scholarly journals Spatial Patterns in Hospital-Acquired Infections in Portugal (2014–2017)

2021 ◽  
Vol 18 (9) ◽  
pp. 4703
Author(s):  
Hugo Teixeira ◽  
Alberto Freitas ◽  
António Sarmento ◽  
Paulo Nossa ◽  
Hernâni Gonçalves ◽  
...  
Keyword(s):  
Spatial Patterns ◽  
Empirical Bayes ◽  
Hospital Admissions ◽  
Healthcare Delivery ◽  
Entire Study ◽  
Local Index ◽  
Hospital Acquired Infections ◽  
Spatial Inequalities ◽  
Tract Infections ◽  
Hospital Acquired

Background: Hospital-Acquired Infections (HAIs) represent the most frequent adverse event associated with healthcare delivery and result in prolonged hospital stays and deaths worldwide. Aim: To analyze the spatial patterns of HAI incidence from 2014 to 2017 in Portugal. Methods: Data from the Portuguese Discharge Hospital Register were used. We selected episodes of patients with no infection on admission and with any of the following HAI diagnoses: catheter-related bloodstream infections, intestinal infections by Clostridium difficile, nosocomial pneumonia, surgical site infections, and urinary tract infections. We calculated age-standardized hospitalization rates (ASHR) by place of patient residence. We used empirical Bayes estimators to smooth the ASHR. The Moran Index and Local Index of Spatial Autocorrelation (LISA) were calculated to identify spatial clusters. Results: A total of 318,218 HAIs were registered, with men accounting for 49.8% cases. The median length of stay (LOS) was 9.0 days, and 15.7% of patients died during the hospitalization. The peak of HAIs (n = 81,690) occurred in 2015, representing 9.4% of the total hospital admissions. Substantial spatial inequalities were observed, with the center region presenting three times the ASHR of the north. A slight decrease in ASHR was observed after 2015. Pneumonia was the most frequent HAI in all age groups. Conclusion: The incidence of HAI is not randomly distributed in the space; clusters of high risk in the central region were seen over the entire study period. These findings may be useful to support healthcare policymakers and to promote a revision of infection control policies, providing insights for improved implementation.

HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

2016 ◽  
pp. 39-43
Author(s):  
Dinh Binh Tran ◽  
Dinh Tan Tran
Keyword(s):  
Surgical Site Infection ◽  
Surgical Intervention ◽  
University Hospital ◽  
Hospital Infections ◽  
Site Infection ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

scholarly journals Attitude of health care professional students towards hand hygiene

2019 ◽  
Vol 6 (9) ◽  
pp. 3969
Author(s):  
Rintu Jayan ◽  
Riya Paul ◽  
Riyamol Abraham ◽  
Riyamol Roy ◽  
Roniya Dominic ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Care Professionals ◽  
Attitude Scale ◽  
Research Approach ◽  
Entire Study ◽  
Professional Students ◽  
Hospital Acquired Infections ◽  
Study Results ◽  
Hospital Acquired

Background: Hands are the principal route of nosocomial infections or hospital acquired infections or health associated infections. Hand hygiene is effective in reducing infection rates. Hand hygiene among the health care professionals play a pivotal role in preventing the transmission of hospital acquired infections. The aim of the study was to assess the attitude regarding hand hygiene among students of healthcare professions.Methods: Quantitative research approach and descriptive survey design were used for the study. The purposive sampling technique was adopted to select 100 samples, 25 each from MBBS, BDS, B.Sc. Nursing and BPT. A structured attitude scale was used to collect the data. The collected data was analyzed using descriptive and inferential statistics.Results: The study results showed that majorities (55%) of sample were in the age of 22 years, majorities (90%) were females, and majority (98%) of sample had previous information regarding hand hygiene. The entire study sample had favorable attitudes towards hand hygiene. The study showed a significant association between attitude scores and receiving previous information on hand hygiene.Conclusions: The study concluded that health professional students have favorable attitude towards hand hygiene. 

scholarly journals Financial Incentives to Reduce Hospital-Acquired Infections Under Alternative Payment Arrangements

2018 ◽  
Vol 39 (5) ◽  
pp. 509-515 ◽  
Author(s):  
Catherine Crawford Cohen ◽  
Jianfang Liu ◽  
Bevin Cohen ◽  
Elaine L. Larson ◽  
Sherry Glied
Keyword(s):  
Patient Safety ◽  
Financial Incentives ◽  
Improve Patient Safety ◽  
Tertiary Care ◽  
Hospital Costs ◽  
Urban Hospital ◽  
Hospital System ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

OBJECTIVEThe financial incentives for hospitals to improve care may be weaker if higher insurer payments for adverse conditions offset a portion of hospital costs. The purpose of this study was to simulate incentives for reducing hospital-acquired infections under various payment configurations by Medicare, Medicaid, and private payers.DESIGNMatched case-control study.SETTINGA large, urban hospital system with 1 community hospital and 2 tertiary-care hospitals.PATIENTSAll patients discharged in 2013 and 2014.METHODSUsing electronic hospital records, we identified hospital-acquired bloodstream infections (BSIs) and urinary tract infections (UTIs) with a validated algorithm. We assessed excess hospital costs, length of stay, and payments due to infection, and we compared them to those of uninfected patients matched by propensity for infection.RESULTSIn most scenarios, hospitals recovered only a portion of excess HAI costs through increased payments. Patients with UTIs incurred incremental costs of $6,238 (P<.01), while payments increased $1,901 (P<.05) at public diagnosis-related group (DRG) rates. For BSIs, incremental costs were $15,367 (P<.01), while payments increased $7,895 (P<.01). If private payers reimbursed a 200% markup over Medicare DRG rates, hospitals recovered 55% of costs from BSI and UTI among private-pay patients and 54% for BSI and 33% for UTI, respectively, across all patients. Under per-diem payment for private patients with no markup, hospitals recovered 71% of excess costs of BSI and 88% for UTI. At 150% markup and per-diem payments, hospitals profited.CONCLUSIONSHospital incentives for investing in patient safety vary by payer and payment configuration. Higher payments provide resources to improve patient safety, but current payment structures may also reduce the willingness of hospitals to invest in patient safety.Infect Control Hosp Epidemiol 2018;39:509–515

scholarly journals The Impact of COVID-19 on the Profile of Hospital-Acquired Infections in Adult Intensive Care Units

Antibiotics ◽  
2021 ◽  
Vol 10 (10) ◽  
pp. 1146
Author(s):  
Aleksa Despotovic ◽  
Branko Milosevic ◽  
Andja Cirkovic ◽  
Ankica Vujovic ◽  
Ksenija Cucanic ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Concern ◽  
Positive Trend ◽  
Hospital Acquired Infections ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Resistance Rates ◽  
Hospital Acquired ◽  
The Impact

Hospital-acquired infections (HAIs) are a global public health concern. As the COVID-19 pandemic continues, its contribution to mortality and antimicrobial resistance (AMR) grows, particularly in intensive care units (ICUs). A two-year retrospective study from April 2019–April 2021 was conducted in an adult ICU at the Hospital for Infectious and Tropical Diseases, Belgrade, Serbia to assess causative agents of HAIs and AMR rates, with the COVID-19 pandemic ensuing halfway through the study. Resistance rates >80% were observed for the majority of tested antimicrobials. In COVID-19 patients, Acinetobacter spp. was the dominant cause of HAIs and more frequently isolated than in non-COVID-19 patients. (67 vs. 18, p = 0.001). Also, resistance was higher for imipenem (56.8% vs. 24.5%, p < 0.001), meropenem (61.1% vs. 24.3%, p < 0.001) and ciprofloxacin (59.5% vs. 36.9%, p = 0.04). AMR rates were aggregated with findings from our previous study to identify resistance trends and establish empiric treatment recommendations. The increased presence of Acinetobacter spp. and a positive trend in Klebsiella spp. resistance to fluoroquinolones (R2 = 0.980, p = 0.01) and carbapenems (R2 = 0.963, p = 0.02) could have contributed to alarming resistance rates across bloodstream infections (BSIs), pneumonia (PN), and urinary tract infections (UTIs). Exceptions were vancomycin (16.0%) and linezolid (2.6%) in BSIs; tigecycline (14.3%) and colistin (0%) in PNs; and colistin (12.0%) and linezolid (0%) in UTIs. COVID-19 has changed the landscape of HAIs in our ICUs. Approval of new drugs and rigorous surveillance is urgently needed.

scholarly journals Urinary tract infections in children

2018 ◽  
Vol 60 (1) ◽  
pp. 35-40
Author(s):  
Elzbieta Osuch ◽  
Andre Marais
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Recurrent Utis ◽  
Hospital Acquired Infections ◽  
Diagnostic Studies ◽  
Tract Infections ◽  
Hospital Acquired

Urinary tract infections (UTIs) are common in childhood and represent approximately 10% of hospital-acquired infections. It is clinically challenging to distinguish cystitis (lower UTI) from pyelonephritis (upper UTI) in those younger than two years. Most UTI patients can however be safely managed as outpatients if diligent follow-up procedures are in place. Recurrent UTIs in children may indicate malfunction or an anatomical defect of the urinary tract, and require specialised diagnostic studies. The proper approach for a child with UTI remains controversial, and treatment often differs according to regional or institutional empirical guidelines.

Modern Trends in Infection Control Practices in Intensive Care Units

2013 ◽  
Vol 29 (6) ◽  
pp. 311-326 ◽  
Author(s):  
Sumanth Gandra ◽  
Richard T. Ellison
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Environmental Cleaning ◽  
Hospital Acquired Infections ◽  
New Methods ◽  
Tract Infections ◽  
Hospital Acquired

Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection.

scholarly journals Healthcare Associated Infections—A New Pathology in Medical Practice?

2020 ◽  
Vol 17 (3) ◽  
pp. 760 ◽  
Author(s):  
Septimiu Voidazan ◽  
Sorin Albu ◽  
Réka Toth ◽  
Bianca Grigorescu ◽  
Anca Rachita ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Intensive Care Units ◽  
Public Hospitals ◽  
Hospital Acquired Infections ◽  
Clostridioides Difficile ◽  
Tract Infections ◽  
Hospital Acquired

Background: Hospital-acquired infections (HAI) contribute to the emotional stress and functional disorders of the patient and in some cases, can lead to a state of disability that reduces quality of life. Often, HAI are one of the factors that lead to death. The purpose of this study was to analyze the cases of HAI identified in public hospitals at the county level, through case report sheets, as they are reported according to the Romanian legislation. Methods: We performed a cross sectional study design based on the case law of the data reported to the Mures Public Health Directorate, by all the public hospitals belonging to this county. We tracked hospital-acquired infections reported for 2017–2018, respectively, a number of 1024 cases, which implies a prevalence rate of 0.44%, 1024/228,782 cases discharged from these hospitals during the studied period. Results: The most frequent HAIs were reported by the intensive care units (48.4%), the most common infections being the following: bronchopneumonia (25.3%), enterocolitis with Clostridioides difficile (23.3%), sepsis, surgical wound infections and urinary tract infections. At the basis of HAI were 22 pathogens, but the five most common germs were Clostridioides difficile, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Bronchopneumonia have been most frequently reported in intensive care units, the most common being identified the Acinetobacter baumannii agent. Sepsis and central catheter infections also appeared predominantly in intensive care units, more often with Klebsiella pneumoniae. The enterocolitis with Clostridioides difficile, were the apanage of the medical sections. Infections with Staphylococcus aureus have been identified predominantly in the surgical sections at the level of the surgical wounds. Urinary infections had a similar distribution in the intensive care units, the medical and surgical sections, with Klebsiella pneumoniae being the most commonly incriminated agent. Conclusions: We showed a clear correspondence between the medical units and the type of HAI: what recommends the rapid, vigilant and oriented application of the prevention and control strategies of the HAI.

scholarly journals A Multifaceted Approach to Reduction of Catheter-Associated Urinary Tract Infections in the Intensive Care Unit With an Emphasis on “Stewardship of Culturing”

2016 ◽  
Vol 38 (2) ◽  
pp. 186-188 ◽  
Author(s):  
Katherine M. Mullin ◽  
Christopher S. Kovacs ◽  
Cynthia Fatica ◽  
Colette Einloth ◽  
Elizabeth A. Neuner ◽  
...  
Keyword(s):  
Critical Care ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Critically Ill Patient ◽  
Multifaceted Approach ◽  
Hospital Acquired Infections ◽  
Control And Prevention ◽  
Tract Infections ◽  
Hospital Acquired ◽  
Successful Reduction

BACKGROUNDCatheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications.OBJECTIVETo implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture.METHODSA project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs. Interventions implemented between year 1 and year 2 included protocols recommended by the Centers for Disease Control and Prevention for placement, maintenance, and removal of catheters. Leaders from all critical care disciplines agreed to align routine culturing practice with American College of Critical Care Medicine (ACCCM) and Infectious Disease Society of America (IDSA) guidelines for evaluating a fever in a critically ill patient. Surveillance data for CAUTI and hospital-acquired bloodstream infection (HABSI) were recorded prospectively according to National Healthcare Safety Network (NHSN) protocols. Device utilization ratios (DURs), rates of CAUTI, HABSI, and urine cultures were calculated and compared.RESULTSThe CAUTI rate decreased from 3.0 per 1,000 catheter days in 2013 to 1.9 in 2014. The DUR was 0.7 in 2013 and 0.68 in 2014. The HABSI rates per 1,000 patient days decreased from 2.8 in 2013 to 2.4 in 2014.CONCLUSIONSEffectively reducing ICU CAUTI rates requires a multifaceted and collaborative approach; stewardship of culturing was a key and safe component of our successful reduction efforts.Infect Control Hosp Epidemiol 2017;38:186–188

scholarly journals A Serendipitous Mutation Reveals the Severe Virulence Defect of a Klebsiella pneumoniae fepB Mutant

mSphere ◽  
2017 ◽  
Vol 2 (4) ◽  
Author(s):  
Michelle Palacios ◽  
Christopher A. Broberg ◽  
Kimberly A. Walker ◽  
Virginia L. Miller
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Klebsiella Pneumoniae ◽  
Drug Targets ◽  
Carbapenem Resistance ◽  
Content Type ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired ◽  
Rapid Emergence

ABSTRACT In addition to having a reputation as the causative agent of several types of hospital-acquired infections, Klebsiella pneumoniae has gained widespread attention as a pathogen with a propensity for acquiring antibiotic resistance. It is capable of causing a range of infections, including urinary tract infections, pneumonia, and sepsis. Because of the rapid emergence of carbapenem resistance among Klebsiella strains, there is a dire need for a better understanding of virulence mechanisms and identification of new drug targets. Here, we identify the periplasmic transporter FepB as one such potential target. Klebsiella pneumoniae is considered a significant public health threat because of the emergence of multidrug-resistant strains and the challenge associated with treating life-threatening infections. Capsule, siderophores, and adhesins have been implicated as virulence determinants of K. pneumoniae, yet we lack a clear understanding of how this pathogen causes disease. In a previous screen for virulence genes, we identified a potential new virulence locus and constructed a mutant (smr) with this locus deleted. In this study, we characterize the smr mutant and show that this mutation renders K. pneumoniae avirulent in a pneumonia model of infection. The smr mutant was expected to have a deletion of three genes, but subsequent genome sequencing indicated that a much larger deletion had occurred. Further analysis of the deleted region indicated that the virulence defect of the smr mutant could be attributed to the loss of FepB, a periplasmic protein required for import of the siderophore enterobactin. Interestingly, a ΔfepB mutant was more attenuated than a mutant unable to synthesize enterobactin, suggesting that additional processes are affected. As FepB is highly conserved among the members of the family Enterobacteriaceae, therapeutic targeting of FepB may be useful for the treatment of Klebsiella and other bacterial infections. IMPORTANCE In addition to having a reputation as the causative agent of several types of hospital-acquired infections, Klebsiella pneumoniae has gained widespread attention as a pathogen with a propensity for acquiring antibiotic resistance. It is capable of causing a range of infections, including urinary tract infections, pneumonia, and sepsis. Because of the rapid emergence of carbapenem resistance among Klebsiella strains, there is a dire need for a better understanding of virulence mechanisms and identification of new drug targets. Here, we identify the periplasmic transporter FepB as one such potential target.

scholarly journals Sensitivity of Antibiotics Containing Citrobacter Bacteria

2019 ◽  
Author(s):  
A Dohtukaeva ◽  
L Molochaeva ◽  
Y Usaeva ◽  
F Turlova ◽  
T Khasanov ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Soft Tissues ◽  
Infectious Agents ◽  
Opportunistic Pathogens ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Abdominal Infections ◽  
Hospital Acquired

Enterobacteria are one of the most common infectious agents among opportunistic pathogens. Both among community-acquired and hospital-acquired infections, such as intestinal and extra-intestinal localization (urinary, respiratory tract infections, intra-abdominal infections, skin and soft tissues, as well as generalized infections), the cases with resistant citrobacteria are quite common to observe. Recently, Citrobacter bacteria are getting widely spread as determinants of antibiotic resistance through its representatives. This fact greatly complicates the therapy towards infections.

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