scholarly journals Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ines Lakbar ◽  
Sophie Medam ◽  
Romain Ronflé ◽  
Nadim Cassir ◽  
Louis Delamarre ◽  
...  
Keyword(s):  
Intensive Care ◽  
Resistant Bacteria ◽  
Matched Sample ◽  
Healthcare Associated Infection ◽  
Icu Mortality ◽  
Surveillance Network ◽  
Icu Length Of Stay ◽  
Mechanical Ventilation Duration ◽  
Healthcare Associated ◽  
The Relationship

AbstractData on the relationship between antimicrobial resistance and mortality remain scarce, and this relationship needs to be investigated in intensive care units (ICUs). The aim of this study was to compare the ICU mortality rates between patients with ICU-acquired pneumonia due to highly antimicrobial-resistant (HAMR) bacteria and those with ICU-acquired pneumonia due to non-HAMR bacteria. We conducted a multicenter, retrospective cohort study using the French National Surveillance Network for Healthcare Associated Infection in ICUs (“REA-Raisin”) database, gathering data from 200 ICUs from January 2007 to December 2016. We assessed all adult patients who were hospitalized for at least 48 h and presented with ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii. The association between pneumonia caused by HAMR bacteria and ICU mortality was analyzed using the whole sample and using a 1:2 matched sample. Among the 18,497 patients with at least one documented case of ICU-acquired pneumonia caused by S. aureus, Enterobacteriaceae, P. aeruginosa, or A. baumannii, 3081 (16.4%) had HAMR bacteria. The HAMR group was associated with increased ICU mortality (40.3% vs. 30%, odds ratio (OR) 95%, CI 1.57 [1.45–1.70], P < 0.001). This association was confirmed in the matched sample (3006 HAMR and 5640 non-HAMR, OR 95%, CI 1.39 [1.27–1.52], P < 0.001) and after adjusting for confounding factors (OR ranged from 1.34 to 1.39, all P < 0.001). Our findings suggest that ICU-acquired pneumonia due to HAMR bacteria is associated with an increased ICU mortality rate, ICU length of stay, and mechanical ventilation duration.

The Sterility of Reusable Surgical Instruments with Pouches Packaging on One of the Private Hospital in Bandung

2017 ◽  
Vol 8 (2) ◽  
Author(s):  
Kurniawansyah I. S. ◽  
Mita S. R. ◽  
Najla E. ◽  
Nindayani E.
Keyword(s):  
Storage Time ◽  
Private Hospital ◽  
Surgical Instruments ◽  
Healthcare Associated Infection ◽  
Sterility Testing ◽  
Reusable Instruments ◽  
Healthcare Associated ◽  
The Relationship ◽  
Common Infection ◽  
Long Storage

Healthcare associated infection is one of the common infection that happens in Indonesia. One form control to prevent healthcare associated infection is the sterilization process of the materials and medical instruments that used for taking care of patients. At the private hospital whereas a place of research, there’s never been done the study of sterility test for reusable instrument with pouches, based on previous studies showed that 8 sets from 40 sets of reusable instrument with linen were not sterile moreover there were positively influence from the amount of time to the sterility of reusable instrument. The purpose of these studies was to determining the relationship between a long storage time and the sterility of reusable instruments with pouches. The method that used in this study was the sterility testing of reusable instrument with pouches which were stored in a central operations room storage with a long storage time of 1 and 2 months. From 30 reusable instruments with pouches which were stored for nine months there were 5 instruments were not sterile. The results of statistic analysis showed that the amount of storage time not significantly associated to the sterility of reusable instrument with pouches in the operating room central storage space.

Healthcare-Associated Infection in Italy Annual Point-Prevalence Surveys, 2002–2004

2009 ◽  
Vol 30 (7) ◽  
pp. 659-665 ◽  
Author(s):  
Simone Lanini ◽  
William R. Jarvis ◽  
Emanuele Nicastri ◽  
Gaetano Privitera ◽  
Giovanni Gesu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Univariate Analysis ◽  
National Health System ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Point Prevalence ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated

Objective.Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality worldwide. During the period from 2002 through 2004, a group of Italian hospitals was recruited to conduct HAI point-prevalence surveys.Design.Three point-prevalence surveys.Methods.A total of 9,609 patients were surveyed.Results.The overall frequency of HAI was 6.7% (645 infections among the 9,609 surveyed patients). The most frequent HAIs were lower respiratory tract infections, which accounted for 35.8% (231 of 645 HAIs) of all HAIs, followed by urinary tract infections (152 [23.6%] of 645 HAIs), bloodstream infections (90 [14.0%] of 645 HAIs), and surgical site infections (79 [12.2%] of 645 HAIs). In both multivariate and univariate analysis, invasive procedures, duration of stay, chemotherapy, trauma, coma, and the location of the hospital were all factors statistically significantly associated with the occurrence of an HAL Enterobacteriaceae were the most common isolates recovered in medical and surgical wards, whereas gram-negative aerobic bacilli were the most common isolates recovered in intensive care units. Approximately one-half of all of the patients surveyed were receiving antibiotics at the time of our study; the most used antibiotic classes were fluoroquinolones in medical wards, cephalosporins in surgical wards, and penicillins and glycopeptides in intensive care units.Conclusion.Our study emphasizes the need for implementing further HAI surveillance to provide the National Health System with proper tools to prevent and manage infection in hospitalized patients.

scholarly journals Surveillance of healthcare-associated infections in a Tunisian university hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Hannachi ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
S Khefacha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
University Hospital ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Healthcare Associated Infection ◽  
Carbapenem Resistant ◽  
Independent Risk Factors ◽  
Healthcare Associated

Abstract Introduction Healthcare -associated infections has become a worldwide public health problem. The aim of this study was to estimate the incidence of healthcare- associated infections in a university hospital of Tunisia. Methods This was a cohort study conducted in six intensive care units in a university hospital of Tunisia during three months (from august to October 2018). Data was provided from patients’ files. Data entry and analysis was done using SPSS version 22. Multivariate analysis was used in order to identify independent risk factors for healthcare associated infection. Results A total of 202 patients were enrolled in this study. The incidence rate of healthcare-associated infections was 53,96%(109/202). The ratio infection/infected was estimated to 1.65(109/66). The incidence of multi-drug resistant pathogens was 21,28% (43/202). The most common resistant pathogens included pseudomonas aeruginosa resistant to cefdazidime in 13,76%(15/109) followed by those resistant to extended spectrum cephalosporin 11.92% (13/109), followed by carbapenem-resistant acinetobcater baumanii 6,42%(7/109) then by carbapenem resistant pathogens and enterococcus resistant to vancomycin 2.75%(3/109) and finally staphylococcus aureus resistant to methicillin 2.1%(2/1.83). The multivariate analysis showed that long duration of central line catheterisation (RR = 7.44; 95%CI[2.79-19.82]), tracheotomy(RR = 8.61;95%CI[2.09-35,39]) and length of stay (RR = 1.08; 95%CI[1.04-1.13]) were found as independent risk factors for healthcare -associated infection. Conclusions The emergence of mutli-drug resistant pathogens needs to be deeply studied and effective measures have to be taken in order to detect and prevent transmission of resistant strains and/or their resistance determinants, especially those with phenotypes having the fewest viable treatment options. Key messages The incidence of healthcare associated infection in the intensive care unit was high. Effective measures have to be taken in the intensive care unit to detect and prevent transmission of resistant pathogens.

Risk factors for healthcare-associated infection in a pediatric intensive care unit*

2010 ◽  
Vol 11 (2) ◽  
pp. 246-252 ◽  
Author(s):  
Maria Júlia Gonçalves de Mello ◽  
Maria de Fátima Pessoa Militão de Albuquerque ◽  
Heloísa Ramos Lacerda ◽  
Maria Tereza Serrano Barbosa ◽  
Ricardo Arraes de Alencar Ximenes
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

scholarly journals Risk factors for healthcare-associated infection in pediatric intensive care units: a systematic review

2009 ◽  
Vol 25 (suppl 3) ◽  
pp. S373-S391 ◽  
Author(s):  
Maria Júlia Gonçalves de Mello ◽  
Maria de Fátima Pessoa Militão de Albuquerque ◽  
Heloísa Ramos Lacerda ◽  
Wayner Vieira de Souza ◽  
Jailson B. Correia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Intensive Care ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
Healthcare Associated Infection ◽  
Pediatric Intensive Care Units ◽  
Healthcare Associated ◽  
Adequate Design

A systematic review of observational studies on risk factors for healthcare-associated infection in pediatric Intensive Care Units (ICU) was carried out. Studies indexed in MEDLINE, LILACS, Cochrane, BDENF, CAPES databases published in English, French, Spanish or Portuguese between 1987 and 2006 were included and cross references added. Key words for search were "cross infection" and "Pediatric Intensive Care Units" with others sub-terms included. 11 studies were selected from 419 originally found: four studies had healthcare-associated infection as the main outcome without a specific site; three articles identified factors associated with lower respiratory tract infection (pneumonia or tracheitis); three articles were concerned with laboratory-confirmed bloodstream infection; and a single retrospective study analyzed urinary tract infection. The production of evidence on risk factors Paediatric ICU has not kept up the same pace of that on adult - there are few studies with adequate design and statistical analysis. The methodological diversity of the studies did not allow for a summarized measurement of risk factors.

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