scholarly journals Evaluation of the increase in invasive device associated infections in cardiovascular surgical intensive care unit

2018 ◽  
Vol 12 (07) ◽  
pp. 508-513
Author(s):  
Esra Kaya Kılıç ◽  
Cemal Bulut ◽  
Muzaffer Çeliköz ◽  
Günay Tuncer Ertem ◽  
Çiğdem Ataman Hatipoğlu ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Health Care Professionals ◽  
Cardiovascular Surgery ◽  
Control Measures ◽  
Surgical Intensive Care Unit ◽  
Hospital Infections ◽  
Surgical Intensive Care

Introduction: Infections related to the use of invasive instruments leads to the risk of treatment difficulties, prolonged hospitalization, increased health care costs, and increased mortality and morbidity rates. The present study examines the results of an infection surveillance study that showed an increased incidence of infections related to the use of invasive instruments in the cardiovascular surgery intensive care unit of the Ankara Training and Research Hospital and mitigating measures were taken following the surveillance program. Methodology: Compared with previous surveillance data, an increase was observed in the incidence of infections related to the use of invasive instruments in cardiovascular surgery intensive care unit (CVS-ICU) during the first six months of 2014. A research team was formed comprising one infectious diseases and microbiology specialist, one cardiovascular surgeon, and two infection-control nurses. Patient data was collected. The compliance of the surgeons, nurses, and other health care professionals to the infection control measures was evaluated. Results: The rate of ventilator-associated pneumonia was 8.20% and the rate of catheter-associated urinary tract infection was 4.47% in the CVS-ICU. There were missing or inadvertent practices regarding antibiotic prophylaxis, asepsis and antisepsis and isolation measures in patient preparation and patient care before and after the operations. The rate of inappropriate antibiotic as prolonged use was 72%. Conclusions: It is one of the basic tasks to take appropriate measures to prevent outbreaks of hospital infections. It is possible to prevent an outbreak of hospital infections only by the accurate analysis of data and establishing strict infection control procedures.

scholarly journals Chlorhexidine Gluconate Bathing Program to Reduce Health Care–Associated Infections in Both Critically Ill and Non–Critically Ill Patients

2021 ◽  
Vol 41 (5) ◽  
pp. e1-e8
Author(s):  
Leigh Chapman ◽  
Lisa Hargett ◽  
Theresa Anderson ◽  
Jacqueline Galluzzo ◽  
Paul Zimand
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Chlorhexidine Gluconate ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Telemetry Unit ◽  
Health Care Associated Infections ◽  
The Impact

Background Critical care nurses take care of patients with complicated, comorbid, and compromised conditions. These patients are at risk for health care–associated infections, which affect patients’ lives and health care systems in various ways. Objective To gauge the impact of routinely bathing patients with 4% chlorhexidine gluconate solution on the incidence of health care–associated infections in a medical-surgical intensive care unit and a postoperative telemetry unit; to outline the framework for a hospital-wide presurgical chlorhexidine gluconate bathing program and share the results. Methods A standard bathing protocol using a 4% chlorhexidine gluconate solution was developed. The protocol included time studies, training, monitoring, and surveillance of health care–associated infections. Results Consistent patient bathing with 4% chlorhexidine gluconate was associated with a 52% reduction in health care–associated infections in a medical-surgical intensive care unit. The same program in a postoperative telemetry unit yielded a 45% reduction in health care–associated infections. Conclusion A comprehensive daily 4% chlorhexidine gluconate bathing program can be implemented with standardized protocols and detailed instructions and can significantly reduce the incidence of health care–associated infections in intensive care unit and non–intensive care unit hospital settings.

Epidemiologic, Clinical, and Economic Evaluation of an Outbreak of Clonal Multidrug-ResistantAcinetobacter baumanniiInfection in a Surgical Intensive Care Unit

2007 ◽  
Vol 28 (11) ◽  
pp. 1247-1254 ◽  
Author(s):  
Lisa S. Young ◽  
Allison L. Sabel ◽  
Connie S. Price
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Significant Risk ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Duration Of Hospitalization ◽  
Tract Infections ◽  
Pulsatile Lavage

Objectives.To determine risk factors for acquisition of multidrug-resistant (MDR)Acinetobacter baumanniiinfection during an outbreak, to describe the clinical manifestations of infection, and to ascertain the cost of infection.Design.Case-control study.Setting.Surgical intensive care unit in a 400-bed urban teaching hospital and level 1 trauma center.Patients.Case patients received a diagnosis of infection due toA. baumanniiisolates with a unique pattern of drug resistance (ie, susceptible to imipenem, variably susceptible to aminoglycosides, and resistant to all other antibiotics) between December 1, 2004, and August 31, 2005. Case patients were matched 1 : 1 with concurrently hospitalized control patients. Isolates' genetic relatedness was established by pulsed-field gel electrophoresis.Results.Sixty-seven patients met the inclusion criteria. Case and control patients were similar with respect to age, duration of hospitalization, and Charlson comorbidity score. MDRA. baumanniiinfections included ventilator-associated pneumonia (in 56.7% of patients), bacteremia (in 25.4%), postoperative wound infections (in 25.4%), central venous catheter-associated infections (in 20.9%), and urinary tract infections (in 10.4%). Conditional multiple logistic regression was used to determine statistically significant risk factors on the basis of results from the bivariate analyses. The duration of hospitalization and healthcare charges were modeled by multiple linear regression. Significant risk factors included higher Acute Physiology and Chronic Health Evaluation II score (odds ratio [OR], 1.1 per point increase;P= .06), duration of intubation (OR, 1.4 per day intubated;P<.01), exposure to bronchoscopy (OR, 22.7;P= .03), presence of chronic pulmonary disease (OR, 77.7;P= .02), receipt of fluconazole (OR, 73.3;P<.01), and receipt of levofloxacin (OR, 11.5;P= .02). Case patients had a mean of $60,913 in attributable excess patient charges and a mean of 13 excess hospital days.Interventions.Infection control measures included the following: limitations on the performance of pulsatile lavage wound debridement, the removal of items with upholstered surfaces, and the implementation of contact isolation for patients with suspected MDRA. baumanniiinfection.Conclusions.This large outbreak of infection due to clonal MDRA. baumanniicaused significant morbidity and expense. Aerosolization of MDRA. baumanniiduring pulsatile lavage debridement of infected wounds and during the management of respiratory secretions from colonized and infected patients may promote widespread environmental contamination. Multifaceted infection control interventions were associated with a decrease in the number of MDRA. baumanniiisolates recovered from patients.

Effectiveness of Surveillance of Central Catheter-Related Bloodstream Infection in an ICU in Korea

2001 ◽  
Vol 22 (7) ◽  
pp. 433-436 ◽  
Author(s):  
Sunmi Yoo ◽  
Mina Ha ◽  
Daeok Choi ◽  
Hyunjoo Pai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Intervention Period ◽  
Active Infection ◽  
Surgical Intensive Care ◽  
And Control

AbstractObjective:To determine whether surveillance and infection control interventions decrease the incidence of catheter-related (CR) bloodstream infections (BSIs) in Korea.Setting:A medical-surgical intensive care unit (ICU) of a university hospital in Korea.Design:The CR infection rate of the intervention period was compared to that of historical controls for a 4-month period.Patients:All patients with a central venous catheter in the intensive care unit (ICU) from October 1998 to January 1999.Methods:Active infection control programs were initiated during the intervention period. Data collected included patient characteristics, risk factors of CR infection, and the microbiology laboratory results. Laboratory-proven CR infection rates were compared between the intervention group and control group.Results:304 catheters were inserted into 248 patients. The intervention group and the control group showed similar characteristics, but more patients in the intervention group received steroid therapy, and subclavian insertion was more common in the intervention group. CR BSI occurred in 1.3 per 1,000 catheter-days in the intervention group and 4.2 in the control group (binomial test, P=.14). CR infections were associated with the duration of ICU admission by multivariate logistic regression.Conclusions:The data suggested that an active infection surveillance and control program could reduce the rate of CR BSI in an ICU.

Dissemination of Bacillus cereus in an Intensive Care Unit

1993 ◽  
Vol 14 (8) ◽  
pp. 459-462 ◽  
Author(s):  
E.A. Bryce ◽  
J.A. Smith ◽  
M. Tweeddale ◽  
B.J. Andruschak ◽  
M.R. Maxwell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacillus Cereus ◽  
Tertiary Care ◽  
Control Measures ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Surgical Intensive Care ◽  
Assembly Area ◽  
Effective Manner

AbstractObjective:To report the contamination of ventilator equipment with Bacillus cereus and to outline the measures taken to trace the source of the organism.Design:A prospective survey of all intensive care unit patients who were culture-positive for B cereus and obtaining of environmental cultures of the cleaning and assembly area of the respiratory services division between October 1991 and September 1992.Setting And Patients:Ventilated patients from a 16-bed medical and surgical intensive care unit (ICU) in a 1,000-bed adult tertiary care hospital.Interventions And Results:From October 1991 to April 1992, B cereus colonized the ventilator circuitry of patients in the ICU. One of two washer/decontaminators in the cleaning and assembly area of the respiratory services division was found to yield the microorganism consistently from the water intake port. The design of the machine precluded easy decontamination of the port with 2% gluteraldehyde and a second outbreak occurred. Following the second outbreak, aqueous chlorhexidine in a final concentration of 0.05% was added to the first of two pasteurization cycles in an attempt to achieve sporicidal activity. This ended the outbreak. Sixty-two patients became colonized with the organism including two with nonfatal Bacillus sepsis and one death due to pneumonia associated with the organism.Conclusion:This experience emphasizes the importance of obtaining cultures of machine parts to identify the source of contamination and thereby direct control measures. Use of chlor-hexidine gluconate at high temperatures effectively eradicated B cereus from ventilator circuitry in a practical and cost-effective manner.

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