An Outbreak of Bloodstream Infections in an Outpatient Hemodialysis Center

2002 ◽  
Vol 23 (12) ◽  
pp. 725-729 ◽  
Author(s):  
Connie S. Price ◽  
Donna Hacek ◽  
Gary A. Noskin ◽  
Lance R. Peterson
Keyword(s):  
Infection Control ◽  
Povidone Iodine ◽  
Bloodstream Infections ◽  
Baseline Period ◽  
Access Site ◽  
Control Programs ◽  
Before And After ◽  
And Control ◽  
Control Study ◽  
Microbiological Data

Objectives:Investigate and control an increase in bloodstream infections (BSIs) in an outpatient hemodialysis center.Patients and Design:A retrospective cohort study was conducted for patients receiving dialysis at the center from February 2000 to April 2001. A case–control study compared microbiological data for all BSIs that occurred during the study period with those for BSIs that occurred during a baseline period Qanuary 1999 to January 2000). BSI rates before and after a 1-month intervention (May 2001) were assessed. A case was defined as a new BSI during the study period.Results:The outbreak was polymicrobial, with approximately 30 species. The baseline BSI rate was 0.7 per 100 patient-months. From February 2000 to April 2001, the BSI rate increased to 4.2 per 100 patient-months. Overall, 75% of the BSIs were associated with central venous catheters (CVCs), but CVC use did not fully explain the increase in BSIs. In January 2000, when the center changed ownership, prepackaged CVC dressing kits and biweekly infection control monitoring were discontinued. Beginning in May 2001, staff were educated on CVC care, chlorhexidine replaced povidone-iodine for cutaneous antisepsis, gauze replaced transparent dressings, antimicrobial ointments containing polyethylene glycol at CVC exit sites were discontinued, and patients with CVCs were educated on cutaneous hygiene. After the intervention period, by October 2001, rates decreased to less than 1 BSI per 100 patient-months.Conclusions:Proper cutaneous antisepsis and access site care is crucial in preventing BSIs in patients receiving hemodialysis. Infection control programs, staff and patient education, and use of optimal antisepsis agents or prepackaged kits are useful toward this end.

Efficacy of a psychoeducational intervention in improving relatives’ knowledge about schizophrenia and reducing rehospitalisation

2001 ◽  
Vol 16 (8) ◽  
pp. 446-450 ◽  
Author(s):  
E. Cassidy ◽  
S. Hill ◽  
E. O’Callaghan
Keyword(s):  
Cost Effective ◽  
Psychoeducational Intervention ◽  
Self Report ◽  
Psychoeducational Group ◽  
Effective Manner ◽  
Before And After ◽  
Matched Case ◽  
And Control ◽  
Hospital Days ◽  
Control Study

SummaryWe sought to establish if a brief psychoeducational intervention for relatives is effective in improving relatives’ knowledge about schizophrenia and reducing rehospitalization. We evaluated 101 relatives of 55 patients with schizophrenia before and after an 8-week psychoeducational group using a self-report method. We also conducted a matched case-control study of the effects on rehospitalisation for 28 of these patients. We calculated the number of hospital days for each index case and control in the 1 and 2 years before and after the intervention.Relatives made significant gains in their knowledge about schizophrenia, particularly about medication. Patients whose relatives attended the group had significantly fewer days in hospital and days per admission compared to controls in the year after the programme but the effect waned in the second year after the intervention. Controls were almost four times more likely to be readmitted at 2 years than cases. Median time to readmission was significantly longer in cases compared to controls. We conclude that a psychoeducational group, which is valued by carers, is effective in increasing their knowledge about schizophrenia as well as reducing and forestalling the rehospitalization of their affected relatives. Such programmes deliver what carers frequently request in a cost-effective manner.

scholarly journals Infection Control in Acute Care Facilities: Evidence-Based Patient Safety

2001 ◽  
Vol 12 (3) ◽  
pp. 131-132 ◽  
Author(s):  
Lindsay E Nicolle
Keyword(s):  
World War Ii ◽  
Infection Control ◽  
Acute Care ◽  
Epidemiological Analysis ◽  
Control Programs ◽  
Care Facilities ◽  
Surveillance Programs ◽  
Acute Care Facilities ◽  
Program Components ◽  
And Control

Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistantStaphylococcus aureusoutbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused surveillance programs, prophylactic antimicrobial therapy, outbreak investigation and control, routine barrier practices and molecular typing of organisms for epidemiological analysis.

Hospital-Acquired Myiasis

1980 ◽  
Vol 1 (5) ◽  
pp. 319-320 ◽  
Author(s):  
Jay A. Jacobson ◽  
Robert L. Kolts ◽  
Marlyn Conti ◽  
John P. Burke
Keyword(s):  
Infection Control ◽  
Thoracic Surgery ◽  
Operating Room ◽  
The Other ◽  
Tissue Destruction ◽  
Access Site ◽  
Control Programs ◽  
Hospital Acquired ◽  
Unusual Problem ◽  
Environmental Access

AbstractIn three years we encountered two patients with hospital-acquired myiasis, a rarely reported nosocomial problem. Both patients were elderly and had lengthy thoracic surgery in August in the same operating room. Larvae removed from the nares of one patient and from the chest incision of the other were of the same species, Phaenicia serricata. There was no evidence of tissue destruction or invasion in either case. Investigation revealed several factors that contributed to the presence of flies in the operating room. After a presumed environmental access site was closed and insecticide spraying was augmented, no additional cases occurred. This experience illustrates an unusual problem that may confront those responsible for infection control programs.

scholarly journals KNOWLEDGE AND HEALTH SEEKING BEHAVIOR RELATED TO KALA-AZAR IN RURAL COMMUNITIES OF EAST CHAMPARAN DISTRICT, BIHAR

2017 ◽  
Vol 10 (9) ◽  
pp. 92
Author(s):  
Navin Kumar ◽  
Singh T B ◽  
Meena L P
Keyword(s):  
Rural Communities ◽  
Control Measures ◽  
Health Seeking ◽  
Health Seeking Behavior ◽  
The Public ◽  
Control Programs ◽  
Kala Azar ◽  
Seeking Behavior ◽  
And Control ◽  
Control Study

  Objective: To find out the sociodemographic characteristics, knowledge and health seeking behavior related to KA in the East Champaran district, Bihar among study subject.Methods: A case-control study was conducted to understand the knowledge and health seeking behavior related to KA in the East Champaran district. A total of 100 KA cases and 100 healthy controls selected from the neighborhoods of cases.Results: The knowledge of the population showed that the male constituted 58% of the total population in which 56% were case and 60% were control. Majority of the respondent 76.5% were aware from the KA. Maximum of the respondent 72.5% believed that biting time of sand flies were in the night. Moreover, 71% respondent cannot know how to protect the KA transmission.Conclusion: These results will be useful for further improvement in the KA control programs for intervention strategies. The knowledge of the study subject about KA, the vectors, the transmission of KA, and control measures was poor which needs some effort of the public health system by the Ministry working in the field of health.

scholarly journals Outbreak ofTsukamurellaSpecies Bloodstream Infection among Patients at an Oncology Clinic, West Virginia, 2011–2012

2014 ◽  
Vol 35 (3) ◽  
pp. 300-306 ◽  
Author(s):  
Isaac See ◽  
Duc B. Nguyen ◽  
Somu Chatterjee ◽  
Thein Shwe ◽  
Melissa Scott ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infection ◽  
Case Control Study ◽  
Significant Risk ◽  
Bloodstream Infections ◽  
Case Control ◽  
Control Measures ◽  
Multiple Infection ◽  
Common Source ◽  
Control Study

Objective.To determine the source and identify control measures of an outbreak ofTsukamurellaspecies bloodstream infections at an outpatient oncology facility.Design.Epidemiologic investigation of the outbreak with a case-control study.Methods.A case was an infection in whichTsukamurellaspecies was isolated from a blood or catheter tip culture during the period January 2011 through June 2012 from a patient of the oncology clinic. Laboratory records of area hospitals and patient charts were reviewed. A case-control study was conducted among clinic patients to identify risk factors forTsukamurellaspecies bloodstream infection. Clinic staff were interviewed, and infection control practices were assessed.Results.Fifteen cases ofTsukamurella (Tsukamurella pulmonisorTsukamurella tyrosinosolvens) bloodstream infection were identified, all in patients with underlying malignancy and indwelling central lines. The median age of case patients was 68 years; 47% were male. The only significant risk factor for infection was receipt of saline flush from the clinic during the period September–October 2011 (P= .03), when the clinic had been preparing saline flush from a common-source bag of saline. Other infection control deficiencies that were identified at the clinic included suboptimal procedures for central line access and preparation of chemotherapy.Conclusion.Although multiple infection control lapses were identified, the outbreak was likely caused by improper preparation of saline flush syringes by the clinic. The outbreak demonstrates that bloodstream infections among oncology patients can result from improper infection control practices and highlights the critical need for increased attention to and oversight of infection control in outpatient oncology settings.

Bloodstream Infections in Pediatric Oncology Outpatients: A New Healthcare Systems Challenge

2002 ◽  
Vol 23 (5) ◽  
pp. 239-243 ◽  
Author(s):  
Theresa L. Smith ◽  
Gregg T. Pullen ◽  
Vonda Crouse ◽  
Jon Rosenberg ◽  
William R. Jarvis
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
Case Patient ◽  
Gram Negative ◽  
Children's Hospital ◽  
Pediatric Hematology ◽  
Patient Demographics ◽  
Children’S Hospital ◽  
And Control ◽  
Control Study

Objective:To investigate a perceived increase in central venous catheter (CVC)–associated bloodstream infections (BSIs) among pediatric hematology–oncology outpatients.Design:A case–control study.Setting:A pediatric hematology–oncology outpatient clinic at Fresno Children's Hospital.Patients:Pediatric hematology–oncology clinic outpatients with CVCs at Fresno Children's Hospital between November 1994 and October 1997.Methods:A case-patient was defined as any hematology–oncology outpatient with a CVC-associated BSI at Fresno Children's Hospital from November 1996 to October 1997 (study period) without a localizable infection. To identify case-patients, we reviewed Fresno Children's Hospital records for all hematology–oncology clinic patients, those with CVCs and those with CVCs and BSIs. Control-patients were randomly selected hematology–oncology outpatients with a CVC but no BSI during the study period. Case-patient and control-patient demographics, diagnoses, caretakers, catheter types, catheter care, and water exposure were compared.Results:Twenty-five case-patients had 42 CVC-associated BSIs during the study period. No significant increase in CVC-associated BSI rates occurred among pediatric hematology–oncology patients. However, there was a statistically significant increase in nonendogenous, gram-negative (eg, Pseudomonas species) BSIs during summer months (May–October) compared with the rest of the year. Case-patients and control-patients differed only in catheter type; case-patients were more likely than control-patients to have a transcutaneous CVC. Summertime recreational water exposures were similar and high in the two groups.Conclusions:Hematology–oncology clinic patients with transcutaneous CVCs are at greater risk for CVC-associated BSI, particularly during the summer. Caretakers should be instructed on proper care of CVCs, particularly protection of CVCs during bathing and recreational summer water activities, to reduce the risk of nonendogenous, gram-negative BSIs.

How Frequent Are Outbreaks of Nosocomial Infection in Community Hospitals?

1985 ◽  
Vol 6 (6) ◽  
pp. 233-236 ◽  
Author(s):  
Robert W. Haley ◽  
James H. Tenney ◽  
James O. Lindsey ◽  
Julia S. Garner ◽  
John V. Bennett
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Nosocomial Infections ◽  
Small Proportion ◽  
Community Hospital ◽  
Control Measures ◽  
Community Hospitals ◽  
Control Programs ◽  
Site Investigations ◽  
And Control

AbstractA statistical algorithm was used to identify potentially important clusters among nosocomial infections reported each month by 7 community hospitals. Epidemiologic review and on-site investigations distinguished outbreaks of clinical disease from factitious clusters. In 1 year, 8 outbreaks were confirmed. They involved 82 patients—approximately 2% of patients with nosocomial infections and 0.09% of all discharges. One true outbreak occurred for every 12,000 discharges—at least 1 outbreak per year for the average community hospital. Five (63%) outbreaks were recognized independently by the hospitals' infection control personnel. Four (50%) resolved spontaneously; the hospitals' own control measures were necessary in 2; and 2 resolved only after an outside investigation. Organized surveillance appears necessary to detect some outbreaks, and control measures are needed to stop many. Since, however, outbreaks account for such a small proportion of nosocomial infections, infection control programs should be sufficiently staffed and managed so that most of the effort is directed toward the surveillance and control of endemic infection problems, but with adequate resources remaining to respond to outbreaks when they occur.

scholarly journals The Effectiveness of 0.6% Povidone Iodine Eye Drops in Reducing the Conjunctival Bacterial Load and Needle Contamination in Patients Undergoing Anti-VEGF Intravitreal Injection: A Prospective, Randomized Study

2019 ◽  
Vol 8 (7) ◽  
pp. 1031 ◽  
Author(s):  
Michele Reibaldi ◽  
Teresio Avitabile ◽  
Francesco Bandello ◽  
Antonio Longo ◽  
Vincenza Bonfiglio ◽  
...  
Keyword(s):  
Prophylactic Treatment ◽  
Povidone Iodine ◽  
Bacterial Load ◽  
Randomized Study ◽  
Control Group ◽  
Study Group ◽  
Eye Drops ◽  
Injection Needle ◽  
Before And After ◽  
And Control

The study purpose was to assess the efficacy of a preservative-free 0.6% povidone iodine eye drops as perioperative prophylactic treatment for reducing conjunctival bacterial load and the rate of needle contamination in patients undergoing intravitreal anti-vascular endothelial growth factor injection. Enrolled patients were randomized to either the study group (0.6% povidone iodine, three day-prophylactic treatment before the injection) or to the control group (placebo, three day-prophylactic treatment). Conjunctival swabs were obtained before and after the prophylactic treatment in both groups. Intravitreal injections were performed in a sterile fashion. The injection needle and a control needle were collected for microbiological culture. Data from 254 and 253 eyes in the study group and control group, respectively, were analyzed. Bacterial growth from conjunctival swab cultures was significantly lower after 0.6% povidone iodine prophylaxis compared to baseline and to placebo prophylaxis (p < 0.001), showing an 82% eradication rate in the study group. No injection needle showed bacterial contamination in the study group, whereas six needles were culture-positive in the control group (p = 0.015). No serious ocular and non-ocular adverse events were recorded. The 0.6% povidone iodine solution proved an effective treatment in reducing conjunctival bacterial load and risk of needle contamination.

scholarly journals Evaluation of Nosocomial Infection Control Programs in health services

2015 ◽  
Vol 23 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Mayra Gonçalves Menegueti ◽  
Silvia Rita Marin da Silva Canini ◽  
Fernando Bellissimo-Rodrigues ◽  
Ana Maria Laus
Keyword(s):  
Health Services ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Epidemiological Surveillance ◽  
Control Programs ◽  
Control And Prevention ◽  
Study Population ◽  
Prevention Of Nosocomial Infection ◽  
And Control ◽  
Mean Compliance

OBJECTIVES: to evaluate the Nosocomial Infection Control Programs in hospital institutions regarding structure and process indicators.METHOD: this is a descriptive, exploratory and quantitative study conducted in 2013. The study population comprised 13 Nosocomial Infection Control Programs of health services in a Brazilian city of the state of São Paulo. Public domain instruments available in the Manual of Evaluation Indicators of Nosocomial Infection Control Practices were used.RESULTS: The indicators with the highest average compliance were "Evaluation of the Structure of the Nosocomial Infection Control Programs" (75%) and "Evaluation of the Epidemiological Surveillance System of Nosocomial Infection" (82%) and those with the lowest mean compliance scores were "Evaluation of Operational Guidelines" (58.97%) and "Evaluation of Activities of Control and Prevention of Nosocomial Infection" (60.29%).CONCLUSION: The use of indicators identified that, despite having produced knowledge about prevention and control of nosocomial infections, there is still a large gap between the practice and the recommendations.

scholarly journals Outbreak of vancomycin-resistant enterococcus on a haematology ward: management and control

2017 ◽  
Vol 18 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Diego García Martínez de Artola ◽  
Beatriz Castro ◽  
María José Ramos ◽  
Zaida Díaz Cuevas ◽  
Sunil Lakhwani ◽  
...  
Keyword(s):  
Infection Control ◽  
Multidisciplinary Approach ◽  
Bloodstream Infections ◽  
Vancomycin Resistant Enterococcus ◽  
Control Policies ◽  
Vancomycin Resistant Enterococci ◽  
Vancomycin Resistant ◽  
Control And Management ◽  
And Control

Vancomycin-resistant enterococci (VRE) infections and outbreaks are still infrequent in Spain. A six-month outbreak, which took place in a haematology ward, its control and management are described in this study. A total of 22 patients were colonised and two bloodstream infections occurred during this period. Even though there were two waves of new colonised patients, a multidisciplinary approach, quick interventions and enhanced infection control policies were required in order to control this outbreak.

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