scholarly journals Attributable Length of Stay, Mortality Risk, and Costs of Bacterial Health Care–Associated Infections in Australia: A Retrospective Case-cohort Study

2020 ◽  
Author(s):  
X J Lee ◽  
A J Stewardson ◽  
L J Worth ◽  
N Graves ◽  
T M Wozniak
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Admissions ◽  
Care Hospital ◽  
Retrospective Case ◽  
Health Care Associated Infections ◽  
Tract Infections ◽  
The Impact

Abstract Background Unbiased estimates of the health and economic impacts of health care–associated infections (HAIs) are scarce and focus largely on patients with bloodstream infections (BSIs). We sought to estimate the hospital length of stay (LOS), mortality rate, and costs of HAIs and the differential effects on patients with an antimicrobial-resistant infection. Methods We conducted a multisite, retrospective case-cohort of all acute-care hospital admissions with a positive culture of 1 of the 5 organisms of interest (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, or Enterococcus faecium) from 1 January 2012 through 30 December 2016. Data linkage was used to generate a data set of statewide hospital admissions and pathology data. Patients with bloodstream, urinary, or respiratory tract infections were included in the analysis and matched to a sample of uninfected patients. We used multistate survival models to generate LOS, and logistic regression to derive mortality estimates. Results We matched 20 390 cases to 75 635 uninfected control patients. The overall incidence of infections due to the 5 studied organisms was 116.9 cases per 100 000 patient days, with E. coli urinary tract infections (UTIs) contributing the largest proportion (51 cases per 100 000 patient days). The impact of a UTI on LOS was moderate across the 5 studied pathogens. Resistance significantly increased LOS for patients with third-generation cephalosporin-resistant K. pneumoniae BSIs (extra 4.6 days) and methicillin-resistant S. aureus BSIs (extra 2.9 days). Consequently, the health-care costs of these infections were higher, compared to corresponding drug-sensitive strains. Conclusions The health burden remains highest for BSIs; however, UTIs and respiratory tract infections contributed most to the health-care system expenditure.

Proportion of Three Types of Health Care Associated Infections among Hospitalized Patients in a Tertiary Care Hospital in Sri Lanka

2021 ◽  
pp. 14-19
Author(s):  
M. B. M. R. D. T. Marapana ◽  
K. S. Dilrukshi ◽  
M. G. S. D Bandara ◽  
M. M. Weerasekara ◽  
J Kottahachchi
Keyword(s):  
Health Care ◽  
Urinary Tract ◽  
Respiratory Tract ◽  
Urinary Tract Infections ◽  
Respiratory Tract Infections ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Health Care Associated Infections ◽  
Tract Infections

Health care associated infections are considered as an indicator of quality and safety of health care institutions. The study aimed to determine the proportion of health care associated urinary tract infections, respiratory tract infections, surgical site infections, and to evaluate the association of medical devices and duration of hospitalization which predispose to health care associated infections. Four hundred and twenty three patients who stayed more than 48 hours or readmitted to surgical, medical, pediatric and gynecology wards in a tertiary care hospital in Sri Lanka during the study period were included in the study. Data extraction sheets were used and were filled with information obtained from bed head tickets and laboratory reports. A total of 79 (18.7%) patients had been diagnosed to have health care associated infection. The predominant type was respiratory tract infections 24 (30.4%) followed by urinary tract infections 21(26.6%), surgical site infections 17 (21.5%), and other infections 17 (21.5%). The highest proportion of urinary tract infections were seen in surgical wards (38.1%) whereas the highest proportion of respiratory tract infections were seen in medical wards (45.8%). Patients aged more than 60 were found to be affected most (27/94). Health care associated infections were significantly associated with usage of medical devices (p<0.05) and length of stay in hospital (p<0.05). The study concludes that these infections account for a noteworthy percentage in hospitalized patients and the predominant type was respiratory tract infections in this tertiary care hospital in Sri Lanka and elders were the mostly affected category compared to children and adults age groups.

scholarly journals Smoke-free legislation and childhood hospitalisations for respiratory tract infections

2015 ◽  
Vol 46 (3) ◽  
pp. 697-706 ◽  
Author(s):  
Jasper V. Been ◽  
Christopher Millett ◽  
John Tayu Lee ◽  
Constant P. van Schayck ◽  
Aziz Sheikh
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Negative Binomial Regression ◽  
Second Hand Smoke ◽  
Incidence Trends ◽  
Group Sex ◽  
Tract Infections ◽  
The Impact

Second-hand smoke exposure is a major risk factor for respiratory tract infections (RTIs). Although evidence suggests important early-life health benefits of smoke-free public environments, the impact on childhood RTIs is unclear. We investigated the association between England's smoke-free legislation and childhood RTI hospitalisations.We used the Hospital Episode Statistics database to obtain nationwide data on hospital admissions for acute RTIs among children (<15 years of age) from 2001 to 2012. Hospitalisation counts were disaggregated by month, age group, sex and small-area level, and linked to urbanisation, region, deprivation index and corresponding population estimates. Negative binomial regression analyses were adjusted for confounders, seasonal variation, temporal autocorrelation, population-size changes and underlying incidence trends. Models allowed for sudden and gradual changes following the smoke-free legislation. We performed sensitivity and subgroup analyses, and estimated number of events prevented.We analysed 1 651 675 hospital admissions. Introduction of smoke-free legislation was followed by an immediate reduction in RTI admissions (−3.5%, 95% CI −4.7– −2.3%), this mainly being attributable to a decrease in lower RTI admissions (−13.8%, 95% CI −15.6– −12.0%). The reductions in admissions for upper RTI were more incremental.The introduction of national smoke-free legislation in England was associated with ∼11 000 fewer hospital admissions per year for RTIs in children.

scholarly journals The Impact of the COVID-19 Pandemic Lockdown on Pediatric Infections—A Single-Center Retrospective Study

2022 ◽  
Vol 10 (1) ◽  
pp. 178
Author(s):  
Magdalena Grochowska ◽  
Dominika Ambrożej ◽  
Aneta Wachnik ◽  
Urszula Demkow ◽  
Edyta Podsiadły ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Bacterial Infections ◽  
Respiratory Tract Infections ◽  
Hospital Admissions ◽  
Substantial Contribution ◽  
Microbiological Analysis ◽  
Gastrointestinal Infections ◽  
Icd 10 ◽  
Tract Infections ◽  
The Impact

Since the SARS-CoV-2 outbreak, many countries have introduced measures to limit the transmission. The data based on ICD-10 codes of lower respiratory tract infections and microbiological analysis of respiratory and gastrointestinal infections were collected. The retrospective five-year analysis of the medical records revealed a substantial decrease in respiratory tract infections during the pandemic year (from April 2020 to March 2021). We noted an 81% decline in the LRTI-associated hospital admissions based on the ICD-10 analysis (from a mean of 1170 admissions per year in the previous four years to 225 admissions between April 2020 through March 2021). According to microbiological analysis, there were 100%, 99%, 87%, and 47% drops in influenza virus, respiratory syncytial virus, rotavirus, and norovirus cases reported respectively during the pandemic season until April 2021 in comparison to pre-pandemic years. However, the prevalence of gastrointestinal bacterial infections was stable. Moreover, in August 2021, an unexpected rise in RSV-positive cases was observed. The measures applied during the COVID-19 pandemic turned out to be effective but also had a substantial contribution to the so-far stable epidemiological situation of seasonal infections.

Evaluation of Parental Knowledge, Attitudes and Practices Regarding Antibiotic Use in Acute Upper Respiratory Tract Infections in Children in a Tertiary Care Hospital in Turkey

2021 ◽  
Author(s):  
Aslınur Albayrak ◽  
Nazmi Mutlu Karakaş ◽  
Bensu Karahalil
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Care Hospital ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Abstract BackgroundUpper respiratory tract infections (URTIs) are common in children. Most URTIs have been shown to be of viral origin. Inappropriate use of antibiotics is one of the main causes of antibiotic resistance. The problem of unnecessary antibiotic use among children is a concern for antibiotic resistance in low- and middle-income developing countries.MethodsOur study is a cross-sectional survey study. It was carried out between 14 December 2020 and 1 April 2021 for parents over 18 years of age with a child under 18 years’ old who applied to the general pediatrics outpatient clinics of Gazi University Faculty of Medicine Hospital Department of Pediatrics.Results554 parents responded to the questionnaire. A total of 15.7% of parents stated to use antibiotics in any child with fever. 37% of parents believed that antibiotics could cure infections caused by viruses. 6.3% of parents declared that they put pressure on pediatricians to prescribe antibiotics. 85.6% of the parents stated that they never gave their children non-prescription antibiotics when they had a high fever. 80.9% of them declared that they never used past antibiotics in the presence of a new infection. Female gender, high level of education, high income level and low number of antibiotics used in the last 1 year were found to be statistically significant with the better knowledge level of the parents (p <0.05).ConclusionAccording to the results of our study of parents' lack of knowledge about antibiotics in Turkey, though generally it shows proper attitude and behavior. It shows that some of the restrictions imposed by the National Action Plan are partially working. However, it is still necessary to continue to inform parents, pediatricians and pharmacists about the use of antibiotics, and to be more sensitive about the prescribing of antibiotics, and if necessary, sanctions should be imposed by the state in order to prevent unnecessary antibiotic prescriptions.

scholarly journals Diagnostic Stewardship in Lower Respiratory Tract Infections Using Procalcitonin

2021 ◽  
Vol 1 (S1) ◽  
pp. s31-s32
Author(s):  
Amanda Gusovsky ◽  
David Burgess ◽  
Donna Burgess ◽  
Emily Slade ◽  
Chris Delcher ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Infectious Diseases ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Length Of Hospital Stay ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Background: A team of infectious diseases physicians, infectious diseases pharmacists, clinical laboratorians, and researchers collaborated to assess the management of lower respiratory tract infections (LRTIs). In 1 sample from our institution, 96.1% of pneumonia cases were prescribed antibiotics, compared to 85.0% in a comparison group. A collaborative effort led to the development of a protocol for procalcitonin (PCT)-guided antibiotic prescribing that was approved by several hospital committees, including the Antimicrobial Stewardship Committee and the Healthcare Pharmacy & Therapeutics Committee in December 2020. The aim of this analysis was to develop baseline information on PCT ordering and antibiotic prescribing patterns in LRTIs. Methods: We evaluated all adult inpatients (March–September 2019 and 2020) with a primary diagnosis of LRTI who received at least 1 antibiotic. Two cohorts were established to observe any potential differences in the 2 most recent years prior to adoption of the PCT protocol. Data (eg, demographics, specific diagnosis, length of stay, antimicrobial therapy and duration, PCT labs, etc) were obtained from the UK Center for Clinical and Translational Science, and the study was approved by the local IRB. The primary outcome of interest was antibiotic duration; secondary outcomes of interest were PCT orders, discharge antibiotic prescription, and inpatient length of stay. Results: In total, 432 patients (277 in 2019 and 155 in 2020) were included in this analysis. The average patient age was 61.2 years (SD, ±13.7); 47.7% were female; and 86.1% were white. Most patients were primarily diagnosed with pneumonia (58.8%), followed by COPD with complication (40.5%). In-hospital mortality was 3.5%. The minority of patients had any orders for PCT (29.2%); among them, most had only 1 PCT level measured (84.1%). The median length of hospital stay was 4 days (IQR, 2–6), and the median duration of antibiotic therapy was 4 days (IQR, 3–6). Conclusions: The utilization of PCT in LRTIs occurs in the minority of patient cases at our institution and mostly as a single measurement. The development and implementation of a PCT-guided therapy could help optimize antibiotic usage in patients with LRTIs.Funding: NoDisclosures: None

scholarly journals Hospital admissions for respiratory tract infections in children aged 0-5 years for 2017/2023

2021 ◽  
Author(s):  
Fredrik Methi ◽  
Ketil Størdal ◽  
Kjetil Elias Telle ◽  
Vilde Bergstad Larsen ◽  
Karin Magnusson
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Hospital Admissions ◽  
Respiratory Support ◽  
Pediatric Hospital ◽  
Policy Makers ◽  
Syncytial Virus ◽  
Tract Infections ◽  
Business As Usual ◽  
Hospital Wards

Background: To compare hospital admissions across common respiratory tract infections (RTI) in 2017-21, and project possible hospital admissions for the RTIs among children aged 0-12 months and 1-5 years in 2022 and 2023. Methods: In 644 885 children aged 0-12 months and 1-5 years, we plotted the observed monthly number of RTI admissions (upper- and lower RTI, influenza, respiratory syncytial virus (RSV), and COVID-19) from January 1st, 2017 until October 31st, 2021. We also plotted the number of RTI admissions with a need for respiratory support. We used the observed data to project four different scenarios of RTI admissions in 2022 and 2023, with different impacts on hospital wards: 1) ″Business as usual″, 2) ″Continuous lockdown″, 3) ″Children′s immunity debt″, and 4) ″Maternal and child immunity debt″. Results: By October 31st, 2021, the number of simultaneous RTI admissions had exceeded the numbers usually observed at the typical season peak in January, i.e. ~900. Based on our observed data and assuming that children and their mothers (who transfer antibodies to the very youngest) have not been exposed to RTI over the last one and a half years, our scenarios suggest that hospitals should be prepared to handle two to three times as many RTI admissions, and two to three times as many RTI admissions requiring respiratory support among 0-5-year-olds as normal, from November 2021 to April 2022. Conclusion: Scenarios with immunity debt suggest that pediatric hospital wards and policy makers should plan for extended capacity.

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