scholarly journals Contribution of microbiology to an effective control of healthcare-associated infections

2011 ◽  
Vol 152 (11) ◽  
pp. 437-442
Author(s):  
István Barcs ◽  
Aranka Kovács ◽  
Katalin Antmann ◽  
Anita Becker ◽  
Gyula Domján
Keyword(s):  
Dna Sequences ◽  
Antibiotic Sensitivity ◽  
Nasal Carriage ◽  
Effective Control ◽  
Clinical Samples ◽  
Specific Method ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
And Cluster Analysis ◽  
Healthcare Associated

An effective control of healthcare-associated infections is not realized without an intensive participation of microbiologic activities. Authors present the model of a centre for healthcare-associated infection control established in 2008 at Semmelweis University. The new model of the surveillance system is based on diagnostic and experimental microbiologic data. Clinical and epidemiological microbiologic examinations are performed in the same laboratory using identical methods, and the results are continually compared. Reports consist of two functional parts; namely list of pathogens isolated and antibiotic sensitivity patterns for clinicians and messages especially for epidemiologists including abbreviated information on bacteria of nosocomial importance. Rapid detection of the most important pathogens both from clinical samples and from those obtained for detecting nasal carriage is carried out by a sensitive and specific method of an automated real time PCR. Biotyping of isolates by detailed biochemical substrate spectrum, genotyping by ready-to-use kits depending on polymorphism of repetitive DNA sequences, and cluster analysis of data are used for up-to-date survey of nosocomial situation. Statistical analysis of reports is performed by the multifactorial software OSIRIS Epidemiology. Orv. Hetil., 2011, 152, 437–442.

Mycobacteriosis as a Healthcare-Associated Infection: A Review of Epidemiologic Studies

2020 ◽  
pp. 37-41
Author(s):  
IV Petrov ◽  
TKh Amirova ◽  
LV Petrova ◽  
FS Petrova
Keyword(s):  
Skin Diseases ◽  
Nontuberculous Mycobacteria ◽  
Clinical Manifestations ◽  
Mycobacterial Infection ◽  
Epidemiologic Studies ◽  
Health Facilities ◽  
Water Supply Systems ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

Introduction: Healthcare-associated infections are of great socio-economic importance and are characterized by a large number of different pathogens. Nontuberculous mycobacteria are ubiquitous microorganisms that can circulate in a medical organization. The purpose of this review of epidemiologic studies was to establish the main features of mycobacteriosis as a healthcare-associated infection, taking into account the significance of the results and the compliance of the reviewed studies with the criteria of evidence-based medicine. Methods: We did a key word search for “nontuberculous mycobacteria”, “healthcare-associated infections”, and “mycobacteriosis” in several electronic bibliographic databases including Web of Science, PubMed, eLIBRARY, and ResearchGate and selected 127 out of 342 search results. Having analyzed the selected articles, we decided to include 34 of them in this study according to the topic of work. We established that nontuberculous mycobacteria can be found in various objects of health facilities, e.g. water supply systems, medical products and equipment. We also found that mycobacterial infection of nosocomial etiology could have various clinical manifestations (arthritis, keratitis, circulatory and skin diseases, etc.) determined by various aspects, such as heterogeneity of the group of nontuberculous mycobacteria, portals of entry (surgical procedures on various organs and systems of the human body, etc.), pathways of exposure and transmission factors. Resistance of nontuberculous mycobacteria to a number of disinfectants is a special question defining the importance of profound research in terms of ensuring sanitary and anti-epidemic (disinfection) safety within health facilities. Conclusions: Our findings indicate that mycobacterial infection can be considered as a healthcare-associated infection requiring an in-depth assessment from various perspectives including a microbiological monitoring of medical objects, statistical accounting of nosocomial infections, and clinical alertness in the diagnosis of mycobacteriosis by attending physicians and bacteriologists, etc.

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.

Preventability of hospital onset bacteremia and fungemia: A pilot study of a potential healthcare-associated infection outcome measure

2019 ◽  
Vol 40 (3) ◽  
pp. 358-361 ◽  
Author(s):  
Raymund B. Dantes ◽  
Clare Rock ◽  
Aaron M. Milstone ◽  
Jesse T. Jacob ◽  
Sheri Chernetsky-Tejedor ◽  
...  
Keyword(s):  
Pilot Study ◽  
Outcome Measure ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Follow Up Studies ◽  
Potential Measure ◽  
Healthcare Associated

AbstractHospital-onset bacteremia and fungemia (HOB), a potential measure of healthcare-associated infections, was evaluated in a pilot study among 60 patients across 3 hospitals. Two-thirds of all HOB events and half of nonskin commensal HOB events were judged as potentially preventable. Follow-up studies are needed to further develop this measure.

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.

scholarly journals Probabilistic transmission models incorporating sequencing data for healthcare-associated Clostridioides difficile outperform heuristic rules and identify strain-specific differences in transmission

2021 ◽  
Vol 17 (1) ◽  
pp. e1008417
Author(s):  
David W. Eyre ◽  
Mirjam Laager ◽  
A. Sarah Walker ◽  
Ben S. Cooper ◽  
Daniel J. Wilson ◽  
...  
Keyword(s):  
Environmental Contamination ◽  
Large Scale ◽  
Epidemiological Data ◽  
Effective Control ◽  
Healthcare Associated Infections ◽  
Sequencing Data ◽  
Medical Specialties ◽  
Clostridioides Difficile ◽  
Healthcare Associated ◽  
Transmission Models

Fitting stochastic transmission models to electronic patient data can offer detailed insights into the transmission of healthcare-associated infections and improve infection control. Pathogen whole-genome sequencing may improve the precision of model inferences, but computational constraints have limited modelling applications predominantly to small datasets and specific outbreaks, whereas large-scale sequencing studies have mostly relied on simple rules for identifying/excluding plausible transmission. We present a novel approach for integrating detailed epidemiological data on patient contact networks in hospitals with large-scale pathogen sequencing data. We apply our approach to study Clostridioides difficile transmission using a dataset of 1223 infections in Oxfordshire, UK, 2007–2011. 262 (21% [95% credibility interval 20–22%]) infections were estimated to have been acquired from another known case. There was heterogeneity by sequence type (ST) in the proportion of cases acquired from another case with the highest rates in ST1 (ribotype-027), ST42 (ribotype-106) and ST3 (ribotype-001). These same STs also had higher rates of transmission mediated via environmental contamination/spores persisting after patient discharge/recovery; for ST1 these persisted longer than for most other STs except ST3 and ST42. We also identified variation in transmission between hospitals, medical specialties and over time; by 2011 nearly all transmission from known cases had ceased in our hospitals. Our findings support previous work suggesting only a minority of C. difficile infections are acquired from known cases but highlight a greater role for environmental contamination than previously thought. Our approach is applicable to other healthcare-associated infections. Our findings have important implications for effective control of C. difficile.

scholarly journals Development of a nursing website for critical care regarding healthcare-associated infections

2021 ◽  
Vol 74 (suppl 5) ◽  
Author(s):  
Eliézer Farias de Mello ◽  
Bárbara Alessandra Tibério ◽  
Mitzy Tannia Reichembach ◽  
Letícia Pontes
Keyword(s):  
Development Process ◽  
Health Care Research ◽  
Product Development Process ◽  
Healthcare Associated Infections ◽  
Infection Rates ◽  
Healthcare Associated Infection ◽  
Computational Tools ◽  
Technological Production ◽  
Research And Education ◽  
Healthcare Associated

ABSTRACT Objective: to describe the development of a website about the main healthcare-associated infections and the respective bundles to prevent these diseases, oriented toward intensive care unit nursing. Methods: experience report describing the development of technological innovation by nurses, using computational tools and technological production methodological research and following the product development process. Results: nurses developed an educational website which can be accessed through computers, tablets, and smartphones at the electronic address irastis.com and focuses on healthcare-associated infections. Final considerations: digital technologies have contributed to fulfill demands in health care, research, and education. The developed website has the potential to support reduction in healthcare-associated infection rates, since it makes preventive measures for these infections available and refers users to publication environments that systematize the implementation of the bundles.

Clinical and Molecular Epidemiology of Healthcare-Associated Infections Due to Extended-Spectrumβ-Lactamase (ESBL)–Producing Strains ofEscherichia coliandKlebsiella pneumoniaeThat Harbor Multiple ESBL Genes

2008 ◽  
Vol 29 (11) ◽  
pp. 1026-1034 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Pattarachai Kiratisin ◽  
Linda M. Mundy
Keyword(s):  
Confidence Interval ◽  
Antimicrobial Therapy ◽  
Odds Ratio ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Middle Income ◽  
E Coli ◽  
Esbl Gene ◽  
Empirical Antimicrobial Therapy ◽  
Healthcare Associated

Objectives.To characterize healthcare-associated infections due to extended-spectrumβ-lactamase (ESBL)-producing strains ofEscherichia coliandKlebsiella pneumoniaethat harbor multiple ESBL genes, as opposed to a single ESBL gene.Methods.All patients with a confirmed healthcare-associated infection due to an ESBL-producing strain ofE. coliorK. pneumoniaewere enrolled in the study. Molecular typing of isolates was performed, and the comparative risks and outcomes of patients were analyzed.Results.Among 71 patients with healthcare-associated infection due to an ESBL-producing strain ofE. coliorK. pneumoniae, the gene for CTX-M, with or without other ESBL genes, was identified in all 51 (100%) of the patients infected with anE. colistrain and in 18 (90%) of the 20 patients infected with aK. pneumoniaestrain. Of these 71 patients, 17 (24%) met the definition of healthcare-associated infection due to an ESBL-producing strain that harbored multiple genes; in multivariate analysis, previous exposure to 3 or more classes of antibiotics (adjusted odds ratio, 4.5 [95% confidence interval, 1.7-75.2]) was the sole risk factor for healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes. Isolates recovered from patients with healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes were more resistant to various antibiotic classes, and, compared with patients with healthcare-associated infection due to an ESBL-producing strain that harbored a single ESBL gene, they were more likely to have ineffective initial empirical antimicrobial therapy (52% vs 94%; odds ratio, 5.1 [95% confidence interval, 1.04-14.5]).Conclusions.CTX-M ESBL is highly prevalent in Thailand. Patients with healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes were more likely to have had ineffective initial empirical antimicrobial therapy, and, given that antibiotic selection pressure was the only associated risk, we suggest focused antimicrobial stewardship programs to limit the emergence and spread of healthcare-associated infection due to ESBL-producing strains in this middle-income country.

scholarly journals Indirect Versus Direct Standardization Methods for Reporting Healthcare-Associated Infections: An Analysis of Central Line–Associated Bloodstream Infections in Maryland

2017 ◽  
Vol 38 (8) ◽  
pp. 989-992 ◽  
Author(s):  
Lyndsay M. O’Hara ◽  
Max Masnick ◽  
Surbhi Leekha ◽  
Sarah S. Jackson ◽  
Natalia Blanco ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Acute Care ◽  
Bloodstream Infections ◽  
Acute Care Hospitals ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated ◽  
Direct Standardization ◽  
Standardization Methods

Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line–associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 methods generate different hospital rankings with payment implications.Infect Control Hosp Epidemiol 2017;38:989–992

Laws Pertaining to Healthcare-Associated Infections: A Review of 3 Legal Requirements

2012 ◽  
Vol 33 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Julie Reagan ◽  
Carl Hacker
Keyword(s):  
Infect Control Hosp ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Legal Requirements ◽  
Us States ◽  
The Public ◽  
Data Submission ◽  
Legal Provisions ◽  
Healthcare Associated

We reviewed US state and territorial healthcare-associated infection (HAI) laws, specifically addressing 3 legal requirements: data submission, reporting of data to the public, and inclusion of facility identifiers in public reports. The majority of US states and territories have HAI laws. The 3 studied legal provisions are all commonly included in state HAI laws in varying forms; however, only a minority of states and territories specifically mandate all 3 legal requirements. The laws of the remaining states vary considerably.Infect Control Hosp Epidemiol 2012;33(1):75-80

Comparison of the Burdens of Hospital-Onset, Healthcare Facility-Associated Clostridium difficile Infection and of Healthcare-Associated Infection due to Methicillin-Resistant Staphylococcus aureus in Community Hospitals

2011 ◽  
Vol 32 (4) ◽  
pp. 387-390 ◽  
Author(s):  
Becky A. Miller ◽  
Luke F. Chen ◽  
Daniel J. Sexton ◽  
Deverick J. Anderson
Keyword(s):  
Clostridium Difficile ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Southeastern United States ◽  
Healthcare Facility ◽  
Control Network ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Community Hospitals ◽  
Common Etiology ◽  
Healthcare Associated

We sought to determine the burden of nosocomial Clostridium difficile infection in comparison to other healthcare-associated infections (HAIs) in community hospitals participating in an infection control network. Our data suggest that C. difficilehas replaced MRSA as the most common etiology of HAI in community hospitals in the southeastern United States.

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