scholarly journals Surveillance of healthcare-associated infections in a Tunisian university hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Hannachi ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
S Khefacha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
University Hospital ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Healthcare Associated Infection ◽  
Carbapenem Resistant ◽  
Independent Risk Factors ◽  
Healthcare Associated

Abstract Introduction Healthcare -associated infections has become a worldwide public health problem. The aim of this study was to estimate the incidence of healthcare- associated infections in a university hospital of Tunisia. Methods This was a cohort study conducted in six intensive care units in a university hospital of Tunisia during three months (from august to October 2018). Data was provided from patients’ files. Data entry and analysis was done using SPSS version 22. Multivariate analysis was used in order to identify independent risk factors for healthcare associated infection. Results A total of 202 patients were enrolled in this study. The incidence rate of healthcare-associated infections was 53,96%(109/202). The ratio infection/infected was estimated to 1.65(109/66). The incidence of multi-drug resistant pathogens was 21,28% (43/202). The most common resistant pathogens included pseudomonas aeruginosa resistant to cefdazidime in 13,76%(15/109) followed by those resistant to extended spectrum cephalosporin 11.92% (13/109), followed by carbapenem-resistant acinetobcater baumanii 6,42%(7/109) then by carbapenem resistant pathogens and enterococcus resistant to vancomycin 2.75%(3/109) and finally staphylococcus aureus resistant to methicillin 2.1%(2/1.83). The multivariate analysis showed that long duration of central line catheterisation (RR = 7.44; 95%CI[2.79-19.82]), tracheotomy(RR = 8.61;95%CI[2.09-35,39]) and length of stay (RR = 1.08; 95%CI[1.04-1.13]) were found as independent risk factors for healthcare -associated infection. Conclusions The emergence of mutli-drug resistant pathogens needs to be deeply studied and effective measures have to be taken in order to detect and prevent transmission of resistant strains and/or their resistance determinants, especially those with phenotypes having the fewest viable treatment options. Key messages The incidence of healthcare associated infection in the intensive care unit was high. Effective measures have to be taken in the intensive care unit to detect and prevent transmission of resistant pathogens.

scholarly journals Identifying Risk Factors for Healthcare-Associated Infections Caused by Carbapenem-Resistant Acinetobacter baumannii in a Neonatal Intensive Care Unit

2018 ◽  
Vol 18 (1) ◽  
pp. 75 ◽  
Author(s):  
Amira M. Sultan ◽  
Wael A. Seliem
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Acinetobacter Baumannii ◽  
Neonatal Intensive Care ◽  
Control Group ◽  
Healthcare Associated Infections ◽  
Carbapenem Resistant ◽  
Healthcare Associated

Objectives: Acinetobacter baumannii is a causative pathogen of various healthcare-associated infections (HAIs) and is particularly prevalent in high-risk hospital settings. This study aimed to determine risk factors associated with HAIs caused by carbapenem-resistant A. baumannii (CRAB) in a neonatal intensive care unit (NICU). Methods: This prospective study was performed between January 2013 and June 2014 among NICU patients at the Mansoura University Children’s Hospital, Mansoura, Egypt. Neonates who developed HAIs due to CRAB were assigned to a case group, while those infected with carbapenem-sensitive A. baumannii (CSAB) were assigned to a control group. Results: Among the 124 neonates who developed A. baumannii-caused HAIs during the study period, 91 (73.4%) were caused by CRAB and 33 (26.6%) were caused by CSAB. Prematurity, premature rupture of the membranes (PROM), a previous stay in another hospital, prolonged NICU stay, the presence of invasive devices, previous exposure to carbapenems or aminoglycosides and prolonged antibiotic therapy before infection were significantly associated with CRAB-caused HAIs. A multivariate logistic regression analysis identified prematurity (adjusted odds ratio [aOR] = 25.3; P <0.01), mechanical ventilation (aOR = 18.9; P <0.01) and the previous use of carbapenems (aOR = 124.7; P <0.01) or aminoglycosides (aOR = 22.6; P = 0.04) to be independent risk factors for CRAB infections. Conclusion: Various risk factors were significantly associated with CRAB-caused HAIs among the studied NICU patients.

Risk factors for healthcare-associated infection in a pediatric intensive care unit*

2010 ◽  
Vol 11 (2) ◽  
pp. 246-252 ◽  
Author(s):  
Maria Júlia Gonçalves de Mello ◽  
Maria de Fátima Pessoa Militão de Albuquerque ◽  
Heloísa Ramos Lacerda ◽  
Maria Tereza Serrano Barbosa ◽  
Ricardo Arraes de Alencar Ximenes
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

scholarly journals Use of personal digital assistants to detect healthcare-associated infections in a neonatal intensive care unit in Egypt

2016 ◽  
Vol 10 (11) ◽  
pp. 1250-1257 ◽  
Author(s):  
Elham AM El-Feky ◽  
Doa’a A Saleh ◽  
Jehan El-Kholy ◽  
Ahmed Mahmoud Sayed ◽  
Yasmeen Mansi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
University Hospital ◽  
Personal Digital Assistants ◽  
Healthcare Associated Infections ◽  
Coagulase Negative Staphylococci ◽  
Promising Alternative ◽  
Healthcare Associated

Introduction: Personal digital assistants (PDAs) used in electronic laboratory-based surveillance are a promising alternative to conventional surveillance to detect healthcare-associated infections (HAIs). The aim of the study was to monitor, detect, and analyze HAIs using PDAs in a neonatal intensive care unit (NICU). Methodology: In this descriptive study, 1,053 neonates admitted to the NICU in the obstetrics and gynecology ward at the Cairo University hospital were included and evaluated for HAIs by collecting data using PDAs programmed by Naval Medical Research Unit 3, Cairo, with the definitions for HAIs provided by the National Healthcare Safety Network of the Centers for Disease Control and Prevention. Case records were reviewed three times a week over 19 months, from March 2012 to September 2013. Results: Of 124 suspected episodes of infection recorded in PDAs, 89 confirmed episodes of infection were identified. HAI and NICU infection rates were 7.4 and 2.72/1,000 patient-days, respectively. Primary bloodstream infection was detected in 81 episodes and pneumonia in 8 episodes. The majority of infections (62%) were acquired in the ward before NICU admission. Klebsiella spp. was isolated most frequently (42%), followed by coagulase-negative Staphylococci (31%). Conclusions: This study is the first to report the use of PDAs in surveillance to detect HAIs in the NICU in our hospital. The majority of infections were acquired at the obstetric care department, indicating the importance of implementing rigorous prevention and control programs and a more detailed surveillance to identify other risk factors for infections.

scholarly journals Fecal carriage of carbapenem resistant Enterobacteriaceae among the intensive care unit patients

2019 ◽  
Vol 7 (8) ◽  
pp. 2956
Author(s):  
Naina . ◽  
Antariksh Deep ◽  
Dhruva Chaudhry ◽  
Aparna Yadav
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Ambient Air ◽  
Diffusion Method ◽  
Healthcare Associated Infections ◽  
Macconkey Agar ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Healthcare Associated

Background: The war against multidrug-resistant bacteria is challenging and of global concern. Hospitals are increasingly plagued by resistant gram negative pathogens. Bacteria of the family Enterobacteriaceae such as Escherichia coli and Klebsiella pneumoniae are part of the normal human intestinal flora but are also often responsible for community- and healthcare-associated infections. These bacteria are prone to acquiring resistance genes.Methods: Rectal swabs/swabs from the peri-anal area of the patients who were admitted in the Intensive Care Unit (ICU) of the accident and emergency department of this teaching hospital. Swabs were collected first on day 1 of admission, then day 4, and thereafter weekly during the period of stay in the ICU. All the swabs were immediately inoculated into trypticase soy broth with one 10μg  meropenem disc and were incubated overnight at 35±2ºC, ambient air. Next day, the broth was vortexed, and then sub-cultured onto a MacConkey agar plate. On the third day, MacConkey agar plates were examined for lactose fermenting (pink-coloured) colonies. The representative isolated colonies were subjected to conventional antimicrobial susceptibility testing by the Kirby Bauer Disc diffusion method following the CLSI guidelines to know the susceptibility to carbapenem and other antimicrobial agents. Carbapenemase production was done by a Modified Hodge Test (MHT) and Imipenem-EDTA test.Results: Out of 89 patients, carbapenem resistant Klebsiella pneumoniae and E. coli isolates were recovered from 35 (39.3%) patients i.e. Klebsiella pneumoniae isolates from fifteen patients and carbapenem resistant E. coli isolates from twenty patients. Prevalence of carbapenemase producing isolates was found to be 1.42%.  Conclusions: Surveillance for CRE can definitely help reduce rates of healthcare associated infections. 

scholarly journals Faucet aerators as a reservoir for Carbapenem-resistant Acinetobacter baumannii: a healthcare-associated infection outbreak in a neurosurgical intensive care unit

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Yu Lv ◽  
Qian Xiang ◽  
Ying Z. Jin ◽  
Ying Fang ◽  
Yu J. Wu ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Emergency Response ◽  
Environmental Samples ◽  
Healthcare Associated Infection ◽  
Outbreak Strain ◽  
Carbapenem Resistant ◽  
Neurosurgical Intensive Care ◽  
Neurosurgical Intensive Care Unit ◽  
Healthcare Associated

Abstract Background On January 7, 2019, we observed an outbreak of healthcare-associated infection (HAI) caused by Carbapenem-resistant Acinetobacter baumannii (CRAB) in the neurosurgical intensive care unit (NSICU). A follow-up epidemiological investigation was conducted, and an emergency response was initiated. We aimed to study the clonal transmission of CRAB and its possible source. Methods A matched case-control (1:2) study was performed to identify the possible predisposing factors. A multifaceted intervention was implemented to control the outbreak. We collected environmental samples from patients’ rooms and living area of the staff. CRAB isolates were tested for genetic relatedness by Pulsed-Field Gel Electrophoresis (PFGE). Results Environmental sampling showed that a faucet aerator was contaminated with A. baumannii. Molecular typing revealed the only outbreak strain, which was isolated from tracheal aspirate cultures of the first case of community-acquired infection and 3 cases of HAI. In environmental samples, the outbreak strain was found only in the faucet aerator of the dining room. This CRAB outbreak was discovered in time, and further progress of this outbreak was prevented through a pre-set emergency response procedure. Conclusions The faucet aerator acted as a reservoir for bacteria in the outbreak, and contamination of the faucet aerator might have occurred from splashes originating from handwashing by the healthcare workers (HCWs). In high-risk areas, such as NSICU, the faucet aerators should not be used during an outbreak or they should be regularly cleaned and disinfected. The start-up criteria for the emergency response played a key role in controlling the CRAB outbreak, and its settings should be discussed more widely.

Sign in / Sign up

Export Citation Format

Share Document