scholarly journals Risk factors for healthcare associated infections and in-hospital mortality in neurological intensive care unit in tertiary hospital in Belgrade, Serbia: A prospective cohort study

2020 ◽  
Vol 77 (10) ◽  
pp. 1060-1066
Author(s):  
Stefan Vidakovic ◽  
Ranko Raicevic ◽  
Marija Grunauer ◽  
Viktor Pasovski ◽  
Vesna Suljagic
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Prevention And Control ◽  
Urinary Catheter ◽  
Significant Risk ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
And Control

Background/Aim. Patients in a neurologic intensive care unit (ICU) are especially susceptible to healthcare-associated infections (HAIs). HAIs are cause of significant morbidity and mortality. Aim of this study was to assess the incidence of HAIs, to identify significant risk factors (RFs) and causative microorganisms for HAIs and to identify RFs for inhospital mortality in a neurological ICU. Methods. A prospective cohort study was conducted in the six-bed ICU of the Clinic for Neurology, Military Medical Academy in Belgrade from January 1, 2014 to December 31, 2016. Active surveillance on HAIs was performed by the hospital infection control team, using methodologies of the European Centre for Disease Prevention and Control and the National Healthcare Safety Network/Centres for Disease Prevention and Control. Results. One hundred forty eight patients with a total of 2,708 patient-days were enrolled. There were 49 HAIs in 39 patients during the study period. The incidence and incidence density of HAIs were 26.3% and 18.1 per 1000 patient-days, respectively. The most frequent HAIs were urinary tract infections (15.5%), pneumonia (10.1%) and bloodstream infections (4%). RFs independently associated with HAIs in the neurological ICU were: urinary catheter [risk ratio (RR): 5.6; 95% confidence interval (CI): 1.153?27.632], urinary catheter-days (RR: 1.1; 95% CI: 1.057?1.188), central-line days (RR: 1.1; 95% CI: 1.010? 1.150), and mechanical ventilation (RR: 0.3; 95% CI: 0.079? 0.859). The most common microorganism was Klebsiella spp. RFs independently associated with in-hospital mortality in the neurological ICU were: mechanical ventilation (RR: 6.5; 95% CI: 2.868?14.116), Glasgow Coma Score (RR: 2.7; 95% CI: 1.135?6,396), and age (RR: 1.03; 95% CI: 1.005? 1.055). Conclusion. Usage of invasive procedures during ICU hospitalization carries significant risk for development of HAIs. HAIs in ICU setting are most often caused by Gram-negative bacteria with substantial antimicrobial resistance. These results stress the importance of infection prevention.

Analysis of diagnostic criteria for ventilator-associated pneumonia: a cohort study

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Caroline Gonçalves Pustiglione Campos ◽  
Aline Pacheco ◽  
Maria Dagmar da Rocha Gaspar ◽  
Guilherme Arcaro ◽  
Péricles Martim Reche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Diagnostic Criteria ◽  
Statistical Tests ◽  
Significant Risk ◽  
Diagnostic Methods ◽  
Ventilator Associated Pneumonia

ABSTRACT Objectives: to analyze the diagnostic criteria for ventilator-associated pneumonia recommended by the Brazilian Health Regulatory Agency and the National Healthcare Safety Network/Centers for Disease Control and Prevention, as well as its risk factors. Methods: retrospective cohort study carried out in an intensive care unit throughout 12 months, in 2017. Analyses included chi-square, simple linear regression, and Kappa statistical tests and were conducted using Stata 12 software. Results: the sample was 543 patients who were in the intensive care unit and under mechanical ventilation, of whom 330 (60.9%) were men and 213 (39.1%) were women. Variables such as gender, age, time under mechanical ventilation, and oral hygiene proved to be significant risk factors for the development of ventilator-associated pneumonia. Conclusions: patients submitted to mechanical ventilation need to be constantly evaluated so the used diagnostic methods can be accurate and applied in an objective and standardized way in Brazilian hospitals.

scholarly journals The prevalence of and risk factors for healthcare-associated infections in Slovenia: results of the second national survey

2016 ◽  
Vol 55 (4) ◽  
pp. 239-247 ◽  
Author(s):  
Irena Klavs ◽  
Jana Kolman ◽  
Tatjana Lejko Zupanc ◽  
Božena Kotnik Kevorkijan ◽  
Aleš Korošec ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Prevention And Control ◽  
Acute Care Hospitals ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Cross Sectional ◽  
Tract Infections ◽  
Healthcare Associated ◽  
And Control

Abstract Introduction In the second Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute-care hospitals, we estimated the prevalence of all types of HAIs and identified risk factors. Methods Patients from acute-care hospitals were enrolled into a one-day cross-sectional study in October 2011. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors. Results Among 5628 patients, 3.8% had at least one HAI and additional 2.6% were still being treated for HAIs on the day of the survey; the prevalence of HAIs was 6.4%. The prevalence of urinary tract infections was the highest (1.4%), followed by pneumoniae (1.3%) and surgical site infections (1.2%). In intensive care units (ICUs), the prevalence of patients with at least one HAI was 35.7%. Risk factors for HAIs included central vascular catheter (adjusted odds ratio (aOR) 4.0; 95% confidence intervals (CI): 2.9-5.7), peripheral vascular catheter (aOR 2.0; 95% CI: 1.5-2.6), intubation (aOR 2.3; 95% CI: 1.4-3.5) and rapidly fatal underlying condition (aOR 2.1; 95% CI: 1.4-3.3). Conclusions The prevalence of HAIs in Slovenian acute-care hospitals in 2011 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.

scholarly journals Prevalence of and factors associated with healthcare-associated infections in Slovenian acute care hospitals: Results of the third national survey

2019 ◽  
Vol 58 (2) ◽  
pp. 62-69 ◽  
Author(s):  
Irena Klavs ◽  
Mojca Serdt ◽  
Aleš Korošec ◽  
Tatjana Lejko Zupanc ◽  
Blaž Pečavar
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Prevention And Control ◽  
Acute Care Hospitals ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Factors Associated ◽  
The Third ◽  
Healthcare Associated ◽  
And Control

Abstract Introduction In the third Slovenian national healthcare-associated infections (HAIs) prevalence survey, conducted within the European point prevalence survey of HAIs and antimicrobial use in acute care hospitals, we estimated the prevalence of all types of HAIs and identified factors associated with them. Methods Patients were enrolled into a one-day cross-sectional study in November 2017. Descriptive analyses were performed to describe the characteristics of patients, their exposure to invasive procedures and the prevalence of different types of HAIs. Univariate and multivariate analyses of association of having at least one HAI with possible risk factors were performed to identify risk factors. Results Among 5,743 patients, 4.4% had at least one HAI and an additional 2.2% were still treated for HAIs on the day of the survey, with a prevalence of HAIs of 6.6%. The prevalence of pneumoniae was the highest (1.8%), followed by surgical site infections (1.5%) and urinary tract infections (1.2%). Prevalence of blood stream infections was 0.3%. In intensive care units (ICUs), the prevalence of patients with at least one HAI was 30.6%. Factors associated with HAIs included central vascular catheter (adjusted odds ratio [aOR] 4.1; 95% confidence intervals [CI]: 3.1–5.4), peripheral vascular catheter (aOR 3.0; 95% CI: 2.3–3.9), urinary catheter (aOR 1.8; 95% CI: 1.4–2.3). Conclusions The prevalence of HAIs in Slovenian acute care hospitals in 2017 was substantial, especially in ICUs. HAIs prevention and control is an important public health priority. National surveillance of HAIs in ICUs should be developed to support evidence-based prevention and control.

scholarly journals Epidemiological features of healthcare associated infections in pediatric cardiac surgery

2021 ◽  
Vol 13 (3) ◽  
pp. 102-106
Author(s):  
A. S. Nabieva ◽  
B. I. Aslanov ◽  
V. N. Timchenko ◽  
N. A. Ponomarev
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Congenital Heart ◽  
Healthcare Associated Infections ◽  
Epidemiological Features ◽  
Surgical Methods ◽  
Healthcare Associated

4—5 congenital heart defect cases per 1000 newborns are diagnosed worldwide. Some malformations require surgical methods of correction. Various risk factors contribute to the development of healthcare associated infections (HAIs). The HAIs are one of the leading causes of the prolongation of hospitalization length both in intensive care unit and in the inpatient departments, and they also play a significant role in increasing the number of lethal outcomes. A number of risk factors play an important role in the development of HAIs: the duration of post-operative mechanical ventilation, neonatal age, low birth weight, co-morbidities, including malformations of other body systems.

scholarly journals Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhijie Zhang ◽  
Yu Cao ◽  
Yanjian Li ◽  
Xufang Chen ◽  
Chen Ding ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Biofilm Formation ◽  
Prevention And Control ◽  
Neonatal Intensive Care ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Anti Fungal ◽  
Hospital Acquired ◽  
And Control

Abstract Background Candida pelliculosa is an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown that C. pelliculosa infects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection. Methods We performed a case-control study, analysing the potential risk factors for neonatal infections of C. pelliculosa so that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections. Results The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection with C. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission. Conclusions The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection with C. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.

Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study

2021 ◽  
pp. 175717742110358
Author(s):  
Sailesh Kumar Shrestha ◽  
Swarup Shrestha ◽  
Sisham Ingnam
Keyword(s):  
Prevention And Control ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Healthcare Associated ◽  
And Control

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

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.

scholarly journals Presence of Invasive Devices and Risks of Healthcare-Associated Infections and Sepsis

2018 ◽  
Vol 07 (04) ◽  
pp. 188-195
Author(s):  
John VanBuren ◽  
Richard Holubkov ◽  
Susan Bratton ◽  
Erin Bennett
Keyword(s):  
Intensive Care Unit ◽  
Retrospective Cohort ◽  
Urinary Catheter ◽  
Pediatric Intensive Care ◽  
Venous Catheter ◽  
Healthcare Associated Infections ◽  
Central Venous ◽  
Endotracheal Tubes ◽  
Daily Risk ◽  
Healthcare Associated

AbstractThe present study evaluated the daily risk of healthcare-associated infections and sepsis (HAIS) events in pediatric intensive care unit patients with invasive devices. This was a retrospective cohort study. Invasive devices were associated with significant daily risk of HAIS (p < 0.05). Endotracheal tubes posed the greatest risk of HAIS (hazard ratio [HR]: 4.39, confidence interval [CI]: 2.59–7.46). Children with both a central venous catheter (CVC) and urinary catheter (UC) had over 2.5-fold increased daily risk (HR: 2.59, CI: 1.18–5.68), in addition to daily CVC risk (HR: 3.06, CI: 1.38–6.77) and daily UC risk (HR: 8.9, CI: 3.62–21.91). We conclude that a multistate hazard model optimally predicts daily HAIS risk.

Sign in / Sign up

Export Citation Format

Share Document