scholarly journals Data-Driven Prediction of COVID-19 Cases in Germany for Decision Making

2021 ◽  
Author(s):  
Lukas Refisch ◽  
Fabian Lorenz ◽  
Torsten Riedlinger ◽  
Hannes Taubenböck ◽  
Martina Fischer ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Infection Rate ◽  
Web Application ◽  
Profile Likelihood ◽  
Time Dependent ◽  
Data Driven ◽  
Likelihood Method ◽  
Uncertainty Estimates ◽  
Incident Cases

Background: The COVID-19 pandemic has led to a high interest in mathematical models describing and predicting the diverse aspects and implications of the virus outbreak. Model results represent an important part of the information base for the decision process on different administrative levels. The Robert-Koch-Institute (RKI) initiated a project whose main goal is to predict COVID-19-specific occupation of beds in intensive care units: Steuerungs-Prognose von Intensivmedizinischen COVID-19 Kapazitäten (SPoCK). The incidence of COVID-19 cases is a crucial predictor for this occupation. Methods: We developed a model based on ordinary differential equations for the COVID-19 spread with a time-dependent infection rate described by a spline. Furthermore, the model explicitly accounts for weekday-specific reporting and adjusts for reporting delay. The model is calibrated in a purely data-driven manner by a maximum likelihood approach. Uncertainties are evaluated using the profile likelihood method. The uncertainty about the appropriate modeling assumptions can be accounted for by including and merging results of different modelling approaches. Results: The model is calibrated based on incident cases on a daily basis and provides daily predictions of incident COVID-19 cases for the upcoming three weeks including uncertainty estimates for Germany and its subregions. Derived quantities such as cumulative counts and 7-day incidences with corresponding uncertainties can be computed. The estimation of the time-dependent infection rate leads to an estimated reproduction factor that is oscillating around one. Data-driven estimation of the dark figure purely from incident cases is not feasible. Conclusions: We successfully implemented a procedure to forecast near future COVID-19 incidences for diverse subregions in Germany which are made available to various decision makers via an interactive web application. Results of the incidence modeling are also used as a predictor for forecasting the need of intensive care units.

P25.03 Bed occupancy and methicillin-resistant Staphylococcus aureus infection rate in intensive care units: 2003–2008

2010 ◽  
Vol 76 ◽  
pp. S73-S74
Author(s):  
M.J. Hernández-Navarrete ◽  
D. Bordonaba-Bosque ◽  
C. Lapresta-Moros ◽  
G. Santana-López ◽  
S. Belkebir ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Infection Rate ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bed Occupancy ◽  
Methicillin Resistant ◽  
Aureus Infection

scholarly journals Care bundle intervention to reduce catheter-associated urinary tract infection rate in intensive care units

2015 ◽  
Vol 48 (2) ◽  
pp. S96
Author(s):  
Ching-Tzu Hung ◽  
Chung Hao Huang ◽  
Tzu-Hui Hung ◽  
Pei-Wen Yang ◽  
Shu-Wen Wu ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Infection Rate ◽  
Care Bundle

scholarly journals Rationality of Time-Dependent Antimicrobial Use in Intensive Care Units in China: A Nationwide Cross-Sectional Survey

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiao Liu ◽  
Sheng Zhang ◽  
Sisi Huang ◽  
Yizhu Chen ◽  
Lidi Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Continuous Infusion ◽  
Intensive Care Units ◽  
Drug Exposure ◽  
Time Dependent ◽  
Therapeutic Drug ◽  
Multivariable Logistic Regression Analysis ◽  
Prescribing Practices ◽  
Cross Sectional Survey

Background: Extended/continuous infusion and therapeutic drug monitoring (TDM) of time-dependent antimicrobials are recommended for optimizing drug exposure for patients in intensive care units (ICUs), although practical application of these measures remains uncertain. We surveyed current practices in infusion and monitoring of commonly prescribed time-dependent antimicrobials in ICUs across China.Methods: From December 2019 to January 2020, we sent online questionnaires about various aspects of infusion and monitoring of time-dependent antimicrobials to intensivists across China. Responses from clinicians were matched with their professional titles using the Sankey diagram. Univariate and multivariate logistic regression analyses were performed to find factors associated with TDM.Results: A total of 3,687 ICU specialists from 31 provincial administrative regions of China responded to our questionnaires. Antibiotic stewardship (ABS) teams were available in hospitals as reported by 3,243 (88.0%) intensivists, including 1,308 (35.5%) who were ABS team members. Although most intensivists (3,490, 94.7%) were acquainted with the concept of prolonged/continuous infusion, nearly half of them (1,634, 44.3%) commonly administered β-lactam antibiotics intermittently. Nearly two-thirds of the respondents reported that their hospitals could not perform TDM. Our multivariable logistic regression analysis revealed that at the hospital level, knowledge of drug sample timing and attitude toward monitoring treatment effects, and drug trough or peak concentration influenced the decision to conduct TDM.Conclusions: We found great variability in prescribing practices, from drug administration to TDM, for several time-dependent antibiotics commonly used for patients with severe infections. Further studies are necessary to effectively evaluate strategies to promote consistent prescribing behavior.

scholarly journals The clinical and economic value of the dipeptide alanyl-glutamine in total parenteral nutrition of critically ill patients treated in intensive care units in Italy

2009 ◽  
Vol 10 (2) ◽  
pp. 83-92
Author(s):  
Maurizio Muscaritoli ◽  
Lorenzo Pradelli ◽  
Orietta Zaniolo ◽  
Sergio Iannazzo ◽  
Mario Eandi
Keyword(s):  
Intensive Care ◽  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Clinical Outcomes ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Infection Rate ◽  
Critically Ill Patients ◽  
Discrete Event ◽  
Sensitivity Analyses

Introduction: the supplementation of alanyl-glutamine dipeptide in critically ill patients necessitating total parenteral nutrition (TPN) improves clinical outcomes, reducing mortality, infection rate, and shortening ICU hospital lengths of stay (LOS), as compared to standard TPN regimens. Here we present a pharmacoeconomic evaluation of alanyl-glutamine dipeptide in critically ill patients admitted to Italian Intensive Care Units (ICUs). Methods: a Discrete Event Simulation model that incorporates outcomes rates from 200 Italian ICUs for over 60,000 patients, alanyl-glutamine dipeptide efficacy data synthesized by means of a Bayesian Random-Effects meta-analysis, and national cost data has been developed to evaluated the alternatives from the point of view of the hospital. Simulated clinical outcomes are death and infection rates in ICU, death rate in general ward, and hospital LOSs. One-way and probabilistic sensitivity analyses are performed by varying all uncertain parameter values in a plausible range. Results: alanyl-glutamine dipeptide results more effective and less costly than standard TPN: reduced mortality rate (23.55% ± 15.2% vs 34.50% ± 2.06%), infection rate (15.91% ± 3.95% vs 18.97% ± 3.94%), and hospital LOS (25.47 ± 0.26 vs 26.00 ± 0.27 days) come at a lower total cost per patient (23,922 ± 3,249 vs 24,145 ± 3,361 Euro). Treatment cost is completely offset by savings on ICU and antibiotic costs. The cost/effectiveness acceptability curve indicates an estimated 78% probability of alanyl-glutamine dipeptide resulting dominant and a 90% probability of resulting cost/effective for a willingness to pay up to 1,500 Euro for one patient death avoided. Conclusions: alanyl-glutamine dipeptide is expected to improve clinical outcomes and to do so with a concurrent saving for the hospital.

Implementing a Multifaceted Intervention to Decrease Central Line–Associated Bloodstream Infections in SEHA (Abu Dhabi Health Services Company) Intensive Care Units: The Abu Dhabi Experience

2015 ◽  
Vol 36 (7) ◽  
pp. 816-822 ◽  
Author(s):  
Asad Latif ◽  
Bernadette Kelly ◽  
Hanan Edrees ◽  
Paula S. Kent ◽  
Sallie J. Weaver ◽  
...  
Keyword(s):  
Intensive Care ◽  
Health Services ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Infection Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Multifaceted Intervention ◽  
Abu Dhabi ◽  
Senior Leaders

OBJECTIVETo determine whether implementation of a multifaceted intervention would significantly reduce the incidence of central line–associated bloodstream infections.DESIGNProspective cohort collaborative.SETTING AND PARTICIPANTSIntensive care units of the Abu Dhabi Health Services Company hospitals in the Emirate of Abu Dhabi.INTERVENTIONSA bundled intervention consisting of 3 components was implemented as part of the program. It consisted of a multifaceted approach that targeted clinician use of evidence-based infection prevention recommendations, tools that supported the identification of local barriers to these practices, and implementation ideas to help ensure patients received the practices. Comprehensive unit-based safety teams were created to improve safety culture and teamwork. Finally, the measurement and feedback of monthly infection rate data to safety teams, senior leaders, and staff in participating intensive care units was encouraged. The main outcome measure was the quarterly rate of central line–associated bloodstream infections.RESULTSEighteen intensive care units from 7 hospitals in Abu Dhabi implemented the program and achieved an overall 38% reduction in their central line–associated bloodstream infection rate, adjusted at the hospital and unit level. The number of units with a quarterly central line–associated bloodstream infection rate of less than 1 infection per 1,000 catheter-days increased by almost 40% between the baseline and postintervention periods.CONCLUSIONA significant reduction in the global morbidity and mortality associated with central line–associated bloodstream infections is possible across intensive care units in disparate settings using a multifaceted intervention.Infect. Control Hosp. Epidemiol. 2015;36(7):816–822

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