scholarly journals Three-year study of health care-associated infections in a Turkish pediatric ward

2014 ◽  
Vol 8 (11) ◽  
pp. 1415-1420 ◽  
Author(s):  
Canan Kuzdan ◽  
Ahmet Soysal ◽  
Gulcan Çulha ◽  
Gulsen Altinkanat ◽  
Guner Soyletir ◽  
...  
Keyword(s):  
Health Care ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Pediatric Ward ◽  
Control Programmes ◽  
Resistance Patterns ◽  
Health Care Associated Infections ◽  
Tract Infections

Introduction: Health care-associated infections (HCAIs) can cause an increase in morbidity, mortality and costs, especially in developing countries. As information on the epidemiology of HCAIs in pediatric patientsinTurkey is limited, we decided to study the annual incidence and antibiotic resistance patterns in our pediatric ward at Marmara University Hospital. Methodology: All hospitalized patients in the pediatric ward were assessed with regard to HCAIs betweenJanuary 1, 2008 and December 31, 2010. Data was prospectively collected according to standard protocols of the National Nosocomial Infections Surveillance System (NosoLINE). Results: A total of 16.5% of all hospitalized patients developed HCAIs in the three years studied. The most frequent HCAIs were urinary tract infections (UTI) (29.3%), bloodstream infections (27%) and pneumonias (21%). While the most frequent agent isolatedfrom UTI was Escherichia coli (26%), the most common agent in blood stream infections was Staphylococcus epidermidis (30.4%). Vancomycin resistance was found in 73.3% of all Enterococcus faecium strains. Extended-spectrum β-lactamase was detected in 58.3% of Klebsiella pneumoniae and E. coli isolates. Conclusions: Continual HCAI surveillance is important to determineits rate. Knowledge of the HCAI incidence can influence people’s use of broad-spectrum antibiotics and encourage antibiotic rotation. Moreover, the knowledge of HCAI incidence may support the infection control programmes, including education and isolation methods which ultimately may help to reducethe rate of the HCAIs.

Health Care–Associated Infections

2012 ◽  
pp. 458-463
Author(s):  
Rodney L Thompson ◽  
Priya Sampathkumar
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Health Care Associated Infections ◽  
Health Care Associated Infection ◽  
Tract Infections ◽  
And Control ◽  
And Training

Health care–associated infection (HAI) is an infection that occurs in hospitals, nursing homes, clinics, or home health care programs. Infection control departments have been constituted to prevent and control infectious complications in health care settings. Prevention and control require combinations of education and training, procedures and policies, surveillance and reporting, and interventions that include isolation and teamwork. Common HAIs (nosocomial infections) include urinary tract infections, surgical site infections, bloodstream infections, and ventilator-associated pneumonia. Diagnosis and treatment of each type of infection are reviewed.

scholarly journals Systemic Infection Facilitates Transmission of Pseudomonas aeruginosa

2019 ◽  
Author(s):  
Kelly E. R. Bachta ◽  
Jonathan P. Allen ◽  
Bettina H. Cheung ◽  
Cheng-Hsun Chiu ◽  
Alan R. Hauser
Keyword(s):  
Health Care ◽  
Pseudomonas Aeruginosa ◽  
Mouse Model ◽  
Virulence Factors ◽  
Systemic Infection ◽  
Bloodstream Infections ◽  
Hospitalized Patients ◽  
Dead End ◽  
Health Care Associated Infections ◽  
A Priority

ABSTRACTHealth care-associated infections such as Pseudomonas aeruginosa (PA) bacteremia pose a major clinical risk for hospitalized patients, and efforts to limit them are a priority. The fitness pressures accounting for PA virulence factors that facilitate bloodstream infections are unclear, as these infections are presumed to be a “dead-end” and have no impact on transmission. Here, we used a mouse model to show that PA spreads from the bloodstream to the gallbladder, where it replicates to extremely high numbers. Bacteria in the gallbladder then seed the intestines and feces, leading to transmission to uninfected cage-mate mice. The findings demonstrate that the gallbladder is critical for spread of PA from the bloodstream to the feces during bacteremia, a process that promotes transmission.

Diagnosis, prevention, and treatment of device-related infection in the ICU

2016 ◽  
Author(s):  
Walter Zingg ◽  
Stephan Harbarth
Keyword(s):  
Health Care ◽  
Urinary Tract ◽  
Clinical Signs ◽  
Bloodstream Infections ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Effective Prevention ◽  
Health Care Associated Infections ◽  
Tract Infections ◽  
Micro Organisms

Many patients in the intensive care unit (ICU) suffer from health care-associated infections. Age, immunosuppression, neutropenia, or multi-organ failure are preconditions, but health care-associated infections are largely related to the use of medical devices. Breaches of aseptic technique are the most important risk factor. Central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections represent up to 75% of all health care-associated infections in the ICU. Ease of diagnosis and effective prevention strategies make the central line-associated bloodstream infection a model of how to diagnose, treat, and prevent health care-associated infections. Identification of ventilator-associated pneumonia is less straightforward and suffers from inconsistent definitions, making surveillance and benchmarking difficult. Catheter-associated urinary tract infection is underestimated in the ICU because clinical signs cannot be assessed in sedated patients. Antibiotic overuse in the ICU selects for multidrug-resistant micro-organisms and thus, broad-spectrum antibiotics must be used to offer empiric treatment of health care-associated infections. Accurate microbiology testing aiming at isolating causative micro-organisms is key to de-escalate antibiotic therapy. Health care-associated infections are preventable, many factors. Successful prevention programmes offer a comprehensive protocol, follow a multidisciplinary approach in preparation, and a multimodal training and education programme in implementation.

scholarly journals Prevalence, co-infection and antibiotic resistance of Escherichia Coli from blood and urine samples at a hospital in Jamaica

2020 ◽  
Vol 14 (02) ◽  
pp. 146-152
Author(s):  
Donna A Cheung ◽  
Alison Nicholson ◽  
Tiffany R Butterfield ◽  
Marsha DaCosta
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Antimicrobial Susceptibility ◽  
Bloodstream Infections ◽  
Empiric Therapy ◽  
University Hospital ◽  
E Coli ◽  
Resistance Patterns ◽  
Tract Infections ◽  
Antibiotic Resistance Patterns

Introduction: Escherichia coli (E. coli) is a very common uro-pathogen and pathogen of bloodstream infections (BSI) in Jamaica. The aim of this study was to examine this organism’s prevalence, determine co-infection rates and assess antibiotic resistance patterns. Methodology: In the absence of automated systems, data on all E. coli isolates identified at the University Hospital of the West Indies in Kingston, Jamaica during the first six months of 2008 and 2012 was collected and sorted. Data were analyzed using IBM SPSS Statistics version 20 for Windows. Results: A total of 1188 isolates (1072 from urine and 116 from blood) was analyzed. Patients with E. coli BSI were older than those with E. coli urinary tract infections (UTI) (55.3 years vs 42.4 years, p < 0.05) and both had a female predominance. Sensitivity profiles in 2012 for E. coli in blood and urine were highest for the carbapenems, Amikacin and Nitrofurantoin and lowest for the fluoroquinolones and Trimethoprim-sulfamethoxazole. Based on antimicrobial susceptibility patterns, Nitrofurantoin was identified as an appropriate choice for empiric therapy for UTI. Ten antibiotics were noted in this study to have developed statistically significant antibiotic resistance. Patients with E. coli BSI had a co-infection E. coli UTI rate of 39%. Conclusions: Resistance patterns change drastically in a few years making frequent antimicrobial susceptibility profiling necessary. Further studies would be beneficial in guiding management of these patients.

scholarly journals Acinetobacter baumannii as a causative agent of health care associated infections

2020 ◽  
Vol 13 (2) ◽  
pp. 116-123
Author(s):  
Miguel Ángel Aguirre Navarrete ◽  
Rocío Pérez y Terrón
Keyword(s):  
Health Care ◽  
Mechanical Ventilation ◽  
Acinetobacter Baumannii ◽  
Membrane Vesicles ◽  
Outer Membrane Vesicles ◽  
Hospitalized Patients ◽  
Extrinsic Factors ◽  
Resistance To Antibiotics ◽  
Health Care Associated Infections ◽  
Tract Infections

Acinetobacter baumannii is an opportunistic pathogen that seriously affects sick patients, causing Health Care Associated Infections (HCAI) such as pneumonia associated with mechanical ventilation, urinary tract infections and bacteremia, in recent years this bacterium has become a health problem worldwide, its isolation from infections present in hospitalized patients has been increasing, and it also has various mechanisms of resistance to antibiotics. The present documentary research aims to describe the mechanisms of pathogenicity and resistance to antibiotics used by Acinetobacter baumannii as a causal agent of HCAI. To carry out this work, a literature search was carried out in databases such as: Scielo, PubMed, NCBI, and Elsevier. The pathogenicity mechanisms that allow it to colonize and develop infections in hospitalized patients are: porins, biofilms, pili, lipopolysaccharides, phospholipases, outer membrane vesicles and the production of siderophores. It has enzymatic resistance mechanisms such as beta-lactamases and non-enzymatic mechanisms such as porin modification, efflux pumps, and modifications in DNA gyrase. There are extrinsic factors that favor the development of HCAI, such as the immunological and health condition of the patient, as well as the association with medical equipment. Studies carried out between the years 2005 to 2018 reveal that A. baumannii is one of the main causative agents of pneumonia associated with mechanical ventilation in patients admitted to the Intensive care unit.

Chlorhexidine Bathing Effects on Health-Care-Associated Infections

2016 ◽  
Vol 19 (2) ◽  
pp. 123-136 ◽  
Author(s):  
Janette Denny ◽  
Cindy L. Munro
Keyword(s):  
Health Care ◽  
Bacterial Colonization ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Good Evidence ◽  
Health Care Associated Infections ◽  
Meta Analyses ◽  
Tract Infections ◽  
The Impact

Background: Health-care-associated infections (HAIs), infections that patients contract during the course of their hospitalization, are receiving a growing amount of attention. Heavy skin bacterial colonization aids in the transmission and development of HAIs. Nurses frequently use bathing with chlorhexidine gluconate (CHG) to reduce patients’ cutaneous microbial burden. This intervention has been shown to have promising but mixed results in the prevention of HAIs. Purpose: This article reviews the literature for evidence on the impact of CHG bathing on HAIs. Method: A literature search was conducted to identify peer-reviewed studies and meta-analyses that examined the impact of CHG bathing on HAIs using PubMed and CINAHL with the following search terms: CHG bathing AND healthcare associated infections, surgical site infections ( SSIs), central line associated bloodstream infections ( CLABSIs), ventilator-associated pneumonias ( VAP), catheter-associated urinary-tract infections ( CAUTIs), and Clostridium difficile-associated disease. The initial search identified 23 articles for review. Additional studies were identified by searching references used in original studies or review articles on this topic. Principle findings: There is good evidence to support incorporating a CHG bathing regimen to reduce the incidence of CLABSIs, SSIs, vancomycin-resistant enterococci (VRE), and methicillin-resistant Staphylococcus aureus (MRSA) HAIs. Conclusion: As CHG becomes a standard practice to prevent HAIs, it is important to monitor for adverse reactions and evidence of resistance/susceptibility.

scholarly journals 53. Incidence of Bloodstream Infections and Outcomes in Patients with Severe COVID-19 Pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S156-S157
Author(s):  
Aikaterini Papamanoli ◽  
Jeanwoo Yoo ◽  
Azad Mojahedi ◽  
Robin Jacob ◽  
Prabhjot Grewal ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Medical Records ◽  
Bloodstream Infections ◽  
Blood Stream ◽  
Blood Cultures ◽  
High Flow ◽  
University Hospital ◽  
Skin Microbiota ◽  
Prolonged Recovery ◽  
The Impact

Abstract Background Coronavirus disease 19 (COVID-19) leading to acute respiratory distress syndrome is associated with need for intensive care (IC), mechanical ventilation (MV), and prolonged recovery. These patients are thus predisposed to blood stream infections which can worsen outcomes. This risk may be aggravated by adjunctive therapies. Methods We reviewed the medical records of all adults admitted to Stony Brook University Hospital, NY, from March 1 to April 15, 2020 with severe COVID-19 pneumonia (requiring high-flow O2). Patients who received MV or died within 24h were excluded. Patients were followed until death or hospital discharge. We reviewed positive blood cultures (PBC) for pathogenic microorganisms, and calculated the incidence of bacteremia, rates of infective endocarditis (IE), and impact on mortality. Microbes isolated only once and belonging to groups defined as commensal skin microbiota were labelled as contaminants. We also examined the impact of adjunctive therapies with immunosuppressive potential (steroids and tocilizumab), on bacteremia. Results A total of 469 patients with severe COVID-19 pneumonia were included (Table 1). Of these, 199 (42.4%) required IC and 172 (36.7%) MV. Median length of stay was 13 days (8–22) and 94 (20.0%) had PBC. Of these, 43 were considered true pathogens (bacteremia), with predominance of E. faecalis and S. epidermidis, and 51 were considered contaminants (Table 2). The incidence of bacteremia (43/469, 9.2%) was 5.1 per 1000 patient-days (95%CI 3.8–6.4). An echocardiogram was performed in 21 patients, 1 had an aortic valve vegetation (IE) by methicillin sensitive S. aureus. Bacteremia rates were nonsignificantly higher with steroids (5.9 vs 3.7 per 1000 patient-days; P=0.057). Use of tocilizumab was not associated with bacteremia (5.8 vs 4.8 per 1000 patient-days; P=0.28). Mortality was nonsignificantly higher in patients with (15/43, 34.9%) vs. without (108/426, 25.4%) bacteremia (P=0.20). Length of stay was the strongest predictor of bacteremia, with risk increasing by 7% (95%CI 6%-9%, P&lt; 0.001) per additional day. Cohort Characteristics of Patients with Severe COVID-19 Pneumonia on High-Flow O2 (N= 469) All Microorganisms Isolated from Blood Cultures Conclusion The incidence of bacteremia was relatively low and IE was uncommon in this study of severe COVID-19 patients. Risk of bacteremia increased with longer hospital stay and with steroids use, but not with tocilizumab. Disclosures All Authors: No reported disclosures

scholarly journals Awareness among health care professionals regarding nosocomial pathogens and role of fomites in their transmission.

2020 ◽  
Vol 27 (05) ◽  
pp. 1032-1037
Author(s):  
Khadija Mumtaz ◽  
Nadia Aslam ◽  
Naima Mehdi ◽  
Nazma Kiran ◽  
Sadaf Farzand ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Nosocomial Infections ◽  
Health Care Professionals ◽  
Basic Knowledge ◽  
Care Hospital ◽  
Nosocomial Pathogens ◽  
Care Workers ◽  
Health Care Associated Infections ◽  
Tract Infections

Objectives: This study was performed to access the knowledge of health care professionals regarding health care associated infections, nosocomial pathogens, fomites and their role in transmission of nosocomial pathogens. Study Design: Descriptive, questionnaire based, cross-sectional study. Setting: Tertiary care hospital of Lahore, Punjab. Period: From October 2017 to January 2018. Material & Methods: Questionnaires were carefully formulated to access basic knowledge of physicians, surgeons and nurses. Responses given were analyzed and recorded as frequency and percentage. Results: Regarding health care associated infections, respiratory tract infections were identified by 72% surgeons, 65% physicians and 59% nurses. Surgical wound infections were identified by 76% of surgeons and 81% nurses. 45.7% physician identified bacteraemia as nosocomial infection. Rate of identification for rest of nosocomial infections was sub optimum (<50%) by health care workers. Regarding identification of nosocomial pathogens, Methicillin Resistant Staphylococcus aureus was marked by 65% of physicians, 83.8% of nurses, 76% of surgeons. Pseudomonas nosocomial pathogen was identified by 40%, 46% and 64% of physicians, nurses and surgeons respectively. The rate of identification for rest of the nosocomial organisms was again sub optimum (<40%) by health care workers. Regarding fomites, mattresses and pillows, thermometer, stethoscopes were identified by 75.7%, 59.2 and 50% of Health care professionals respectively. Conclusion: This survey identified positive attitude among Health care workers towards infection control but low level of knowledge regarding health care associated infections and nosocomial pathogens. Therefore, to prevent nosocomial infections, there is strong need to develop strategies for improving knowledge of Health care professionals.

scholarly journals Device associated –health care associated infections monitoring, prevention and cost assessment at intensive care unit of University Hospital in Poland (2015–2017)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wieslawa Duszynska ◽  
Victor Daniel Rosenthal ◽  
Aleksander Szczesny ◽  
Katarzyna Zajaczkowska ◽  
Michal Fulek ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Compliance Rate ◽  
University Teaching ◽  
University Hospital ◽  
Incidence Density ◽  
Infection Group ◽  
Health Care Associated Infections

Abstract Background Device-associated health care-associated infections (DA-HAIs) in intensive care unit (ICU) patients constitute a major therapeutic issue complicating the regular hospitalisation process and having influence on patients’ condition, length of hospitalisation, mortality and therapy cost. Methods The study involved all patients treated > 48 h at ICU of the Medical University Teaching Hospital (Poland) from 1.01.2015 to 31.12.2017. The study showed the surveillance and prevention of DA-HAIs on International Nosocomial Infection Control Consortium (INICC) Surveillance Online System (ISOS) 3 online platform according to methodology of the INICC multidimensional approach (IMA). Results During study period 252 HAIs were found in 1353 (549F/804M) patients and 14,700 patient-days of hospitalisation. The crude infections rate and incidence density of DA-HAIs was 18.69% and 17.49 ± 2.56 /1000 patient-days. Incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI) and catheter-associated urinary tract infection (CA-UTI) per 1000 device-days were 12.63 ± 1.49, 1.83 ± 0.65 and 6.5 ± 1.2, respectively. VAP(137) constituted 54.4% of HAIs, whereas CA-UTI(91) 36%, CLA-BSI(24) 9.6%.The most common pathogens in VAP and CA-UTI was multidrug-resistant (MDR) Acinetobacter baumannii (57 and 31%), and methicillin-resistant Staphylococcus epidermidis (MRSE) in CLA-BSI (45%). MDR Gram negative bacteria (GNB) 159 were responsible for 63.09% of HAIs. The length of hospitalisation of patients with a single DA-HAI at ICU was 21(14–33) days, while without infections it was 6.0 (3–11) days; p = 0.0001. The mortality rates in the hospital-acquired infection group and no infection group were 26.1% vs 26.9%; p = 0.838; OR 0.9633;95% CI (0.6733–1.3782). Extra cost of therapy caused by one ICU acquired HAI was US$ 11,475/Euro 10,035. Hand hygiene standards compliance rate was 64.7%, while VAP, CLA-BSI bundles compliance ranges were 96.2–76.8 and 29–100, respectively. Conclusions DA-HAIs was diagnosed at nearly 1/5 of patients. They were more frequent than in European Centre Disease Control report (except for CLA-BSI), more frequent than the USA CDC report, yet less frequent than in limited-resource countries (except for CA-UTI). They prolonged the hospitalisation period at ICU and generated substantial additional costs of treatment with no influence on mortality. The Acinetobacter baumannii MDR infections were the most problematic therapeutic issue. DA-HAIs preventive methods compliance rate needs improvement.

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