Device-Associated Infection Rate and Mortality in Intensive Care Units of 9 Colombian Hospitals: Findings of the International Nosocomial Infection Control Consortium

2006 ◽  
Vol 27 (4) ◽  
pp. 349-356 ◽  
Author(s):  
Carlos Álvarez Moreno ◽  
Victor D. Rosenthal ◽  
Narda Olarte ◽  
Wilmer Villamil Gomez ◽  
Otto Sussmann ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Intensive Care Units ◽  
Latin American ◽  
Venous Catheter ◽  
Attributable Mortality ◽  
Healthcare Associated Infection ◽  
Prospective Surveillance ◽  
Control And Prevention ◽  
Device Associated Infection

Objective.To perform active targeted prospective surveillance to measure device-associated infection (DAI) rates, attributable mortality due to DAI, and the microbiological and antibiotic resistance profiles of infecting pathogens at 10 intensive care units (ICUs) in 9 hospitals in Colombia, all of which are members of the International Infection Control Consortium.Methods.We conducted prospective surveillance of healthcare-associated infection in 9 hospitals by using the definitions of the US Centers for Disease Control and Prevention National Nosocomial Surveillance System (NNIS). DAI rates were calculated as the number of infections per 100 ICU patients and per 1,000 device-days.Results.During the 3-year study, 2,172 patients hospitalized in an ICU for an aggregate duration of 14,603 days acquired 266 DAIs, for an overall DAI rate of 12.2%, or 18.2 DAIs per 1,000 patient-days. Central venous catheter (CVC)–related bloodstream infection (BSI) (47.4% of DAIs; 11.3 cases per 1,000 catheter-days) was the most common DAI, followed by ventilator-associated pneumonia (VAP) (32.3% of DAIs; 10.0 cases per 1,000 ventilator-days) and catheter-associated urinary tract infection (CAUTI) (20.3% of DAIs; 4.3 cases per 1,000 catheter-days). Overall, 65.4% of all Staphylococcus aureus infections were caused by methicillin-resistant strains; 40.0% of Enterobacteriaceae isolates were resistant to ceftriaxone and 28.3% were resistant to ceftazidime; and 40.0% of Pseudomonas aeruginosa isolates were resistant to fluoroquinolones, 50.0% were resistant to ceftazidime, 33.3% were resistant to piperacillin-tazobactam, and 19.0% were resistant to imipenem. The crude unadjusted attributable mortality was 16.9% among patients with VAP (relative risk [RR], 1.93; 95% confidence interval [CI], 1.24-3.00; P = .002); 18.5 among those with CVC-associated BSI (RR, 2.02; 95% CI, 1.42-2.87; P<.001); and 10.5% among those with CAUTI (RR, 1.58; 95% CI, 0.78-3.18; P = .19).Conclusion.The rates of DAI in the Colombian ICUs were lower than those published in some reports from other Latin American countries and were higher than those reported in US ICUs by the NNIS. These data show the need for more-effective infection control interventions in Colombia.

Antibiotic consumption and healthcare associated infection in a third level Italian hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F Gori ◽  
N Vonci ◽  
A Tinturini ◽  
C Basagni ◽  
G Messina ◽  
...  
Keyword(s):  
Infection Control ◽  
Teaching Hospital ◽  
General Medicine ◽  
Venous Catheter ◽  
Antibiotic Consumption ◽  
Healthcare Associated Infection ◽  
Peripheral Venous Catheter ◽  
Control And Prevention ◽  
Medical Wards ◽  
Clinical Records

Abstract Background The extended length of stay (LoS) is one of the main causes of hospital infections (HAI), followed by an increase in antibiotics consumption. The final step is the development of multiresistant microorganisms, with a consequent increase in costs for the national healthcare system. Aim of this study is to evaluate the prevalence of HAI and to analyze ATB consumption in a teaching hospital Methods Between 17-21 June 2019 the infection control team collected the clinical records of 425 patients to perform a point of prevalence analysis (PPA). Eligible patients were hospitalized in surgical and medical wards of the teaching Hospital (615 beds) in Siena, Italy. For each patients according to guidelines of European Centers for Disease Control and Prevention (ECDC 4.2) we searched for evidence of HAI and for all indication of ATB consumption. Data were processed using Stata12 Results Overall 425 patients have been analyzed (48.24% female), mean age was 60.88 (SD 26.11) years, mean LoS 8.37 (min 1 max 86) days. Patients were admitted mostly in General Medicine wards (48.94%); 34% underwent surgery. 63.8% of patients had Peripheral Venous Catheter, 20% Central Venous Catheter and 31.06% Urinary Catheter. Twenty-nine HAI were discovered (PPA 6.82%); the higher prevalence (19.23%) was in Intensive Care Unit. LoS (OR:1.07;IC95%1.04-1.1) and devices (OR:2.17;IC95%1.39-3.37) were the two variables that significantly influenced the infection risk. Forty-six percent of all patients received ATB, the most used were third generation Cephalosporines (26,18%), followed by Penicillines (24,73%). The main use was to treat community infections (62.12%), followed by medical prophylaxis (30.81%) Conclusions PPA of HAI was 6.82%, comparable to 2017 national PPA (6.5%); prolonged LoS is probably the main cause of this result. Our analysis showed that ATB consumption was quite high, in agreement with the Italian prevalence (44.9%), but the percentage of medical prophylaxis was still high. Key messages The way to achieve the health care infection control is still long, the length of the hospitalization could be a field to be improved. High consumption of antibiotics for prophylaxis is still the main point to fight in the battle against the multiresistant microorganisms.

Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in 21 adult intensive-care units from 10 cities in India: findings of the International Nosocomial Infection Control Consortium (INICC)

2013 ◽  
Vol 141 (12) ◽  
pp. 2483-2491 ◽  
Author(s):  
Y. MEHTA ◽  
N. JAGGI ◽  
V. D. ROSENTHAL ◽  
C. RODRIGUES ◽  
S. K. TODI ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Intensive Care Units ◽  
Ventilator Associated Pneumonia ◽  
Multidimensional Approach ◽  
Time Period ◽  
Control And Prevention ◽  
Quasi Experimental ◽  
And Performance

SUMMARYWe report on the effect of the International Nosocomial Infection Control Consortium's (INICC) multidimensional approach for the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 21 intensive-care units (ICUs), from 14 hospitals in 10 Indian cities. A quasi-experimental study was conducted, which was divided into baseline and intervention periods. During baseline, prospective surveillance of VAP was performed applying the Centers for Disease Control and Prevention/National Healthcare Safety Network definitions and INICC methods. During intervention, our approach in each ICU included a bundle of interventions, education, outcome and process surveillance, and feedback of VAP rates and performance. Crude stratified rates were calculated, and by using random-effects Poisson regression to allow for clustering by ICU, the incidence rate ratio for each time period compared with the 3-month baseline was determined. The VAP rate was 17·43/1000 mechanical ventilator days during baseline, and 10·81 for intervention, showing a 38% VAP rate reduction (relative risk 0·62, 95% confidence interval 0·5–0·78, P = 0·0001).

scholarly journals Motivation of infection control in nurses' viewpoint

2020 ◽  
Vol 85 ◽  
pp. 02001
Author(s):  
Diana Platace ◽  
Kristine Puzirevska ◽  
Amanda Kreile ◽  
Inga Millere
Keyword(s):  
Internal Medicine ◽  
Intensive Care ◽  
Infection Control ◽  
Intensive Care Units ◽  
Therapy Resistance ◽  
Underlying Disease ◽  
Hospital Infections ◽  
Motivating Factors ◽  
Prevention Measures ◽  
Control And Prevention

The spread of hospital infections in high-risk units remains even though infection control and prevention measures are being improved annually. It is associated with factors such as age, severity of the underlying disease, duration of hospitalization, antibacterial therapy, resistance to microorganisms, and the number of invasive procedures. The human resources and the financial distribution in medicine play the key role in controlling infections. Intensive care nurses supervising and taking care of the patients 24 hours a day have an invaluable role in controlling infections and reducing hospital infections. The aim of the study is to find out the nurses' opinions about the factors motivating infection control in the intensive care units and in the department of internal medicine. The study used a quantitative study method-survey (n = 160). The questionnaire included questions about the factors influencing infection control and the factors motivating the nurse. Questionnaires involved nurses in the intensive care units and in the department of internal medicine, who care for patients in Latvian multifunctional regional hospitals. The study suggests that nurses are motivated by both material and non-material motivating factors. The material motivating factors in nurses' viewpoint are maintenance of workplace, the premium of work quality, the premium for night work and overtime, premium for work on holidays, possibility to attend courses and training, vacation pay, as well as environment of work. The non-material motivating factors in nurses' viewpoint are the attitude of the supervisor, being respectful of their workplace, the relations with colleagues, acknowledgment for the work done, the responsibility at work, the pride and respect for the work to be done, the challenges, interesting job and variety in work tasks, as well as the growth and development in the workplace.

scholarly journals Gram-Negative Infections in Adult Intensive Care Units of Latin America and the Caribbean

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Carlos M. Luna ◽  
Eduardo Rodriguez-Noriega ◽  
Luis Bavestrello ◽  
Manuel Guzmán-Blanco
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Intensive Care Units ◽  
Latin American ◽  
Control Strategies ◽  
Multidrug Resistant ◽  
Biomedical Literature ◽  
Reference List ◽  
Gram Negative ◽  
Hygiene Measures

This review summarizes recent epidemiology of Gram-negative infections in selected countries from Latin American and Caribbean adult intensive care units (ICUs). A systematic search of the biomedical literature (PubMed) was performed to identify articles published over the last decade. Where appropriate, data also were collected from the reference list of published articles, health departments of specific countries, and registries. Independent cohort data from all countries (Argentina, Brazil, Chile, Colombia, Cuba, Mexico, Trinidad and Tobago, and Venezuela) signified a high rate of ICU infections (prevalence: Argentina, 24%; Brazil, 57%). Gram-negative pathogens, predominantlyAcinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, andEscherichia coli, accounted for>50% of ICU infections, which were often complicated by the presence of multidrug-resistant strains and clonal outbreaks. Empirical use of antimicrobial agents was identified as a strong risk factor for resistance development and excessive mortality. Infection control strategies utilizing hygiene measures and antimicrobial stewardship programs reduced the rate of device-associated infections. To mitigate the poor health outcomes associated with infections by multidrug-resistant Gram-negative bacteria, urgent focus must be placed on infection control strategies and local surveillance programs.

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