scholarly journals 91. Implementing Criteria to Reduce Blood Cultures Ordering: A Pre- and Post-Intervention Retrospective Study in a Critical Access Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S61-S61
Author(s):  
Rattanaporn Mahatanan ◽  
Gina Gomez ◽  
Bridget Olsen ◽  
Racheal Henderson
Keyword(s):  
Severe Sepsis ◽  
Blood Culture ◽  
Blood Stream Infection ◽  
Demographic Data ◽  
Intervention Group ◽  
Vital Signs ◽  
Blood Stream ◽  
Blood Cultures ◽  
Post Intervention ◽  
Chi Square

Abstract Background Blood culture utilization has been performed widely. Typically, clinicians order blood cultures in patients whom bacteremia is suspected. Our previous study showed that 35% of blood cultures performed in May 2019 could have been prevented since they did not meet the certain criteria. This study sought to examine the outcomes after education intervention by implementing criteria of blood culture ordering whether it could reduce unnecessary blood cultures. Methods Electronic medical records of adult patients who had blood cultures done during pre-and post-study period were reviewed. Demographic data, clinical presentation, vital signs, location, quantities and sites of blood cultures were obtained. The measurement of qSOFA, SIRS and severe sepsis criteria were collected on the presentation. There were some clinical prediction rules for blood stream infection described in the previous studies. For this study, we use the criteria of at least 2 SIRS and/or at least one of the qSOFA criteria or severe sepsis to be a minimum indication for ordering blood cultures. The follow-up study was done after 6 weeks of educational intervention with implementation of criteria. Chi-square was used to compare the differences between two groups. Results There were a total of 165 patients included in our study (112 in pre- and 53 in post-intervention group). There were a total of 18 patients with positive blood cultures (12/112;10.71% in pre-intervention gr. vs 6/53;11.32% in post-intervention gr., p=0.91). Six out of 18 (33%) were deemed to be contaminated (3/12;25% vs 3/6;50%, p=0.29). Gram positive cocci were the most common organisms of the true positive blood cultures (10/12;83%). Of 165 patients, 78 (47%) had at least one of qSOFA (47/112;41% vs 31/53;58%, p=0.05), 18 (11%) had met severe sepsis criteria (9/112;8% vs 9/53;17%, p=0.09). There were 47 (28%) patients who had less than 2 criteria of SIRS and did not meet either criteria of qSOFA or severe sepsis (39/112; 35% vs 8/53; 15%, chi 6.87, p< 0.01). There was no true bacteremia in this group of patients. Conclusion Our study found that implementation of criteria for blood cultures successfully reduces the unnecessary blood cultures orders approximately 20% without missing true bacteremia in suspected patients. Disclosures All Authors: No reported disclosures

scholarly journals Health education through mass media announcements by loudspeakers about malaria care: prevention and practice among people living in a malaria endemic area of northern Myanmar

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Pyae Linn Aung ◽  
Tepanata Pumpaibool ◽  
Than Naing Soe ◽  
Jessica Burgess ◽  
Lynette J. Menezes ◽  
...  
Keyword(s):  
Intervention Group ◽  
Malaria Prevention ◽  
Care Seeking ◽  
Endemic Region ◽  
Post Intervention ◽  
Chi Square ◽  
Transmission Season ◽  
Baseline Knowledge ◽  
Peak Transmission

Abstract Background Interventions to raise community awareness about malaria prevention and treatment have used various approaches with little evidence on their efficacy. This study aimed to determine the effectiveness of loudspeaker announcements regarding malaria care and prevention practices among people living in the malaria endemic villages of Banmauk Township, Sagaing Region, Myanmar. Methods Four villages among the most malaria-burdened areas were randomly selected: two villages were assigned as the intervention group, and two as the control. Prior to the peak transmission season of malaria in June 2018, a baseline questionnaire was administered to 270 participants from randomly selected households in the control and intervention villages. The loudspeaker announcements broadcasted health messages on malaria care and prevention practices regularly at 7:00 pm every other day. The same questionnaire was administered at 6-month post intervention to both groups. Descriptive statistics, Chi-square, and the t-test were utilized to assess differences between and within groups. Results Participants across the control and intervention groups showed similar socio-economic characteristics; the baseline knowledge, attitude and practice mean scores were not significantly different between the groups. Six months after the intervention, improvements in scores were observed at p-value < 0.001 in both groups, however; the increase was greater among the intervention group. The declining trend of malaria was also noticed during the study period. In addition, more than 75% of people expressed positive opinions of the intervention. Conclusions The loudspeaker intervention was found to be feasible and effective, as shown by the significant improvement in scores related to prevention and care-seeking practices for malaria as well as reduced malaria morbidity. Expanding the intervention to a larger population in this endemic region and evaluating its long-term effectiveness are essential in addition to replicating this in other low-resource malaria endemic regions.

scholarly journals A Sterile Collection Bundle Intervention Reduces the Recovery of Bacteria from Neonatal Blood Culture

2018 ◽  
Vol 3 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Linze F. Hamilton ◽  
Helen E. Gillett ◽  
Adam Smith-Collins ◽  
Jonathan W. Davis
Keyword(s):  
Intensive Care ◽  
Blood Culture ◽  
False Positive ◽  
Neonatal Intensive Care ◽  
Intervention Group ◽  
Group Versus ◽  
Antibiotic Use ◽  
Culture Collection ◽  
Blood Cultures ◽  
Before And After

Background: In neonatal intensive care, coagulase-negative Staphylococcus species can be both blood culture contaminants and pathogens. False-positive cultures can result in clinical uncertainty and unnecessary antibiotic use. Objective: This study sought to assess whether a sterile blood culture collection bundle would reduce the incidence of false-positive blood cultures in a regional neonatal intensive care unit. Method: Clinical data was collected from all infants who had blood cultures taken before and after the introduction of the sterile blood culture collection bundle intervention. This intervention required 2% chlorhexidine and full sterile precautions for blood culture collection. False-positive blood culture rates (presence of skin commensals and ≥3 clinical infection signs) were compared before and after the intervention. The number of days of unnecessary antibiotics associated with false-positive blood cultures was also analysed. Results: In the pre-intervention group (PRE) 197 cultures were taken from 161 babies. In the post-intervention group (POST) 170 cultures from 133 babies were acquired. Baseline demographics were similar in both groups. The rate of false-positive cultures in the PRE group versus the POST group was 9/197 (4.6%) compared to 1/170 (0.6%) (p < 0.05). Unnecessary antibiotic exposure was reduced in the PRE group in comparison to the POST group (27 vs. 0 days, p < 0.01). Conclusions: Implementation of sterile blood culture collection intervention reduced the number of false-positive results. This has potential benefit in reducing unnecessary antibiotic use.

Effectiveness of an Educational Intervention to Participation in Physical Activity: A quasi-experimental model-based study

2020 ◽  
Author(s):  
Saeideh Shahsavari ◽  
Sakineh dadipoor ◽  
Mohtasham Ghaffari ◽  
Ali Safari-Moradabadi
Keyword(s):  
Physical Activity ◽  
Educational Intervention ◽  
Stages Of Change ◽  
Intervention Group ◽  
T Test ◽  
Control Group ◽  
Post Intervention ◽  
Chi Square ◽  
Significant Difference ◽  
Quasi Experimental

Abstract Background: The aim of the present study was to assess readiness to become or stay physically active according to the Stages of Change Model.Methods: The present quasi-experimental study was conducted on 100 women working in the healthcare centres of Bandar Abbas, Iran. The sampling method is clustering in type. The subjects were assigned into two groups of intervention and control. The collected data were analysed by SPSS-16 software using descriptive and inferential statistics, including independent-sample t-test, paired-sample t-test and Chi-square test.Results: Before the educational intervention, 19 subjects (0.38%) from the intervention group showed to have regular physical activity (4-5 stages). This number changed to 29 (0.58%) and 25 (0.50%) after three months and six months of intervention. A statistically significant difference was found before the intervention and 3 and 6 months afterwards (P˂.001). In the control group, no statistically significant difference was found between the pre-intervention and post-intervention (three months (P=.351) and six months (P=.687).Conclusion: The educational intervention based on the stages of behaviour change model showed to be effective in promoting the physical activity of employed women. These findings may benefit health education researchers and practitioners who tend to develop innovative theory-based interventions and strategies to increase the level of physical activity in women.

Does the CATCH Early Childhood Program Increase Physical Activity Among Low-Income Preschoolers?—Results From a Pilot Study

2017 ◽  
Vol 32 (2) ◽  
pp. 344-348 ◽  
Author(s):  
Ru-Jye Chuang ◽  
Shreela V. Sharma ◽  
Cheryl Perry ◽  
Pamela Diamond
Keyword(s):  
Physical Activity ◽  
Early Childhood ◽  
Head Start ◽  
Low Income ◽  
Demographic Data ◽  
Intervention Group ◽  
Post Intervention ◽  
Low Income Children ◽  
School Year ◽  
Observation Method

Purpose: To explore whether the physical activity (PA) component of the Coordinated Approach to Child Health Early Childhood (CATCH EC) program helps increasing preschoolers’ PA during active times at preschool. Design: Nonrandomized controlled experimental study. Setting: Head Start centers in Houston, Texas, 2009 to 2010 school year. Participants: A total of 439 preschoolers aged 3 to 5 years (3 intervention centers, n = 220; 3 comparison centers, n = 219). Intervention: The CATCH EC preschool-based teacher-led nutrition and PA program. Measures: Preschoolers’ PA was measured at baseline and postintervention using the System for Observing Fitness Instruction Time–Preschool version, a direct observation method measuring PA at the classroom level. Parent surveys provided demographic data. Analysis: Pre-to-post changes in preschoolers’ PA were examined using the Mann-Whitney U test. Results: Results show a significant decrease in the percentage time preschoolers spent in level 2 PA (low activity) at intervention ( P = .005) and comparison ( P = .041) centers. Indoor vigorous activity increased significantly on an average by +6.04% pre-to-post intervention among preschoolers in the intervention group ( P = .049); no significant change was found in the comparison group. Conclusion: The CATCH EC favorably increased indoor vigorous PA level among low-income children attending Head Start.

Nosocomial Bloodstream Infections in Patients Receiving Extracorporeal Life Support: Variability in Prevention Practices

2016 ◽  
Vol 31 (10) ◽  
pp. 654-669 ◽  
Author(s):  
Lily B. Glater-Welt ◽  
James B. Schneider ◽  
Marcia M. Zinger ◽  
Lisa Rosen ◽  
Todd M. Sweberg
Keyword(s):  
Infection Prevention ◽  
Life Support ◽  
Antimicrobial Prophylaxis ◽  
Blood Stream Infection ◽  
Extracorporeal Life Support ◽  
Bloodstream Infections ◽  
The United States ◽  
Blood Stream ◽  
Blood Cultures ◽  
Support Organization

Nosocomial blood stream infections (BSIs) increase both the morbidity and the mortality of patients receiving extracorporeal life support (ECLS). The aim of this study was to identify common practices for blood stream infection prevention among national Extracorporeal Membrane Oxygenation (ECMO) programs. An electronic survey that comprised of a 16-item questionnaire was sent out to all ECMO program directors and coordinators within the United States that are part of the Extracorporeal Life Support Organization (ELSO) registry. A total of 152 institutions in 40 states were surveyed, with 85 (55%) responses. One-quarter of the institutions responded that an ECMO infection-prevention bundle or checklist was used during the cannulation. Less than half responded that an ECMO infection-prevention bundle or checklist was used for cannula maintenance, although a majority (82.9%) of institutions responded that a “standard approach to cannula dressings” was used. Half of the respondents reported antimicrobial prophylaxis was routinely prescribed for patients on ECMO, although specific regimens varied widely. Of the institutions, 34.2% reported sending daily blood cultures as part of routine surveillance. Smaller programs were more likely to send daily surveillance blood cultures (58.8%, P < .01). We found no clear consensus on practices used to prevent BSI in patients receiving ECMO.

scholarly journals Performance of QMAC-dRASTTM (Direct Rapid Antimicrobial Susceptibility Testing) - a Newcomer in Phenotypic Automatic AST

2021 ◽  
Vol 15 (1) ◽  
pp. 43-50
Author(s):  
Jens J. Christensen ◽  
Hanne Junker ◽  
Connie B. Madsen ◽  
Camilla F. Christiansen ◽  
Tina Kristensen ◽  
...  
Keyword(s):  
Blood Culture ◽  
Susceptibility Testing ◽  
Testing Procedure ◽  
Blood Stream ◽  
Blood Cultures ◽  
Test Results ◽  
Routine Testing ◽  
Treatment Conditions ◽  
Chip Technology ◽  
Report Data

Objective: QMAC-dRASTTM is a phenotypic automatized Antibiotic Susceptibility Testing (AST) system based on microfluidic chip technology enabling observation of changes in a single bacterial cell under antibiotic treatment conditions. The 96 wells plate with dried antibiotics comprises 19 and 17 antibiotics for the Gram-Negatives (GNs) and Gram-Positives (GPs), respectively. Categorical (Sensitive, Intermediate or Resistant) results were compared to results obtained by our laboratory standard susceptibility testing procedure and given as Categorical Agreement (CA). Methods: In a 3-month period (2019/2020), blood cultures detected positive were included. Excluded were known off-panel strains of QMAC-dRASTTM, such as Gram-positive bacilli, Streptococcus and Candida species. Percentages of CA (CA, %) between QMAC-dRASTTM and routine testing methods used in the laboratory (EUCAST disc diffusion and/or etest/Broth Micro Dilution MIC), were calculated. Results: 255 positive blood cultures from as many patients were examined. Of the positive blood culture strains, 144 were GNs, and 111 were GPs. An overall combined CA,% of 96.3 (2410 of 2502 determinations) was obtained, and discrepancies were noted in 92 of 2502 test results (3.7%). The percentage of very major errors (VMEs) was 0.7% for GNs and 2.2% for GPs. For 87% of blood culture specimens examined, susceptibility reports were available within 6-7 hours. Conclusion: The high CA,% for as well GNs as GPs are promising. The presented time to report data obtained by QMAC-dRASTTM in this study being of 3-8 hours for blood culture specimens examined strongly support a further possible improvement in the workflow for handling blood stream infections.

scholarly journals Frequency and Microbiological Profile of Catheter-Related Infections in Hemodialysis Patients Receiving Gentamicin as Antimicrobial Lock Therapy for Prophylaxis

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Sumbal Nasir Mahmood ◽  
Sabaa Asif ◽  
Muhammad Amim Anwar ◽  
Osama Kunwer Naveed
Keyword(s):  
Blood Culture ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Immunosuppressive Drugs ◽  
Hemodialysis Patients ◽  
Exit Site ◽  
Cross Sectional ◽  
Exit Site Infection ◽  
Antibiotic Lock

Antibiotic lock solution (ALS) in the lumen of catheter is a mean to decrease the possibility of catheter related blood stream infection (CRBSI). We conducted this study using Gentamicin as ALS to observe the frequency of catheter related infections (CRI) including CRBSI and exit site infection in this hemodialysis patients being dialyzed through tunneled and temporary hemodialysis catheters. Methods This descriptive, cross sectional study was conducted at Dr. Ziauddin Hospital, North Campus between January 2017- December 2017. Symptomatic patients for CRBSI were included in this study. Blood culture from the catheter ports and periphery and exit site swab if pus visible were sent for culture sensitivity.  Results Total 138 patients of either gender with age more than 18 years to less than 80 years were evaluated. 44.9% were male and mean age of patients was 58.79±14.05 years. 70.3% patients were diabetic for 15.61±4.61 years and 11.6% were using immunosuppressive drugs. The overall mean catheter duration was 22.27±14.39 days and mean hemodialysis duration was 25.32±44.31 weeks. Tunneled catheter was placed in 40.6% and 46.4% had femoral temporary catheters. Blood culture was done for 51 cases and 21.5% were positive. Tip culture was positive in 33.3% patients. In our study, 23.18% patients were found to have catheter related infections, out of which 61.5% were found with gentamicin resistance including colonization. Conclusion We report a high frequency of catheter related infections despite using ALS as prophylaxis, with predominant organisms being gram positives and a high incidence of gentamycin resistance.

scholarly journals 210. Outcomes of Kidney Transplant Recipients with Donor Positive Blood Cultures

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S213-S214
Author(s):  
Petros Svoronos ◽  
Prakhar Vijayvargiya ◽  
Pradeep Vaitla ◽  
James j Wynn ◽  
Elena Beam ◽  
...  
Keyword(s):  
Blood Culture ◽  
Kidney Transplant ◽  
Demographic Data ◽  
Blood Cultures ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Donor Blood ◽  
Post Transplantation ◽  
Duration Of Therapy

Abstract Background Based on expert opinion, solid organ transplant recipients from donors with bacteremia are treated with 7-14 days of pre-emptive antibiotic therapy (PAT). However, studies addressing necessity, optimal duration of therapy, and outcomes in kidney transplant recipients (KTR) are lacking. Methods We retrospectively reviewed all kidney transplants performed at our institution from 01/01/2015-01/01/2021 to identify those cases where matched deceased donors had positive blood cultures. Bacteremia was defined per CDC criteria. We analyzed rate of infection in the KTR with the same organism identified in the donor blood culture within 30 days of transplantation. Results A total of 56 KTRs with donor positive blood cultures were identified. Demographic data are summarized in Table 1. Twenty of 56 cases (35.8%) had bacteremia and 36 (64.2%) had organisms classified as common commensals. The most common organisms in the bacteremia group were Gram-negative bacteria (12/20) and Staphylococcus aureus (6/20). Most common commensals were coagulase-negative staphylococci (26/36) (Table 2). All KTR received preoperative antibiotics at the time of transplantation, primarily cefazolin (15/20), and vast majority received TMP/SMX prophylaxis, for Pneumocystis jirovecii, post-transplant (19/20). PAT was administered in 70% (14/20) cases of bacteremia for a median of 8.5 days (IQR 7-14), while six cases were left untreated (Table 2). In contrast, majority of cases with common commensals were not treated (75%, 27/36). Of the cases treated (9/36), median duration of therapy was 7 days (IQR 5-14). No cases of infection with the same organism identified in the donor blood culture were reported in KTR within 30 days of transplantation. Conclusion KTR donors with bacteremia who were treated received a median of 8.5 days of PAT with no instances of breakthrough infection. In contrast, majority of donor blood cultures with organisms classified as common commensals were not treated and did well. Future studies are needed to assess whether perioperative antibiotics coupled with TMP/SMX prophylaxis post-transplantation are sufficient in select cases of transplantation from donors with bacteremia. Disclosures All Authors: No reported disclosures

scholarly journals TEICOPLANIN RESISTANCE IN GRAM-POSITIVE BACTERIAL ISOLATE: AN EMERGING THREAT

2021 ◽  
pp. 136-139
Author(s):  
SATISH CHANDEL ◽  
PARAG SHARMA ◽  
PRATIK AKHANI ◽  
RAMESH AGRAWAL
Keyword(s):  
Blood Culture ◽  
Blood Stream Infection ◽  
Central India ◽  
Blood Stream ◽  
Diffusion Method ◽  
Gram Positive ◽  
Disk Diffusion Method ◽  
Gram Positive Bacteria ◽  
Antibiotic Susceptibility Test ◽  
The Future

Objectives: Development of antimicrobial resistance in microorganism isolated from blood stream infection constitutes a major concern about their treatment. Teicoplanin is a glycopeptide antibiotic used in the treatment of infection caused by Gram-positive bacteria. This study was planned to determine Teicoplanin resistance in the Central India and recommend policy changes for prevention of the future resistance to the higher antibiotics. Methods: A total of 1855 septicemia suspected blood samples were studied. The blood culture samples were processed and identified in the microbiology laboratory according to the Clinical and Laboratory Standards Institute guidelines. Antibiotic susceptibility test was done using Kirby B disk diffusion method. Results: About 39.5% of blood culture samples showed positive growth for organism. We observed high teicoplanin resistance (29.5%) among Gram-positive isolates, predominantly (53%) in the Enterococcus species. Conclusion: Teicoplanin resistance has emerged tremendously in the present study. Hence, attention is required about this serious issue otherwise very limited choice of antibiotics will be available for treating infections in the future.

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