scholarly journals 2020. Impact of Local Antimicrobial Stewardship Guidelines through a Cellphone App to Lower Hospital-acquired MDR Infections in a Private Hospital in Mexico City

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S678-S678
Author(s):  
Marco Villanueva Reza ◽  
Lorena Lanz-Zubiria ◽  
Israel Rojas de Ita ◽  
Paulo Castañeda-Méndez ◽  
Esperanza Aleman Aguilar ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Private Hospital ◽  
Standard Of Care ◽  
Hospital Staff ◽  
Antimicrobial Drugs ◽  
Hospital Acquired Infection ◽  
Healthcare Program ◽  
Local Patterns ◽  
The One ◽  
Hospital Acquired

Abstract Background Hospital-acquired multi-drug-resistant organisms (HA-MDRO) infections are associated with increased cost, length of stay, morbidity, and mortality. The prevalence of HA-MDRO has been increasing worldwide. We look to describe how the implementation of local guidelines as an app available for tablets or cellphones in our hospital in 2014 decrease the prevalence of HA-MDRO. Methods Local guidelines were implemented as an electronic application available and intended for hospital staff only. This app gives local patterns of resistance for bacteria with treatment recommendations alongside suggested antimicrobial drugs for empiric treatment. Descriptive statistics were performed. Results In 2013, before implementing the app, HA-MDRO were reported in 25% of hospital-acquired infection. After the introduction of the app, compliance in 2014 was 56.7% with HA-MDRO reported in 20%, 2015 use was 60.7% and HA-MDRO in 18%, 2016 compliance 68.7% and HA-MDRO in 16%, 2017 compliance in 73.7% and HA-MDRO in 14%, lastly in 2018 prevalence was 15% of HA-MDRO while use of local guidelines was 78.7%. Different type of infections (VAP, HAP, UTI, SSI, BSI) also decreased while following guidelines recommendations. Conclusion These programs are needed as a part of the healthcare program to control the HA-MDRO morbidity and complications. Simple friendly-user electronic applications such as the one implemented in our hospital led to higher compliance and lower hospital-acquired infections. Antimicrobial stewardship programs and local guidelines should be part of the standard of care of all hospitals. Disclosures All authors: No reported disclosures.

Isolation of post operative hospital acquired infections in a private hospital of Bangladesh and identification of clonal relatedness of E. coli by using Pulse filed gel electrophoresis

2012 ◽  
Vol 6 (2) ◽  
pp. 7-10
Author(s):  
Mohammad Murshed ◽  
Sabeena Shahnaz ◽  
Md. Abdul Malek
Keyword(s):  
Private Hospital ◽  
Isolation And Identification ◽  
College Hospital ◽  
Hospital Acquired Infection ◽  
E Coli ◽  
Hospital Acquired Infections ◽  
Medical College ◽  
Clonal Relatedness ◽  
Hospital Acquired ◽  
Dressing Materials

Isolation and identification of post operative hospital acquired infection was carried out from July 2008 to December 2008 in Holy Family Red Crescent Medical College Hospital (private hospital). The major pathogen of wound infection was E. coli. A total; of 120 samples were collected from the surrounding environment of post operative room like floor, bed sheets, instruments, dressing materials, catheter, nasogastric and endotracheal tube. E. coli (40%) was the predominant organism followed by S. aureus (24%). DNA fingerprinting analysis using pulsed field gel electreopheresis of XbaI restriction digested genomic DNA showed that clonal relatedness between the two clinical nd environmental isolates were 100%.DOI: http://dx.doi.org/10.3329/bjmm.v6i2.19369 Bangladesh J Med Microbiol 2012; 06(02): 7-10

Hospital-acquired infection awareness and control practices among healthcare staff: an evaluation

2021 ◽  
Vol 27 (11) ◽  
pp. 296-302
Author(s):  
Pallavi Saraswat ◽  
Rajnarayan R Tiwari ◽  
Muralidhar Varma ◽  
Sameer Phadnis ◽  
Monica Sindhu
Keyword(s):  
Infection Control ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Control Measures ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Control Policies ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Background/Aims Hospital-acquired infections pose a risk to the wellbeing of both patients and staff. They are largely preventable, particularly if hospital staff have adequate knowledge of and adherence to infection control policies. This study aimed to assess the knowledge, awareness and practice of hospital-acquired infection control measures among hospital staff. Methods A cross-sectional study was conducted among 71 staff members in a tertiary healthcare facility in Karnataka, India. The researchers distributed a questionnaire containing 33 questions regarding knowledge of hospital-acquired infections, awareness of infection control policies and adherence to control practices. The results were analysed using the Statistical Package for the Social Sciences, version 16.0 and a Kruskal–Wallis test. Results Respondents' mean percentage score on the knowledge of hospital-acquired infections section was 72%. Their mean percentage scores on the awareness and practice of infection prevention measures sections were 82% and 77% respectively. Doctors and those with more years of experience typically scored higher. Conclusion The respondents had an acceptable level of knowledge, awareness and adherence to infection control practices. However, continued training is essential in the prevention of hospital-acquired infections. The majority of the respondents stated that they were willing to undertake training in this area, and this opportunity should be provided in order to improve infection control quality.

Antimicrobial drugs in critical illness

2016 ◽  
Author(s):  
A. P. R. Wilson ◽  
Preet Panesar
Keyword(s):  
Antibiotic Use ◽  
Surgical Patient ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Antimicrobial Drugs ◽  
Hospital Acquired Infection ◽  
Extended Spectrum Beta Lactamase ◽  
Mrsa Infection ◽  
Hospital Acquired ◽  
Emergence Of Resistance

The pharmacokinetics of antimicrobials are altered in critically-ill patients, particularly in the presence of renal or hepatic failure. Maintaining a choice or diversity of antibiotics is important due to the emergence of resistance. Antibiotic use should also be kept to the minimum and local protocols need to be established. For community-acquired infection, co-amoxiclav or a parenteral cephalosporin can be used, while for hospital-acquired infection, piperacillin/tazobactam, ciprofloxacin, or ceftazidime are recommended. For suspected vascular catheter infection or methicillin-resistant Staphylococcus aureus (MRSA) infection, teicoplanin or vancomycin should be used, with meropenem or imipenem reserved for second line treatment. Prophylactic antibiotics should not be continued once a surgical patient has returned from the theatre. Patients with febrile neutropenia receive piptazobactam, meropenem, ceftazidime or ciprofloxacin and a glycopeptide. Antifungals, usually caspofungin or liposomal amphotericin, are used if fungal infection is suspected, especially after failed antibacterial treatment. Cephalosporin use has declined as they have been linked with emergence of MRSA and Clostridium difficile. However, this reflects overuse and they still have a place as part of a diverse choice of antibiotics. Vancomycin and teicoplanin use has increased greatly in order to treat MRSA and line infections, but resistance remains unusual. Carbapenem use has increased rapidly with the emergence of extended spectrum beta-lactamase producing Gram-negative bacteria.

Topographische Orientierung bei Patienten mit erworbener Hirnschädigung

1999 ◽  
Vol 10 (2) ◽  
pp. 77-86
Author(s):  
Martina Kindsmüller ◽  
Andrea Kaindl ◽  
Uwe Schuri ◽  
Alf Zimmer
Keyword(s):  
Brain Damage ◽  
Cognitive Deficits ◽  
Hospital Setting ◽  
Hospital Staff ◽  
Reading Test ◽  
Map Reading ◽  
Several Variables ◽  
Topographical Orientation ◽  
The One ◽  
Behavioral Memory

Topographical Orientation in Patients with Acquired Brain Damage Abstract: A study was conducted to investigate the abilities of topographical orientation in patients with acquired brain damage. The first study investigates the correlation between wayfinding in a hospital setting and various sensory and cognitive deficits as well as the predictability of navigating performance by specific tests, self-rating of orientation ability and rating by staff. The investigation included 35 neuropsychological patients as well as 9 control subjects. Several variables predicted the wayfinding performance reasonably well: memory tests like the one introduced by Muramoto and a subtest of the Rivermead Behavioral Memory Test, the Map Reading Test and the rating by hospital staff. Patients with hemianopia experienced significant difficulty in the task.

scholarly journals Protection and Response of a Tertiary Hospital in Shenzhen, China to the COVID-19 Outbreak—the Practice of the Comprehensive Response Mode

2021 ◽  
pp. 1-17
Author(s):  
Benling Hu ◽  
Le Yang ◽  
Chan Wei ◽  
Min Luo
Keyword(s):  
Prevention And Control ◽  
Tertiary Hospital ◽  
Control Model ◽  
Normal Operation ◽  
Process Reengineering ◽  
Equipment Management ◽  
Hospital Acquired Infection ◽  
Public Health Emergencies ◽  
Hospital Acquired ◽  
And Control

ABSTRACT Objective: To evaluate the management mode for the prevention and control of coronavirus 2019 (COVID-19) transmission utilized at a general hospital in Shenzhen, China, with the aim to maintain the normal operation of the hospital. Methods: From January 2, 2020 to April 23, 2020, Hong Kong–Shenzhen Hospital, a tertiary hospital in Shenzhen, has operated a special response protocol named comprehensive pandemic prevention and control model, which mainly includes six aspects: 1) human resource management; 2) equipment management; 3) logistics management; 4) cleaning, disinfection and process reengineering; 5) environment layout; 6) and training and assessment. The detail of every aspect was described and its efficiency was evaluated. Results: A total of 198,802 patients were received. Of those, 10,821 were hospitalized; 26,767 were received by the emergency department and fever clinics; 288 patients were admitted for observation with fever; and 324 were admitted as suspected cases for isolation. Under the protocol of comprehensive pandemic prevention and control model, no case of hospital-acquired infection with COVID-19 occurred among the inpatients or staff. Conclusion: The present comprehensive response model may be useful in large public health emergencies to ensure appropriate management and protect the health and life of individuals.

39 Managing Burn Wounds with Silvadene

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S29-S30
Author(s):  
Tomer Lagziel ◽  
Louis J Born ◽  
Luis H Quiroga ◽  
Eliana Duraes ◽  
Pragna N Shetty ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Wound Infection ◽  
Standard Of Care ◽  
Infection Rates ◽  
Average Amount ◽  
Once Daily ◽  
Preliminary Results ◽  
The Difference ◽  
Dressing Change ◽  
Hospital Acquired

Abstract Introduction Topical delivery of antibacterial agents is typically incorporated and is an essential component of burn wound therapy. The goal is to prevent infection and promote the healing process. Poorly treated wounds can result in scarring or severely in sepsis and multi-organ dysfunction. Topical SSD cream has been the gold-standard for initial local care in partial thickness or full thickness burns. Due to immediate burst release of the drug into the exposed areas, application is relatively frequent (usually twice daily). However, it remains unknown whether twice-daily SSD dressings are superior to once-daily. Methods We maintained a twice-daily dressing change standard of care until 01/01/2019. Patients admitted after that date had their dressing changed once-daily. Our goal is to review outcomes for 75 patients before the change-of-practice and 75 patients after. The main outcomes recorded are wound infection rates, hospital-acquire complications (non-wound related), pain scores, daily narcotic requirements, average amount of SSD used, and length-of-stay. Results Preliminary results of the 75 pre-change-of-practice and 75 post-change-of-practice patients showed slightly better outcomes in the post-change group. Wound-infection rates were the same for both groups (pre=5.33%, post=5.33%), average daily pain-levels for the pre-change group were slightly higher but the difference was negligible and not statistically significant (pre=5.76, post=5.69). The pre-change group had a higher average daily narcotic dosage (pre=6.81mg, post=6.38mg), hospital-acquired complication rates were higher pre-change (pre=10.67%, post=6.67%), and length-of-stay was longer in the pre-change group (pre=10.81, post=9.25). The average amount of SSD jars used per patient was higher as well (pre=6.30, post=2.85). Statistical analysis of the distribution of burn type, age, and burn depth showed no discrepancy and a generalized decreased length-of-stay with once-daily SSD dressing change. Conclusions Preliminary results show that once-daily dressing changes of SSD in burn wounds have no negative impact on wound outcomes. However, it is associated with a decreased length-of-stay, decreased pain levels, and less hospital-acquired complications. A decreased length-of-stay means reduced medical expenses for the patient and the hospital. In addition, less hospital-acquired complications result in better patient recovery. Since the difference in wound outcomes is negligible and statistically insignificant, changing the standard-of-care to once-daily could prove beneficial.

The funding and organization of infection control in NHS hospital trusts: a study of infection control professionals' views

2003 ◽  
Vol 16 (2) ◽  
pp. 71-84 ◽  
Author(s):  
B. Croxson ◽  
P. Allen ◽  
J. A. Roberts ◽  
K. Archibald ◽  
S. Crawshaw ◽  
...  
Keyword(s):  
Infection Control ◽  
Nationwide Survey ◽  
Organizational Structures ◽  
Hospital Infection ◽  
Hospital Acquired Infection ◽  
Hospital Infection Control ◽  
Complex Picture ◽  
Ward Level ◽  
Almost All ◽  
Hospital Acquired

The problems associated with hospital-acquired infection have been causing increasing concern in England in recent years. This paper reports the results of a nationwide survey of hospital infection control professionals' views concerning the organizational structures used to manage and obtain funding for control of infection. A complex picture with significant variation between hospitals emerges. Although government policy dictates that specific funding for hospital infection control is formally made available, it is not always the case that infection control professionals have adequate resources to undertake their roles. In some cases this reflects the failure of hospitals' infection control budgetary mechanisms; in others it reflects the effects of decentralizing budgets to directorate or ward level. Some use was made of informal mechanisms either to supplement or to substitute for the formal ones. But almost all infection control professionals still believed they were constrained in their ability to protect the hospital population from the risk of infectious disease. It is clear that recent government announcements that increased effort will be made to support local structures and thereby improve the control of hospital acquired infection are to be welcomed.

scholarly journals Implementation of a Rapid Phenotypic Susceptibility Platform for Gram-Negative Bloodstream Infections With Paired Antimicrobial Stewardship Intervention: Is the Juice Worth the Squeeze?

2021 ◽  
Author(s):  
Evan D Robinson ◽  
Allison M Stilwell ◽  
April E Attai ◽  
Lindsay E Donohue ◽  
Megan D Shah ◽  
...  
Keyword(s):  
Median Time ◽  
Antimicrobial Stewardship ◽  
A Priori ◽  
Bloodstream Infections ◽  
Standard Of Care ◽  
Post Intervention ◽  
Gram Negative ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
The Impact

Abstract Background Implementation of the Accelerate PhenoTM Gram-negative platform (RDT) paired with antimicrobial stewardship program (ASP) intervention projects to improve time to institutional-preferred antimicrobial therapy (IPT) for Gram-negative bacilli (GNB) bloodstream infections (BSIs). However, few data describe the impact of discrepant RDT results from standard of care (SOC) methods on antimicrobial prescribing. Methods A single-center, pre-/post-intervention study of consecutive, nonduplicate blood cultures for adult inpatients with GNB BSI following combined RDT + ASP intervention was performed. The primary outcome was time to IPT. An a priori definition of IPT was utilized to limit bias and to allow for an assessment of the impact of discrepant RDT results with the SOC reference standard. Results Five hundred fourteen patients (PRE 264; POST 250) were included. Median time to antimicrobial susceptibility testing (AST) results decreased 29.4 hours (P < .001) post-intervention, and median time to IPT was reduced by 21.2 hours (P < .001). Utilization (days of therapy [DOTs]/1000 days present) of broad-spectrum agents decreased (PRE 655.2 vs POST 585.8; P = .043) and narrow-spectrum beta-lactams increased (69.1 vs 141.7; P < .001). Discrepant results occurred in 69/250 (28%) post-intervention episodes, resulting in incorrect ASP recommendations in 10/69 (14%). No differences in clinical outcomes were observed. Conclusions While implementation of a phenotypic RDT + ASP can improve time to IPT, close coordination with Clinical Microbiology and continued ASP follow up are needed to optimize therapy. Although uncommon, the potential for erroneous ASP recommendations to de-escalate to inactive therapy following RDT results warrants further investigation.

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