scholarly journals Epidemiology of Surgical Site Infections Considering the NHSN Standardized Infection Ratio in Hip and Knee Arthroplasties

2020 ◽  
Vol 17 (9) ◽  
pp. 3167
Author(s):  
Róża Słowik ◽  
Małgorzata Kołpa ◽  
Marta Wałaszek ◽  
Anna Różańska ◽  
Barbara Jagiencarz-Starzec ◽  
...  
Keyword(s):  
Optimal Solution ◽  
Surgical Site Infections ◽  
Incidence Density ◽  
Coagulase Negative Staphylococci ◽  
Surveillance Network ◽  
Hospital Acquired Infections ◽  
Etiologic Agents ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Introduction Surgical site infections (SSIs) are a predominant form of hospital-acquired infections in surgical wards. The objective of the study was analysis of the incidence of SSI in, both primary and revision, hip and knee arthroplasties. Material and methods: The study was conducted in 2012–2018 in a Trauma and Orthopedics Ward in Tarnów according to the methodology of the Healthcare-Associated Infections Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). Results: The surveillance comprised 2340 surgery patients, including: 1756 Hip Arthroplasties (HPRO) and 584 Knee Arthroplasties (KPRO). In the group of patients under study, 37 cases of SSI were detected, including: 26 cases of SSI after HPRO and 11 cases in KPRO. The average incidence of SSI amounted to 1.6% (1.5% HPRO and 1.9% KPRO) and in-hospital incidence density rates were 1.23 and 1.53 per 1000 patient-days, respectively. Median age of surgical patients in both HPRO and KPRO was 70 years. Women were undergoing arthroplasty surgery more often than men, HPRO (p < 0.05) and KPRO (p < 0.001). Patients with SSI stayed in the ward longer (SSI-HPRO, p < 0.001) (SSI-KPRO p < 0.01). In KPRO operations, the incidence of SSI was higher than expected, calculated according to the Standardized Infection Ratio (SIR). The most common etiologic agents isolated from SSIs in both HPRO and KPRO were coagulase-negative staphylococci. Conclusions: Establishing a thorough surveillance of hospital-acquired infections that takes into consideration epidemiological indicators is indispensable to properly assess the epidemiological situation in the ward. The optimal solution is to carry out long-term and multi-center surveillance in the framework of a uniform program, however, even results of single-center studies provide valuable data indicating challenges and needs in improving patient safety.

scholarly journals Analysis of the incidence of surgical site infections after open reposition of long bone fractures and closed fracture settings in a 7-year follow-up in an orthopedic and trauma ward in southern Poland

2020 ◽  
pp. 336-345
Author(s):  
Róża Słowik ◽  
Marta Wałaszek ◽  
Witold Zieńczuk
Keyword(s):  
Bone Fractures ◽  
Risk Index ◽  
Trauma Surgery ◽  
Surgical Site Infections ◽  
Long Bone ◽  
Women Patients ◽  
Surveillance Network ◽  
Healthcare Associated ◽  
And Control

INTRODUCTION. Surgical Site Infection (SSI) is the most common clinical form of Healthcare-Associated Infections (HAI) in orthopedic and trauma wards. MATERIAL AND METHOD. A retrospective study was conducted at the Department of Orthopedics and Trauma Surgery in Tarnów in 2012-2018. 3 155 patients treated for bone fractures were analyzed, including 1961 Open Reduction of Fracture (FX) and 1 194 Closed Reduction of Fracture with Internal Fixation (CR) surgeries. The study was conducted in accordance with the methodology recommended by the Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC). The aim of the study was to assess the incidence of SSI in patients undergoing the FX and CR procedures. RESULTS. 28 SSIs were identified in the examined ward; 16 SSI cases related to the FX procedure and 12 cases related to CR. The incidence for FX was 0.8% and for CR 1%. In patients with diagnosed SSI, the stay in the ward was longer (p <0.001) than in patients without SSI. In FX operations, the standardized risk index (SIR) did not exceed the value of one. Staphylococcus aureus was the most common organism isolated from materials from patients with SSI. CONCLUSIONS. In the examined period, the median age of women was higher than that of men, which may indicate a higher incidence of fractures in women. Patients with diagnosed SSI had a longer stay in the ward than patients without SSI. The incidence of SSI in FX and CR has been reduced compared to previous studies in the same ward.

scholarly journals Incidence of Surgical Site Infections in Multicenter Study—Implications for Surveillance Practice and Organization

2021 ◽  
Vol 18 (10) ◽  
pp. 5374
Author(s):  
Anna Różańska ◽  
Jerzy Rosiński ◽  
Andrzej Jarynowski ◽  
Katarzyna Baranowska-Tateno ◽  
Małgorzata Siewierska ◽  
...  
Keyword(s):  
Surgical Site Infections ◽  
Weather Conditions ◽  
Incidence Rates ◽  
Healthcare Associated Infections ◽  
Country Level ◽  
Significant Difference ◽  
Surveillance Practice ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Introduction: WHO core components of healthcare-associated infections (HAIs) prevention and control include their surveillance system. In Poland, there are no widespread multi-center infection surveillance networks based on continuous, targeted, active methodology. One of the most important form of HAIs are surgical site infections (SSIs). The aim of this study was to analyze the incidence of SSIs, in the context of seasonal differentiation. Seasonal differentiation could be connected with weather conditions, but it also can be affected by personnel absence due to holidays and furlough. The second aspect may influence organization of work and increased absenteeism may contribute to lowering the quality of patient care. Healthcare associated infections are the phenomenon which can be especially affected by such factors. Methods: The data used originate from the targeted, active surveillance reports obtained from the six years period, based on the ECDC recommendations. Results: Highest incidence rates of SSIs were found after operations performed in June and August, equal to 1.8% and 1.5% respectively and the lowest in October was 0.8%. These differences were statistically significant: for June incidence: OR 1.6, 95% CI 1.03–2.5, p = 0.015. Another approach showed a significant difference between the level of incidence in the period from November to January together with from June to August (1.35%), comparing to the rest of the year (1.05%). Also the rates of enterococcal and Enterobacterales infections were significantly higher for the period comprising months from November till January and from June to August. In Poland these are periods of increased number of absences associated with summer, national and religious holidays. Conclusions: Our results show that the short-term surveillance data limited to several days or months are not sufficient to obtain a valuable description of the epidemiological situation due to HAI. Efforts should be undertaken in order to implement wide net of hospital acquired infections, including SSI on the country level.

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 Infectious events in patients with severe COVID-19: results of a cohort of patients with high prevalence of underlying immune defect

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anastasia Saade ◽  
Giulia Moratelli ◽  
Guillaume Dumas ◽  
Asma Mabrouki ◽  
Jean-Jacques Tudesq ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cumulative Incidence ◽  
Cumulative Risk ◽  
Incidence Density ◽  
Hospital Acquired Infections ◽  
Underlying Malignancy ◽  
Single Center Study ◽  
High Prevalence ◽  
Immune Defect ◽  
Hospital Acquired

Abstract Background Empirical antibiotic has been considered in severe COVID-19 although little data are available regarding concomitant infections. This study aims to assess the frequency of infections, community and hospital-acquired infections, and risk factors for infections and mortality during severe COVID-19. Methods Retrospective single-center study including consecutive patients admitted to the intensive care unit (ICU) for severe COVID-19. Competing-risk analyses were used to assess cumulative risk of infections. Time-dependent Cox and fine and gray models were used to assess risk factors for infections and mortality. Propensity score matching was performed to estimate the effect of dexamethasone. Results We included 100 patients including 34 patients with underlying malignancies or organ transplantation. First infectious event was bacterial for 35 patients, and fungal for one. Cumulative incidence of infectious events was 27% [18–35] at 10 ICU-days. Prevalence of community-acquired infections was 7% [2.8–13.9]. Incidence density of hospital-acquired infections was 125 [91–200] events per 1000 ICU-days. Risk factors independently associated with hospital-acquired infections included MV. Patient’s severity and underlying malignancy were associated with mortality. Dexamethasone was associated with increased infections (36% [20–53] vs. 12% [4–20] cumulative incidence at day-10; p = 0.01). After matching, dexamethasone was associated with hospital-acquired infections (35% [18–52] vs. 13% [1–25] at 10 days, respectively, p = 0.03), except in the subset of patients requiring MV, and had no influence on mortality. Conclusions In this population of COVID-19 patients with high prevalence of underlying immune defect, a high risk of infections was noted. MV and use of steroids were independently associated with infection rate.

scholarly journals Assessing Knowledge, Attitude, and Practices on Hospital Acquired Infections Control by Anaesthesia Practitioners in the Operating Theatres of the Tamale Teaching Hospital (TTH); Ghana

2020 ◽  
Vol 5 (06) ◽  
Author(s):  
Martin Mumuni Danaah Malick ◽  
Edem Yao Akpa ◽  
Peter Paul Bamaalabong
Keyword(s):  
Infection Control ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Face To Face ◽  
Hospital Acquired Infections ◽  
Hospital Infection Control ◽  
Operating Theatres ◽  
Control And Prevention ◽  
Healthcare Associated ◽  
Hospital Acquired

Background: Hospital Acquired Infections (HAIs) place a significant economic burden on the healthcare system. Infection control practices are important in minimizing healthcare associated infections. However, low compliance with Universal and Standard Precautions has been reported in a number of studies. The Centre for Disease Control and Prevention (CDC) developed baseline definitions for HAIs that were republished in 2004 and has defined HAIs as those that develop during hospitalization but are neither present nor incubating upon the patient’s admission to the hospital; generally, these infections occur between 48 to 72 hours after admission and within 10 days after hospital discharge. this study aimed at unveiling the level of knowledge, attitude and practices on infection prevention control in the operating theatres by anaesthesia practitioners at TTH. Materials and Methods: A cross-sectional study design was employed. A mixed-method approach was used for data collection which includes a structured questionnaire carried out via face to face interview and observation. Results: The study showed that 100% of the respondents have knowledge on hospital acquired infection control in the theatre in one way or the other whereas attitude and practices toward hospital infection control in the operating theatres are undesirable in some specific areas of infection control such as wearing of sterile gowns and goggle. As high as 80.6% and 69.4% do not wear goggle and gowns respectively whilst performing regional anaesthesia.  Conclusions:  This study demonstrated that anaesthetists at TTH have reported sub-optimal levels of compliance i.e. attitude and practices with selective infection control. The study further demonstrated that discrepancies exist between anaesthetists’ attitudes towards a guideline as well as their actual practice.

scholarly journals Editorial

1996 ◽  
Vol 1 (4) ◽  
pp. 25-32
Author(s):  
Collective Editorial Committee
Keyword(s):  
Communicable Diseases ◽  
Stages Of Development ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
And Control

Eurosurveillance this month presents European liaisons for the surveillance and control of communicable diseases at different stages of development. HELICS - the scheme for standardising the data collected about hospital acquired infections - has come and

scholarly journals 819. Antibiotic Resistance in Pathogens Causing Hospital Acquired Infections in Brazil: A Multicenter Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S502-S503
Author(s):  
Carlos Starling ◽  
Bráulio R G M Couto ◽  
Estevão Urbano Silva ◽  
Virginia Andrade ◽  
Edna M M Leite ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Healthcare Associated Infections ◽  
Gram Positive ◽  
Resistance Profile ◽  
Hospital Acquired Infections ◽  
Microbiological Methods ◽  
Belo Horizonte ◽  
Healthcare Associated ◽  
Hospital Acquired

Abstract Background In the present study we determined the prevalence of antibiotic resistance in the most common organisms causing healthcare-associated infections in tertiary-care hospitals in Belo Horizonte, a 3,000,000 inhabitants city from Brazil. Methods Microbiology data of hospital acquired infections (HAI) defined by the National Healthcare Safety Network (NHSN)/CDC protocols of seven general hospitals were analyzed: three public institutions, two philanthropic, and two private hospitals. Samples from different topographies were plate in an ideal culture medium and after growth, the microorganisms were identified by standard biochemical and microbiological methods, using the VITEK 2 compact system (Biomerieux), which allows the simultaneous identification of Gram-positive and Gram bacteria -negative and combine the identification and TSA results in a single report. Six hospitals used automated methods and one institution used manual method for antimicrobial susceptibility testing. Results Samples of seven Gram-negative and two Gram-positive bacteria collected between Dec/2019-Nov/2020 from HAI isolates were analyzed: 565 Klebsiella, 293 Escherichia coli, 153 Proteus, 403 Pseudomonas, 275 Acinetobacter, 174 Serratia, 153, 361 Staphylococcus aureus, and 176 Enterococcus. Antibiotic resistance profile of each strain is summarized in Figures 1, 2, and 3. Resistance profile: Klebsiella, E. coli, Proteus. ATB profile: Pseudomonas, Acinetobacter, Serratia. ATB profile: Enterobacter, S. aureus, Enterococcus . Conclusion Benchmarks for antibiotic resistance in the most common organisms causing healthcare-associated infections were defined, and can be used as indicators for healthcare assessment, specially in developing countries institutions. Disclosures All Authors: No reported disclosures

scholarly journals Etiologic Agents and Antibiotic Resistance Pattern of Community- and Hospital-Acquired Infections

2018 ◽  
Vol 25 (1) ◽  
pp. 41-48
Author(s):  
Mohammad Mahdi Majzoobi ◽  
Azar Pirdehghan ◽  
Zahra Rashidian ◽  
Ali Saadatmand ◽  
◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Pattern ◽  
Hospital Acquired Infections ◽  
Antibiotic Resistance Pattern ◽  
Etiologic Agents ◽  
Hospital Acquired

scholarly journals Characterising within-hospital SARS-CoV-2 transmission events: a retrospective analysis integrating epidemiological and viral genomic data from a UK tertiary care setting across two pandemic waves

2021 ◽  
Author(s):  
Benjamin B Lindsey ◽  
Ch. Julián Villabona-Arenas ◽  
Finlay Campbell ◽  
Alexander J Keeley ◽  
Matthew D Parker ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Rapid Identification ◽  
Control Measures ◽  
Hospital Acquired Infections ◽  
Prevention And Control Measures ◽  
Hospital Acquired ◽  
And Control ◽  
Second Wave

Objectives - To characterise within-hospital SARS-CoV-2 transmission across two waves of the COVID-19 pandemic. Design - A retrospective Bayesian modelling study to reconstruct transmission chains amongst 2181 patients and healthcare workers using combined viral genomic and epidemiological data. Setting - A large UK NHS Trust with over 1400 beds and employing approximately 17,000 staff. Participants - 780 patients and 522 staff testing SARS-CoV-2 positive between 1st March 2020 and 25th July 2020 (Wave 1); and 580 patients and 299 staff testing SARS-CoV-2 positive between 30th November 2020 and 24th January 2021 (Wave 2). Main outcome measures - Transmission pairs including who-infected-whom; location of transmission events in hospital; number of secondary cases from each individual, including differences in onward transmission from community and hospital onset patient cases. Results - Staff-to-staff transmission was estimated to be the most frequent transmission type during Wave 1 (31.6% of observed hospital-acquired infections; 95% CI 26.9 to 35.8%), decreasing to 12.9% (95% CI 9.5 to 15.9%) in Wave 2. Patient-to-patient transmissions increased from 27.1% in Wave 1 (95% CI 23.3 to 31.4%) to 52.1% (95% CI 48.0 to 57.1%) in Wave 2, to become the predominant transmission type. Over 50% of hospital-acquired infections were concentrated in 8/120 locations in Wave 1 and 10/93 locations in Wave 2. Approximately 40% to 50% of hospital-onset patient cases resulted in onward transmission compared to less than 4% of definite community-acquired cases. Conclusions - Prevention and control measures that evolved during the COVID-19 pandemic may have had a significant impact on reducing infections between healthcare workers, but were insufficient during the second wave to prevent a high number of patient-to-patient transmissions. As hospital-acquired cases appeared to drive most onward transmissions, more frequent and rapid identification and isolation of these cases will be required to break hospital transmission chains in subsequent pandemic waves

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