scholarly journals The Standardization of Hospital-Acquired Infection Rates Using Prediction Models in Iran: Observational Study of National Nosocomial Infection Registry Data

10.2196/33296 ◽  
2021 ◽  
Vol 7 (12) ◽  
pp. e33296
Author(s):  
Neda Izadi ◽  
Koorosh Etemad ◽  
Yadollah Mehrabi ◽  
Babak Eshrati ◽  
Seyed Saeed Hashemi Nazari
Keyword(s):  
Internal Medicine ◽  
Infectious Disease ◽  
Prediction Models ◽  
Scientific Evidence ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Rates ◽  
Hospital Acquired Infection ◽  
Tract Infections ◽  
Hospital Acquired

Background Many factors contribute to the spreading of hospital-acquired infections (HAIs). Objective This study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method. Methods In this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, the hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals, including 357 hospitals from all over the country, were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs. Results The mean age of the 100,110 patients with an HAI was 40.02 (SD 23.56) years. The corrected SIRs based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical site infections (SSIs), and bloodstream infections (BSIs) were 0.03 (95% CI 0-0.09), 1.02 (95% CI 0.95-1.09), 0.93 (95% CI 0.85-1.007), and 0.91 (95% CI 0.54-1.28), respectively. Moreover, the corrected SIRs for RTIs in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards; UTIs in the burn, infectious disease, internal medicine, and intensive care unit wards; SSIs in the burn and infectious disease wards; and BSIs in most wards were >1, indicating that more HAIs were observed than expected. Conclusions The results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system.

scholarly journals The Standardization of Hospital-Acquired Infection Rates Using Prediction Models in Iran: Observational Study of National Nosocomial Infection Registry Data (Preprint)

2021 ◽  
Author(s):  
Neda Izadi ◽  
Koorosh Etemad ◽  
Yadollah Mehrabi ◽  
Babak Eshrati ◽  
Seyed Saeed Hashemi Nazari
Keyword(s):  
Internal Medicine ◽  
Infectious Disease ◽  
Prediction Models ◽  
Scientific Evidence ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Rates ◽  
Hospital Acquired Infection ◽  
Tract Infections ◽  
Hospital Acquired

BACKGROUND Many factors contribute to the spreading of hospital-acquired infections (HAIs). OBJECTIVE This study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method. METHODS In this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, the hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals, including 357 hospitals from all over the country, were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs. RESULTS The mean age of the 100,110 patients with an HAI was 40.02 (SD 23.56) years. The corrected SIRs based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical site infections (SSIs), and bloodstream infections (BSIs) were 0.03 (95% CI 0-0.09), 1.02 (95% CI 0.95-1.09), 0.93 (95% CI 0.85-1.007), and 0.91 (95% CI 0.54-1.28), respectively. Moreover, the corrected SIRs for RTIs in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards; UTIs in the burn, infectious disease, internal medicine, and intensive care unit wards; SSIs in the burn and infectious disease wards; and BSIs in most wards were >1, indicating that more HAIs were observed than expected. CONCLUSIONS The results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system.

scholarly journals Bugs Can Be Busted: How to Prevent Hospital-Acquired Infections A Success Story of Norwegian American Hospital, Chicago, U.S.A, in Substantially Reducing Hospital-acquired Infection (HAI) Rates

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Gap Analysis ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Rates ◽  
Clinical Practices ◽  
American Hospital ◽  
Hospital Acquired Infections ◽  
Stewardship Program ◽  
Tract Infections ◽  
Hospital Acquired

Hospital-acquired infections (HAIs) including Central Line -Associated Bloodstream Infections (CLABSI), CatheterAssociated Urinary Tract Infections (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA) infections, Clostridium difficle Infections (CDI), Surgical Site Infections (SSI), and Ventilator-Associated Pneumonia (VAP) are among the most common and serious patient safety threats in the health care settings, which contribute to significant morbidity, mortali-ty, length of patient stay, and healthcare cost. To combat increasing number of HAI, Norwegian American Hospital (NAH), Chicago, Illinois, USA, strategically developed, and successfully implemented a HAI control and prevention initia-tive in 2013. As a result, NAH dramatically reduced its infection rates over the next several years and the trend continues to date. Guided by Gap analysis, driven by data, gathered from both internal and external sources, and supported by hospital leadership, NAH initiated a process of gradual and transformational re-forms, by engaging, educating and empowering all clinical and administrative staff, patients, their families and community, promoting a culture of mutual responsibility, incorporating best practic-es, integrating technology into clinical practices, developing electronic standing order- sets and nurse-driven protocols, creating hand hygiene, sepsis and sexually transmitted infections task forces, and antimicrobial stewardship program, NAH successfully managed to achieve and maintain high-quality standards of patient care and lower then national benchmarks HAI rates for the last four consecutive years (January 2016 to December 2019). Among the device-associated infections (CAUTI/CLABSI), we encountered only one CAUTI and no CLABSI in 2016, none in 2017, only one CAUTI and no CLABSIs in 2018 and only one CAU-TI and one CLABSI in 2019. Furthermore, our VAP rate remained zero, we had only one SSI in 2019 and the C. Difficle Infection rates have also been steadily declining since the implementation of new preventive measures. As a result, NAH received several recognition awards from the lo-Cal as well as national health organizations.

Effect of Bacteriologic Monitoring of Urinary Catheters on Recognition and Treatment of Hospital-Acquired Urinary Tract Infections

1981 ◽  
Vol 2 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Jay A. Jacobson ◽  
John P. Burke ◽  
Evelyn Kasworm
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Monitoring Program ◽  
Hospital Service ◽  
Infection Rates ◽  
Urinary Catheters ◽  
Hospital Acquired Infection ◽  
Daily Monitoring ◽  
Tract Infections ◽  
Hospital Acquired

AbstractCatheter-associated urinary tract infections remain the most common hospital-acquired infection. Regular bacteriologie monitoring of urine from catheterized patients has been advocated as a measure for reducing the morbidity associated with this infection. To assess the effectiveness of this measure we reviewed the records of 100 catheterized patients hospitalized before implementation of a monitoring program and 200 such patients admitted after a daily monitoring program was operational. We found that culturing urine from catheterized patients was infrequent prior to monitoring but, when done, patients usually were febrile, cultures usually were positive, and patients were treated. Monitoring identified more cases of bacteriuria, but less than half of the patients so identified were treated. Being febrile was associated with receiving antibiotics. Infection rates increased with duration of catheterization; long periods of catheterization typically occurred on the neurosurgical, orthopedic, and medical services. Daily bacteriologie monitoring of all catheterized patients is relatively inefficient and does not predictably lead to therapeutic intervention in infected patients. The cost:benefit ratio of this measure might be decreased by applying it to selected patients chosen on the basis of risk factors, including hospital service assignment (Infect Control 1981; 2(3):227-232.)

Prevention of healthcare associated infections

2019 ◽  
pp. 233-304 ◽  
Author(s):  
Nizam Damani
Keyword(s):  
Prevention And Control ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

This chapter provides the most up-to-date advice on infection prevention and control (IPC) of the four most common healthcare-associated infections (HAIs). These are: surgical site infections; infection associated with peripheral IV line/cannula and central line-associated bloodstream infections (CLABSIs); catheter-associated urinary tract infections (CAUTI); and hospital-acquired and ventilator-acquired pneumonias (VAP). The chapter examines and summarizes various key elements and discusses implementation of HAI care bundles and high impact interventions which are necessary to reduce these infections.

scholarly journals The Importance of Continued Quality Improvement Efforts in Monitoring Hospital-Acquired Infection Rates: A Cardiac Surgery Experience

2015 ◽  
Vol 99 (6) ◽  
pp. 2061-2069 ◽  
Author(s):  
Valentin Mocanu ◽  
Karen J. Buth ◽  
Lynn B. Johnston ◽  
Ian Davis ◽  
Gregory M. Hirsch ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Quality Improvement ◽  
Infection Rates ◽  
Hospital Acquired Infection ◽  
Hospital Acquired

Healthcare-Associated Infection in Italy Annual Point-Prevalence Surveys, 2002–2004

2009 ◽  
Vol 30 (7) ◽  
pp. 659-665 ◽  
Author(s):  
Simone Lanini ◽  
William R. Jarvis ◽  
Emanuele Nicastri ◽  
Gaetano Privitera ◽  
Giovanni Gesu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Univariate Analysis ◽  
National Health System ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Point Prevalence ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated

Objective.Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality worldwide. During the period from 2002 through 2004, a group of Italian hospitals was recruited to conduct HAI point-prevalence surveys.Design.Three point-prevalence surveys.Methods.A total of 9,609 patients were surveyed.Results.The overall frequency of HAI was 6.7% (645 infections among the 9,609 surveyed patients). The most frequent HAIs were lower respiratory tract infections, which accounted for 35.8% (231 of 645 HAIs) of all HAIs, followed by urinary tract infections (152 [23.6%] of 645 HAIs), bloodstream infections (90 [14.0%] of 645 HAIs), and surgical site infections (79 [12.2%] of 645 HAIs). In both multivariate and univariate analysis, invasive procedures, duration of stay, chemotherapy, trauma, coma, and the location of the hospital were all factors statistically significantly associated with the occurrence of an HAL Enterobacteriaceae were the most common isolates recovered in medical and surgical wards, whereas gram-negative aerobic bacilli were the most common isolates recovered in intensive care units. Approximately one-half of all of the patients surveyed were receiving antibiotics at the time of our study; the most used antibiotic classes were fluoroquinolones in medical wards, cephalosporins in surgical wards, and penicillins and glycopeptides in intensive care units.Conclusion.Our study emphasizes the need for implementing further HAI surveillance to provide the National Health System with proper tools to prevent and manage infection in hospitalized patients.

scholarly journals EMERGENCE AND ANTIBIOTIC SENSITIVITY PATTERN OF ACINETOBACTER BAUMANNII IN HOSPITAL FACILITY

2017 ◽  
Vol 10 (3) ◽  
pp. 77
Author(s):  
Anania Arjuna ◽  
Dinobandhu Nandi
Keyword(s):  
Acinetobacter Baumannii ◽  
Nosocomial Infections ◽  
Antibiotic Sensitivity ◽  
Hospital Environment ◽  
Sensitivity Testing ◽  
Hospital Acquired Infection ◽  
Clinical Specimens ◽  
Sensitivity Pattern ◽  
Tract Infections ◽  
Hospital Acquired

ABSTRACTObjective: Nosocomial infections or Hospital acquired infection (HAI) are one of the major threats to hospitalized patients as well as for the hospitalassociated personnel. In last few years there is a gross change in causative agents, new organisms have come out with great threat to hospitals as theypossess antibiotic resistance property e.g. production of biofilm, production of enzymes such as β- lactamases. Among many organisms, Acinetobacterbaumannii has emerged as a potent nosocomial pathogen. Our objective of this study was to find the burden of Acinetobacter baumannii infectionswhich are associated as nosocomial infections and to determine the drug of choice for an effective treatment.Methods: Clinical specimens were collected from patients of different unit of the hospital by maintaining universal precautions and standardmicrobiological protocols. All the respective specimens were cultured in respective culture medium i.e. MacConkey agar, blood agar, chocolate agar,cysteine lactose electrolyte deficient (CLED) agar and, fluid thioglycolate (TG) medium at 37˚C for 24-48 hours. After incubation of 24-48 hours cultureplates were examined for bacterial growth and identification and antibiotic sensitivity test was made by Vitek2 compact.Result: The study was conducted at the department of microbiology from January 2016 to April 2016. A total of 2582 specimens were collected andprocessed for identification and sensitivity testing. Specimens of all age group (2 days- 93 years) and both sexes were processed for identificationof A. baumannii and antibiotic sensitivity testing. A total of 119 isolates (4.60%) of A. baumannii were obtained from 2582 clinical specimens. Themost common infection A. baumannii was found as lower respiratory tract infection (89.07%) followed by abscess (6.72%), septicaemia (2.52%),urinary tract infections (0.84%), and soft tissue infections (0.84%). The maximum sensitivity of A. baumannii isolates were seen to Colistin (CL) (119,100%), followed by Tigecycline (TGC) (63, 52.94%) and Minocycline (MIN) (27, 22.69%). The maximum resistant was observed for Imipenem (IMI),Aztreonam (AZT) and Ticarcillin- clavulanic acid (TIC) (119, 100%).Conclusion: The Gram- negative coccobacillus, Acinetobacter baumannii poses a formidable threat to patients. It has emerged as a superbug inhospital environment particularly in ICU units. The chances of A. baumannii infections increase in the presence of iatrogenic factors like inadequatelong- term antibiotic therapy and new interventions in a medical facility. To control the burden of Acinetobacter infections new therapies suchas combine therapy must be obtained and followed with proper dose as recommend by physicians; along with awareness of the importance ofthis infection should be implicated. Proper sanitation, good housekeeping, sterilization of equipment, hand hygiene, water purification, isolationprocedures and maintaining of the hospital environment, use of infection control practices are some of the measures to control the transmission ofAcinetobacter spp. among hospital personnel.Keywords: Acinetobacter baumannii, Biofilm, β-lactamases, Hospital acquired infection.

Fever in the Neurosurgical Patient

2019 ◽  
pp. 123-155
Author(s):  
Rakhshanda Akram ◽  
Crystal Benjamin ◽  
Linda Mwamuka ◽  
Katherine A. Belden
Keyword(s):  
Patient Population ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Acalculous Cholecystitis ◽  
Postoperative Fever ◽  
Neurosurgical Patient ◽  
Neurosurgical Patients ◽  
Postoperative Meningitis ◽  
Tract Infections ◽  
The Cost

Postoperative fever falls under the category of nosocomial fever, not incubating at the time of surgery. Early postoperative fever is more likely to be a part of the cytokine-mediated physiologic response to surgery and does not always need an infectious workup. Other important noninfectious causes of postoperative fever in neurosurgical patients include dysautonomia and central fever, which are often diagnoses of exclusion after infectious etiologies have been ruled out. Infections in neurosurgical patients can be secondary to the surgical procedure, such as postoperative meningitis, cerebrospinal fluid shunt and drain infections, cranial or spinal epidural abscess, and osteomyelitis and surgical site infections. Other hospital-associated infections, such as nosocomial pneumonia, sinusitis, diarrhea, urinary tract infections, bloodstream infections, and acalculous cholecystitis, are other important causes to be considered as part of the infectious workup. Hyperthermia-induced brain injury is a significant concern in neurosurgical patient population. Therefore, careful management of fever in this patient population is imperative to improve patient outcomes and decrease the cost of medical care.

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