scholarly journals Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center

2022 ◽  
Author(s):  
Oscar A. Fernández-García ◽  
María F. González-Lara ◽  
Marco Villanueva-Reza ◽  
Nereyda de-León-Cividanes ◽  
Luis F. Xancal-Salvador ◽  
...  
Keyword(s):  
Intensive Care ◽  
Care Center ◽  
Tertiary Care ◽  
Collateral Damage ◽  
Surge Capacity ◽  
Hospital Acquired Infections ◽  
High Workload ◽  
Pandemic Response ◽  
Hospital Acquired

The SARS-CoV-2 pandemic has resulted in a surge of critically ill patients. Hospitals have had to adapt to the demand by repurposing areas as intensive care units. This has resulted in high workload and disruption of usual hospital workflows. Surge capacity guidelines and pandemic response plans do not contemplate how to limit collateral damage from issues like hospital-acquired infections. It is vital to ensure quality of care in surge scenarios.

scholarly journals Correlation between Antibiotic Consumption and Hand Hygiene Compliance Among Anesthesia and Intensive Care Healthcare Professionals

2020 ◽  
Vol 14 (1) ◽  
pp. 42-48
Author(s):  
Emanuela Santoro ◽  
Marco Fiore ◽  
Sebastiano Leone ◽  
Armando Masucci ◽  
Roberta Manente ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Healthcare Professionals ◽  
Tertiary Care ◽  
Antibiotic Consumption ◽  
Alcoholic Solution ◽  
Hand Washing ◽  
Hospital Acquired Infections ◽  
Consumption Data ◽  
Hospital Acquired

Aims: The aim of this study was to investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals working in the Department of Anesthesia and Intensive Care of a tertiary care University Hospital. Background: Two centuries have passed since the discovery of Semmelweis that the “puerperal fever” was due to an infection transmitted by the hands. Currently the hand hygiene is still not well performed, rather it is often replaced by the improper use of gloves. Microbial transmission is estimated to occur in one-fifth of all contact cases. Objective: To investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals. Furthermore, to correlate the consumption data of the hydroalcoholic solution and the amount of antibiotics used for the treatment of hospital-acquired infections. Method: The study was conducted over six months period (from January to June 2018); during this period, 20 monitoring sessions were performed. The following indicators were evaluated: a) Non-adherence to hand hygiene with concomitant use of gloves; b) Adhesion to alcoholic friction of hands; c) Hand-washing adhesion. Instead, the consumption data, provided by the hospital ward itself, were used for the evaluation of d) The antibiotics used in the treatment of hospital-acquired infections; e) The hydro-alcoholic solution used by the healthcare professionals for hand hygiene. Results: The frequency of non-adherence to hand hygiene was very high at the beginning of the study, subsequently it decreased to about a half percent to that at the initial stage. The adhesion to alcoholic friction of hands increased during the study period. Otherwise, the hand-washing adhesion slightly reduced, especially in March probably due to the recruitment of new inadequately trained nursing staff. The trend of antibiotic consumption was similar to handwashing. The consumption of hydro-alcoholic solution was very low, however over time, it increased considerably until the end of the study. Conclusion: In light of the findings from this work, it is necessary to make the hospital staff increasingly aware of the correct practice of hand hygiene and to organize training and informative sessions to promote the health of the individual and the community.

scholarly journals Epidemiology of hospital-acquired infections at a tertiary care center in Lebanon

2011 ◽  
Vol 5 (S6) ◽  
Author(s):  
S Kanj ◽  
G Kamel ◽  
L Alamuddin ◽  
N Zahreddine ◽  
N Sidani ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

The Relationship of Paranasal Sinus Opacification to Hospital-Acquired Pneumonia in the Neurologic Intensive Care Unit Patient

2017 ◽  
Vol 34 (10) ◽  
pp. 844-850
Author(s):  
Phillip Huyett ◽  
Nicholas R. Rowan ◽  
Berrylin J. Ferguson ◽  
Stella Lee ◽  
Eric W. Wang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Paranasal Sinus ◽  
Care Center ◽  
Tertiary Care ◽  
Lower Airway ◽  
Icu Admission ◽  
Airway Infections ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Background: The association between intensive care unit (ICU) sinusitis and the development of lower airway infections remains unclear. The objective of this study was to determine the correlation between the development of radiographic sinus opacification and pneumonia in the neurologic ICU setting. Methods: A retrospective review of head computed tomography or magnetic resonance imaging of 612 patients admitted to the neurocritical care unit at a tertiary care center from April 2013 through April 2014 was performed. Paranasal sinus opacification was measured using Lund-Mackay scores (LMS). A diagnosis of pneumonia was determined by the ICU team from radiographic, laboratory, and pulmonary data. Exclusion criteria included a history of endonasal surgery, sinonasal malignancy, facial fractures, ICU admission less than 3 days, or inadequate imaging. Results: Worsening sinus opacification occurred in 42.6% of patients and pneumonia in 18.5% of patients during ICU admission. Of the patients who developed pneumonia, 71.7% also developed worsening sinus opacification ( P < .001). In 80.2% of cases, the sinus opacification developed prior to the diagnosis of pneumonia. The mean highest LMS for patients who developed pneumonia was 4.24 compared to 1.99 in patients who did not develop pneumonia ( P < .001). Sinus air–fluid levels or complete sinus opacification occurred in a larger proportion of patients who developed pneumonia (46.9% vs 19.4%, P < .001). Mortality rates for patients with no pneumonia or sinusitis, pneumonia only, sinusitis only, and sinusitis with pneumonia were 7.6%, 15.6%, 18.3%, and 25.9%, respectively ( P < .001). Conclusions: This study finds a strong relationship between worsening sinus opacification in the neurologic ICU patient to the development of hospital-acquired pneumonia and increased mortality.

scholarly journals Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 182
Author(s):  
Bernardo A. Martinez-Guerra ◽  
Maria F. Gonzalez-Lara ◽  
Nereyda A. de-Leon-Cividanes ◽  
Karla M. Tamez-Torres ◽  
Carla M. Roman-Montes ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Coagulase Negative Staphylococci ◽  
Hospital Acquired Infections ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment ◽  
Hospital Acquired ◽  
Antimicrobial Prescription

Objective: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms. Methods: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI. Results: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p < 0.05). Conclusion: A high frequency of empiric antibiotic treatment in patients admitted with COVID-19 was seen. VAP and BSI were the most frequent hospital-acquired infections, due to Enterobacteriaceae and coagulase negative staphylococci, respectively.

The effect of increased mobility on morbidity in the neurointensive care unit

2012 ◽  
Vol 116 (6) ◽  
pp. 1379-1388 ◽  
Author(s):  
W. Lee Titsworth ◽  
Jeannette Hester ◽  
Tom Correia ◽  
Richard Reed ◽  
Peggy Guin ◽  
...  
Keyword(s):  
Unit Length ◽  
Care Center ◽  
Tertiary Care ◽  
Neurointensive Care ◽  
Neurointensive Care Unit ◽  
Hospital Acquired Infections ◽  
Medical Icus ◽  
Hospital Acquired ◽  
Observation Period

Object The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit of mobility protocols. Currently no study has investigated the role of increased mobility in the neurointensive care unit population. This study was a single-institution prospective intervention trial to investigate the effectiveness of increased mobility among neurointensive care unit patients. Methods All patients admitted to the neurointensive care unit of a tertiary care center over a 16-month period (April 2010 through July 2011) were evaluated. The study consisted of a 10-month (8025 patient days) preintervention observation period followed by a 6-month (4455 patient days) postintervention period. The intervention was a comprehensive mobility initiative utilizing the Progressive Upright Mobility Protocol (PUMP) Plus. Results Implementation of the PUMP Plus increased mobility among neurointensive care unit patients by 300% (p < 0.0001). Initiation of this protocol also correlated with a reduction in neurointensive care unit length of stay (LOS; p < 0.004), hospital LOS (p < 0.004), hospital-acquired infections (p < 0.05), and ventilator-associated pneumonias (p < 0.001), and decreased the number of patient days in restraints (p < 0.05). Additionally, increased mobility did not lead to increases in adverse events as measured by falls or inadvertent line disconnections. Conclusions Among neurointensive care unit patients, increased mobility can be achieved quickly and safely with associated reductions in LOS and hospital-acquired infections using the PUMP Plus program.

scholarly journals Community-acquired and hospital-acquired respiratory tract infection and bloodstream infection in patients hospitalized with COVID-19 pneumonia

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Kirstine K. Søgaard ◽  
Veronika Baettig ◽  
Michael Osthoff ◽  
Stephan Marsch ◽  
Karoline Leuzinger ◽  
...  
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Bloodstream Infection ◽  
Bacterial Infections ◽  
Fungal Infections ◽  
Icu Patients ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

Abstract Objectives SARS-CoV-2 may cause acute lung injury, and secondary infections are thus relevant complications in patients with COVID-19 pneumonia. However, detailed information on community- and hospital-acquired infections among patients with COVID-19 pneumonia is scarce. Methods We identified 220 SARS-CoV-2-positive patients hospitalized at the University Hospital Basel, Switzerland (between 25 February and 31 May 2020). We excluded patients who declined the general consent (n = 12), patients without clinical evidence of pneumonia (n = 29), and patients hospitalized for < 24 h (n = 17). We evaluated the frequency of community- and hospital-acquired infections using respiratory and blood culture materials with antigen, culture-based, and molecular diagnostics. For ICU patients, all clinical and microbial findings were re-evaluated interdisciplinary (intensive care, infectious disease, and clinical microbiology), and agreement reached to classify patients with infections. Results In the final cohort of 162 hospitalized patients (median age 64.4 years (IQR, 50.4–74.2); 61.1% male), 41 (25.3%) patients were admitted to the intensive care unit, 34/41 (82.9%) required mechanical ventilation, and 17 (10.5%) of all hospitalized patients died. In total, 31 infections were diagnosed including five viral co-infections, 24 bacterial infections, and three fungal infections (ventilator-associated pneumonia, n = 5; tracheobronchitis, n = 13; pneumonia, n = 1; and bloodstream infection, n = 6). Median time to respiratory tract infection was 12.5 days (IQR, 8–18) and time to bloodstream infection 14 days (IQR, 6–30). Hospital-acquired bacterial and fungal infections were more frequent among ICU patients than other patients (36.6% vs. 1.7%). Antibiotic or antifungal treatment was administered in 71 (43.8%) patients. Conclusions Community-acquired viral and bacterial infections were rare among COVID-19 pneumonia patients. By contrast, hospital-acquired bacterial or fungal infections were frequently complicating the course among ICU patients.

Sign in / Sign up

Export Citation Format

Share Document