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.

The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Multidrug-Resistant Organisms

2010 ◽  
Vol 31 (S1) ◽  
pp. S18-S21 ◽  
Author(s):  
Aaron M. Milstone ◽  
Kristina A. Bryant ◽  
W. Charles Huskins ◽  
Danielle M. Zerr
Keyword(s):  
Hospital Stay ◽  
Infection Prevention ◽  
Multidrug Resistant ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Research Topics ◽  
The Past ◽  
Multidrug Resistant Organisms ◽  
Healthcare Associated

Multidrug resistant organisms (MDROs) and healthcare-associated infections (HAIs) are associated with increased lengths of hospital stay, increased costs, and increased mortality. We explore the scope of MDRO HAIs in children, current MDRO HAI prevention practices and data to support these practices, and we propose research topics targeting MDRO HAI prevention in children.

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 ECDC recruiting scientific experts

2007 ◽  
Vol 12 (51) ◽  
Author(s):  
Keyword(s):  
Antimicrobial Resistance ◽  
Disease Prevention ◽  
Prevention And Control ◽  
Respiratory Diseases ◽  
Healthcare Associated Infections ◽  
European Centre ◽  
Scientific Experts ◽  
Surveillance Unit ◽  
Healthcare Associated ◽  
And Control

The European Centre for Disease Prevention and Control (ECDC) is inviting applications for the position of: Senior Expert for Respiratory Diseases in the Surveillance Unit Expert in Surveillance Unit – Antimicrobial Resistance and Healthcare-associated Infections

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 An overview of antimicrobial resistance surveillance among healthcare-associated pathogens in South Africa

2018 ◽  
Vol 7 (2) ◽  
Author(s):  
Ashika Singh-Moodley ◽  
Husna Ismail ◽  
Olga Perovic
Keyword(s):  
Antimicrobial Resistance ◽  
Treatment Guidelines ◽  
Resistance Mechanisms ◽  
Health Concern ◽  
Infection Prevention And Control ◽  
Surveillance Systems ◽  
African Countries ◽  
Lack Of Information ◽  
Healthcare Associated ◽  
And Control

Healthcare-associated infections are a serious public health concern resulting in morbidity and mortality particularly in developing countries. The lack of information from Africa, the increasing rates of antimicrobial resistance and the emergence of new resistance mechanisms intensifies this concern warranting the need for vigorous standardised surveillance platforms that produce reliable and accurate data which can be used for addressing these concerns. The implementation of national treatment guidelines, policies, antimicrobial stewardship programmes and infection prevention and control practices within healthcare institutions require a platform from which it can draw information and direct its approach. In this review, the importance of standardised surveillance systems, the challenges faced in the application of a surveillance system and the condition (existence and nonexistence) of such systems in African countries is discussed. This review also reports on some South African data.

scholarly journals Multiple Secondary Healthcare-Associated Infections Due to Carbapenem-Resistant Organisms in a Critically Ill COVID-19 Patient on Extensively Prolonged Venovenous Extracorporeal Membrane Oxygenation Support—A Case Report

2021 ◽  
Vol 10 (1) ◽  
pp. 19
Author(s):  
Hiroaki Baba ◽  
Hajime Kanamori ◽  
Issei Seike ◽  
Ikumi Niitsuma-Sugaya ◽  
Kentaro Takei ◽  
...  
Keyword(s):  
Secondary Infection ◽  
Perianal Abscess ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Healthcare Associated Infections ◽  
Prevention Measures ◽  
Carbapenem Resistant ◽  
Multidrug Resistant Organisms ◽  
Healthcare Associated ◽  
Vv Ecmo

Patients with severe Coronavirus disease 2019 (COVID-19) are at high risk for secondary infection with multidrug-resistant organisms (MDROs). Secondary infections contribute to a more severe clinical course and longer intensive care unit (ICU) stays in patients with COVID-19. A man in his 60s was admitted to the ICU at a university hospital for severe COVID-19 pneumonia requiring mechanical ventilation. His respiratory condition worsened further due to persistent bacteremia caused by imipenem-non-susceptible Klebsiella aerogenes and he required VV-ECMO. Subsequently, he developed a catheter-related bloodstream infection (CRBSI) due to Candida albicans, ventilator-associated pneumonia (VAP) due to multidrug-resistant Pseudomonas aeruginosa (MDRP), and a perianal abscess due to carbapenem-resistant K. aerogenes despite infection control procedures that maximized contact precautions and the absence of MDRO contamination in the patient’s room environment. He was decannulated from VV-ECMO after a total of 72 days of ECMO support, and was eventually weaned off ventilator support and discharged from the ICU on day 138. This case highlights the challenges of preventing, diagnosing, and treating multidrug-resistant organisms and healthcare-associated infections (HAIs) in the critical care management of severe COVID-19. In addition to the stringent implementation of infection prevention measures, a high index of suspicion and a careful evaluation of HAIs are required in such patients.

scholarly journals Public consultation on strategies for improving patient safety by prevention and control of healthcare-associated infections

2006 ◽  
Vol 11 (1) ◽  
Author(s):  
Collective Editorial team
Keyword(s):  
Patient Safety ◽  
European Commission ◽  
Prevention And Control ◽  
Public Consultation ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
And Control

The European Commission is inviting all professionals and stakeholders concerned with prevention of healthcare-associated infections

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