were identical on the basis of 16S-rRNA gene sequencing.CONCLUSIONSThe source of RGM in the outbreak of bloodstream infections likely was the ward tap water supply. Awareness of catheter-related bloodstream infections due to nontuberculous mycobacteria should be emphasized, especially where immunocompromised patients are at risk. Also, using antimicrobials after catheter removal to treat central line–associated bloodstream infection due to RGM may not be necessary.Infect Control Hosp Epidemiol 2015;36(1): 76–80

scholarly journals Impact of Rapid PCR Influenza Testing on the Rate of Inpatient Admissions During Influenza Season at a Tertiary-Care Center

2020 ◽  
Vol 41 (S1) ◽  
pp. s263-s264
Author(s):  
Jordan Polistico ◽  
Avnish Sandhu ◽  
Teena Chopra ◽  
Erin Goldman ◽  
Jennifer LeRose ◽  
...  
Keyword(s):  
Influenza Season ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Turnaround Time ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Pediatric Hospital ◽  
Rapid Pcr ◽  
The Impact

Background: Influenza causes a high burden of disease in the United States, with an estimate of 960,000 hospitalizations in the 2017–2018 flu season. Traditional flu diagnostic polymerase chain reaction (PCR) tests have a longer (24 hours or more) turnaround time that may lead to an increase in unnecessary inpatient admissions during peak influenza season. A new point-of-care rapid PCR assays, Xpert Flu, is an FDA-approved PCR test that has a significant decrease in turnaround time (2 hours). The present study sought to understand the impact of implementing a new Xpert Flu test on the rate of inpatient admissions. Methods: A retrospective study was conducted to compare rates of inpatient admissions in patients tested with traditional flu PCR during the 2017–2018 flu season and the rapid flu PCR during the 2018–2019 flu season in a tertiary-care center in greater Detroit area. The center has 1 pediatric hospital (hospital A) and 3 adult hospitals (hospital B, C, D). Patients with influenza-like illness who presented to all 4 hospitals during 2 consecutive influenza seasons were analyzed. Results: In total, 20,923 patients were tested with either the rapid flu PCR or the traditional flu PCR. Among these, 14,124 patients (67.2%) were discharged from the emergency department and 6,844 (32.7%) were admitted. There was a significant decrease in inpatient admissions in the traditional flu PCR group compared to the rapid flu PCR group across all hospitals (49.56% vs 26.6% respectively; P < .001). As expected, a significant proportion of influenza testing was performed in the pediatric hospital, 10,513 (50.2%). A greater reduction (30% decrease in the rapid flu PCR group compared to the traditional flu PCR group) was observed in inpatient admissions in the pediatric hospital (Table 1) Conclusions: Rapid molecular influenza testing can significantly decrease inpatient admissions in a busy tertiary-care hospital, which can indirectly lead to improved patient quality with easy bed availability and less time spent in a private room with droplet precautions. Last but not the least, this testing method can certainly lead to lower healthcare costs.Funding: NoneDisclosures: None

scholarly journals Effect of Removing Contact Precautions for Multidrug-Resistant Organisms on Hospital Infections in a Pediatric Health System

2020 ◽  
Vol 41 (S1) ◽  
pp. s199-s200
Author(s):  
Matthew Linam ◽  
Dorian Hoskins ◽  
Preeti Jaggi ◽  
Mark Gonzalez ◽  
Renee Watson ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Contact Precautions ◽  
Stewardship Program ◽  
Tract Infections ◽  
The Impact

Background: Discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) have failed to show an increase in associated transmission or infections in adult healthcare settings. Pediatric experience is limited. Objective: We evaluated the impact of discontinuing contact precautions for MRSA, VRE, and extended-spectrum β-lactamase–producing gram-negative bacilli (ESBLs) on device-associated healthcare-associated infections (HAIs). Methods: In October 2018, contact precautions were discontinued for children with MRSA, VRE, and ESBLs in a large, tertiary-care pediatric healthcare system comprising 2 hospitals and 620 beds. Coincident interventions that potentially reduced HAIs included blood culture diagnostic stewardship (June 2018), a hand hygiene education initiative (July 2018), a handshake antibiotic stewardship program (December 2018) and multidisciplinary infection prevention rounding in the intensive care units (November 2018). Compliance with hand hygiene and HAI prevention bundles were monitored. Device-associated HAIs were identified using standard definitions. Annotated run charts were used to track the impact of interventions on changes in device-associated HAIs over time. Results: Average hand hygiene compliance was 91%. Compliance with HAI prevention bundles was 81% for ventilator-associated pneumonias, 90% for catheter-associated urinary tract infections, and 97% for central-line–associated bloodstream infections. Overall, device-associated HAIs decreased from 6.04 per 10,000 patient days to 3.25 per 10,000 patient days after October 2018 (Fig. 1). Prior to October 2018, MRSA, VRE and ESBLs accounted for 10% of device-associated HAIs. This rate decreased to 5% after October 2018. The decrease in HAIs was likely related to interventions such as infection prevention rounds and handshake stewardship. Conclusions: Discontinuation of contact precautions for children with MRSA, VRE, and ESBLs were not associated with increased device-associated HAIs, and such discontinuation is likely safe in the setting of robust infection prevention and antibiotic stewardship programs.Funding: NoneDisclosures: None

scholarly journals 409. Changing Epidemiology of Fungal Bloodstream Infections in a Tertiary Care Center in India

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S156-S157
Author(s):  
Vidya Menon ◽  
Binny P P ◽  
Fabia E T ◽  
Sanjeev Singh ◽  
Keith S Kaye ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Tertiary Care Center

scholarly journals Central line replacement following infection does not improve reinfection rates in pediatric pulmonary hypertension patients receiving intravenous prostanoid therapy

2018 ◽  
Vol 8 (1) ◽  
pp. 204589321875488 ◽  
Author(s):  
Elisa K. McCarthy ◽  
Michelle T. Ogawa ◽  
Rachel K. Hopper ◽  
Jeffrey A. Feinstein ◽  
Hayley A. Gans
Keyword(s):  
Pulmonary Hypertension ◽  
Care Center ◽  
Tertiary Care ◽  
Management Strategies ◽  
Blood Stream ◽  
Central Line ◽  
Infectious Complications ◽  
Infection Rates ◽  
Significant Difference ◽  
Line Management

Treatment of pediatric pulmonary hypertension (PH) with IV prostanoids has greatly improved outcomes but requires a central line, posing inherent infection risk. This study examines the types of infections, infection rates, and importantly the effect of line management strategies on reinfection in children receiving IV prostanoids for PH. This study is a retrospective review of all pediatric PH patients receiving intravenous epoprostenol (EPO) or treprostinil (TRE) at one academic tertiary care center between 2000 and 2014. No patients declined participation in the study or were otherwise excluded. Infectious complications were characterized by organism(s), infection rates, time to next infection, and line management decisions (salvage vs. replace). Of the 40 patients followed, 13 sustained 38 infections involving 49 pathogens, with a predominance of gram-positive (GP) organisms (n = 35). The pooled infection rate was 1.06 per 1000 prostanoid days with no difference between EPO and TRE. No significant difference in reinfection rate was observed when comparing line salvage to replacement, regardless of organism type. Both overall and organism-type comparisons suggest longer time between line infections following line salvage compared with line replacement (732 vs. 410 days overall; 793 vs. 363 days for GP; 611 vs. 581 days for gram-negative [GN]; P > 0.05 for all comparisons). Central line replacement following blood stream infections in pediatric PH patients does not improve subsequent infection rates or time to next infection, and may lead to unnecessary risks associated with line replacement, including potential loss of vascular access. A revised approach to central line infections in pediatric PH is proposed.

scholarly journals Chlorhexidine Bathing in a Tertiary Care Neonatal Intensive Care Unit: Impact on Central Line–Associated Bloodstream Infections

2014 ◽  
Vol 35 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Caroline Quach ◽  
Aaron M. Milstone ◽  
Chantal Perpête ◽  
Mario Bonenfant ◽  
Dorothy L. Moore ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Adverse Events ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
The Impact

Background.Despite implementation of recommended best practices, our central line-associated bloodstream infection (CLABSI) rates remained high. Our objective was to describe the impact of chlorhexidine gluconate (CHG) bathing on CLABSI rates in neonates.Methods.Infants with a central venous catheter (CVC) admitted to the neonatal intensive care unit from April 2009 to March 2013 were included. Neonates with a birth weight of 1,000 g or less, aged less than 28 days, and those with a birth weight greater than 1,000 g were bathed with mild soap until March 31, 2012 (baseline), and with a 2% CHG-impregnated cloth starting on April 1, 2012 (intervention). Infants with a birth weight of 1,000 g or less, aged 28 days or more, were bathed with mild soap during the entire period. Neonatal intensive care unit nurses reported adverse events. Adjusted incidence rate ratios (aIRRs), using Poisson regression, were calculated to compare CLABSIs/1,000 CVC-days during the baseline and intervention periods.Results.Overall, 790 neonates with CVCs were included in the study. CLABSI rates decreased during the intervention period for CHG-bathed neonates (6.00 vs 1.92/1,000 CVC-days; aIRR, 0.33 [95% confidence interval (CI), 0.15-0.73]) but remained unchanged for neonates with a birth rate of 1,000 g or less and aged less than 28 days who were not eligible for CHG bathing (8.57 vs 8.62/1,000 CVC-days; aIRR, 0.86 [95% CI, 0.17-4.44]). Overall, 195 infants with a birth weight greater than 1,000 g and 24 infants with a birth weight of 1,000 g or less, aged 28 days or more, were bathed with CHG. There was no reported adverse event.Conclusions.We observed a decrease in CLABSI rates in CHG-bathed neonates in the absence of observed adverse events. CHG bathing should be considered if CLABSI rates remain high, despite the implementation of other recommended measures.

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