409. Changing Epidemiology of Fungal Bloodstream Infections in a Tertiary Care Center in India

Abstract A comparative retrospective study to quantify the impact of Coronavirus Disease 2019 (COVID-19) on patient safety. We found a statistically significant increase in central line-associated blood stream infections and blood culture contamination rates during the pandemic. Increased length of stay and mortality was also observed during COVID-19.

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Bloodstream infections in febrile neutropenic patients at a tertiary care center in Lebanon: a view of the past decade

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2006.12.008 ◽

2007 ◽

Vol 11 (5) ◽

pp. 450-453 ◽

Cited By ~ 25

Author(s):

Zeina A. Kanafani ◽

Ghenwa K. Dakdouki ◽

Khalil I. El-Chammas ◽

Shaker Eid ◽

George F. Araj ◽

...

Keyword(s):

Care Center ◽

Tertiary Care ◽

Bloodstream Infections ◽

Tertiary Care Center ◽

The Past ◽

Neutropenic Patients

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Insertion site inflammation was associated with central-line–associated bloodstream infections at a tertiary-care center, 2015–2018

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.445 ◽

2020 ◽

pp. 1-3

Author(s):

Takaaki Kobayashi ◽

Gosia S. Clore ◽

Mary E. Kukla ◽

Mohammed Alzunitan ◽

Jeffrey Kritzman ◽

...

Keyword(s):

Care Center ◽

Tertiary Care ◽

Insertion Site ◽

Bloodstream Infections ◽

Central Line ◽

Tertiary Care Center ◽

Central Line Insertion ◽

Line Insertion ◽

Automated Surveillance ◽

Site Evaluation

Abstract There are currently no guidelines for central-line insertion site evaluation. Our study revealed an association between insertion site inflammation (ISI) and the development of central-line–associated bloodstream infections (CLABSIs). Automated surveillance for ISI is feasible and could help prevent CLABSI.

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Trends of Multidrug-Resistant Pathogens, Difficult to Treat Bloodstream Infections, and Antimicrobial Consumption at a Tertiary Care Center in Lebanon from 2015–2020: COVID-19 Aftermath

Antibiotics ◽

10.3390/antibiotics10081016 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1016

Author(s):

Amanda Chamieh ◽

Rita Zgheib ◽

Sabah El-Sawalhi ◽

Laure Yammine ◽

Gerard El-Hajj ◽

...

Keyword(s):

Medical Center ◽

Care Center ◽

Tertiary Care ◽

Bloodstream Infections ◽

Multidrug Resistant ◽

Infection Prevention And Control ◽

P Value ◽

Tertiary Care Center ◽

Antimicrobial Consumption ◽

Dynamic Collaboration

Introduction: We studied the trend of antimicrobial resistance and consumption at Saint George Hospital University Medical Center (SGHUMC), a tertiary care center in Beirut, Lebanon, with a focus on the SARS-CoV-2 pandemic. Materials and Methods: We calculated the isolation density/1000 patient-days (PD) of the most isolated organisms from 1 January 2015–31 December 2020 that included: E. coli (Eco), K. pneumoniae (Kp), P. aeruginosa (Pae), A. baumannii (Ab), S. aureus (Sau), and E. faecium (Efm). We considered March–December 2020 a surrogate of COVID-19. We considered one culture/patient for each antimicrobial susceptibility and excluded Staphylococcus epidermidis, Staphylococcus coagulase-negative, and Corynebacterium species. We analyzed the trends of the overall isolates, the antimicrobial susceptibilities of blood isolates (BSI), difficult-to-treat (DTR) BSI, carbapenem-resistant Enterobacteriaceae (CRE) BSI, and restricted antimicrobial consumption as daily-defined-dose/1000 PD. DTR implies resistance to carbapenems, beta-lactams, fluoroquinolones, and additional antimicrobials where applicable. Results and Discussion: After applying exclusion criteria, we analyzed 1614 blood cultures out of 8314 cultures. We isolated 85 species, most commonly Eco, at 52%. The isolation density of total BSI in 2020 decreased by 16%: 82 patients were spared from bacteremia, with 13 being DTR. The isolation density of CRE BSI/1000 PD decreased by 64% from 2019 to 2020, while VREfm BSI decreased by 34%. There was a significant decrease of 80% in Ab isolates (p-value < 0.0001). During COVID-19, restricted antimicrobial consumption decreased to 175 DDD/1000 PD (p-value < 0.0001). Total carbapenem consumption persistently decreased by 71.2% from 108DDD/1000 PD in 2015–2019 to 31 DDD/1000 PD in 2020. At SGHUMC, existing epidemics were not worsened by the pandemic. We attribute this to our unique and dynamic collaboration of antimicrobial stewardship, infection prevention and control, and infectious disease consultation.

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A Cluster of Central Line–Associated Bloodstream Infections Due to Rapidly Growing Nontuberculous Mycobacteria in Patients with Hematologic Disorders at a Japanese Tertiary Care Center: An Outbreak Investigation and Review of the Literature

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2014.14 ◽

2015 ◽

Vol 36 (1) ◽

pp. 76-80 ◽

Cited By ~ 22

Author(s):

Yasuaki Tagashira ◽

Yasuji Kozai ◽

Hitomi Yamasa ◽

Masako Sakurada ◽

Tetsuya Kashiyama ◽

...

Keyword(s):

Water Supply ◽

Bloodstream Infection ◽

Nontuberculous Mycobacteria ◽

Care Center ◽

Tertiary Care ◽

Bloodstream Infections ◽

Central Line ◽

Catheter Removal ◽

Tertiary Care Center ◽

Oncology Ward

BACKGROUNDRapidly growing nontuberculous mycobacteria (RGM) are considered rare pathogens, causing central line–associated bloodstream infection. We identified an outbreak of central line–associated bloodstream infection due to RGM at a hematology-oncology ward during a 5-month period.DESIGNOutbreak investigation and literature review.SETTINGA Japanese tertiary care center.PATIENTSAdults who were hospitalized at the hematology-oncology ward from October 15, 2011, through February 17, 2012.RESULTSA total of 5 patients with a bloodstream infection due to RGM (4 cases ofMycobacterium mucogenicumand 1 case ofMycobacterium canariasenseinfection) were identified; of these, 3 patients had acute myeloid leukemia, 1 had acute lymphocytic leukemia, and 1 had aplastic anemia. Four of the 5 patients received cord blood transplantation prior to developing the bloodstream infection. All central venous catheters in patients with a bloodstream infection were removed. These patients promptly defervesced after catheter removal and their care was successfully managed without antimicrobial therapy. Surveillance cultures from the environment and water detectedM. mucogenicumandM. canariasensein the water supply of the hematology-oncology ward. The isolates from the bloodstream infection and water sources were identical on the basis of 16S-rRNA gene sequencing.CONCLUSIONSThe source of RGM in the outbreak of bloodstream infections likely was the ward tap water supply. Awareness of catheter-related bloodstream infections due to nontuberculous mycobacteria should be emphasized, especially where immunocompromised patients are at risk. Also, using antimicrobials after catheter removal to treat central line–associated bloodstream infection due to RGM may not be necessary.Infect Control Hosp Epidemiol 2015;36(1): 76–80

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