Comparison of Hospitalwide Surveillance and Targeted Intensive Care Unit Surveillance of Healthcare-Associated Infections

2007 ◽  
Vol 28 (12) ◽  
pp. 1361-1366 ◽  
Author(s):  
David J. Weber ◽  
Emily E. Sickbert-Bennett ◽  
Vickie Brown ◽  
William A. Rutala
Keyword(s):  
Intensive Care ◽  
Tertiary Care ◽  
Surveillance Data ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Surgical Services ◽  
Control And Prevention ◽  
Step Down ◽  
Tract Infections ◽  
Healthcare Associated

Objectives.To assess the surveillance coverage obtained with Centers for Disease Control and Prevention (CDC)-recommended surveillance of healthcare-associated infections (HAIs), which is focused on intensive care units (ICUs) and emphasizes device-related infections (ie, those associated with central venous catheters, ventilators, and/or urinary catheters), compared with the surveillance coverage achieved by comprehensive hospitalwide surveillance. In addition, we assessed whether the infection rates in step-down units more resemble those in wards or ICUs.Methods.Review of prospectively obtained, comprehensive hospitalwide surveillance data from 2004 through 2005 for an acute care tertiary care hospital with approximately 700 beds. Surveillance data was obtained by trained infection control professionals using standard CDC criteria for HAIs.Results.CDC-recommended ICU surveillance for catheter-related bloodstream infection (BSI) and ventilator-associated pneumonia would have detected only 87 (21.4%) of 407 catheter-related BSIs and only 66 (37.9%) of 174 respiratory tract infections that occurred in the medical and surgical services. Only 31 (34.8%) of 89 infections caused by methicillin-resistant Staphylococcus aureus and 7 (31.8%) of 22 infections caused by vancomycin-resistant Enterococcus occurred in our adult ICUs.Conclusions.Rates of HAIs were highest in the ICUs, intermediate in step-down units, and lowest in the wards. The rates of infections in the step-down units were more similar to those in the wards than to those in the ICUs. To prevent HAIs, more comprehensive surveillance may be indicated.

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

Antibiotic Molecules Involved in Increasing Microbial Resistance

2019 ◽  
Vol 70 (7) ◽  
pp. 2622-2626 ◽  
Author(s):  
Letitia Doina Duceac ◽  
Constantin Marcu ◽  
Daniela Luminita Ichim ◽  
Irina Mihaela Ciomaga ◽  
Elena Tarca ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Enterobacter Aerogenes ◽  
Healthcare Associated Infections ◽  
Medical Department ◽  
Microbial Resistance ◽  
Antimicrobial Sensitivity ◽  
Interpretation Criteria ◽  
Tract Infections ◽  
Healthcare Associated

Over the past two decades, the resistance to antibiotics, especially for Gram-negative bacteria, has increased at an alarming rate, requiring constant concern for resolving and controlling this extremely important therapeutic aspect in any medical department but in particular, in Anaesthesia and Intensive Care Units, in units of neonatology, paediatrics, neurosurgery, burned patients and immunosuppressed. Specialists note a particular concern for the resistance of Enterobacteriaceae to third-generation cephalosporins and aztreonam, with a resistance profile frequently associated with the expression of extended-spectrum �-lactamases (ESBL). The Enterobacter genus comprises 14 species, but two are of medical interest, Enterobacter aerogenes and E. cloacae, which are involved in inducing healthcare-associated infections such as urinary tract infections, pneumonia associated with mechanical ventilation, bacteremia, septicemia, etc. The purpose of the study was to highlight the antibiotic molecules in which microbial resistance of some circulating strains of enterobacteria was detected. A descriptive and retrospective study was conducted between 2012-2017, on a batch of 35 patients, admitted to the Sf. Maria Emergency Clinical Hospital for Children of Iasi, from whom various pathological products were collected to highlight the Enterobacter sp strains involved in the production of infections associated with the inpatient medical care. The antimicrobial sensitivity of each strain was determined by diffusimetric method, while the interpretation criteria were considered to be those of the laboratory standards. Most cases were reported in 2017 (31.42%). The majority were registered in new-borns (42.85%) and infants (25.71%). The Anaesthesia and Intensive Care Units and Neonatology Anaesthesia and Intensive Care Units departments were the most involved. Microbial antibacterial resistance of Enterobacter sp isolates showed that all manifested resistance to ampicillin, amoxicillin and clavulanic acid, 48.57% were resistant to Cefuroxime, 42.85% resistant to Ceftazidime and Ceftriaxone, 14.28% to ciprofloxacin, 11.42% to ertapenem, 5.71% to Meronem. Although it showed relatively few cases with infections associated with healthcare in which strains of Enterobacter sp. were isolated our study, which was carried out over a period of 5 years, provides useful indications regarding the prevalence of healthcare associated infections with Enterobacter sp in paediatric patients and guidelines for antibiotic therapy.

scholarly journals Longitudinal Trends in All Healthcare-Associated Infections through Comprehensive Hospital-wide Surveillance and Infection Control Measures over the Past 12 Years: Substantial Burden of Healthcare-Associated Infections Outside of Intensive Care Units and “Other” Types of Infection

2015 ◽  
Vol 36 (10) ◽  
pp. 1139-1147 ◽  
Author(s):  
Hajime Kanamori ◽  
David J. Weber ◽  
Lauren M. DiBiase ◽  
Emily E. Sickbert-Bennett ◽  
Rebecca Brooks ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Linear Models ◽  
Infection Type ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Control Measures ◽  
Healthcare Associated Infections ◽  
Healthcare Associated

OBJECTIVETargeted surveillance has focused on device-associated infections and surgical site infections (SSIs) and is often limited to healthcare-associated infections (HAIs) in high-risk areas. Longitudinal trends in all HAIs, including other types of HAIs, and HAIs outside of intensive care units (ICUs) remain unclear. We examined the incidences of all HAIs using comprehensive hospital-wide surveillance over a 12-year period (2001–2012).METHODSThis retrospective observational study was conducted at the University of North Carolina (UNC) Hospitals, a tertiary care academic facility. All HAIs, including 5 major infections with 14 specific infection sites as defined using CDC criteria, were ascertained through comprehensive hospital-wide surveillance. Generalized linear models were used to examine the incidence rate difference by infection type over time.RESULTSA total of 16,579 HAIs included 6,397 cases in ICUs and 10,182 cases outside ICUs. The incidence of overall HAIs decreased significantly hospital-wide (−3.4 infections per 1,000 patient days), in ICUs (−8.4 infections per 1,000 patient days), and in non-ICU settings (−1.9 infections per 1,000 patient days). The incidences of bloodstream infection, urinary tract infection, and pneumonia in hospital-wide settings decreased significantly, but the incidences of SSI and lower respiratory tract infection remained unchanged. The incidence of Clostridium difficile infection (CDI) increased remarkably. The outcomes were estimated to include 700 overall HAIs prevented, 40 lives saved, and cost savings in excess of $10 million.CONCLUSIONSWe demonstrated success in reducing overall HAIs over a 12-year period. Our data underscore the necessity for surveillance and infection prevention interventions outside of the ICUs, for non–device-associated HAIs, and for CDI.Infect Control Hosp Epidemiol 2015;36(10):1139–1147

Healthcare-associated Infections in Pediatric Cardiovascular Surgery Intensive Care Unit between 2016-2020

2021 ◽  
Author(s):  
Mehmet Emirhan Işık ◽  
Ergin Arslanoğlu ◽  
Ömer Faruk Şavluk ◽  
Hakan Ceyran
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiovascular Surgery ◽  
Heart Diseases ◽  
Bloodstream Infections ◽  
Healthcare Associated Infections ◽  
Developmental Problems ◽  
Pediatric Cardiovascular Surgery ◽  
Tract Infections ◽  
Healthcare Associated

Objectives: Healthcare-associated infections are the most common problem in intensive care unit worldwide. Children with congenital heart diseases have many complications such as developmental problems, respiratory tract infections, endocarditis,pneumonia and after long-term hospital and intensive care stays and surgeries patients become vulnerable to healthcare-associated infections. Patients and Methods: The study presents the frequency of infection, microorganisms in patients hospitalized at SBÜ Koşuyolu High Spesialization Research and Training Hospital pediatric cardiovascular surgery intensive care unit between 2016-2020. Results: One hundred-eight HAI episodes were seen in 83 of 1920 patients hospitalized in pediatric cardiovascular surgery intensive care unit between 2016-2020.HAI rates varied between 4.8% and 7.77%. In the 5-year period,a total of 118 different microorganisms were detected.Among all microorganisms, Candida species (n: 43, 36.4%) ranked first. central line-associated bloodstream infections (CLABSI) 53 (49%), ventilator-associated pneumonia (VAP)40 (37%), surgical site infection (SSI) 8 (6.5%), catheter -associated urinary tract infection (CAUTI) 7 (6%) Conclusion: Healthcare-associated infections are require special attention in pediatric cardiovascular intensive care units. In order to prevent, innovations such as bundle applications should be implemented as well as personnel training.

scholarly journals Device associated and surgical site infections, quality indicators in a tertiary care hospital: A 5 year study

2021 ◽  
Vol 9 (3) ◽  
pp. 132-146
Author(s):  
Bilolikar AK ◽  
Banerjee J ◽  
Thomas KM
Keyword(s):  
Quality Indicators ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Central Line ◽  
Bench Mark ◽  
Care Hospital ◽  
Statistical Tool ◽  
Hospital Infection Control ◽  
Control And Prevention ◽  
Healthcare Associated

Purpose: In the present study, an attempt is made to understand the pattern of HAIs (Healthcare Associated Infections) [device associated infections such as Catheter Associated Urinary Tract Infection (CAUTI), Ventilator Associated Event (VAE), Central Line-Associated Bloodstream Infection (CLABSI) & Surgical Site Infection (SSI) by analyzing statistical tool of quality indicators] and to establish a bench mark for HAIs in a single hospital for a period of 5 years. Methods: The Microbiologist & ICN’s conduct rounds in ICU’s & wards and collect data for active surveillance. The details of culture positive samples are collected by Microbiologist from the laboratory for passive surveillance. The surveillance forms (active & passive) capture details of individual patients. The data collection forms are prepared and updated as per Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN) guidelines. The data is analyzed and presented in the meeting of Hospital Infection Control Committee meeting & discussed with clinicians. Results: The cumulative (5 years) CAUTI rate is 0.45, VAE is 2.42, CLABSI is 1.35 & SSI is 0.21. HAI rates were highest for VAE (2.42/1000 ventilator days), the next was CLABSI (1.35/1000 central line days), followed by CAUTI (0.45/1000 urinary catheter days). SSI rate was 0.21/ 100 surgeries. Conclusions: Before the study was started, the benchmark were 2 for CAUTI, 5.5 for VAE, 3 for CLABSI and 2 for SSI. We could able to reduce the baseline benchmark and established our new benchmark as 1 for CAUTI, 3 for VAE, 2 for CLABSI and 1 for SSI that can be used in developing HAI prevention policies by the institution.

scholarly journals MICROORGANISMS VARIANTS FOR HEALTHCARE-ASSOCIATED INFECTIONS IN A SELECTED TERTIARY CARE HOSPITAL

2021 ◽  
pp. 22-25
Author(s):  
SARALA KS ◽  
NANDAKUMAR BS ◽  
NARENDRANATH V
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Secondary Data ◽  
Blood Stream ◽  
Microbial Flora ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Set Up ◽  
Healthcare Associated

Objective: Microorganisms are minute and can be only in microscope and these are not visible to naked eyes. Various types of microbe include bacteria, virus, fungi, and protozoa. These microorganisms are subclassified and these are disease causing leading to mortality and morbidity. Healthcare-associated infections (HAIs) arise from different variants of microbes and knowing the category of microbes for treating the diseases with specific antibiotics is important for better patient outcome. Methods: Using secondary data, all the patients who had HAI for 3 years were taken into consideration by considering the different variants of microorganisms. Results: Retrospective data collected for the period of 3 years the inpatients who got admitted for more than 48 h of duration, the data collected included the parameters for various microorganisms such as Bacilli, cocci, Klebsiella, Acinetobacter, and Aures, other micro-organisms such as Escherichia coli, Citrobacter, and Pseudomonas microorganisms. Bacilli group of microorganisms was more common for urinary tract infection, blood stream infection, and ventilator-associated pneumonia. Aures was more common among surgical site infection infections. Conclusions: Most of the patients who had an HAI had two or more different kind of microorganisms which are responsible for spreading infection. There is a need to control microbial flora in the hospital set up as the rate of HAI increases with microbial flora.

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