scholarly journals Antimicrobial Resistance Patterns and Antibiotic Use during Hospital Conversion in the COVID-19 Pandemic

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 182
Author(s):  
Bernardo A. Martinez-Guerra ◽  
Maria F. Gonzalez-Lara ◽  
Nereyda A. de-Leon-Cividanes ◽  
Karla M. Tamez-Torres ◽  
Carla M. Roman-Montes ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Care Center ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Coagulase Negative Staphylococci ◽  
Hospital Acquired Infections ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment ◽  
Hospital Acquired ◽  
Antimicrobial Prescription

Objective: To describe empirical antimicrobial prescription on admission in patients with severe COVID-19, the prevalence of Hospital-Acquired Infections, and the susceptibility patterns of the causing organisms. Methods: In this prospective cohort study in a tertiary care center in Mexico City, we included consecutive patients admitted with severe COVID-19 between March 20th and June 10th and evaluated empirical antimicrobial prescription and the occurrence of HAI. Results: 794 patients with severe COVID-19 were admitted during the study period. Empiric antibiotic treatment was started in 92% of patients (731/794); the most frequent regimes were amoxicillin-clavulanate plus atypical coverage in 341 (46.6%) and ceftriaxone plus atypical coverage in 213 (29.1%). We identified 110 HAI episodes in 74/656 patients (11.3%). Ventilator-associated pneumonia (VAP) was the most frequent HAI, in 56/110 (50.9%), followed by bloodstream infections (BSI), in 32/110 (29.1%). The most frequent cause of VAP were Enterobacteriaceae in 48/69 (69.6%), followed by non-fermenter gram-negative bacilli in 18/69 (26.1%). The most frequent cause of BSI was coagulase negative staphylococci, in 14/35 (40.0%), followed by Enterobacter complex in 7/35 (20%). Death occurred in 30/74 (40.5%) patients with one or more HAI episodes and in 193/584 (33.0%) patients without any HAI episode (p < 0.05). Conclusion: A high frequency of empiric antibiotic treatment in patients admitted with COVID-19 was seen. VAP and BSI were the most frequent hospital-acquired infections, due to Enterobacteriaceae and coagulase negative staphylococci, respectively.

scholarly journals Epidemiology of hospital-acquired infections at a tertiary care center in Lebanon

2011 ◽  
Vol 5 (S6) ◽  
Author(s):  
S Kanj ◽  
G Kamel ◽  
L Alamuddin ◽  
N Zahreddine ◽  
N Sidani ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Hospital Acquired Infections ◽  
Hospital Acquired

scholarly journals Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center

2022 ◽  
Author(s):  
Oscar A. Fernández-García ◽  
María F. González-Lara ◽  
Marco Villanueva-Reza ◽  
Nereyda de-León-Cividanes ◽  
Luis F. Xancal-Salvador ◽  
...  
Keyword(s):  
Intensive Care ◽  
Care Center ◽  
Tertiary Care ◽  
Collateral Damage ◽  
Surge Capacity ◽  
Hospital Acquired Infections ◽  
High Workload ◽  
Pandemic Response ◽  
Hospital Acquired

The SARS-CoV-2 pandemic has resulted in a surge of critically ill patients. Hospitals have had to adapt to the demand by repurposing areas as intensive care units. This has resulted in high workload and disruption of usual hospital workflows. Surge capacity guidelines and pandemic response plans do not contemplate how to limit collateral damage from issues like hospital-acquired infections. It is vital to ensure quality of care in surge scenarios.

The effect of increased mobility on morbidity in the neurointensive care unit

2012 ◽  
Vol 116 (6) ◽  
pp. 1379-1388 ◽  
Author(s):  
W. Lee Titsworth ◽  
Jeannette Hester ◽  
Tom Correia ◽  
Richard Reed ◽  
Peggy Guin ◽  
...  
Keyword(s):  
Unit Length ◽  
Care Center ◽  
Tertiary Care ◽  
Neurointensive Care ◽  
Neurointensive Care Unit ◽  
Hospital Acquired Infections ◽  
Medical Icus ◽  
Hospital Acquired ◽  
Observation Period

Object The detrimental effects of immobility on intensive care unit (ICU) patients are well established. Limited studies involving medical ICUs have demonstrated the safety and benefit of mobility protocols. Currently no study has investigated the role of increased mobility in the neurointensive care unit population. This study was a single-institution prospective intervention trial to investigate the effectiveness of increased mobility among neurointensive care unit patients. Methods All patients admitted to the neurointensive care unit of a tertiary care center over a 16-month period (April 2010 through July 2011) were evaluated. The study consisted of a 10-month (8025 patient days) preintervention observation period followed by a 6-month (4455 patient days) postintervention period. The intervention was a comprehensive mobility initiative utilizing the Progressive Upright Mobility Protocol (PUMP) Plus. Results Implementation of the PUMP Plus increased mobility among neurointensive care unit patients by 300% (p < 0.0001). Initiation of this protocol also correlated with a reduction in neurointensive care unit length of stay (LOS; p < 0.004), hospital LOS (p < 0.004), hospital-acquired infections (p < 0.05), and ventilator-associated pneumonias (p < 0.001), and decreased the number of patient days in restraints (p < 0.05). Additionally, increased mobility did not lead to increases in adverse events as measured by falls or inadvertent line disconnections. Conclusions Among neurointensive care unit patients, increased mobility can be achieved quickly and safely with associated reductions in LOS and hospital-acquired infections using the PUMP Plus program.

scholarly journals Hospital-Acquired Bloodstream Infections With MRSA and VRE: Standardized Admission Screening Did Not Impact Rates

2020 ◽  
Vol 41 (S1) ◽  
pp. s253-s254
Author(s):  
Jennifer Ellison ◽  
Blanda Chow ◽  
Andrea Howatt ◽  
Ted Pfister ◽  
Kathryn Bush
Keyword(s):  
Tertiary Care ◽  
Bloodstream Infections ◽  
Cost Of Care ◽  
Early Initiation ◽  
Solid Organ ◽  
Screening Practices ◽  
Contact Precautions ◽  
Admission Screening ◽  
Hospital Acquired ◽  
Standardized Screening

Background: Bloodstream infections (BSIs) are an important cause of morbidity and mortality in severely ill patients, contributing to increased length of stay and a higher cost of care. Surveillance of hospital-acquired (HA) BSI is considered a measure of quality of care and has been performed provincially in Alberta since 2011. Prior to October 2015, a nonstandardized, risk-factor–based VRE screening process was used. Screening practices for antibiotic-resistant organisms (AROs) were aligned in October 2015 with a provincially standardized admission screening tool to allow for early initiation of contact precautions for patients colonized or infected with MRSA or VRE. In this data review, we sought to determine whether this admission screening change influenced ARO infections through review of HA-BSI rates. Methods: Prospectively, we reviewed reports of all patients admitted to Alberta Health Services/Covenant Health acute-care and acute-/tertiary-care rehabilitation facilities who met inclusion criteria: (1) positive blood culture identified with MRSA or VRE; (2) new episode for the patient; and (3) positive result occurred on or after calendar day 3 of admission. Data are presented as quarterly rates. Screening practices for MRSA and VRE were standardized provincially in October 2015 to include screening for MRSA on admission for patients who had an inpatient admission, received hemodialysis, or was an inmate in a correctional facility in the past 6 months. We also screened for VRE patients admitted to a solid-organ transplant unit or a hematology unit, regardless of risk factors. Results: We detected no changes in the quarterly rates of HA-BSI with MRSA or VRE after admission screening was standardized. Prior to standardized screening, MRSA BSI rates ranged from 0.12 to 0.25 per 10,000 patient days, with an overall rate of 0.18 per 10,000 patient days. After standardization, rates ranged from 0.09 to 0.30 per 10,000 patient days, with an overall rate of 0.17 per 10,000 patient days (P = .46). VRE BSI rates prior to standardization ranged from 0.03 to 0.13 per 10,000 patient days, with an overall rate of 0.08 per 10,000 patient days, which increased slightly to 0.09 per 10,000 patient days after standardized screening, ranging between 0.04 and 0.16 per 10,000 patient days (P = .61). Conclusions: Following the implementation of standardized admission screening and the early initiation of contact precautions, no significant changes were observed in rates of either HA-BSI with MRSA or VRE. Further investigation is required to identify the most effective strategies to reduce HA-BSIs caused by MRSA and VRE.Funding: NoneDisclosures: None

Empiric Antibiotic Treatment Reduces Mortality in Severe Sepsis and Septic Shock From the First Hour

2014 ◽  
Vol 42 (8) ◽  
pp. 1749-1755 ◽  
Author(s):  
Ricard Ferrer ◽  
Ignacio Martin-Loeches ◽  
Gary Phillips ◽  
Tiffany M. Osborn ◽  
Sean Townsend ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Antibiotic Treatment ◽  
Empiric Antibiotic ◽  
Empiric Antibiotic Treatment ◽  
Sepsis And Septic Shock
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