scholarly journals Impact on mortality of a bundle for the management of enterococcal bloodstream infection

2019 ◽  
Author(s):  
Michele Bartoletti ◽  
Sara Tedeschi ◽  
Luigia Scudeller ◽  
Renato Pascale ◽  
Elena Rosselli Del Turco ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Blood Cultures ◽  
Healthcare Associated Infections ◽  
Hospital Acquired Infection ◽  
Enterococcus Spp ◽  
Quasi Experimental ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
Post Period

Abstract BACKGROUND In this study we evaluated the effectiveness of a management bundle for Enterococcus spp BSI (E-BSI). METHODS This was a single-center quasi-experimental (pre/post) study. In the “pre” phase (January 2014 to December 2015) patients with monomicrobial E-BSI were retrospectively enrolled. During the “post” or “intervention” phase (January 2016 to December 2017), all patients with incident E-BSI were prospectively enrolled in a non-mandatory intervention arm consisting in infectious disease consultation, echocardiography, follow-up blood cultures and early targeted antibiotic treatment. Patients were followed-up to 1 year after E-BSI. The primary outcome was 30-day mortality. RESULTS Overall, 368 patients were enrolled, 173 in the “pre” phase and 195 in the “post” phase. The entire bundle was applied in 15% and 61% patients during the “pre” and “post” phase, respectively (P<0.001). Patients enrolled in the post-phase had a significant lower 30-day mortality rate (20% vs 32%, P=0.0042). At multivariate analysis, factors independently associated to mortality were age [HR 1.03 (95%CI 1.00-1.05)], ICU admission [HR 2.51 (95%CI 1.18-3.89)] healthcare associated [HR 2.32 (95%CI 1.05-5.16)] and hospital-acquired infection [HR 2.85 (95%CI 1.34-4.76)] whereas being enrolled in the “post” period [HR 0.49 (95%CI 0.32-0.75)] was associated with improved survival. Results were consistent also in the subgroups with severe sepsis [HR 0.37 (95%CI 0.16-0.90)] or healthcare-associated infections [HR 0.53 (95%CI 0.31-0.93)]. A significative lower 1-year mortality was observed in patients enrolled in the “post” period (50% vs 68%,p<0.001). CONCLUSION The introduction of a bundle for the management of E-BSI was associated with improved 30-day and 1-year survival.

scholarly journals Hand Hygiene Practices to Reduce Hospital Acquired Infection

2019 ◽  
pp. 1-4
Author(s):  
Liana Monica DEAC Babes ◽  
Keyword(s):  
Hand Hygiene ◽  
Personal Hygiene ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Effective Measure ◽  
Hospital Acquired Infection ◽  
Hygiene Practices ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Hands are the most effective mode of transfer of microorganism in healthcare and can result in healthcare associated infections which are major causes of morbidity and mortality worldwide. Reduction of infection by this mode of transfer can be achieved by a simple but very effective measure of performing hand hygiene at the appropriate time which is one of the most fundamental principles in infection prevention and control. Good hand hygiene practices have been shown to reduce healthcare associated infections. Hand washing with soap and water has been considered a measure of personal hygiene for several years

scholarly journals Hand Hygiene Practices to Reduce Hospital Acquired Infection

2019 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Hand Hygiene ◽  
Personal Hygiene ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Effective Measure ◽  
Hospital Acquired Infection ◽  
Hygiene Practices ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Hands are the most effective mode of transfer of microorganism in healthcare and can result in healthcare associated infections which are major causes of morbidity and mortality worldwide. Reduction of infection by this mode of transfer can be achieved by a simple but very effective measure of performing hand hygiene at the appropriate time which is one of the most fundamental principles in infection prevention and control. Good hand hygiene practices have been shown to reduce healthcare associated infections. Hand washing with soap and water has been considered a measure of personal hygiene for several years [1].

scholarly journals Partnership among hospitals to reduce healthcare associated infections: a quasi-experimental study in Brazilian ICUs

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ladjane Santos Wolmer de Melo ◽  
Maria Verônica Monteiro de Abreu ◽  
Bernuarda Roberta de Oliveira Santos ◽  
Maria das Graças Washington Casimiro Carr ◽  
Maria Fernanda Aparecida Moura de Souza ◽  
...  
Keyword(s):  
Experimental Study ◽  
Length Of Stay ◽  
Public Hospitals ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Collaborative Project ◽  
Quasi Experimental ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Over Time

Abstract Background Healthcare-associated infections (HAIs) are relevant in developing countries where frequencies can be at least 3 times higher than in developed countries. The purpose of this research was to describe the intervention implemented in intensive care units (ICUs) to reduce HAIs through collaborative project and analyze the variation over 18 months in the incidence density (ID) of the three main HAIs: ventilator associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs) and catheter-related urinary tract infections (CAUTIs) and also the length of stay and mortality in these ICUs. Methods A quasi-experimental study in five public adult clinical-surgical ICUs, to reduce HAIs, through interventions using the BTS-IHI “Improvement Model”, during 18 months. In the project, promoted by the Ministry of Health, Brazilian philanthropic hospitals certified for excellence (HE), those mostly private, certified as excellence and exempt from security contributions, regularly trained and monitored public hospitals in diagnostics, data collection and in developing cycles to improve quality and to prevent HAIs (bundles). In the analysis regarding the length of stay, mortality, the IDs of VAP, CLABSIs and CAUTIs over time, a Generalized Estimating Equation (GEE) model was applied for continuous variables, using the constant correlation (exchangeable) between assessments over time. The model estimated the average difference (β coefficient of the model) of the measures analyzed during two periods: a period in the year 2017 (prior to implementing the project) and in the years 2018 and 2019 (during the project). Result A mean monthly reduction of 0.427 in VAP ID (p = 0.002) with 33.8% decrease at the end of the period and 0.351 in CAUTI ID (p = 0.009) with 45% final decrease. The mean monthly reduction of 0.252 for CLABSIs was not significant (p = 0.068). Length of stay and mortality rates had no significant variation. Conclusions Given the success in reducing VAP and CAUTIs in a few months of interventions, the achievement of the collaborative project is evident. This partnership among public hospitals/HE may be applied to other ICUs including countries with fewer resources.

Preventability of hospital onset bacteremia and fungemia: A pilot study of a potential healthcare-associated infection outcome measure

2019 ◽  
Vol 40 (3) ◽  
pp. 358-361 ◽  
Author(s):  
Raymund B. Dantes ◽  
Clare Rock ◽  
Aaron M. Milstone ◽  
Jesse T. Jacob ◽  
Sheri Chernetsky-Tejedor ◽  
...  
Keyword(s):  
Pilot Study ◽  
Outcome Measure ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Follow Up Studies ◽  
Potential Measure ◽  
Healthcare Associated

AbstractHospital-onset bacteremia and fungemia (HOB), a potential measure of healthcare-associated infections, was evaluated in a pilot study among 60 patients across 3 hospitals. Two-thirds of all HOB events and half of nonskin commensal HOB events were judged as potentially preventable. Follow-up studies are needed to further develop this measure.

Surveillance of Hospital-Acquired Infection in England, Germany, and The Netherlands Will International Comparison of Rates Be Possible?

2001 ◽  
Vol 22 (6) ◽  
pp. 393-397 ◽  
Author(s):  
Rosa Coello ◽  
Petra Gastmeier ◽  
Annette S. de Boer
Keyword(s):  
The Netherlands ◽  
International Comparison ◽  
Surveillance Systems ◽  
Surveillance Strategy ◽  
Data Set ◽  
Hospital Acquired Infection ◽  
Or Groups ◽  
Study Population ◽  
Hospital Acquired

AbstractThree national surveillance systems for nosocomial infection have been developed independently and implemented successfully in England, Germany, and The Netherlands. All three are based on the American National Nosocomial Infections Surveillance System and have adopted a surveillance strategy that is targeted at specific infections or groups of patients for limited time periods. Case-finding methods, the minimum data set, and analysis of data are similar and could be standardized easily. Resolution of the differences in the definitions of infection, the study population, and follow-up should make possible the international comparison of infection rates. Such comparisons may identify differences in healthcare practices between countries and suggest areas for improvement.

Evidence That Classroom-Based Behavioral Interventions Reduce Pregnancy-Related School Dropout Among Nairobi Adolescents

2016 ◽  
Vol 44 (2) ◽  
pp. 297-303 ◽  
Author(s):  
Clea Sarnquist ◽  
Jake Sinclair ◽  
Benjamin Omondi Mboya ◽  
Nickson Langat ◽  
Lee Paiva ◽  
...  
Keyword(s):  
Adolescent Pregnancy ◽  
Low Income ◽  
Behavioral Interventions ◽  
Primary Outcome ◽  
School Dropout ◽  
School Dropouts ◽  
Quasi Experimental ◽  
Important Addition ◽  
Behavioral Empowerment

Purpose. To evaluate the effect of behavioral, empowerment-focused interventions on the incidence of pregnancy-related school dropout among girls in Nairobi’s informal settlements. Method. Retrospective data on pregnancy-related school dropout from two cohorts were analyzed using a matched-pairs quasi-experimental design. The primary outcome was the change in the number of school dropouts due to pregnancy from 1 year before to 1 year after the interventions. Results. Annual incidence of school dropout due to pregnancy decreased by 46% in the intervention schools (from 3.9% at baseline to 2.1% at follow-up), whereas the comparison schools remained essentially unchanged ( p < .029). Sensitivity analysis shows that the findings are robust to small levels of unobserved bias. Conclusions. Results suggest that these behavioral interventions significantly reduced the number of school dropouts due to pregnancy. As there are limited promising studies on behavioral interventions that decrease adolescent pregnancy in low-income settings, this intervention may be an important addition to this toolkit.

scholarly journals 819. Antibiotic Resistance in Pathogens Causing Hospital Acquired Infections in Brazil: A Multicenter Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S502-S503
Author(s):  
Carlos Starling ◽  
Bráulio R G M Couto ◽  
Estevão Urbano Silva ◽  
Virginia Andrade ◽  
Edna M M Leite ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Healthcare Associated Infections ◽  
Gram Positive ◽  
Resistance Profile ◽  
Hospital Acquired Infections ◽  
Microbiological Methods ◽  
Belo Horizonte ◽  
Healthcare Associated ◽  
Hospital Acquired

Abstract Background In the present study we determined the prevalence of antibiotic resistance in the most common organisms causing healthcare-associated infections in tertiary-care hospitals in Belo Horizonte, a 3,000,000 inhabitants city from Brazil. Methods Microbiology data of hospital acquired infections (HAI) defined by the National Healthcare Safety Network (NHSN)/CDC protocols of seven general hospitals were analyzed: three public institutions, two philanthropic, and two private hospitals. Samples from different topographies were plate in an ideal culture medium and after growth, the microorganisms were identified by standard biochemical and microbiological methods, using the VITEK 2 compact system (Biomerieux), which allows the simultaneous identification of Gram-positive and Gram bacteria -negative and combine the identification and TSA results in a single report. Six hospitals used automated methods and one institution used manual method for antimicrobial susceptibility testing. Results Samples of seven Gram-negative and two Gram-positive bacteria collected between Dec/2019-Nov/2020 from HAI isolates were analyzed: 565 Klebsiella, 293 Escherichia coli, 153 Proteus, 403 Pseudomonas, 275 Acinetobacter, 174 Serratia, 153, 361 Staphylococcus aureus, and 176 Enterococcus. Antibiotic resistance profile of each strain is summarized in Figures 1, 2, and 3. Resistance profile: Klebsiella, E. coli, Proteus. ATB profile: Pseudomonas, Acinetobacter, Serratia. ATB profile: Enterobacter, S. aureus, Enterococcus . Conclusion Benchmarks for antibiotic resistance in the most common organisms causing healthcare-associated infections were defined, and can be used as indicators for healthcare assessment, specially in developing countries institutions. Disclosures All Authors: No reported disclosures

scholarly journals Partnership Among Hospitals To Reduce Healthcare Associated Infections: A Quasi-Experimental Study In Brazilian ICUs

2021 ◽  
Author(s):  
Ladjane Santos Wolmer de Melo ◽  
Maria Verônica Monteiro de Abreu ◽  
Bernuarda Roberta de Oliveira Santos ◽  
Maria das Graças Washington Casimiro Carreteiro ◽  
Maria Carolina Andrade Lins de Albuquerque ◽  
...  
Keyword(s):  
Experimental Study ◽  
Length Of Stay ◽  
Public Hospitals ◽  
Healthcare Associated Infections ◽  
Ministry Of Health ◽  
Collaborative Project ◽  
Quasi Experimental ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Over Time

Abstract Background: Healthcare-associated infections (HAIs) are relevant in developing countries where frequencies can be at least 3 times higher than in developed countries. The purpose of this research was to describe the intervention implemented in intensive care units (ICUs) to reduce HAIs through collaborative project and analyze the variation over 18 months in the incidence density (ID) of the three main HAIs: ventilator associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs) and catheter-related urinary tract infections (CAUTIs) and also the length of stay and mortality in these ICUs. Methods: A quasi-experimental study in 5 public adult clinical-surgical ICUs, to reduce HAIs, through interventions using the BTS-IHI “Improvement Model”, during 18 months. In the project, promoted by the Ministry of Health, Brazilian philanthropic hospitals of excellence (HE), those mostly private, certified as excellence and exempt from security contributions, regularly trained and monitored public hospitals in diagnostics, data collection and in developing cycles to improve quality and to prevent HAIs (bundles). In the analysis regarding the length of stay, mortality, the IDs of VAP, CLABSIs and CAUTIs over time, a Generalized Estimating Equation (GEE) model was applied for continuous variables, using the constant correlation (exchangeable) between assessments over time. The model estimated the average difference (β coefficient of the model) of the measures analyzed during two periods: a period in the year 2017 (prior to implementing the project) and in the years 2018 and 2019 (during the project).Result: A mean monthly reduction of 0.427 in VAP ID (p = 0.002) with 33.8% decrease at the end of the period and 0.351 in CAUTI ID (p = 0.009) with 45% final decrease. The mean monthly reduction of 0.252 for CLABSIs was not significant (p = 0.068). Length of stay and mortality rates had no significant variation. Conclusions: Given the success in reducing VAP and CAUTIs in a few months of interventions, the achievement of the collaborative project is evident. This partnership among public hospitals/HE may be applied to other ICUs including countries with fewer resources.Trial registration: Promoted by Brazilian Ministry of Health. Approved by the Hospital das Clínicas – UFPE Ethics Committee (No. 3,307,293).

scholarly journals Comparative Characteristics of the Incidence of Healthcare-Associated Infections in the Chelyabinsk region and in the Russian Federation in Total

2015 ◽  
Vol 14 (5) ◽  
pp. 56-61 ◽  
Author(s):  
O. A. Orlova
Keyword(s):  
Health Care ◽  
Russian Federation ◽  
Healthcare Associated Infections ◽  
Prevention And Treatment ◽  
Hospital Acquired Pneumonia ◽  
The Russian Federation ◽  
General Demand ◽  
Chelyabinsk Region ◽  
Healthcare Associated ◽  
Hospital Acquired

Currently, the problem of prevention and treatment of healthcare-associated infections (HAI), only in hospitals from 5 to 20% of patients HAI get sick. In Chelyabinsk region, in comparison with the Russian Federation, the quantity of the infections connected with delivery of health care tends to growth. The greatest number of HAI is registered in hospitals of a surgical profile 70.3 ± 5.7% (in the Russian Federation - 31.4 ± 0.2%). In area hospital-acquired pneumonia steadily holds the first - second place in structure of HAI (38.2 ± 10.3%) in the country - the fourth - fifth (10.1 ± 5.1%). Detection of distinctions in structure of HAI in Chelyabinsk region and in the country in general demand further studying for the purpose of identification and introduction of the most effective preventive and antiepidemic actions.

Sign in / Sign up

Export Citation Format

Share Document