scholarly journals Healthcare-associated infections in a newly opened pediatric intensive care unit in Turkey: Results of four-year surveillance

2016 ◽  
Vol 10 (03) ◽  
pp. 254-259 ◽  
Author(s):  
Serkan Atici ◽  
Ahmet Soysal ◽  
Eda Kepenekli Kadayifci ◽  
Ayşe Karaaslan ◽  
Gülşen Akkoç ◽  
...  

Introduction: Healthcare-associated infections (HAIs) are important causes of morbidity and mortality, especially in critically ill patients in intensive care units. The aim of this study was to assess the rate and distribution of HAIs, pathogens, and antimicrobial susceptibility patterns in a newly opened pediatric intensive care unit (PICU). Methodology: The infection control team detected and recorded HAI cases according to the Centers for Disease Control and Prevention’s criteria in the PICU of Marmara University Pendik Training and Research Hospital over a four-year period following its opening. Laboratory-based HAIs surveillance was performed prospectively from 1 January 2011 to 30 November 2014. Results: During the study period, 1,007 patients hospitalized in the PICU and 224 HAIs were identified. The overall HAI rate was 22.24%, and the incidence density was 20.71 per 1,000 patient-days. The most commonly observed HAIs were bloodstream infection (35.7%), pneumonia (21.4%), and urinary tract infection (20.5%), and the three most common HAI pathogens were Klebsiella spp. (19.4%), Pseudomonas aeruginosa (13.8%), and Acinetobacter baumanii (12%). Methicillin resistance was detected in 78% of coagulase-negative Staphylococcus. Presence of extended-spectrum beta-lactamases was determined in 45% and 54% of Klebsiella spp. strains and Escherichia coli isolates, respectively. Conclusions: Our rate of HAIs is higher than the mean rates reported in PICU studies from developed countries. Active surveillance studies of HAIs is an essential component of infection control, which may contribute to improving preventive strategies in developing countries.

2020 ◽  
Author(s):  
Ayşe Ulus ◽  
Soner Sertan Kara

INTRODUCTION: The pediatric intensive care unit (PICU) is a unit in which the general condition and vital signs of patients aged one month to 18 years are continuously monitored, and support treatments after advanced pediatric and surgical procedures are provided. Healthcare-associated infections (HAIs) can develop during some interventions and treatments. The purpose of this study was to investigate infection and handwashing rates for the previous five years in a hospital PICU providing tertiary intensive care and to examine HAI agent microorganisms and their resistance rates. METHODS: Data for patients followed-up at the Aydın Adnan Menderes University Hospital PICU between 1 January 2015, and 30 October 2020, were examined retrospectively. The study data were obtained from the hospital microbiology laboratory culture specimen results, radiology data, clinical visits, and information recorded on the National Healthcare-Associated Infections Surveillance System. HAIs rates, density, infectious agents and resistance rates, and hand hygiene compliance rates were calculated from these data. RESULTS: Two hundred and thirty-three patients were included in the study. The mean annual number of patient days was 1742±322. The mean annual total number of infections was 9.0±3.9, the mean infection rate was 4.2±2.8, and the mean infection density was 5.0±1.5. Bloodstream infections constituted the most common infections, followed by ventilator-associated pneumonia (VAP). Carbapenem resistance at a rate of 50% was determined for both Acinetobacter spp. and Pseudomonas aeruginosa. A strong correlation was determined between VAP and patient days (p=0.05, r=0.80). Hand hygiene observations revealed compliance rates of 48.1±14.3 in nurses, 33.9±28.2 in patient carers, 31.8±12.5 in physicians, and 30.9±26.2 in cleaning personnel DISCUSSION AND CONCLUSION: Mean annual infection numbers in this study were similar to those of previous studies from other centers. The most common infection was bloodstream infections. Nurses had the highest handwashing rates, with physicians in the third place. Higher VAP was correlated with increased patient days.


Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1349
Author(s):  
Yu-Ren Lin ◽  
Yen-Yue Lin ◽  
Chia-Peng Yu ◽  
Ya-Sung Yang ◽  
Chun-Gu Cheng ◽  
...  

Background: Healthcare-associated infections (HAIs) cause increases in length of stay, mortality, and healthcare costs. A previous study conducted in Taiwan obtained similar results to those reported in Korea and Japan in 2015. Changes in microorganisms have been noted in recent years. Understanding the recent condition of HAIs in intensive care units (ICUs) can enable healthcare providers to develop effective infection control protocols to reduce HAIs. Methods: We used the Taiwan Nosocomial Infection Surveillance System to evaluate the incidence densities of HAIs, the proportions of causative pathogens, and the proportions of antimicrobial resistance (AMR). The Poisson regression model was constructed to incidence density, and the chi-square test was used to assess proportion. Results: The incidence density of HAIs decreased 5.7 to 5.4 per 1000 person-days. However, the proportions of Klebsiella pneumoniae and Enterococcus faecium significantly increased. In addition, the proportions of carbapenem-resistant K. pneumoniae and vancomycin-resistant Enterococcus faecium significantly increased over time. Conclusion: Analysis of the microorganisms involved in HAIs in ICUs showed elevated proportions of K. pneumoniae and E. faecium with AMR. Infection control protocols have been implemented for several years and require improvements regarding environmental cleanliness and medical staff prevention.


1989 ◽  
Vol 10 (11) ◽  
pp. 515-520 ◽  
Author(s):  
E.L. Ford-Jones ◽  
C.M. Mindorff ◽  
E. Pollock ◽  
R. Milner ◽  
D. Bohn ◽  
...  

AbstractTo improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS).Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the “gold standard” became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.


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