NOSOCOMIAL INFECTIONS DUE TO KANAMYCIN-RESISTANT, [R]-FACTOR CARRYING ENTERIC ORGANISMS IN AN INTENSIVE CARE NURSERY

PEDIATRICS ◽  
1972 ◽  
Vol 50 (3) ◽  
pp. 395-402
Author(s):  
Kathleen Davis Eisenach ◽  
Rose Marie Reber ◽  
Donald V. Eitzman ◽  
Herman Baer
Keyword(s):  
Intensive Care ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
Intestinal Tract ◽  
Risk Of Infection ◽  
Perinatal Complications ◽  
R Factor ◽  
Increased Risk ◽  
Therapeutic Procedures ◽  
Intensive Care Nursery

During a 12-month period, an infection rate of 10% with kanamycin-resistant, resistance-factor (R-factor) carrying enteric organisms was observed in 236 infants admitted to an intensive care nursery (ICN), with a mortality of 38%. Maternal and perinatal complications did not predispose to infection. In contrast, a combination of therapeutic procedures (surgery, use of penicillin and kanamycin, catheters, ventilation) was associated with increased risk of infection. About 90% of the infants admitted to the ICN became colonized with the resistant organisms, and intestinal tract and groin showed the highest rate of colonization. The majority of the personnel in the ICN carried the organisms in the intestinal tract and on the hands. Handwashing with hexachlorophene failed to reduce the contamination significantly. While the main source of organisms was the colonized and/or infected infants, transmission probably occurred via the hands of personnel.

Device-Associated Nosocomial Infection Rates in Turkish Medical-Surgical Intensive Care Units

2006 ◽  
Vol 27 (4) ◽  
pp. 343-348 ◽  
Author(s):  
Dilara Inan ◽  
Rabin Saba ◽  
Ata Nevzat Yalcin ◽  
Murat Yilmaz ◽  
Gozde Ongut ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urinary Tract ◽  
Nosocomial Infection ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
University Hospital ◽  
Infection Rates ◽  
Surgical Intensive Care ◽  
The Mean ◽  
Device Associated Infection

Objective.To describe the incidence of device-associated nosocomial infections in medical-surgical intensive care units (MS ICUs) in a university hospital in Turkey and compare it with National Nosocomial Infections Surveillance (NNIS) system rates.Design.Prospective surveillance study during a period of 27 months. Device utilization ratios and device-associated infection rates were calculated using US Centers for Disease Control and Prevention and NNIS definitions.Setting.Two separate MS ICUs at Akdeniz University Hospital, Antalya, Turkey.Patients.All patients were included who presented with no signs and symptoms of infection within the first 48 hours after admission.Results.Data on 1,985 patients with a total of 16,892 patient-days were analyzed. The mean overall infection rate per 100 patients was 29.1 infections, and the mean infection rate per 1,000 patient-days was 34.2 infections. The rate of ventilator-associated pneumonia was 20.76 infections per 1,000 ventilator-days, the rate of catheter-associated urinary tract infection was 13.63 infections per 1,000 urinary catheter–days, and the rate of catheter-associated bloodstream infection was 9.69 infections per 1,000 central line–days. The most frequently isolated pathogens were Pseudomonas species among patients with ventilator-associated pneumonias (35.8% of cases), Candida species among patients with catheter-associated urinary tract infections (37.1% of cases), and coagulase-negative staphylococci among patients with catheter-associated bloodstream infections (20.0% of cases).Conclusion.We found both higher device-associated infection rates and higher device utilization ratios in our MS ICUs than those reported by the NNIS system. To reduce the rate of infection, implementation of infection control practices and comprehensive education are required, and an appropriate nationwide nosocomial infection and control system is needed in Turkey.

Lack of Statistical Power

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 313-314
Author(s):  
JOHN M. PASCOE
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Sample Size ◽  
Pediatric Intensive Care Unit ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
Statistical Power ◽  
Pediatric Intensive Care ◽  
Negative Trial

To the Editor.— Dr Donowitz described an interesting research project in which the efficacy of overgown use in the prevention of pediatric intensive care unit nosocomial infection was examined.1 He concludes that "overgowns were an expensive and ineffective method of preventing or decreasing nosocomial infections."1 Although Dr Donowitz may be correct, his inattention to sample size and statistical power in this negative trial makes his argument less than compelling. Given the nosocomial "base rate" of about 10% without gowns, the detection of an infection rate difference of 50% between the nongown and gown subgroups (α = .05, β = .2) would require a sample size of about 500 in each subgroup.2

Infections in the Intensive Care Unit

2017 ◽  
Author(s):  
Samina Afreen ◽  
Hector R. Wong ◽  
Marian G. Michaels
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infections ◽  
Care Setting ◽  
Blood Products ◽  
Intensive Care Setting ◽  
Increased Risk ◽  
Immune Deficiencies ◽  
Frequent Problem ◽  
Infectious Condition

Infections are a frequent problem for children cared for in the intensive care setting. The child can have a primary infectious condition that is severe enough to require hospitalization in the intensive care unit (ICU). Alternatively once in the ICU setting children are at risk for nosocomial infections due to a need for catheters that breech the cutaneous barriers, mechanical ventilation and exposures to blood products. Finally, many children sick enough to be in an intensive care setting have underlying immune deficiencies which put that at increased risk. This chapter reviews some of the major underlying infections that lead to intensive care stays as well as the major nosocomial infections which can plague our patients.

scholarly journals Practical recommendations for physical rehabilitation in patients with severe COVID-19 in intensive care units

2020 ◽  
Vol 26 (3) ◽  
pp. 327-342 ◽  
Author(s):  
E. A. Demchenko ◽  
V. V. Krasnikova ◽  
S. N. Yanishevskiy
Keyword(s):  
Intensive Care ◽  
Medical Personnel ◽  
Physical Rehabilitation ◽  
Medical Rehabilitation ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Therapeutic Exercises ◽  
Mechanism Of Interaction ◽  
Coronavirus Infection ◽  
Practical Recommendations

The article presents a literature review on physical rehabilitation (PR) in patients with the new coronavirus infection (COVID-19) of extremely severe, severe and moderate course in acute (in the intensive care unit, ICU) and subacute (immediately after transfer from the ICU) stage of the disease in a pandemic. The authors defined the aims and principles of medical rehabilitation assistance, the appropriate amount of PR exercises, and the mechanism of interaction between the rehabilitation staff and the ICU, in conditions of increased risk of infection of medical personnel. PR programs and therapeutic exercises complexes for different clinical situations (patient models) are proposed, depending on the severity of the patient’s condition, medical care conditions and the need for various respiratory support.

scholarly journals A Comparison of Nosocomial Infection Density in Intensive Care Units on Relocating to a New Hospital

2020 ◽  
Vol 6 (3) ◽  
pp. 175-180
Author(s):  
Zeynep Ture ◽  
Tugba Ustuner ◽  
Ario Santini ◽  
Serhat Aydogan ◽  
İlhami Celik
Keyword(s):  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Nosocomial Infection ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
Infection Density ◽  
One Year

AbstractBackgroundThe study aimed to investigate the changes in nosocomial infection density after patients were transferred to the intensive care unit (ICU) of a new-build hospital.MethodsThe types and rates of nosocomial infections were obtained for a one-year period retrospectively before leaving the old hospital premises and for a one-year periods after moving into the new hospital. The intensive care unit in the “old” premises was comprised of a 17-bedded hall, and thirty-three nurses shifted to work forty-eight hours a week, with each nurse assigned to provide care for two patients. The intensive care unit in the “new” premises consisted of single rooms, each with twenty-eight beds.ResultsThe median nosocomial infection density decreased from 23 to 15 per 1000 in-patient days. The catheter-related urinary tract infection rate decreased from 7.5 to 2.6 per100 catheter days.ConclusionsTreatment of patients in the new hospital resulted in a decrease in nosocomial infection density.

A cluster-controlled clinical trial of two prophylactic silicone sacral dressings to prevent sacral pressure injuries in critically ill patients

2019 ◽  
pp. 21-26 ◽  
Author(s):  
Monica Stankiewicz ◽  
Jodie Gordon ◽  
Joel Dulhunty ◽  
Wendy Brown ◽  
Hamish Pollock ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care ◽  
Similar Efficacy ◽  
Care Patient ◽  
Controlled Clinical Trial ◽  
Cost Difference ◽  
Increased Risk ◽  
Pressure Injury ◽  
Risk Patients ◽  
The Mean

Objective Patients in the intensive care unit (ICU) have increased risk of pressure injury (PI) development due to critical illness. This study compared two silicone dressings used in the Australian ICU setting for sacral PI prevention. Design A cluster-controlled clinical trial of two sacral dressings with four alternating periods of three months' duration. Setting A 10-bed general adult ICU in outer-metropolitan Brisbane, Queensland, Australia. Participants Adult participants who did not have a sacral PI present on ICU admission and were able to have a dressing applied for more than 24 hours without repeated dislodgement or soiling in a 24-hour period (>3 times). Interventions Dressing 1 (Allevyn Gentle Border Sacrum™, Smith & Nephew) and Dressing 2 (Mepilex Border Sacrum™, Mölnlycke). Main outcomes measures The primary outcome was the incidence of a new sacral PI (stage 1 or greater) per 100 dressing days in the ICU. Secondary outcomes were the mean number of dressings per patient, the cost difference of dressings to prevent a sacral PI and product integrity. Results There was no difference in the incidence of a new sacral PI (0.44 per 100 dressing days for both products, p = 1.00), the mean number of dressings per patient per day (0.50 for both products, p = 0.51) and product integrity (85% for Dressing 1 and 84% for Dressing 2, p = 0.69). There was a dressing cost difference per patient (A$10.29 for Dressing 1 and A$28.84 for Dressing 2, p < 0.001). Conclusions Similar efficacy, product use and product integrity, but differential cost, were observed for two prophylactic silicone dressings in the prevention of PIs in the intensive care patient. We recommend the use of sacral prophylactic dressings for at-risk patients, with the choice of product based on ease of application, clinician preference and overall cost-effectiveness of the dressing.

PREVALENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS (ICUS) OF JPMC, KARACHI

2019 ◽  
Author(s):  
Rabia Arshad
Keyword(s):  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Carbapenem Resistance ◽  
Chronic Obstructive ◽  
Surgical Intensive Care ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
Increased Risk

Background: Antimicrobial resistance is one of the research priorities of health organizations due to increased risk of morbidity and mortality. Outbreaks of nosocomial infections caused by carbapenem-resistant Acinetobacter Baumannii (CRAB) strains are at rise worldwide. Antimicrobial resistance to carbapenems reduces clinical therapeutic choices and frequently led to treatment failure. The aim of our study was to determine the prevalence of carbapenem resistance in A. baumannii isolated from patients in intensive care units (ICUs). Methods: This cross-sectional study was carried out in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2016 to November 2017. Total 63 non-repetitive A. baumannii were collected from the patients’ specimens, admitted to medical and surgical ICUs and wards of JPMC, Karachi. The bacterial isolates were processed according to standard microbiological procedures to observe for carbapenem resistance. SPSS 21 was used for data analysis. Results: Out of the 63 patients, 40 (63.5%) were male. The age of the patient ranged from 15-85 year, with average of 43 year. 34.9% patients had been hospitalized for 3 days. Chronic obstructive pulmonary disease was present in highest number with average of 58.7% for morbidity. Number of patients on mechanical ventilation was highest (65.1%). All isolates were susceptible to colistin. The resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, amikacin, piperacillin- tazobactam and meropenem was 82.5%, 81%, 100%, 87.3%, 82.5% and 82% respectively. Out of 82% CRAB, 77% were obtained from ICUs. Conclusion: This study has revealed the high rate of carbapenem resistance in A. baumannii isolates in ICUs thus leaving behind limited therapeutic options.

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