scholarly journals Burden of nosocomial COVID-19 in Wales: results from a multicentre retrospective observational study of 2508 hospitalised adults

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2021-216964
Author(s):  
Mark J Ponsford ◽  
Rhys Jefferies ◽  
Chris Davies ◽  
Daniel Farewell ◽  
Ian R Humphreys ◽  
...  
Keyword(s):  
Observational Study ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Control Measures ◽  
Retrospective Observational Study ◽  
Inpatient Mortality ◽  
Case Definitions ◽  
Hospital Acquired Infection ◽  
Infection Control Measures ◽  
Hospital Acquired

The burden of nosocomial SARS-CoV-2 infection remains poorly defined. We report on the outcomes of 2508 adults with molecularly-confirmed SARS-CoV-2 admitted across 18 major hospitals, representing over 60% of those hospitalised across Wales between 1 March and 1 July 2020. Inpatient mortality for nosocomial infection ranged from 38% to 42%, consistently higher than participants with community-acquired infection (31%–35%) across a range of case definitions. Those with hospital-acquired infection were older and frailer than those infected within the community. Nosocomial diagnosis occurred a median of 30 days following admission (IQR 21–63), suggesting a window for prophylactic or postexposure interventions, alongside enhanced infection control measures.

scholarly journals The burden of nosocomial covid-19: results from the Wales multi-centre retrospective observational study of 2518 hospitalised adults

2021 ◽  
Author(s):  
Mark J Ponsford ◽  
Rhys Jefferies ◽  
Chris Davies ◽  
Daniel Farewell ◽  
Ian R. Humphreys ◽  
...  
Keyword(s):  
Observational Study ◽  
Nosocomial Infection ◽  
Diagnostic Testing ◽  
Control Measures ◽  
Post Exposure Prophylaxis ◽  
Inpatient Mortality ◽  
Case Definitions ◽  
Infection Control Measures ◽  
The Uk ◽  
Hospital Acquired

AbstractObjectivesTo define the burden of nosocomial (hospital-acquired) novel pandemic coronavirus (covid-19) infection among adults hospitalised across Wales.DesignRetrospective observational study of adult patients with polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection between 1st March – 1st July 2020 with a recorded hospital admission within the subsequent 31 days. Outcomes were collected up to 20th November using a standardised online data collection tool.SettingService evaluation performed across 18 secondary or tertiary care hospitals.Participants4112 admissions with a positive SARS-CoV-2 PCR result between 1st March to 1st July 2020 were screened. Anonymised data from 2518 participants were returned, representing over 60% of adults hospitalised across the nation of Wales.Main outcome measuresThe prevalence and outcomes (death, discharge) for nosocomial covid-19, assessed across of a range of possible case definitions.ResultsInpatient mortality rates for nosocomial covid-19 ranged from 38% to 42% and remained consistently higher than participants with community-acquired infection (31% to 35%) across a range of case definitions. Participants with nosocomial-acquired infection were an older, frailer, and multi-morbid population than those with community-acquired infection. Based on the Public Health Wales case definition, 50% of participants had been admitted for 30 days prior to diagnostic testing.ConclusionsThis represents the largest assessment of clinical outcomes for patients with nosocomial covid-19 in the UK to date. These findings suggest that inpatient mortality rates from nosocomial-infection are likely higher than previously reported, emphasizing the importance of infection control measures, and supports prioritisation of vaccination for covid-19 negative admissions and trials of post-exposure prophylaxis in inpatient cohorts.Trial registrationThis project was approved and sponsored by the Welsh Government, as part of a national audit and quality improvement scheme for patients hospitalised covid-19 across Wales.Key MessagesWhat is already known on this topicWe searched PubMed and ISI Web of Science up until 31-December-2020 for studies reporting on patient outcomes following hospital-acquired infection due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We identified a range of case-definitions for hospital-acquired infection, based on timing of diagnostic testing 5 to 15 days following admission. The largest and only multi-centre study concluded individuals with nosocomial infection are at a lower risk of death from SARS-CoV-2 than those infected in the community, however, was performed early in the pandemic and utilised a conservative definition of nosocomial infection.What this study addsOur multi-centre observational study represents the largest assessment of clinical outcomes for patients with nosocomial covid-19 in the UK to date, and suggests the burden of nosocomial SARS-CoV-2 infection has been underestimated. Nosocomial-infection occurred in older, frailer, and multi-morbid individuals, and was consistently associated with greater inpatient mortality than amongst those who were infected in the community across a spectrum of case-definitions. Our findings support implementation of enhanced infection control measures to reduce this burden during future waves, especially given the recent emergence of novel viral variants with enhanced transmissibility. Furthermore, roughly half of the patients meeting the Public Health Wales definition of definite nosocomial SARS-CoV-2 infection had been admitted for 30 days prior to diagnosis, highlighting a potential window of opportunity for inpatient pre-exposure and/or post-exposure prophylaxis.

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.

scholarly journals The interplay of SARS-CoV-2 and Clostridioides difficile infection

2021 ◽  
Vol 16 (6) ◽  
pp. 439-443
Author(s):  
Sahil Khanna ◽  
Colleen S Kraft
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Gastrointestinal Symptoms ◽  
Control Measures ◽  
Antibiotic Exposure ◽  
Hospital Acquired Infections ◽  
Infection Control Measures ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Hospital Acquired

The COVID-19 pandemic has changed the way we practice medicine and lead our lives. In addition to pulmonary symptoms; COVID-19 as a syndrome has multisystemic involvement including frequent gastrointestinal symptoms such as diarrhea. Due to microbiome alterations with COVID-19 and frequent antibiotic exposure, COVID-19 can be complicated by Clostridioides difficile infection. Co-infection with these two can be associated with a high risk of complications. Infection control measures in hospitals is enhanced due to the COVID-19 pandemic which in turn appears to reduce the incidence of hospital-acquired infections such as C. difficile infection. Another implication of COVID-19 and its potential transmissibility by stool is microbiome-based therapies. Potential stool donors should be screened COVID-19 symptoms and be tested for COVID-19.

scholarly journals Knowledge and practices of nurses regarding nosocomial infection control measures in private hospitals in Sana’a City, Yemen

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Gamil Alrubaiee ◽  
Anisah Baharom ◽  
Hayati Kadir Shahar ◽  
Shaffe Mohd Daud ◽  
Huda Omar Basaleem
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Control Measures ◽  
Private Hospitals ◽  
Infection Control Measures

Relationship between the Prevalence of Methicillin-ResistantStaphylococcus aureusInfection and Indicators of Nosocomial Infection Control Measures A Population-Based Study in French Hospitals

2009 ◽  
Vol 30 (9) ◽  
pp. 861-869 ◽  
Author(s):  
Leslie Grammatico-Guillon ◽  
Jean-Michel Thiolet ◽  
Pascale Bernillon ◽  
Bruno Coignard ◽  
Babak Khoshnood ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Population Based ◽  
Mean Value ◽  
Control Measures ◽  
Prevalence Survey ◽  
Infection Control Measures ◽  
Mrsa Infection ◽  
The Mean ◽  
National Prevalence

Objective.To assess whether infection control indicators are associated with the prevalence of methicillin-resistantStaphylococcus aureus(MRSA) infection in French hospitals.Methods.We linked the database for the 2006 national prevalence survey of nosocomial infection with the database of infection control indicators (comprised of ICALIN, an indicator of infection control organization, resources, and action, and ICSHA, an indicator of alcohol-based handrub consumption) recorded from hospitals by the Ministry of Health. Data on MRSA infection were obtained from the national prevalence survey database and included the site and origin of infection, the microorganism responsible, and its drug resistance profile. Because the prevalence of MRSA infection was low and often nil, especially in small hospitals, we restricted our analysis to hospitals with at least 300 Patients. We used a multilevel logistic regression model to assess the joint effects of patient-level variables (eg, age, sex, or infection) and hospital-level variables (infection control indicators).Results.Two hundred two hospitals had at least 300 patients, for a total of 128,631 Patients. The overall prevalence of MRSA infection was 0.34% (95% confidence interval [CI], 0.29%-0.39%). The mean value for ICSHA was 7.8 L per 1,000 patient-days (median, 6.1 L per 1,000 patient-days; range, 0-33 L per 1,000 patient-days). The mean value for ICALIN was 92 of a possible 100 points (median, 94.5;range, 67-100). Multilevel analyses showed that ICALIN scores were associated with the prevalence of MRSA infection (odds ratio for a score change of 1 standard deviation, 0.80;95% CI, 0.69-0.93). We found no association between prevalence of MRSA infection and ICSHA. Other variables significantly associated with the prevalence of MRSA infection were sex, vascular or urinary catheter, previous surgery, and the McCabe score.Conclusions.We found a significant association between the prevalence of MRSA infection and ICALIN that suggested that a higher ICALIN score may be predictive of a lower prevalence of MRSA infection.

scholarly journals Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures

2011 ◽  
Vol 32 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Vincent C. C. Cheng ◽  
Lisa M. W. Wong ◽  
Josepha W. M. Tai ◽  
Jasper F. W. Chan ◽  
Kelvin K. W. To ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Infection Control Team ◽  
Concurrent Control ◽  
Infection Control Measures ◽  
Control Team ◽  
Hospital Networks ◽  
Polymerase Chain ◽  
Hospital Acquired

Background.Nosocomial outbreaks of norovirus infection pose a great challenge to the infection control team.Methods.Between November 1, 2009, and February 28, 2010, strategic infection control measures were implemented in a hospital network. In addition to timely staff education and promotion of directly observed hand hygiene, reverse-transcription polymerase chain reaction for norovirus was performed as an added test by the microbiology laboratory for all fecal specimens irrespective of the request for testing. Laboratory-confirmed cases were followed up by the infection control team for timely intervention. The incidence of hospital-acquired norovirus infection per 1,000 potentially infectious patient-days was compared with the corresponding period in the preceding 12 months, and the incidence in the other 6 hospital networks in Hong Kong was chosen as the concurrent control. Phylogenetic analysis of norovirus isolates was performed.Results.Of the 988 patients who were tested, 242 (25%) were positive for norovirus; 114 (47%) of those 242 patients had norovirus detected by our added test. Compared with the corresponding period in the preceding 12 months, the incidence of hospital-acquired norovirus infection decreased from 131 to 16 cases per 1,000 potentially infectious patient-days (P < .001 ), although the number of hospital-acquired infections was low in both the study period (n = 8) and the historical control periods (n = 11). The incidence of hospital-acquired norovirus infection in our hospital network (0.03 cases per 1,000 patient-days) was significantly lower than that of the concurrent control (0.06 cases per 1,000 patient-days) (P = .015). Forty-three (93%) of 46 norovirus isolates sequenced belonged to the genogroup II.4 variant.Conclusions.Strategic infection control measures with an added test maybe useful in controlling nosocomial transmission of norovirus.

112 Outbreak of Carbapenemase-Producing Enterobacteriaceae in a Regional Burn Centre

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S75-S75
Author(s):  
Sarah Rehou ◽  
Sydney Rotman ◽  
Melisa Avaness ◽  
Marc G Jeschke ◽  
Shahriar Shahrokhi
Keyword(s):  
Infection Control ◽  
Total Body Surface Area ◽  
Skin Barrier ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Environmental Cleaning ◽  
Infection Control Measures ◽  
Potential Source ◽  
Total Body ◽  
Hospital Acquired

Abstract Introduction Antimicrobial resistance is an increasing problem in hospitals worldwide, though the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) in our region is low. Burn patients are among the most vulnerable to infection because of the loss of the protective skin barrier. Because of this, burn centres prioritize infection prevention and control with measures like additional precautions, enhanced environmental cleaning, dedicated facilities, and mandatory use of personal protective equipment (PPE). Methods This report describes a CPE outbreak in a regional burn centre. We hypothesized that contamination of in-room hand hygiene sinks with CPE was a potential source of transmission. In a period of 2.5 months, four nosocomial cases of CPE were identified, three containing the KPC gene and one VIM gene. There was more than one month between the first and second KPC case, with no overlap in patient stay or rooms. Results The first two cases were identified while there was no CPE patient source on the unit. CPE KPC gene was isolated in sink drains of three different rooms. In addition to the rigorous infection control practices already in place due to the unique patient population, additional outbreak control measures were implemented. The burn centre restricted admissions to complex burns or burns &gt;10% total body surface area, in consultation with the attending surgeon. No elective admissions were permitted. To avoid CPE exposure to new patients, initial admissions were rerouted to the emergency department and, if possible, the patient was admitted to another unit. Patient cohorting was implemented through nursing team separation for CPE positive and negative patients and geographical separation of CPE positive cases to one side of the unit. Conclusions Despite aggressive infection control measures already in place at our burn centre, there was hospital acquired CPE colonization/infection. Given there was CPE acquisition when there was no positive patients on the unit and CPE contaminated sinks of the same enzyme were identified, it suggests that hospital sink drains can become a potential source of CPE.

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