Evaluation of Manual and Electronic Health-care associated infections (HAIs) Surveillance: a prospective multi-center study (Preprint)

2019 ◽  
Author(s):  
Wensen Chen ◽  
Wensen Chen ◽  
Weihong Zhang ◽  
Yue Yang ◽  
Yun Liu
Keyword(s):  
Health Care ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Significant Heterogeneity ◽  
General Hospitals ◽  
Health Care Associated Infections ◽  
Multi Center Study ◽  
Platform System ◽  
The Impact ◽  
Center Study

UNSTRUCTURED A large multi-center study including 21 tertiary general hospitals and 63 wards were recruited to evaluate the impact of electronic surveillance and interaction platform system (SIPS) for health-care associated infections (HAIs). We collected 4098 consecutive patients and found that the hospitals installed with SIPS significantly increased work efficiency of infection control practitioners (ICPs) achieving satisfactory diagnostic performance of HAIs with 0.73 for sensitivity, 0.81 for specificity and 0.81 area under the curve (AUC). However, there were significant heterogeneity own to regions, time of SIPS installation, departments and sample size.

scholarly journals Chlorhexidine Gluconate Bathing Program to Reduce Health Care–Associated Infections in Both Critically Ill and Non–Critically Ill Patients

2021 ◽  
Vol 41 (5) ◽  
pp. e1-e8
Author(s):  
Leigh Chapman ◽  
Lisa Hargett ◽  
Theresa Anderson ◽  
Jacqueline Galluzzo ◽  
Paul Zimand
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Chlorhexidine Gluconate ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Telemetry Unit ◽  
Health Care Associated Infections ◽  
The Impact

Background Critical care nurses take care of patients with complicated, comorbid, and compromised conditions. These patients are at risk for health care–associated infections, which affect patients’ lives and health care systems in various ways. Objective To gauge the impact of routinely bathing patients with 4% chlorhexidine gluconate solution on the incidence of health care–associated infections in a medical-surgical intensive care unit and a postoperative telemetry unit; to outline the framework for a hospital-wide presurgical chlorhexidine gluconate bathing program and share the results. Methods A standard bathing protocol using a 4% chlorhexidine gluconate solution was developed. The protocol included time studies, training, monitoring, and surveillance of health care–associated infections. Results Consistent patient bathing with 4% chlorhexidine gluconate was associated with a 52% reduction in health care–associated infections in a medical-surgical intensive care unit. The same program in a postoperative telemetry unit yielded a 45% reduction in health care–associated infections. Conclusion A comprehensive daily 4% chlorhexidine gluconate bathing program can be implemented with standardized protocols and detailed instructions and can significantly reduce the incidence of health care–associated infections in intensive care unit and non–intensive care unit hospital settings.

Tumor complexity and the impact on MIC and trifecta in robot-assisted partial nephrectomy: a multi-center study of over 500 cases

2018 ◽  
Vol 36 (5) ◽  
pp. 783-788 ◽  
Author(s):  
Burkhard Ubrig ◽  
Alexander Roosen ◽  
Christian Wagner ◽  
Guenter Trabs ◽  
Frank Schiefelbein ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Robot Assisted ◽  
Multi Center Study ◽  
The Impact ◽  
Center Study

scholarly journals Can a Computer-Aided Mass Diagnosis Model Based on Perceptive Features Learned From Quantitative Mammography Radiology Reports Improve Junior Radiologists’ Diagnosis Performance? An Observer Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Zilong He ◽  
Yue Li ◽  
Weixiong Zeng ◽  
Weimin Xu ◽  
Jialing Liu ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Breast Mass ◽  
Cad Model ◽  
Breast Masses ◽  
Radiology Reports ◽  
Computer Aided ◽  
Mass Lesions ◽  
The Impact

Radiologists’ diagnostic capabilities for breast mass lesions depend on their experience. Junior radiologists may underestimate or overestimate Breast Imaging Reporting and Data System (BI-RADS) categories of mass lesions owing to a lack of diagnostic experience. The computer-aided diagnosis (CAD) method assists in improving diagnostic performance by providing a breast mass classification reference to radiologists. This study aims to evaluate the impact of a CAD method based on perceptive features learned from quantitative BI-RADS descriptions on breast mass diagnosis performance. We conducted a retrospective multi-reader multi-case (MRMC) study to assess the perceptive feature-based CAD method. A total of 416 digital mammograms of patients with breast masses were obtained from 2014 through 2017, including 231 benign and 185 malignant masses, from which we randomly selected 214 cases (109 benign, 105 malignant) to train the CAD model for perceptive feature extraction and classification. The remaining 202 cases were enrolled as the test set for evaluation, of which 51 patients (29 benign and 22 malignant) participated in the MRMC study. In the MRMC study, we categorized six radiologists into three groups: junior, middle-senior, and senior. They diagnosed 51 patients with and without support from the CAD model. The BI-RADS category, benign or malignant diagnosis, malignancy probability, and diagnosis time during the two evaluation sessions were recorded. In the MRMC evaluation, the average area under the curve (AUC) of the six radiologists with CAD support was slightly higher than that without support (0.896 vs. 0.850, p = 0.0209). Both average sensitivity and specificity increased (p = 0.0253). Under CAD assistance, junior and middle-senior radiologists adjusted the assessment categories of more BI-RADS 4 cases. The diagnosis time with and without CAD support was comparable for five radiologists. The CAD model improved the radiologists’ diagnostic performance for breast masses without prolonging the diagnosis time and assisted in a better BI-RADS assessment, especially for junior radiologists.

scholarly journals Evaluating the Rapid Emergence of Daptomycin Resistance in Corynebacterium: A Multi-Center Study

2021 ◽  
Author(s):  
Kaitlin F. Mitchell ◽  
Erin McElvania ◽  
Meghan A. Wallace ◽  
Lauren E. Droske ◽  
Amy E. Robertson ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Exposure Period ◽  
Corynebacterium Striatum ◽  
Before And After ◽  
Multi Center Study ◽  
High Level ◽  
The Impact ◽  
Repeated Subculture ◽  
Center Study

Background: Members of the genus Corynebacterium are increasingly recognized as pathobionts and can be very resistant to antimicrobial agents. Previous studies have demonstrated that Corynebacterium striatum can rapidly develop high-level daptomycin resistance (HLDR) (minimum inhibitory concentration [MIC] ≥256 μg/mL). Here we conducted a multi-center study to assay for this in vitro phenotype in diverse Corynebacterium species. Methods: Corynebacterium clinical isolates (n=157) from four medical centers were evaluated. MIC values to daptomycin, vancomycin, and telavancin were determined before and after overnight exposure to daptomycin to identify isolates able to rapidly develop daptomycin non-susceptibility. To investigate assay reproducibility, 18 isolates were evaluated at three study sites. In addition, stability of daptomycin non-susceptibility was tested using repeated subculture without selective pressure. The impact of different media brands was also investigated. Results: Daptomycin non-susceptibility emerged in 12 of 23 species evaluated in this study (C. afermentans, amycolatum, aurimucosum, bovis, jeikeium, macginleyi, pseudodiphtheriticum, resistens, simulans, striatum, tuberculostearicum, and ulcerans) and was detected in 50 of 157 (31.8%) isolates tested. All isolates displayed low (susceptible) MIC values to vancomycin and telavancin before and after daptomycin exposure. Repeated subculture demonstrated 2 of 9 isolates (22.2%) exhibiting HLDR reverted to a susceptible phenotype. Of 30 isolates tested on three media brands, 13 (43.3%) had differences in daptomycin MIC values between brands. Conclusions: Multiple Corynebacterium species can rapidly develop daptomycin non-susceptibility, including HLDR, after a short daptomycin exposure period.

scholarly journals The prognostic value of serum albumin levels and respiratory rate for community-acquired pneumonia: A prospective, multi-center study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248002
Author(s):  
Lili Zhao ◽  
Jing Bao ◽  
Ying Shang ◽  
Ying Zhang ◽  
Lu Yin ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Respiratory Rate ◽  
Prognostic Value ◽  
Cox Regression ◽  
Pneumonia Severity Index ◽  
Area Under The Curve ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Multi Center Study ◽  
Center Study

Community-acquired pneumonia (CAP) is a respiratory disease frequently requiring hospital admission, and a significant cause of death worldwide. This study aimed to investigate the prognostic value of clinical indicators. A prospective, multi-center study was conducted (January 2017–December 2018) where patient demographic and clinical data were recorded (N = 366). The 30-day mortality rate was 5.46%. Cox Regression analyses showed that serum albumin (ALB) and respiratory rate (RR) were independent prognostic variables for 30-day survival in patients with CAP. Albumin negatively correlated with the Pneumonia Severity Index (PSI) and CURB-65 scores using Pearson and Spearman tests. Survival curves showed that a RR >24 breaths/min or ALB ≤30 g/L were associated with a significantly higher risk of mortality. The area-under-the-curve (AUC) for predicting 30-day mortality in patients with CAP was 0.762, 0.763, 0.790, and 0.784 for ALB, RR, PSI, and CURB-65, respectively. The AUC for the prediction of 30-day mortality using ALB combined with PSI, CURB-65 scores, and RR was 0.822 (95% CI 0.731–0.912), 0.847 (95% CI 0.755–0.938), and 0.847 (95% CI 0.738–0.955), respectively. Albumin and RR were found to be reliable prognostic factors for CAP. This combination showed equal predictive value when compared to adding ALB assessment to PSI and CURB-65 scores, which could improve their prognostic accuracy.

The impact of fatigue on patients with psoriatic arthritis: a multi-center study of the TLAR-network

2020 ◽  
Vol 40 (11) ◽  
pp. 1803-1815
Author(s):  
Mehmet Tuncay Duruöz ◽  
Halise Hande Gezer ◽  
Kemal Nas ◽  
Erkan Kilic ◽  
Betül Sargin ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Multi Center Study ◽  
The Impact ◽  
Center Study
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