Device-Associated Nosocomial Infection Rates in Turkish Medical-Surgical Intensive Care Units

2006 ◽  
Vol 27 (4) ◽  
pp. 343-348 ◽  
Author(s):  
Dilara Inan ◽  
Rabin Saba ◽  
Ata Nevzat Yalcin ◽  
Murat Yilmaz ◽  
Gozde Ongut ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Nosocomial Infection ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
University Hospital ◽  
Infection Rates ◽  
Surgical Intensive Care ◽  
The Mean ◽  
Device Associated Infection

Objective.To describe the incidence of device-associated nosocomial infections in medical-surgical intensive care units (MS ICUs) in a university hospital in Turkey and compare it with National Nosocomial Infections Surveillance (NNIS) system rates.Design.Prospective surveillance study during a period of 27 months. Device utilization ratios and device-associated infection rates were calculated using US Centers for Disease Control and Prevention and NNIS definitions.Setting.Two separate MS ICUs at Akdeniz University Hospital, Antalya, Turkey.Patients.All patients were included who presented with no signs and symptoms of infection within the first 48 hours after admission.Results.Data on 1,985 patients with a total of 16,892 patient-days were analyzed. The mean overall infection rate per 100 patients was 29.1 infections, and the mean infection rate per 1,000 patient-days was 34.2 infections. The rate of ventilator-associated pneumonia was 20.76 infections per 1,000 ventilator-days, the rate of catheter-associated urinary tract infection was 13.63 infections per 1,000 urinary catheter–days, and the rate of catheter-associated bloodstream infection was 9.69 infections per 1,000 central line–days. The most frequently isolated pathogens were Pseudomonas species among patients with ventilator-associated pneumonias (35.8% of cases), Candida species among patients with catheter-associated urinary tract infections (37.1% of cases), and coagulase-negative staphylococci among patients with catheter-associated bloodstream infections (20.0% of cases).Conclusion.We found both higher device-associated infection rates and higher device utilization ratios in our MS ICUs than those reported by the NNIS system. To reduce the rate of infection, implementation of infection control practices and comprehensive education are required, and an appropriate nationwide nosocomial infection and control system is needed in Turkey.

Failure of the Overgown to Prevent Nosocomial Infection in a Pediatric Intensive Care Unit

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 35-38
Author(s):  
Leigh G. Donowitz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Pediatric Intensive Care Unit ◽  
Infection Rate ◽  
Pediatric Intensive Care ◽  
Infection Rates ◽  
Intravascular Catheter ◽  
Catheter Colonization ◽  
The Mean

In a pediatric intensive care unit we conducted a 1-year prospective study of 454 patients to determine whether wearing a gown decreased the overall nosocomial infection rate, incidence of intravascular catheter colonization, breaks in handwashing technique, and traffic. The overall infection rate was 26 (13%) of 198 admissions during the gown-wearing periods v 23 (9%) of 256 admissions for the periods when gowns were not worn (P < .25). Of 348 intravascular catheter tips cultured 16 (4.6%) were colonized during gown-wearing periods compared with 21 (6.3%) of 330 when no gowns were worn (P < .25). Of 78 patient contacts 54 (69%) were followed by no handwashing during gown-wearing periods and 59 (70%) of 84 contacts were followed by no handwashing during periods when no gowns were worn. The mean occurrence of visits per patient per hour and total visits per hour differed between gown-wearing and no-gown-wearing periods by analysis of variance, P < .01 and P < .005, respectively. Although traffic was decreased during periods of gown use, overgowns are an expensive, ineffective method of decreasing nosocomial infection rates, vascular catheter colonization rates, and breaks in handwashing technique.

Nosocomial Infections in Combined Medical-Surgical Intensive Care Units in the United States

2000 ◽  
Vol 21 (8) ◽  
pp. 510-515 ◽  
Author(s):  
Michael J. Richards ◽  
Jonathan R. Edwards ◽  
David H. Culver ◽  
Robert P. Gaynes ◽  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Nosocomial Pneumonia ◽  
Nosocomial Infections ◽  
The United States ◽  
Infection Rates ◽  
Major Teaching ◽  
Device Associated Infection

Objective:To describe the epidemiology of nosocomial infections in combined medical-surgical (MS) intensive care units (ICUs) participating in the National Nosocomial Infection Surveillance (NNIS) System.Design:Analysis of surveillance data on 498,998 patients with 1,554,070 patient-days, collected between 1992 and 1998 from 205 MS ICUs following the NNIS Intensive Care Unit protocol, representing 152 participating NNIS hospitals in the United States.Results:Infections at three major sites represented 68% of all reported infections (nosocomial pneumonia, 31%; urinary tract infections (UTIs), 23%; and primary bloodstream infections (BSIs), 14%: 83% of episodes of nosocomial pneumonia were associated with mechanical ventilation, 97% of UTIs occurred in catheterized patients, and 87% of primary BSIs in patients with a central line. In patients with primary BSIs, coagulase-negative staphylococci (39%) were the most common pathogens reported; Staphylococcus aureus (12%) was as frequently reported as enterococci (11%). Coagulase-negative staphylococcal BSIs were increasingly reported over the 6 years, but no increase was seen in candidemia or enterococcal bacteremia. In patients with pneumonia, S aureus (17%) was the most frequently reported isolate. Of reported isolates, 59% were gram-negative bacilli. In patients with UTIs, Escherichia coli (19%) was the most frequently reported isolate. Of reported isolates, 31% were fungi. In patients with surgical-site infections, Enterococcus (17%) was the single most frequently reported pathogen. Device-associated nosocomial infection rates for BSIs, pneumonia, and UTIs did not correlate with length of ICU stay, hospital bed size, number of beds in die ICU, or season. Combined MS ICUs in major teaching hospitals had higher device-associated infection rates compared to all other hospitals with combined medical-surgical units.Conclusions:Nosocomial infections in MS ICUs at the most frequent infection sites (bloodstream, urinary, and respiratory tract) almost always were associated with use of an invasive device. Device-associated infection rates were die best available comparative rates between combined MS ICUs, but the distribution of device-associated rates should be stratified by a hospital's major teaching affiliation status.

scholarly journals A Comparison of Nosocomial Infection Density in Intensive Care Units on Relocating to a New Hospital

2020 ◽  
Vol 6 (3) ◽  
pp. 175-180
Author(s):  
Zeynep Ture ◽  
Tugba Ustuner ◽  
Ario Santini ◽  
Serhat Aydogan ◽  
İlhami Celik
Keyword(s):  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Nosocomial Infection ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
Infection Density ◽  
One Year

AbstractBackgroundThe study aimed to investigate the changes in nosocomial infection density after patients were transferred to the intensive care unit (ICU) of a new-build hospital.MethodsThe types and rates of nosocomial infections were obtained for a one-year period retrospectively before leaving the old hospital premises and for a one-year periods after moving into the new hospital. The intensive care unit in the “old” premises was comprised of a 17-bedded hall, and thirty-three nurses shifted to work forty-eight hours a week, with each nurse assigned to provide care for two patients. The intensive care unit in the “new” premises consisted of single rooms, each with twenty-eight beds.ResultsThe median nosocomial infection density decreased from 23 to 15 per 1000 in-patient days. The catheter-related urinary tract infection rate decreased from 7.5 to 2.6 per100 catheter days.ConclusionsTreatment of patients in the new hospital resulted in a decrease in nosocomial infection density.

Impact of International Nosocomial Infection Control Consortium’s multidimensional approach on central line–associated bloodstream infection rates in Bahrain

2019 ◽  
Vol 21 (4) ◽  
pp. 481-489
Author(s):  
Safaa Alkhawaja ◽  
Nermeen Kamal Saeed ◽  
Victor Daniel Rosenthal ◽  
Sana Abdul-Aziz ◽  
Ameena Alsayegh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Infection Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Multidimensional Approach ◽  
Infection Rates

Background: Central line–associated bloodstream infections are serious life-threatening infections in the intensive care unit setting. Methods: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line–associated bloodstream infection rates in Bahrain from January 2013 to December 2016, we conducted a prospective, before-after surveillance, cohort, observational study in one intensive care unit in Bahrain. During baseline, we performed outcome and process surveillance of central line–associated bloodstream infection on 2320 intensive care unit patients, applying Centers for Disease Control and Prevention’s National Healthcare Safety Network definitions. During intervention, we implemented IMA through ISOS, including (1) a bundle of infection prevention interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on central line–associated bloodstream infection rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the central line–associated bloodstream infection rate. Results: During baseline, 672 central line days and 7 central line–associated bloodstream infections were recorded, accounting for 10.4 central line–associated bloodstream infections per 1000 central line days. During intervention, 13,020 central line days and 48 central line–associated bloodstream infections were recorded. After the second year, there was a sustained 89% cumulative central line–associated bloodstream infection rate reduction to 1.2 central line–associated bloodstream infections per 1000 central line days (incidence density rate, 0.11; 95% confidence interval 0.1–0.3; p, 0.001). The average extra length of stay of patients with central line–associated bloodstream infection was 23.3 days, and due to the reduction of central line–associated bloodstream infections, 367 days of hospitalization were saved, amounting to a reduction in hospitalization costs of US$1,100,553. Conclusion: Implementing IMA was associated with a significant reduction in the central line–associated bloodstream infection rate in Bahrain.

scholarly journals Nosocomial Infection in an Intensive Care Unit in a Brazilian University Hospital

2010 ◽  
Vol 18 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Adriana Cristina de Oliveira ◽  
Christine Tassone Kovner ◽  
Rafael Souza da Silva
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urinary Tract ◽  
Relative Risk ◽  
Nosocomial Infection ◽  
Clinical Characteristics ◽  
University Hospital ◽  
Emergency Unit ◽  
Invasive Procedures ◽  
Community Infection

This prospective study aimed to determine the nosocomial infection (NI) incidence in an Intensive Care Unit (ICU), its association with clinical characteristics and occurrence sites. It was carried out among 1.886 patients admitted in an ICU of a University Hospital, from August 2005 to January 2008. Data analysis was done using Fisher’s test and Relative Risk (RR). There were 383 NIs (20.3%). The infections were in the urinary tract (n=144; 37.6%), pneumonia (n=98; 25.6%), sepsis (n=58; 15.1%), surgical site (n=54; 14.1%) and others (n=29; 7.7%). Hospitalization average was 19.3 days for patients with NI and 20.2 days for those with colonization by resistant microorganisms. The mortality was 39.5% among patients with NI (RR: 4.4; 3.4-5.6). The NI was associated with patients originated from other units of the institution/emergency unit, more than 4 days of hospitalization, community infection, colonized by resistant microorganisms, using invasive procedures and deaths resulting from NI.

A Decade of Prevalence Surveys in a Tertiary-Care Center: Trends in Nosocomial Infection Rates, Device Utilization, and Patient Acuity

1999 ◽  
Vol 20 (8) ◽  
pp. 543-548 ◽  
Author(s):  
Jeffrey W. Weinstein ◽  
Dorothy Mazon ◽  
Elizabeth Pantelick ◽  
Patricia Reagan-Cirincione ◽  
Louise M. Dembry ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Bloodstream Infection ◽  
Acute Care ◽  
Nosocomial Infections ◽  
Tertiary Care ◽  
Infection Rates ◽  
Nosocomial Bloodstream Infection ◽  
Abnormal Laboratory ◽  
Infection Surveillance ◽  
The Mean

AbstractObjective:To evaluate the usefulness of repeated prevalence surveys to determine trends in the rates of nosocomial infections and to detect changes in risk factors (eg, use of invasive devices) associated with nosocomial infections.Patients And Methods:Ten annual prevalence surveys were conducted by trained infection control practitioners between 1985 and 1995 for acute-care patients on the medical, surgical, pediatric, and obstetric-gynecologic services at a 900-bed, tertiary-care, teaching hospital with 750 acute-care beds. The same methods of chart review and concurrent reporting from nursing, the microbiology and clinical laboratory, and the pharmacy were used each year to collect data on the prevalence of nosocomial infections, invasive-device utilization, and abnormal laboratory indicators. Although data were collected on a single day, a period-prevalence study approach was used, because charts were reviewed for any infection data occurring within the 7 days prior to the survey.Results:The hospital census for acute-care patients, as measured by the prevalence surveys, declined sharply over the 10 years, from 673 to 575 patients (P=.02). However, the medical service census increased from 150 to 188 patients (P=.01). During the same period, there was a significant decrease in the mean length of stay, from 7.3 to 6.0 days (P=.01), and a concomitant increase in the mean diagnosis-related-group case-mix index, from 1.03 to 1.24 (P=.001). Overall, nosocomial infection rates remained unchanged over the study period (mean of 9.85 infections per 100 patients), but rates of nosocomial bloodstream infection increased from 0.0% in 1985 to 2.3% in 1995 (P=.05). Nosocomial infection rates were significantly higher on the medical and surgical services than on other services (P<.001). Utilization rates increased significantly for Foley catheters (9.0% to 16.0%, P=.002) and ventilators (5.0% to 8.0%, P=.05).Conclusions:Despite apparent increases in the severity of illness of our patients, overall rates of nosocomial infection remained stable during a decade of study. Rates of nosocomial bloodstream infection increased, in parallel with National Nosocomial Infection Surveillance System data. We found repeated prevalence surveys to be useful in following trends and rates of infection, device utilization, and abnormal laboratory values among patients at our institution. Such methodologies can be valuable and low-cost components of a comprehensive infection surveillance, prevention, and control program and other potential quality-improvement initiatives, because they enable better annual planning of departmental strategies to meet hospital needs

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