scholarly journals Are Invasive Procedures and a Longer Hospital Stay Increasing the Risk of Healthcare-Associated Infections among the Admitted Patients at Hiwot Fana Specialized University Hospital, Eastern Ethiopia?

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Moti Tolera ◽  
Dadi Marami ◽  
Degu Abate ◽  
Merga Dheresa
Keyword(s):  
Cigarette Smoking ◽  
Hospital Stay ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Invasive Procedures ◽  
Healthcare Associated Infection ◽  
Eastern Ethiopia ◽  
Healthcare Associated ◽  
The Impact

Background. Healthcare-associated infection is a major public health problem, in terms of mortality, morbidity, and costs. Majorities of the cause of these infections were preventable. Understanding the potential risk factors is important to reduce the impact of these avoidable infections. The study was aimed to identify factors associated with healthcare-associated infections among patients admitted at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. Methods. A cross-sectional study was carried out among 433 patients over a period of five months at Hiwot Fana Specialized University Hospital. Sociodemographic and clinical data were obtained from a patient admitted for 48 hours and above in the four wards (surgical, medical, obstetrics/gynecology, and pediatrics) using a structured questionnaire. A multivariate logistic regression model was applied to identify predictors of healthcare-associated infections. A p value <0.05 was considered statistically significant. Results. Fifty-four (13.7%) patients had a history of a previous admission. The median length of hospital stay was 6.1 days. Forty-six (11.7%) participants reported comorbid conditions. Ninety-six (24.4%) participants underwent surgical procedures. The overall prevalence of healthcare-associated infection was 29 (7.4%, 95% CI: 5.2–10.6). Cigarette smoking (AOR: 5.18, 95% CI: 2.15–20.47), staying in the hospital for more than 4 days (AOR: 4.29, 95% CI: 2.31–6.15), and undergoing invasive procedures (AOR: 3.58, 95% CI: 1.11–7.52) increase the odds of acquiring healthcare-associated infections. Conclusion. The cumulative prevalence of healthcare-associated infections in this study was comparable with similar studies conducted in developing countries. Cigarette smoking, staying in the hospital for more than 4 days, and undergoing invasive procedures increase the odds of healthcare-associated infections. These factors should be considered in the infection prevention and control program of the hospital.

Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study

2021 ◽  
pp. 175717742110358
Author(s):  
Sailesh Kumar Shrestha ◽  
Swarup Shrestha ◽  
Sisham Ingnam
Keyword(s):  
Prevention And Control ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Healthcare Associated ◽  
And Control

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

scholarly journals Surveillance of healthcare-associated infections in a Tunisian university hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Hannachi ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
S Khefacha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
University Hospital ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Healthcare Associated Infection ◽  
Carbapenem Resistant ◽  
Independent Risk Factors ◽  
Healthcare Associated

Abstract Introduction Healthcare -associated infections has become a worldwide public health problem. The aim of this study was to estimate the incidence of healthcare- associated infections in a university hospital of Tunisia. Methods This was a cohort study conducted in six intensive care units in a university hospital of Tunisia during three months (from august to October 2018). Data was provided from patients’ files. Data entry and analysis was done using SPSS version 22. Multivariate analysis was used in order to identify independent risk factors for healthcare associated infection. Results A total of 202 patients were enrolled in this study. The incidence rate of healthcare-associated infections was 53,96%(109/202). The ratio infection/infected was estimated to 1.65(109/66). The incidence of multi-drug resistant pathogens was 21,28% (43/202). The most common resistant pathogens included pseudomonas aeruginosa resistant to cefdazidime in 13,76%(15/109) followed by those resistant to extended spectrum cephalosporin 11.92% (13/109), followed by carbapenem-resistant acinetobcater baumanii 6,42%(7/109) then by carbapenem resistant pathogens and enterococcus resistant to vancomycin 2.75%(3/109) and finally staphylococcus aureus resistant to methicillin 2.1%(2/1.83). The multivariate analysis showed that long duration of central line catheterisation (RR = 7.44; 95%CI[2.79-19.82]), tracheotomy(RR = 8.61;95%CI[2.09-35,39]) and length of stay (RR = 1.08; 95%CI[1.04-1.13]) were found as independent risk factors for healthcare -associated infection. Conclusions The emergence of mutli-drug resistant pathogens needs to be deeply studied and effective measures have to be taken in order to detect and prevent transmission of resistant strains and/or their resistance determinants, especially those with phenotypes having the fewest viable treatment options. Key messages The incidence of healthcare associated infection in the intensive care unit was high. Effective measures have to be taken in the intensive care unit to detect and prevent transmission of resistant pathogens.

scholarly journals Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic

2021 ◽  
Vol 58 ◽  
pp. 004695802110679
Author(s):  
Hela Ghali ◽  
Asma Ben Cheikh ◽  
Sana Bhiri ◽  
Selwa Khefacha ◽  
Houyem Said Latiri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Protective Factor ◽  
Bloodstream Infections ◽  
Point Prevalence ◽  
University Hospital ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Background Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. Aim To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. Methods The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. Results Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% ( P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). Conclusion Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.

scholarly journals The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network

2021 ◽  
pp. 1-14 ◽  
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Vaishnavi Pattabiraman ◽  
Rebecca Y. Konnor ◽  
Prachi R. Patel ◽  
Emily Wong ◽  
...  
Keyword(s):  
State Level ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Objectives: To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infection (HAI) incidence in US hospitals, national- and state-level standardized infection ratios (SIRs) were calculated for each quarter in 2020 and compared to those from 2019. Methods: Central–line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), select surgical site infections, and Clostridioides difficile and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia laboratory-identified events reported to the National Healthcare Safety Network for 2019 and 2020 by acute-care hospitals were analyzed. SIRs were calculated for each HAI and quarter by dividing the number of reported infections by the number of predicted infections, calculated using 2015 national baseline data. Percentage changes between 2019 and 2020 SIRs were calculated. Supporting analyses, such as an assessment of device utilization in 2020 compared to 2019, were also performed. Results: Significant increases in the national SIRs for CLABSI, CAUTI, VAE, and MRSA bacteremia were observed in 2020. Changes in the SIR varied by quarter and state. The largest increase was observed for CLABSI, and significant increases in VAE incidence and ventilator utilization were seen across all 4 quarters of 2020. Conclusions: This report provides a national view of the increases in HAI incidence in 2020. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics.

Positive deviance in infection prevention and control: A systematic literature review

2020 ◽  
pp. 1-8
Author(s):  
Mohammed A. Alzunitan ◽  
Michael B. Edmond ◽  
Mohammed A. Alsuhaibani ◽  
Riley J. Samuelson ◽  
Marin L. Schweizer ◽  
...  
Keyword(s):  
Literature Review ◽  
Hand Hygiene ◽  
Systematic Literature Review ◽  
Positive Deviance ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Single Intervention ◽  
Healthcare Associated ◽  
And Control ◽  
The Impact

Abstract Background: Healthcare-associated infections (HAIs) remain a major challenge. Various strategies have been tried to prevent or control HAIs. Positive deviance, a strategy that has been used in the last decade, is based on the observation that a few at-risk individuals follow uncommon, useful practices and that, consequently, they experience better outcomes than their peers who share similar risks. We performed a systematic literature review to measure the impact of positive deviance in controlling HAIs. Methods: A systematic search strategy was used to search PubMed, CINAHL, Scopus, and Embase through May 2020 for studies evaluating positive deviance as a single intervention or as part of an initiative to prevent or control healthcare-associated infections. The risk of bias was evaluated using the Downs and Black score. Results: Of 542 articles potentially eligible for review, 14 articles were included for further analysis. All studies were observational, quasi-experimental (before-and-after intervention) studies. Hand hygiene was the outcome in 8 studies (57%), and an improvement was observed in association with implementation of positive deviance as a single intervention in all of them. Overall HAI rates were measured in 5 studies (36%), and positive deviance was associated with an observed reduction in 4 (80%) of them. Methicillin-resistant Staphylococcus aureus infections were evaluated in 5 studies (36%), and positive deviance containing bundles were successful in all of them. Conclusions: Positive deviance may be an effective strategy to improve hand hygiene and control HAIs. Further studies are needed to confirm this effect.

scholarly journals Healthcare associated infections in a tertiary care cardiac hospital: A point prevalence survey.

2019 ◽  
Vol 2 (1) ◽  
pp. 8-12
Author(s):  
Maham Zahid ◽  
Aysha Siddiqa ◽  
Rehna Javaid ◽  
Hafsa Khalil ◽  
Farrah Pervaiz
Keyword(s):  
Hospital Stay ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Hospitalized Patients ◽  
Point Prevalence ◽  
Major Public Health Problem ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

Objective: Hospitalized patients can pick infections from healthcare facilities which may lead to extended hospital stay, increased morbidity and mortality of hospitalized patients and economic burden on health care. Active surveillance of HAIs that is continuous and prospective in nature has been accepted as a gold standard approach in preventing and controlling healthcare associated infections. To estimate the prevalence HAIs and their types in a tertiary care cardiac center and to identify associated risk factors. Methodology: Nine prospective point prevalence surveys were conducted on three separate days in three consecutive weeks for three months. A data collectors team comprising of two research officers and an infection control nurse, visited the enrolled patients and patient’s history, demographics, physical examination, laboratory findings and other details were reviewed from patient files and recorded on study questionnaire. Results: A total of 559 patients were enrolled in the study. The prevalence of HAIs was 6.4%, which means 36 HAIs were identified in 559 patients. Univariate analysis showed a significant association between HAI and being in ICU/CCU ward (OR 3.4, 95% CI 1.5-7.4) longer duration of hospital stay (OR 3.0, 95% CI 1.5-6.0, P=0.001), exposure to urinary catheter, use of antimicrobials (OR 2.8, 95% CI 1.3-6.1, P=0.006), and diabetes (OR 2.5, 95% CI 1.2-5.2, P=0.008). Conclusion: Healthcare associated infection is a major public health problem and rate of HAIs in the selected centers was found to be 6.4%. Present survey provided baseline evidence for further surveillance and multifaceted infection.

Healthcare-associated infections over an eight year period in a large university hospital in Sicily (Italy, 2011–2018)

2021 ◽  
pp. 175717742110124
Author(s):  
Giusy Russo Fiorino ◽  
Marialuisa Maniglia ◽  
Valentina Marchese ◽  
Luigi Aprea ◽  
Maria V Torregrossa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Data Entry ◽  
Antimicrobial Treatment ◽  
University Hospital ◽  
Healthcare Associated Infection ◽  
Fatal Disease ◽  
Klebsiella Species ◽  
Hospitalised Patients ◽  
Healthcare Associated ◽  
The Impact

Background: Up to 7% of hospitalised patients acquire at least one healthcare-associated infection (HAI). The aim of the present study was to quantify the burden of HAIs in an Italian hospital, identifying involved risk factors. Methods: Prevalence point study carried out from 2011 to 2018. For each recruited patient, a data entry form was compiled including information on demographics, hospital admission, risk factors, antimicrobial treatment, and infection if present. Results: A total of 2844 patients were included and 218 (7.03%) reported an infection. HAI prevalence rates showed a significant increase (average annual per cent change (AAPC) +33.9%; p=0.018) from 2011 to 2014 whereas from 2014 to 2018 a gradual decline was observed (AAPC –6.15%; p=0.35). Urinary tract infection was the most common HAI (25.2%) and a total of 166 (76.1%) pathogens were isolated from 218 infections. Enterococcus and Klebsiella species were the most prevalent pathogens, causing 15.1% and 14.5% of HAIs, respectively. A significant higher risk of HAIs was found in patients exposed to central catheter (adjusted odds ratio (adj-OR)=5.40), peripheral catheter (adj-OR=1.89), urinary catheter (adj-OR=1.46), National Healthcare Safety Network surgical intervention (adj-OR=1.48), ultimately fatal disease (adj-OR=2.19) or rapidly fatal disease (adj-OR=2.09) and in patients with longer hospital stay (adj-OR=1.01). Conclusion: Intervention programmes based on guidelines dissemination and personnel training can contribute to reduce the impact of HAI. Moreover, McCabe score can be a very powerful and efficient predictor of risk for HAI. Finally, an unexpected very high burden of disease due to Enterobacteriaceae and Gram positive cocci that could be related to the frequent use of carbapenems and third generation cephalosporins in this hospital was found.

Analysis of the role of copper impregnated composite hard surfaces, bed linens and patient gowns in reducing healthcare-associated infection rates

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
Gene H Burke ◽  
Jacqueline P Butler
Keyword(s):  
Infection Risk ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Infection Rates ◽  
Healthcare Associated Infection ◽  
Before And After ◽  
New Construction ◽  
Healthcare Associated ◽  
The Impact

The aim of this study was to evaluate the impact of copper-impregnated composite hard surfaces, bed linens and patient gowns on healthcare-associated infections (HAIs). We took in account potentially confounding factors of new construction and Det Norse Veritas Managing Infection Risk (DNV MIR) certification to mitigate risk of HAIs, multi drug resistant organisms (MDRO) and Clostridium difficile HAIs. The study was conducted in the acute care units from three hospitals within a regional healthcare system and these were assessed retrospectively. Facility 1 and Facility 2 shared the circumstance of new construction. Facility 1 and Facility 3 shared the processes of DNV-MIR. Only Facility 1 undertook the intervention of copper-impregnated hard surfaces, bed linens and patient gowns. We compared infection rates (IR) following their normalization per 10,000 patient hospitalization days before and after complete implementation of copper-impregnated composite hard surfaces, bed linens and patient gowns. Facility 1 had a 28% reduction in total C. difficile and MDRO IR, while Facilities 2 and 3 had 103% and 48% increases in total IR respectively. Although the rate changes per facility were not statistically significantly changed from baseline (p>0.05), there was consistent divergence between the IR at the copper enabled facility and the others. As this divergence occurred when other pertinent factors were constant between them, including new construction and new processes for mitigation of infection risks, these outcomes support the contention that copper-impregnated linens and composite hard surfaces were shown to reduce HAI rates.

Healthcare-Associated Infections Due to Multidrug-Resistant Organisms: a Surveillance Study on Extra Hospital Stay and Direct Costs

2019 ◽  
Vol 20 (8) ◽  
pp. 643-652 ◽  
Author(s):  
Guglielmo Giraldi ◽  
Marzietta Montesano ◽  
Christian Napoli ◽  
Paola Frati ◽  
Raffaele La Russa ◽  
...  
Keyword(s):  
Patient Safety ◽  
Antimicrobial Resistance ◽  
Hospital Stay ◽  
Multidrug Resistant ◽  
Surveillance Systems ◽  
Healthcare Associated Infections ◽  
Multidrug Resistant Organisms ◽  
Healthcare Associated ◽  
And Control ◽  
The Impact

Background: The increasing antimicrobial resistance poses a challenge to surveillance systems and raises concerns about the impact of multidrug-resistant organisms on patient safety. Objective: The study aimed to estimate extra hospital stay and economic burden of infections due to alert organisms - mostly multidrug-resistant - in a teaching hospital. Methods: The present retrospective matched cohort study was conducted based on the analysis of hospital admissions at Sant’Andrea Teaching Hospital in Rome from April to December 2015. Extra hospital stay was the difference in the length of stay between each case and control. All the patients developing an infection due to an alert organism were considered cases, all others were eligible as controls. The costs of LOS were evaluated by multiplying the extra stay with the hospital daily cost. Results: Overall, 122 patients developed an infection due to alert organisms and were all matched with controls. The attributable extra stay was of 2,291 days (mean 18.8; median 19.0) with a significantly increased hospitalization in intensive care units (21.2 days), bloodstream infections (52.5 days), and infections due to Gram-negative bacteria (mean 29.2 days; median 32.6 days). Applying the single day hospital cost, the overall additional expenditure was 11,549 euro per patient. The average additional cost of antibiotic drugs for the treatment of infections was about 1,200 euro per patient. Conclusion: The present study presents an accurate mapping of the clinical and economic impact of infections attributable to alert organisms demonstrating that infections due to multidrug-resistant organisms are associated with higher mortality, longer hospital stays, and increased costs. Article Highlights Box: The increasing antimicrobial resistance poses a challenge for surveillance systems and raises concerns about the impact of multidrug-resistant organisms on patient safety. • Healthcare-associated infections (HAIs) have historically been recognized as a significant public health problem requiring close surveillance. • Despite several and reliable findings have been achieved on clinical issues, our knowledge on the economic impact of healthcare-associated infections due to multidrug-resistant organisms needs to be widened. • Estimating the cost of infections due to multidrug-resistant organisms in terms of extra hospital stay and economic burden is complex, and the financial impact varies across different health systems. • Evaluations of social and economic implications of hospital infections play an increasingly important role in the implementation of surveillance systems. • The costs of infection prevention and control programs and dedicated personnel are relatively low and self-sustainable when efficient.

scholarly journals Reorganization of nurse scheduling reduces the risk of healthcare associated infections

2019 ◽  
Author(s):  
Eugenio Valdano ◽  
Chiara Poletto ◽  
Pierre-Yves Boëlle ◽  
Vittoria Colizza
Keyword(s):  
Infection Control ◽  
Wearable Sensors ◽  
Healthcare Services ◽  
University Hospital ◽  
Transmission Model ◽  
Healthcare Associated Infections ◽  
Nurse Scheduling ◽  
Hospital Infection Control ◽  
Healthcare Associated ◽  
The Impact

ABSTRACTBackgroundEfficient prevention and control of healthcare associated infections (HAIs) is still an open problem.ObjectiveTo design efficient hospital infection control strategies by reorganizing nurse scheduling.Design, setting, and participantsProof-of-concept modeling study based on high-resolution contact data from wearable sensors between patients, nurses, doctors, and administrative staff at a short-stay geriatric ward of a University hospital.MethodsWe considered isolation and contact removal to identify the most important class of individuals for HAI dissemination. We introduced a novel intervention based on the reorganization of nurse scheduling. This strategy switches and reassigns nurses’ tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. We evaluated the impact of interventions through a Susceptible-Colonized-Susceptible transmission model on the empirical and reorganized contacts.ResultsIsolation and contact removal produced the largest risk reduction when acting on nurses. Reorganizing their schedules reduced HAI risk by 27% (95% confidence interval [24,29]%) while preserving the timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. No overall change in the number of nurses per patient resulted from the intervention.ConclusionsReorganization of nurse scheduling offers an alternative change of practice that substantially limits HAI risk in the ward while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for better infection control in hospitals.

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