scholarly journals 853. Hospital-acquired Infections by Vancomycin-Resistant Enterococcus (VRE): Results in 3 Years of Multicenter Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S467-S467
Author(s):  
Luciana Coelho Tanure ◽  
Rafaela Tonholli Pinho ◽  
Érico Macedo Pacheco Alves ◽  
Bárbara Caldeira Pires ◽  
Joice Ribeiro Lopes ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Hospital Setting ◽  
Bloodstream Infections ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Vancomycin Resistant Enterococcus ◽  
Hospital Acquired Infections ◽  
Vancomycin Resistant ◽  
Tract Infections ◽  
Hospital Acquired

Abstract Background Vancomycin-Resistant Enterococcus (VRE) is considered one of the main pathogens of hospital-acquired infections (HAI), responsible for high morbidity and mortality rates. HAI caused by this bacteria, especially in intensive care units (ICU), are concerning for the health system, given that the microorganism is multi resistant to most antimicrobials available, especially vancomycin. Therefore, the present study is built from and analyzes the data of VRE, collected by the Infection Prevetion and Control Service of hospitals in Brazil, to clarify: the incidence rate, the gross lethality of these infections and what are the profiles of infected patients. Methods Collection and analysis of epidemiological data, according to the National Healthcare Safety Network (NHSN) protocol of the Centers for Disease Control and Prevention (CDC), in 10 hospitals in Brazil, between Jan/2017 - Dec/2019. Results In three years, 118 VRE infections were diagnosed in the hospitals analyzed: 51 from ICU (43%), 24 from Vascular Acess (20%), 18 from General Clinic (15%), 10 from General Surgery (8%) and 15 from Others (13%). Patients ages ranged from 0 to 93 years, with a mean of 62 years (standard deviation of 20 years) and a median of 66 years. Time between admission and diagnosis of infection was 1 to 1001 days, with a mean of 68 days (standard deviation of 25 days) and a median of 59 days. The gross lethality for VRE infections was 47/118 (40%). The infection sites were: Bloodstream Infections – BSI = 34 (29%); Urinary Tract Infections – UTI = 28 (24%); Surgical Site Infections – SSI = 27 (23%); Skin and Soft Tissue Infections – SST = 14 (12%); Bone and Joint Infections – BJ = 5 (4%); Cardiovascular System Infections – CVS = 5 (4%); Lower Respiratory System Infections, other than pneumonia – LRI = 2 (2%); Pneumonia – PNEU = 2 (2%) and Gastrointestinal System Infections – GI = 1 (1%). Percentage of VRE infections by hospital units Percentage of VRE infections by infection sites Infection sites of VRE infections by hospital Conclusion VRE infection is a highly lethal event that usually occurs after two months of hospitalization. The main site of infection is the BSI, with a higher incidence in patients over 62 years or the ones in ICU. Early and accurate investigations of multiresistant microorganisms in a hospital setting are necessary to reduce patient morbidity and mortality. Disclosures All Authors: No reported disclosures

scholarly journals Infection Prevention in the ICU

2021 ◽  
Keyword(s):  
Healthcare Professionals ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Morbidity And Mortality ◽  
Resistant Bacteria ◽  
Multidrug Resistant Bacteria ◽  
Hospital Acquired Infections ◽  
Hospitalised Patients ◽  
Tract Infections ◽  
Hospital Acquired

Hospital-acquired infections are among the most significant issues within the healthcare system, both in Greece and abroad. This is because they are associated with severe morbidity and mortality. As a rule, in Intensive Care Units (ICU), hospital-acquired infections are caused by multidrug-resistant bacteria. The spread of infections by multidrug-resistant bacteria occurs in steps. Step one is usually considered to be colonisation of the ICU host-patient via indirect contact. A transmission vehicle in these cases are the hands of healthcare professionals. The main infections in this category are the ones that affect the respiratory system, followed by bloodstream infections, mainly through endovascular catheters, and urinary tract infections. Therefore, some simple measures can limit the spread of infections, improving the clinical outcomes for hospitalised patients. These include following hand hygiene, ensuring that the medical and nursing staff change disposable gloves, keeping the ICU areas extremely clean and keeping together hospitalised patients who are colonised by the same multidrug-resistant bacteria. However, many healthcare professionals fail to consistently comply with these guidelines, which leads to the spread of multidrug-resistant bacteria, and increased morbidity and mortality.

Modern Trends in Infection Control Practices in Intensive Care Units

2013 ◽  
Vol 29 (6) ◽  
pp. 311-326 ◽  
Author(s):  
Sumanth Gandra ◽  
Richard T. Ellison
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Environmental Cleaning ◽  
Hospital Acquired Infections ◽  
New Methods ◽  
Tract Infections ◽  
Hospital Acquired

Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection.

scholarly journals ACINETOBACTER MAIN CAUSE OF HOSPITAL ACQUIRED INFECTIONS: A REVIEW

2017 ◽  
Vol 10 (5) ◽  
pp. 53
Author(s):  
Anania Arjuna
Keyword(s):  
Acinetobacter Baumannii ◽  
Medical Devices ◽  
Efflux Pump ◽  
Bloodstream Infections ◽  
Vital Role ◽  
Hospital Environment ◽  
Gram Negative ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Hospital acquired infections (HAIs) are mostly caused by Gram-negative organisms and is one of the major issues in patient safety. These infectionsare often associated with the medical processes of hospitals such as invasive medical devices and various surgical procedures. Gram-negativeorganisms account for most infections in the hospital environment because of their ability to acquire resistant against multiple antibiotics. Throughdifferent mechanisms including the synthesis of β- lactamases, overexpression of transmembrane efflux pump, loss of porins, synthesis of antibiotic modifying enzymes, target mutations, ribosomal mutation or modifications, mutations in lipopolysaccharide structure etc. these organisms have developed drug-resistant property and the genes encoded in plasmids play a vital role in developing the resistant. Among all Gram-negative bacteria, Acinetobacter baumannii is an emerging pathogen that accounts for about 80% of all reported infections. Although other species of Acinetobacter are also often associated with HAIs. Acinetobacter is non-motile, obligate aerobic Gram-negative coccobacillus and are ubiquitous free-living saprophytes in soil and water. It is commonly transmitted through medical devices such as ventilators, urinary catheters and other invasive devices in hospitals but its ability to colonize on the skin of individuals often increases the rate of transmission through person to person contact. Patients admitted to Intensive Care Unit (ICU) are at the major risk of getting infected by A. baumannii and these includes pneumonia/ ventilator associated pneumonia(VAP), bloodstream infections, wound abscesses, urinary tract infections etc.Keywords: HAI, Acinetobacter baumannii, β- lactamases, VAP

scholarly journals 406. Incidence of Community and Hospital Acquired Infections in Critically Ill COVID-19 Patients in the Dominican Republic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S304-S305
Author(s):  
Rita Alexandra Rojas-Fermin ◽  
Anel E Guzman ◽  
Ann Sanchez ◽  
Edwin Germosen ◽  
Cesar Matos ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Dominican Republic ◽  
Critically Ill ◽  
Urinary Tract Infections ◽  
Bloodstream Infections ◽  
Central Venous ◽  
Health Crisis ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Abstract Background The disease caused by SARS-CoV-2, COVID-19, has caused a global public health crisis. COVID-19 causes lower respiratory tract infection (LRTI) and hypoxia. There is a paucity of data on bacterial and fungal coinfection rates in patients with COVID-19 at low and middle income countries (LMICs). Our objective is to describe the clinical characteristics of critically ill patients with COVID-19 in the Dominican Republic (DR) Methods We performed a retrospective review of patients admitted to the ICU with COVID-19 from March 14th to December 31st 2020, at a 296-bed tertiary care level and teaching Hospital in the Dominican Republic. Demographic and clinical information was collected and tabulated. Laboratory confirmed bacterial and fungal infections were defined as community acquired infections (CAI) if diagnosed within 48 hours of admission and hospital acquired infections (HAI) when beyond 48 hours. Microbiologic data was tabulated by source and attribution. Results Our cohort had 382 COVID-19 patients. Median age was 64 and most were male (64.3%) and 119 (31.1%) were mechanically ventilated and 200 (52%) had central venous catheters. A total of 28 (7%) laboratory confirmed community acquired infections and 55 (14%) HAIs occurred. Community acquired infections included 13 (46%) bloodstream infections (BSIs), 11 (39%) urinary tract infections (UTI) and 6 (21%) LRTIs. HAIs included 39 (70%) BSIs, 11 (20%) UTIs and 6 (11%) ventilator associated pneumonias (VAP). Causal organisms of community and hospital acquired BSI and UTI are in Figure 1 and Figure 2 respecively. All-cause mortality was 35.3% (135/382) in our cohort, and 100% mortality (76) in those with coinfections. Figure 1. Community acquired and hospital acquired bloodstream infections in COVID-19 patients admitted to the ICU Figure 2. Community acquired and hospital acquired urinary tract infections in COVID-19 patients admitted to the ICU Conclusion Community and hospital acquired infections were common and in the ICU and likely contributed to patient outcomes. More than two thirds of HAIs in the ICU were BSIs. Central venous catheter device utlization and maintenance may play a role in BSIs, along with immunosuppression from COVID-19 therapeutics and translocation from mucosal barrier injury. Mortality in patients with coinfections was higher than those without. Infection prevention strategies to reduce device utilization during COIVD-19 in LMICs may have an impact on HAIs. Disclosures All Authors: No reported disclosures

scholarly journals Bugs Can Be Busted: How to Prevent Hospital-Acquired Infections A Success Story of Norwegian American Hospital, Chicago, U.S.A, in Substantially Reducing Hospital-acquired Infection (HAI) Rates

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Gap Analysis ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Rates ◽  
Clinical Practices ◽  
American Hospital ◽  
Hospital Acquired Infections ◽  
Stewardship Program ◽  
Tract Infections ◽  
Hospital Acquired

Hospital-acquired infections (HAIs) including Central Line -Associated Bloodstream Infections (CLABSI), CatheterAssociated Urinary Tract Infections (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA) infections, Clostridium difficle Infections (CDI), Surgical Site Infections (SSI), and Ventilator-Associated Pneumonia (VAP) are among the most common and serious patient safety threats in the health care settings, which contribute to significant morbidity, mortali-ty, length of patient stay, and healthcare cost. To combat increasing number of HAI, Norwegian American Hospital (NAH), Chicago, Illinois, USA, strategically developed, and successfully implemented a HAI control and prevention initia-tive in 2013. As a result, NAH dramatically reduced its infection rates over the next several years and the trend continues to date. Guided by Gap analysis, driven by data, gathered from both internal and external sources, and supported by hospital leadership, NAH initiated a process of gradual and transformational re-forms, by engaging, educating and empowering all clinical and administrative staff, patients, their families and community, promoting a culture of mutual responsibility, incorporating best practic-es, integrating technology into clinical practices, developing electronic standing order- sets and nurse-driven protocols, creating hand hygiene, sepsis and sexually transmitted infections task forces, and antimicrobial stewardship program, NAH successfully managed to achieve and maintain high-quality standards of patient care and lower then national benchmarks HAI rates for the last four consecutive years (January 2016 to December 2019). Among the device-associated infections (CAUTI/CLABSI), we encountered only one CAUTI and no CLABSI in 2016, none in 2017, only one CAUTI and no CLABSIs in 2018 and only one CAU-TI and one CLABSI in 2019. Furthermore, our VAP rate remained zero, we had only one SSI in 2019 and the C. Difficle Infection rates have also been steadily declining since the implementation of new preventive measures. As a result, NAH received several recognition awards from the lo-Cal as well as national health organizations.

HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

2016 ◽  
pp. 39-43
Author(s):  
Dinh Binh Tran ◽  
Dinh Tan Tran
Keyword(s):  
Surgical Site Infection ◽  
Surgical Intervention ◽  
University Hospital ◽  
Hospital Infections ◽  
Site Infection ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

scholarly journals The contribution of hospital-acquired infections to the COVID-19 epidemic in England in the first half of 2020

2021 ◽  
Author(s):  
Gwenan M. Knight ◽  
Thi Mui Pham ◽  
James Stimson ◽  
Sebastian Funk ◽  
Yalda Jafari ◽  
...  
Keyword(s):  
Medical Research ◽  
Symptom Onset ◽  
Research Council ◽  
Medical Research Council ◽  
National Level ◽  
Hospital Setting ◽  
Hospital Acquired Infections ◽  
Hospitalised Patients ◽  
Total Burden ◽  
Hospital Acquired

AbstractBackgroundSARS-CoV-2 spreads in hospitals, but the contribution of these settings to the overall COVID-19 burden at a national level is unknown.MethodsWe used comprehensive national English datasets and simulation modelling to determine the total burden (identified and unidentified) of symptomatic hospital-acquired infections. Those unidentified would either be 1) discharged before symptom onset (“missed”), or 2) have symptom onset 7 days or fewer from admission (“misclassified”). We estimated the contribution of “misclassified” cases and transmission from “missed” symptomatic infections to the English epidemic before 31st July 2020.FindingsIn our dataset of hospitalised COVID-19 patients in acute English Trusts with a recorded symptom onset date (n = 65,028), 7% were classified as hospital-acquired (with symptom onset 8 or more days after admission and before discharge). We estimated that only 30% (range across weeks and 200 simulations: 20-41%) of symptomatic hospital-acquired infections would be identified. Misclassified cases and onward transmission from missed infections could account for 15% (mean, 95% range over 200 simulations: 14·1%-15·8%) of cases currently classified as community-acquired COVID-19.From this, we estimated that 26,600 (25,900 to 27,700) individuals acquired a symptomatic SARS-CoV-2 infection in an acute Trust in England before 31st July 2020, resulting in 15,900 (15,200-16,400) or 20.1% (19.2%-20.7%) of all identified hospitalised COVID-19 cases.ConclusionsTransmission of SARS-CoV-2 to hospitalised patients likely caused approximately a fifth of identified cases of hospitalised COVID-19 in the “first wave”, but fewer than 1% of all SARS-CoV-2 infections in England. Using symptom onset as a detection method for hospital-acquired SARS-CoV-2 likely misses a substantial proportion (>60%) of hospital-acquired infections.FundingNational Institute for Health Research, UK Medical Research Council, Society for Laboratory Automation and Screening, UKRI, Wellcome Trust, Singapore National Medical Research Council.Research in contextEvidence before this studyWe searched PubMed with the terms “((national OR country) AND (contribution OR burden OR estimates) AND (“hospital-acquired” OR “hospital-associated” OR “nosocomial”)) AND Covid-19” for articles published in English up to July 1st 2021. This identified 42 studies, with no studies that had aimed to produce comprehensive national estimates of the contribution of hospital settings to the COVID-19 pandemic. Most studies focused on estimating seroprevalence or levels of infection in healthcare workers only, which were not our focus. Removing the initial national/country terms identified 120 studies, with no country level estimates. Several single hospital setting estimates exist for England and other countries, but the percentage of hospital-associated infections reported relies on identified cases in the absence of universal testing.Added value of this studyThis study provides the first national-level estimates of all symptomatic hospital-acquired infections with SARS-CoV-2 in England up to the 31st July 2020. Using comprehensive data, we calculate how many infections would be unidentified and hence can generate a total burden, impossible from just notification data. Moreover, our burden estimates for onward transmission suggest the contribution of hospitals to the overall infection burden.Implications of all the available evidenceLarge numbers of patients may become infected with SARS-CoV-2 in hospitals though only a small proportion of such infections are identified. Further work is needed to better understand how interventions can reduce such transmission and to better understand the contributions of hospital transmission to mortality.

scholarly journals Emergence and spread of vancomycin resistance among enterococci in Europe

2008 ◽  
Vol 13 (47) ◽  
Author(s):  
G Werner ◽  
T M Coque ◽  
A M Hammerum ◽  
R Hope ◽  
W Hryniewicz ◽  
...  
Keyword(s):  
Population Analysis ◽  
Vancomycin Resistance ◽  
Vancomycin Resistant Enterococcus ◽  
Phenotypic Marker ◽  
Vancomycin Resistant Enterococci ◽  
Distinct Subpopulation ◽  
Typing Methods ◽  
Vancomycin Resistant ◽  
Hospital Acquired ◽  
Animal Strains

Vancomycin-resistant enterococci (VRE) first appeared in the late 1980s in a few European countries. Nowadays, six types of acquired vancomycin resistance in enterococci are known; however, only VanA and to a lesser extent VanB are widely prevalent. Various genes encode acquired vancomycin resistance and these are typically associated with mobile genetic elements which allow resistance to spread clonally and laterally. The major reservoir of acquired vancomycin resistance is Enterococcus faecium; vancomycin-resistant Enterococcus faecalis are still rare. Population analysis of E. faecium has revealed a distinct subpopulation of hospital-acquired strain types, which can be differentiated by molecular typing methods (MLVA, MLST) from human commensal and animal strains. Hospital-acquired E. faecium have additional genomic content (accessory genome) including several factors known or supposed to be virulence-associated. Acquired ampicillin resistance is a major phenotypic marker of hospital-acquired E. faecium in Europe and experience has shown that it often precedes increasing rates of VRE with a delay of several years. Several factors are known to promote VRE colonisation and transmission; however, despite having populations with similar predispositions and preconditions, rates of VRE vary all over Europe.

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