scholarly journals The Impact of Health Care Restructuring on Nosocomially Acquired Blood Stream Infections

2000 ◽  
Vol 11 (1) ◽  
pp. 34-37 ◽  
Author(s):  
Geoffrey D Taylor ◽  
Margare McKenzie ◽  
Teresa Kirkland ◽  
Maureen Buchanan-Chell ◽  
Rhoda Wiens
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Blood Stream Infection ◽  
Venous Catheter ◽  
Blood Stream ◽  
Infection Rates ◽  
Blood Stream Infections ◽  
Hospital Restructuring ◽  
Hospital Bed ◽  
The Impact

OBJECTIVE: To assess the impact of the health care restructuring, which occurred in Alberta in 1995, on the occurrence of nosocomial blood stream infection and risk factors for these infections at the University of Alberta Hospital.PATIENTS AND METHODS: Changes in patient population, hospital bed numbers, admissions and hospital days for 1993 and 1994 (1993/94) were compared with those for 1996 and 1997(1996/97). Central venous catheter (CVC) use in intensive care units (ICU), days of total parenteral nutrition (TPN) and hemodialysis were compared for the two time periods. Prospectively collected data obtained by monitoring blood culture results on nosocomial blood stream infections in 1993/94 were compared with those obtained in 1996/97.RESULTS: Hospital bed number fell by 10% between 1993/94 and 1996/97. Annual admissions fell by 19% and patient days by 17%. Some services markedly increased patient days (neurosurgery 49%, nephrology 30%, orthopedic surgery 24%), and others markedly reduced patient days (obstetrics and gynecology 99%, ophthalmology 100%, adult medicine 41%, general paediatrics 38%). ICU use of CVCs increased by 41%, TPN days increased by 25% and hemodialysis runs increased by 9%. Annual nosocomial blood stream infections increased by 31% and the annual rate per 10,000 patient days increased by 60%. TPN-related blood stream infection rates and ICU CVC infection rates did not change from 1993/94 to 1996/97.CONCLUSIONS: Hospital restructuring has been associated with a 31% increase in nosocomial blood stream infection number and a 60% increase in rate. The increase has been associated with a change in patient populations and increases in risk factors for blood stream infection.

scholarly journals Peripheral venous catheter related blood stream infection in intensive care unit

2018 ◽  
Vol 5 (3) ◽  
pp. 668 ◽  
Author(s):  
Satish Kumar Dalai ◽  
Sanghamitra Padhi ◽  
Abhishek Padhi ◽  
Banojini Parida
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Signs And Symptoms ◽  
Venous Catheter ◽  
Blood Stream ◽  
Sensitivity Testing ◽  
Klebsiella Species ◽  
Blood Stream Infections ◽  
Peripheral Venous Catheter ◽  
Microbial Profile

Background: Peripheral venous catheter related blood stream infections (PVC-BSI) are a common cause of morbidity and mortality in hospitals. Most of the catheter related blood stream infections occurs due to lack of proper aseptic measures. This study points out the risk factors microbial profile and antimicrobial susceptibility of isolates associated with PVC-BSI. The common organisms causing Catheter related BSI are Staphylococcus aureus (41.1%), and Klebsiella species (17.6%) followed by CONS and Enterococcus species. Objective of present study was to isolate and identify the organisms causing PCV-BSI, perform antimicrobial sensitivity testing of isolated organisms and to identify the associated risk factors and preventive measures that should be used.Methods: The study was conducted over a period of one year from August 2015 to July 2016 in the Department of Microbiology. Study group comprised of all the patients with peripheral venous catheterization who developed signs and symptoms of septicemia after 48 hrs of insertion of PVC. These patients were followed up from the time of catheterization till discharge. Peripheral venous catheter tip was collected under aseptic condition along with peripheral blood samples from a site other than the catheterized one. Samples were collected from patients at any point of time who developed signs and symptoms of septicemia after 48 hrs of catheter insertion. The length of time for which the PVC was in place was recorded.Results: In total, 87 cases were included in the study with mean catheter duration of 4.8 days accounting for 418 catheter days. Out of these 87 cases, 17 cases developed PVC-BSI (19.5%) and 34 cases developed colonization (24.1%). Staphylococcus species (41.1%) was the most common isolate.Conclusions: PVC-BSI has a significant role in hospital acquired infections and more studies are needed to establish this.

scholarly journals Potential impact of novel diagnostics and treatments on the burden of antibiotic resistant in Escherichia coli

2016 ◽  
Author(s):  
Pierre Nouvellet ◽  
J.V. Robotham ◽  
N.R. Naylor ◽  
N. Woodford ◽  
Neil M. Ferguson
Keyword(s):  
Escherichia Coli ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Case Scenario ◽  
Worst Case ◽  
Blood Stream Infections ◽  
E Coli ◽  
Hospital Bed ◽  
The Impact ◽  
Excess Deaths

AbstractThe rising threat of antibiotic resistance in Europe and beyond is of increasing concern and is prompting renewed effort to better understand and mitigate their impact. Escherichia Coli blood stream infections are a more major concern in Europe given their incidence and severe associated outcomes. Additionally the level of 3rd generation cephalosporins and carbapenems resistance among those bacteraemia has significantly increased, limiting available treatment options. We estimated the current burden associated with E. coli blood stream infections in Europe at 17,000 (95%CI [8,000; 30,000]) excess deaths and 960,000 (95%CI [600,000; 1,450,000]) extra hospital bed days. From those, the contribution due to 3rd generation cephalosporins and carbapenems resistant strains reached 6,000 (95%CI [2,000; 12,000]) excess deaths, and 200,000 (95%CI [76,000; 420,000]) extra hospital bed stay. In the worst case scenario, we estimated the burden of E. coli blood stream infection in 2026 could increase over 4-fold, mostly resulting from an increase in the level of resistance rather than an increase in the incidence of blood stream infections. Finally, we estimated that the impact of combined novel diagnostics and treatments could substantially reduce the excess mortality by 18.5% to 55.5%, and length of stay by 13.2% to 75.6%.

scholarly journals Evaluation of Specific Risk Factors and Outcomes of Colistin-Resistant Klebsiella pneumoniae Infections in a Tertiary Care Centre - An Observational Study

2021 ◽  
Vol 4 (2) ◽  
pp. 1-6
Author(s):  
Prakash Shastri ◽  
Shamanth A Shankarnarayan
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Line ◽  
Multidrug Resistant ◽  
Automated System ◽  
Tertiary Care Centre ◽  
Broth Microdilution Method

Background: Incidence of multidrug resistant Klebsiella pnumoniae infections are increasing globally especially in ICUs. Aim: We evaluated the burden of colistin resistant K. pneumoniae (ColR KP) and the risk factors associated with the outcome of these patients. Methods: Consecutive patients developing K. pneumoniae infections were included. K. pneumoniae from endotracheal tube and catheterized urine sample, having cell count <105 cfu/ml, and which did not necessitate a change in antibiotics as per the treating physicians was considered as colonizer. Demographic and clinical details were collected and samples were processed as per standard protocol. Any growth was identified and its antimicrobial susceptibility was carried out by using Vitek 2 automated system. Minimum inhibitory concentration of >4 μg/ml for Colistin was considered as resistant. The resistant isolates were confirmed with Broth microdilution method. Risk factor associated with the outcome of ColR KP was analyzed. Findings: Burden of K. pneumoniae infection was 50.02 per 1000 admissions. K. pneumonie (n=155) was isolated from patients with ventilator associated pneumonia (84, 54.2%), followed by blood stream infection (49, 31.6%) and urinary tract infection (22, 14.2%). ColR KP and intermediate (ColI KP) isolates were 58 (37.41%) and 97 (62.6%) respectively. Among ColR KP infected patients 32 (55.1%) died whereas 26 (44.8%) patients were discharged. Higher mortality was witnessed in ColI KP cases (75, 77.3%) compared to ColR-KP cases (32, 55.1%) (p=0.004; OR=2.77; 95% CI=1.37 to 5.59). Colistin resistance and presence of central line were independently associated with mortality. Conclusion: Colistin resistant K. pneumoniae infections among ICU patients are on rise. Presence of central venous catheter and resistance to colistin were independent predictors of mortality.

scholarly journals Linezolid lock prophylaxis of central venous catheter infection

2008 ◽  
Vol 57 (4) ◽  
pp. 534-535 ◽  
Author(s):  
Jérôme Patrick Fennell ◽  
Martin O'Donohoe ◽  
Martin Cormican ◽  
Maureen Lynch
Keyword(s):  
Central Venous Catheter ◽  
Hospital Admissions ◽  
Blood Stream Infection ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Blood Stream ◽  
Central Venous ◽  
Central Venous Catheter Infection ◽  
The Impact

Central venous catheter (CVC)-related infections are a major problem for patients requiring long-term venous access and may result in frequent hospital admissions and difficulties in maintaining central venous access. CVC-related blood stream infections are associated with increased duration of inpatient stay and cost approximately \#8364;13 585 per patient [Blot, S. I., Depuydt, P., Annemans, L., Benoit, D., Hoste, E., De Waele, J. J., Decruyenaere, J., Vogelaers, D., Colardyn, F. & Vandewoude, K. H. (2005). Clin Infect Dis 41, 1591–1598]. Antimicrobial lock therapy may prevent CVC-related blood stream infection, preserve central venous access and reduce hospital admissions. In this paper, the impact of linezolid lock prophylaxis in a patient with short bowel syndrome is described.

Central venous catheter—related blood stream infections: incidence, risk factors, outcome, and associated pathogens

2004 ◽  
Vol 18 (3) ◽  
pp. 304-308 ◽  
Author(s):  
Mandakini Pawar ◽  
Yatin Mehta ◽  
Pawan Kapoor ◽  
Jitendra Sharma ◽  
Abhinav Gupta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Venous ◽  
Blood Stream Infections ◽  
Incidence Risk

scholarly journals Hemodialysis Catheter-Related Infection in a Teaching Hospital of Central Nepal

2019 ◽  
Vol 41 (2) ◽  
pp. 11-16
Author(s):  
Arun Sedhain ◽  
Abja Sapkota ◽  
Narayan B Mahotra
Keyword(s):  
Risk Factors ◽  
Blood Stream Infection ◽  
Antibiotic Sensitivity ◽  
Major Complication ◽  
Venous Catheter ◽  
Blood Stream ◽  
Recent Change ◽  
Catheter Related Infection ◽  
Hemodialysis Catheter ◽  
A Prospective Study

Introduction: Infection of the central venous catheter (CVC) is a major complication seen among patients undergoing hemodialysis. Identifying CVC related infection (CRI) and its risk factors and causative organisms is important for better implementation of preventive strategies. Methods: A prospective study was conducted at Chitwan Medical College for duration of 2 years from January 2017to December 2018 among the patients undergoing hemodialysis via CVC. The data collected were related to patients’ demographics, site of catheter insertion, and duration, microbiological data including cultures from catheter sites, blood, and catheters’ tips and antibiotic sensitivity. Catheter related infection was divided into catheter related local infection (CRLI) and catheter related blood stream infection (CRBSI). Data was analyzed using IBM SPSS Statistics version 21.0. Results: A total of 41 cases of CVC related infection (CRI) were documented with an incidence rate of 6.94 episodes per 1000 catheter days at risk. Out of the total CRI, 39.02% were CRLI and 60.98% were CRBSI. Fever with chills and rigor were the most common clinical presentation. Risk factors for the development of CRI were duration of catheter in situ, repeated change of CVC and the use of CVC for indications other than hemodialysis (HD).Staphylococci and Klebsiella were the most common organisms isolated in culture. Conclusion: The rate of CRI among Nepalese patients undergoing hemodialysis is high. Prolonged duration of CVC usage, recent change of catheter and the use of the HD catheter for the purpose of institution of intravenous medication have been found as the risk factors for CRI.

Patient and central venous catheter related risk factors for blood stream infections in children receiving chemotherapy

2014 ◽  
Vol 62 (3) ◽  
pp. 471-476 ◽  
Author(s):  
Joanne Yacobovich ◽  
Tal Ben-Ami ◽  
Tameemi Abdalla ◽  
Hannah Tamary ◽  
Gal Goldstein ◽  
...  
Keyword(s):  
Risk Factors ◽  
Central Venous Catheter ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Venous ◽  
Blood Stream Infections ◽  
Related Risk

scholarly journals Bacterial and Fungal Profile, Drug Resistance Pattern and Associated Factors of Isolates Recovered From Blood Samples of Patients Referred to Ethiopian Public Health Institute: Cross-Sectional Study

2021 ◽  
Author(s):  
Etsehiwot Adamu Tsegaye ◽  
Dejenie Shiferaw Teklu ◽  
Zelalem Tazu Bonger ◽  
Abebe Assefa Negeri ◽  
Tesfaye Legesse Bedada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Burkholderia Cepacia ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Blood Stream Infections ◽  
Gram Positive Bacteria ◽  
Blood Specimens

Abstract Background Blood stream infections are serious infections that usually induce prolongation of hospital stay, morbidity and mortality in several countries including Ethiopia. The aim of this study was to determine bacterial and fungal profile, their drug resistance patterns, and risk factors associated with blood stream infections. Methods A cross sectional study design was conducted from February 23 to June 23, 2020 at Ethiopian public health. A structured questionnaire was used to collect data on socio-demographic factors and clinical conditions. Blood specimens were analyzed using standard microbiological techniques. Antimicrobial susceptibility tests were performed using Kirby-Bauer disc diffusion technique and Vitek compact 2. Simple and multiple logistic regressions were used to assess the potential risk factors. Results A total of 175 pathogens isolated from 346 blood specimens. Of these, 60% Gram-negative bacteria, 30.86% Gram-positive bacteria and 9.14% fungal isolates were identified. Burkholderia cepacia and Coagulase negative staphylococcus were the predominant pathogen among Gram-negative and Gram-positive bacteria respectively. Among fungus, Candidia krusei (56.25%) was the most predominant isolate. The highest proportions of antibacterial resistance were observed among 3rd generation cephalosporin and penicillin. Most fungal isolates expressed resistance to fluconazole. Sex (p = 0.007), age (p < 0.001) and use of invasive medical devices (p = 0.003) were identified as risk factors for bacterial blood stream infections. Conclusion The study showed high prevalence of blood stream infection was due to Burkholderia cepacia and non-Candidia albicans spp. This finding alarming ongoing investigation of blood stream infection is important for recognizing future potential preventive strategies including environmental hygiene and management of comorbid medical diseases to reduce the problem.

scholarly journals Health care-associated infection surveillance: A prospective study of a tertiary neonatal intensive care unit

2019 ◽  
Vol 13 (03) ◽  
pp. 181-187 ◽  
Author(s):  
Atila Kilic ◽  
Emel Okulu ◽  
Bilge Aldemir Kocabas ◽  
Serdar Alan ◽  
Ufuk Cakir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Intensive Care ◽  
Mortality Rate ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Venous Catheter ◽  
Care Quality ◽  
Multivariable Logistic Regression Analysis ◽  
Health Care Associated Infection

Introduction: Health care-associated infection (HCAI) is a serious problem of neonatal intensive care units (NICUs) which is related to morbidity, mortality and increased cost of medical care. This study aimed to determine the incidence of HCAI in a tertiary NICU and identify the risk factors. Methodology: This prospective cohort study was conducted between July 1, 2011 and June 30, 2012. All newborns admitted to the NICU except for those who died or were discharged within 48 hours after admission were included. The definitions of Centers for Disease Control and Prevention (CDC) were used to diagnose specific types of infections. The incidence, causative organisms, risk factors and mortality of HCAIs were evaluated. Results: Among 352 newborns, a total of 60 HCAI episodes were evaluated in 37 (10.5%) of the patients over 5,212 patient-days. The overall incidence of HCAI was 17%, and the rate was 11.5/1,000 patient-days. Blood stream infection (BSI) was the most common HCAI (n = 42, 70%). In a multivariable logistic regression analysis, the presence of a central venous catheter/umbilical catheter (CVC/UC), the presence of a urinary catheter, and gestational age (< 32 weeks of gestation) were identified as significant independent risk factors. Gram-negative pathogens were the most common isolates. The overall mortality rate was 4%. The HCAI-related mortality rate was 10.8%. Conclusions: Patient care quality can be improved with surveillance of HCAI. The incidence and rate of HCAI in our NICU were found to be higher than international reports with a direct impact on mortality of preterm infants.

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