scholarly journals Application of a Novel PM Model to Assess the Risk of Clostridioides difficile Infections in Medical Facilities as a Tool for Improving the Quality of Health Services and the Safety of Patients

Author(s):  
Zofia Maria Kiersnowska ◽  
Ewelina Lemiech-Mirowska ◽  
Aleksandra Sierocka ◽  
Michał Zawadzki ◽  
Michał Michałkiewicz ◽  
...  

Infections with multi-drug resistant microorganisms associated with the provision of health services have become an acute problem worldwide. These infections cause increased morbidity as well as mortality and are a financial burden for the healthcare system. Effective risk management can reduce the spread of infections and thus minimize their number in hospitalized patients. We have developed a new approach to the analysis of hazards and of exposure to the risk of adverse events by linking the patient’s health record system to the entire infrastructure of the hospital unit. In this study, using the developed model, we focused on infections caused by the Clostridioides difficile bacterium, as they constitute a significant number of nosocomial infections in Poland and worldwide. The study was conducted in a medical facility located in the central part of Poland which provides tertiary care. In the proposed PM model, a risk analysis of hospital acquired infections at the Intensive Care and Anesthesiology Unit combined with the hospital’s technical facilities and organizational factors was conducted. The obtained results indicate the most critical events which may have an impact on potential hazards or risks which may result from the patient’s stay at the specific ward. Our method can be combined with an anti-problem approach, which minimizes the critical level of infection in order to determine the optimal functioning of the entire hospital unit. Research has shown that in most situations the spread dynamics of nosocomial infections can be controlled and their elimination may be attempted. In order to meet these conditions, the persons responsible for the daily operation of the medical facility and its individual wards have to indicate potential events and factors which present a risk to the hospitalized patients. On the basis of a created spreadsheet directions for improvement may be finally established for all potential events, their frequency may be minimized, and information may be obtained on actions which should be undertaken in a crisis situation caused by the occurrence of a given phenomenon. We believe that the proposed method is effective in terms of risk reduction, which is important for preventing the transmission of multi-drug resistant microorganisms in the hospital environment.

2020 ◽  
Vol 8 (A) ◽  
pp. 297-302
Author(s):  
Blerta Kika ◽  
Erjona Abazaj ◽  
Oltiana Petri ◽  
Andi Koraqi

AIM: The aim of this study was to evaluate the prevalence of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) in clinical specimens hospitalized to “Mother Theresa” Hospital Center for 2 years. METHODS: We isolated and identified S. aureus on 356 clinical specimens using standard tests. Furthermore, for further accurate microbial identification, we have to use the VITEK® 2 system. The samples were tested to detect the presence of MRSA by a slide latex agglutination kit for the rapid detection of PBP2. RESULTS: The overall prevalence of S. aureus in patients was 34.2%. The prevalence of MRSA was 20.5% of cases. Of the MRSA isolates identified in this study, 28% were susceptible to antibiotics, 24% demonstrated intermediate resistance, and 48% were multi-drug resistant with resistance to nineteen antibiotics involved in the examination. In addition, seven of the 25 MRSA cases showed 100% resistance to norfloxacin, imipenem, meropenem, levofloxacin, etc. CONCLUSIONS: The rate of S. aureus in hospitalized patients on this study was 34.2% and the MRSA 20.5%. These results indicated that this type of infection is a significant concern for health services and patients included. A screening of all hospitalized cases can lead to reduce the incidence of this infection in the hospital environment.


Anaerobe ◽  
2020 ◽  
Vol 61 ◽  
pp. 102081 ◽  
Author(s):  
Amelia K. Sofjan ◽  
Mohammad Aminul Islam ◽  
Kakali Halder ◽  
Nayel D. Kabir ◽  
Ahmed Abu Saleh ◽  
...  

2021 ◽  
Vol 6 (1) ◽  
pp. 1-10
Author(s):  
Amin Sadeghi Dousari ◽  
Naghmeh Satarzadeh

Introduction: The emergence and global spread of carbapenemases produced by Klebsiella pneumoniae is a serious problem to health services worldwide. K. pneumoniae, belonging to the Enterobacteriaceae family, is commonly found in the human gastrointestinal tract and environment, especially in the hospital environment. Carbapenem is administered as the first treatment for severe infections created by multi-drug resistant K. pneumoniae. Despite the fact that the carbapenemase-producing K. pneumoniae has become more prevalent in Iran, few investigations have probed into the prevalence of different carbapenemase genes in Iran. Method: The aim of this study was to examine the prevalence of carbapenemase genes in K. pneumoniae from 2010 to 2018 in Iran. PubMed and Scopus databases were searched for the articles published between 2010 and 2018 in Iran. Results: A total of 25 papers published between 2012 and 2018 were selected. The highest frequency of blaNDM, blaIMP, blaVIM, blaKPC and, blaOXA48 genes were related to cities of Shiraz in 2017 [23 (26.14%)], Hamedan in 2017 [2 (50%)], Babol in 2015 [15 (41.66%)], Isfahan in 2013 [65 (44.83%)] and, and Isfahan in 2018 [90 (76.27%)], respectively. The results showed that the frequency of blaNDM, blaOXA48, and blaIMP genes increased in 2017 and 2018, and there was an increase in the frequency of the blaVIM gene in 2014 and 2015, and the blaKPC gene in 2013. The highest percentage of carbapenemases genes isolated in Iran were related to blaKPC [145 (37.08%)], blaOXA48 [118 (30.18%)], and blaNDM [88 (22.51%)], and the lowest percentages were reported in blaIMP [4 (1.02%)], and blaVIM [36 (9.21%)], respectively. Conclusion: The results of our review showed that blaNDM and blaOXA48 carbapenemase genes have been increasing in Iran, and it seems that traveling is one of the most important factors in the transmission of carbapenemase genes.


2019 ◽  
Vol 13 (2) ◽  
pp. 81
Author(s):  
Monica Cecilia ◽  
Novarianti Novarianti ◽  
Christine Christine

The unhygienic environment of the hospital will allow the transmission of diseases that can affect public health in that hospital.  Therefore, hospital sanitation services need to be organized in order to create a comfortable and clean hospital environment, so that it can support efforts to cure and prevent the transmission of nosocomial infections in the hospital environment.  The purpose of this study was to determine the number of germs on the inpatient bed of District Madani Hospital of Palu.  The method of this study used descriptive with observational approach. The study population was all inpatient beds in Melon, Jambu, Rambutan, Nangka, Semangka, dan Markisa treatment rooms at Madani Regional Hospital of Palu.  The sample of this study was a part of the impatient bed in rooms of Melon 10, Jambu 10, Rambutan 10, Rambutan 9,  Semangka 7, and Markisa 4, which were taken by simple random sampling.  The results showed that the number of germs did not meet the requirements of> 10 colonies / cm².  So it can be concluded that the number of germs on the inpatient bed of the treatment room at the Palu Madani Regional Hospital does not meet the requirements.


Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 630
Author(s):  
Diaa Alrahmany ◽  
Ahmed F. Omar ◽  
Gehan Harb ◽  
Wasim S. El El Nekidy ◽  
Islam M. Ghazi

Background Acinetobacter baumannii (AB), an opportunistic pathogen, could develop into serious infections with high mortality and financial burden. The debate surrounding the selection of effective antibiotic treatment necessitates studies to define the optimal approach. This study aims to compare the clinical outcomes of commonly used treatment regimens in hospitalized patients


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Amit Gaurav ◽  
Varsha Gupta ◽  
Sandeep K. Shrivastava ◽  
Ranjana Pathania

AbstractThe increasing prevalence of antimicrobial resistance has become a global health problem. Acinetobacter baumannii is an important nosocomial pathogen due to its capacity to persist in the hospital environment. It has a high mortality rate and few treatment options. Antibiotic combinations can help to fight multi-drug resistant (MDR) bacterial infections, but they are rarely used in the clinics and mostly unexplored. The interaction between bacteriostatic and bactericidal antibiotics are mostly reported as antagonism based on the results obtained in the susceptible model laboratory strain Escherichia coli. However, in the present study, we report a synergistic interaction between nalidixic acid and tetracycline against clinical multi-drug resistant A. baumannii and E. coli. Here we provide mechanistic insight into this dichotomy. The synergistic combination was studied by checkerboard assay and time-kill curve analysis. We also elucidate the mechanism behind this synergy using several techniques such as fluorescence spectroscopy, flow cytometry, fluorescence microscopy, morphometric analysis, and real-time polymerase chain reaction. Nalidixic acid and tetracycline combination displayed synergy against most of the MDR clinical isolates of A. baumannii and E. coli but not against susceptible isolates. Finally, we demonstrate that this combination is also effective in vivo in an A. baumannii/Caenorhabditis elegans infection model (p < 0.001)


2020 ◽  
Vol 7 (12) ◽  
Author(s):  
Lindsay A Petty ◽  
Valerie M Vaughn ◽  
Scott A Flanders ◽  
Twisha Patel ◽  
Anurag N Malani ◽  
...  

Abstract Background Reducing antibiotic use in patients with asymptomatic bacteriuria (ASB) has been inpatient focused. However, testing and treatment is often started in the emergency department (ED). Thus, for hospitalized patients with ASB, we sought to identify patterns of testing and treatment initiated by emergency medicine (EM) clinicians and the association of treatment with outcomes. Methods We conducted a 43-hospital, cohort study of adults admitted through the ED with ASB (February 2018–February 2020). Using generalized estimating equation models, we assessed for (1) factors associated with antibiotic treatment by EM clinicians and, after inverse probability of treatment weighting, (2) the effect of treatment on outcomes. Results Of 2461 patients with ASB, 74.4% (N = 1830) received antibiotics. The EM clinicians ordered urine cultures in 80.0% (N = 1970) of patients and initiated treatment in 68.5% (1253 of 1830). Predictors of EM clinician treatment of ASB versus no treatment included dementia, spinal cord injury, incontinence, urinary catheter, altered mental status, leukocytosis, and abnormal urinalysis. Once initiated by EM clinicians, 79% (993 of 1253) of patients remained on antibiotics for at least 3 days. Antibiotic treatment was associated with a longer length of hospitalization (mean 5.1 vs 4.2 days; relative risk = 1.16; 95% confidence interval, 1.08–1.23) and Clostridioides difficile infection (CDI) (0.9% [N = 11] vs 0% [N = 0]; P = .02). Conclusions Among hospitalized patients ultimately diagnosed with ASB, EM clinicians commonly initiated testing and treatment; most antibiotics were continued by inpatient clinicians. Antibiotic treatment was not associated with improved outcomes, whereas it was associated with prolonged hospitalization and CDI. For best impact, stewardship interventions must expand to the ED.


Author(s):  
Noor Zaidan ◽  
J. Patrik Hornak ◽  
David Reynoso

Extremely drug resistant (XDR) Acinetobacter baumannii cause challenging nosocomial infections. We report the case of a patient with XDR A. baumannii pneumonia and septic shock successfully treated with cefiderocol and a novel antibiotic obtained via expanded access protocol. With focused research and drug development efforts, the poor outcomes associated with these infections may be mitigated.


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