scholarly journals Healthcare-associated infection in the Grey’s Hospital paediatric intensive care unit: does an Infection Control Programme work?

2018 ◽  
Vol 33 (5) ◽  
Author(s):  
Anne L. Armour ◽  
Mark E. Patrick ◽  
Zelda Reddy ◽  
Wilbert Sibanda ◽  
Logandran Naidoo ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Infection Control ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Control Programme ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Infection Control Programme

Background: Healthcare-associated infections are an important cause of morbidity and mortality globally. Grey’s Hospital introduced an Infection Control Programme in August 2016, which included Best Care Always bundles for reducing the occurrence of central line-associated bloodstream infections, catheter-associated urinary tract infections and ventilatorassociated pneumonia. Methods: An observational before–after quasi-experiment was conducted retrospectively reviewing healthcare-associated infection rates in the Grey’s Hospital paediatric intensive care unit a year prior to (August 2015 to July 2016) and after (September 2016 to August 2017) implementation of an Infection Control Programme.Results: There was an absolute decrease in healthcare-associated infection from 102 to 81 and a statistically significant decrease in bloodstream infections per 1 000 central venous catheter days from 36/1 000–15/1 000 after intervention (RR 0.42, 95% CI 0.23–0.79, p = 0.004). The rate of healthcare-associated infection decreased from 23/100 admissions prior to the intervention to 20/100 admissions after the intervention (RR 0.87, 95% CI 0.51–1.48, p = 0.61) and from 40/1 000 patient days to 32/1 000 patient days (RR 0.80, 95% CI 0.51–1.26, p = 0.34). Reductions in healthcare-associated infection were also seen in bloodstream infections and urinary tract infections.Conclusion: The observed downward trend in overall healthcare-associated infections, bloodstream infections and urinary tract infections did not reach statistical significance except for bloodstream infections per 1 000 central venous catheter days. Further research or audit is needed to ascertain reasons for this less than expected decrease in healthcare-associated infections. In the meantime, meticulous adherence to bundles should be encouraged.

Costs of ambulatory pediatric healthcare-associated infections: Central-line–associated bloodstream infection (CLABSIs), catheter-associated urinary tract infection (CAUTIs), and surgical site infections (SSIs)

2020 ◽  
Vol 41 (11) ◽  
pp. 1292-1297
Author(s):  
Michael L. Rinke ◽  
Suzette O. Oyeku ◽  
William J. H. Ford ◽  
Moonseong Heo ◽  
Lisa Saiman ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Ambulatory Surgery ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Retrospective Case ◽  
Additional Costs ◽  
Tract Infections ◽  
Healthcare Associated

AbstractObjective:Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This study estimated additional costs associated with pediatric ambulatory central-line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSIs) following ambulatory surgery.Design:Retrospective case-control study.Setting:Four academic medical centers.Patients:Children aged 0–22 years seen between 2010 and 2015 and at risk for HAI as identified by electronic queries.Methods:Chart review adjudicated HAIs. Charges were obtained for patients with HAIs and matched controls 30 days before HAI, on the day of, and 30 days after HAI. Charges were converted to costs and 2015 USD. Mixed-effects linear regression was used to estimate the difference-in-differences of HAI case versus control costs in 2 models: unrecorded charge values considered missing and a sensitivity analysis with unrecorded charge considered $0.Results:Our search identified 177 patients with ambulatory CLABSIs, 53 with ambulatory CAUTIs, and 26 with SSIs following ambulatory surgery who were matched with 382, 110, and 75 controls, respectively. Additional cost associated with an ambulatory CLABSI was $5,684 (95% confidence interval [CI], $1,005–$10,362) and $6,502 (95% CI, $2,261–$10,744) in the 2 models; cost associated with a CAUTI was $6,660 (95% CI, $1,055, $12,145) and $2,661 (95% CI, −$431 to $5,753); cost associated with an SSI following ambulatory surgery at 1 institution only was $6,370 (95% CI, $4,022–$8,719).Conclusions:Ambulatory HAI in pediatric patients are associated with significant additional costs. Further work is needed to reduce ambulatory HAIs.

scholarly journals Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic

2021 ◽  
Vol 58 ◽  
pp. 004695802110679
Author(s):  
Hela Ghali ◽  
Asma Ben Cheikh ◽  
Sana Bhiri ◽  
Selwa Khefacha ◽  
Houyem Said Latiri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urinary Tract ◽  
Protective Factor ◽  
Bloodstream Infections ◽  
Point Prevalence ◽  
University Hospital ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Background Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. Aim To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. Methods The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. Results Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 ± 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% ( P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). Conclusion Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.

scholarly journals 593. Burden of Healthcare-Associated Infections among Hospitalized Infants within Community Hospitals

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S279-S280
Author(s):  
Ibukunoluwa C Akinboyo ◽  
Rebecca R Young ◽  
Michael J Smith ◽  
Becky A Smith ◽  
Sarah S Lewis ◽  
...  
Keyword(s):  
Infection Control ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Control Network ◽  
Healthcare Associated Infections ◽  
Community Hospitals ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Background Healthcare-associated infections (HAI) remain the leading cause of morbidity and mortality among hospitalized children. Within community hospitals with targeted infection prevention efforts, participation in an infection control network has led to significant decreases in device or procedure-related infections among adult patients. The impact of these interventions has not been assessed in pediatric patients admitted to community hospitals. Methods We conducted a retrospective cohort study to describe the burden of HAI among hospitalized infants (< 1 year old) within 53 community hospitals participating in the Duke Infection Control Outreach Network (DICON) from 2013–2018. We determined the frequency of device-related HAI, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI) and hospital-associated pneumonia or ventilator-associated events (HAP/VAE) using National Healthcare Safety Network (NHSN) definitions; and the burden of HAIs among neonatal intensive care units (NICU) and non-NICU centers. The trend of HAI was analyzed with Spearman’s correlation. Results Thirty hospitals reported 150 HAI among 141 infants over the 6-year period. Median (IQR) time to infection was 10 (4, 20) days after admission. Hospitals with a NICU (15) reported more HAI (median 5, (IQR: 3, 12)) than hospitals without a NICU (median 2 (IQR: 1, 2)) (P = 0.031). CLABSI represented 35% of HAI, HAP/VAE were 23% and CAUTI were 12%. The most frequently isolated primary organism for all HAI was Escherichia coli (22 HAI, 15%) which was also isolated in 39% of CAUTI. Methicillin-resistant and methicillin-susceptible Staphylococcus aureus (S. aureus) were the most commonly isolated organisms among CLABSI (17%) and HAP/VAE (33%). Nine centers with ≥4 years of NICU and Central line (CL) use data reported a median (IQR) rate of 1.2 (0, 2.4) CLABSIs/1,000 central line days. There was no change in median CLABSI rate over time (P = 0.47), Figure 1. Conclusion CLABSI, most commonly caused by S. aureus, represented the majority of HAI reported from hospitalized infants within community hospitals participating in an infection control network. Further research into device utilization practices may inform future interventions to reduce HAI. Disclosures All authors: No reported disclosures.

The Network Approach for Prevention of Healthcare-Associated Infections: Long-Term Effect of Participation in the Duke Infection Control Outreach Network

2011 ◽  
Vol 32 (4) ◽  
pp. 315-322 ◽  
Author(s):  
Deverick J. Anderson ◽  
Becky A. Miller ◽  
Luke F. Chen ◽  
Linda H. Adcock ◽  
Evelyn Cook ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infections ◽  
Central Line ◽  
Incidence Rates ◽  
Healthcare Associated Infections ◽  
Bloodborne Pathogens ◽  
Average Decrease ◽  
Tract Infections ◽  
Healthcare Associated

Objective.To describe the rates of several key outcomes and healthcare-associated infections (HAIs) among hospitals that participated in the Duke Infection Control Outreach Network (DICON).Design and Setting.Prospective, observational cohort study of patients admitted to 24 community hospitals from 2003 through 2009.Methods.The following data were collected and analyzed: incidence of central line-associated bloodstream infections (CLABSIs), ventilator-associated pneumonia (VAP), catheter-associated urinary tract infections (CAUTIs), and HAIs caused by methicillin-resistant Staphylococcus aureus (MRSA); employee exposures to bloodborne pathogens (EBBPs); physician EBBPs; patient-days; central line-days; ventilator-days; and urinary catheter-days. Poisson regression was used to determine whether incidence rates of these HAIs and exposures changed during the first 5 and 7 years of participation in DICON; nonrandom clustering of each outcome was controlled for. Cost saved and lives saved were calculated on the basis of published estimates.Results.In total, we analyzed 6.5 million patient-days, 4,783 EBPPs, 2,948 HAIs due to MRSA, and 2,076 device-related infections. Rates of employee EBBPs, HAIs due to MRSA, and device-related infections decreased significantly during the first 5 years of participation in DICON (P < .05 for all models; average decrease was approximately 50%); in contrast, physician EBBPs remained unchanged. In aggregate, 210 CLABSIs, 312 cases of VAP, 332 CAUTIs, 1,042 HAIs due to MRSA, and 1,016 employee EBBPs were prevented. Each hospital saved approximately $100,000 per year of participation, and collectively the hospitals may have prevented 52-105 deaths from CLABSI or VAP. The 7-year analysis demonstrated that these trends continued with further participation.Conclusions.Hospitals with long-term participation in an infection control network decreased rates of significant HAIs by approximately 50%, decreased costs, and saved lives.

Healthcare-Associated Infection in Italy Annual Point-Prevalence Surveys, 2002–2004

2009 ◽  
Vol 30 (7) ◽  
pp. 659-665 ◽  
Author(s):  
Simone Lanini ◽  
William R. Jarvis ◽  
Emanuele Nicastri ◽  
Gaetano Privitera ◽  
Giovanni Gesu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Univariate Analysis ◽  
National Health System ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Point Prevalence ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated

Objective.Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality worldwide. During the period from 2002 through 2004, a group of Italian hospitals was recruited to conduct HAI point-prevalence surveys.Design.Three point-prevalence surveys.Methods.A total of 9,609 patients were surveyed.Results.The overall frequency of HAI was 6.7% (645 infections among the 9,609 surveyed patients). The most frequent HAIs were lower respiratory tract infections, which accounted for 35.8% (231 of 645 HAIs) of all HAIs, followed by urinary tract infections (152 [23.6%] of 645 HAIs), bloodstream infections (90 [14.0%] of 645 HAIs), and surgical site infections (79 [12.2%] of 645 HAIs). In both multivariate and univariate analysis, invasive procedures, duration of stay, chemotherapy, trauma, coma, and the location of the hospital were all factors statistically significantly associated with the occurrence of an HAL Enterobacteriaceae were the most common isolates recovered in medical and surgical wards, whereas gram-negative aerobic bacilli were the most common isolates recovered in intensive care units. Approximately one-half of all of the patients surveyed were receiving antibiotics at the time of our study; the most used antibiotic classes were fluoroquinolones in medical wards, cephalosporins in surgical wards, and penicillins and glycopeptides in intensive care units.Conclusion.Our study emphasizes the need for implementing further HAI surveillance to provide the National Health System with proper tools to prevent and manage infection in hospitalized patients.

Burden of healthcare-associated infections among hospitalized children within community hospitals participating in an infection control network

2021 ◽  
pp. 1-3
Author(s):  
Ibukunoluwa C. Akinboyo ◽  
Rebecca R. Young ◽  
Michael J. Smith ◽  
Sarah S. Lewis ◽  
Becky A. Smith ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infections ◽  
Central Line ◽  
Control Network ◽  
Hospitalized Children ◽  
Healthcare Associated Infections ◽  
Community Hospitals ◽  
Prospective Surveillance ◽  
Healthcare Associated ◽  
Pediatric Healthcare

Abstract We describe the frequency of pediatric healthcare-associated infections (HAIs) identified through prospective surveillance in community hospitals participating in an infection control network. Over a 6-year period, 84 HAIs were identified. Of these 51 (61%) were pediatric central-line–associated bloodstream infections, and they often occurred in children <1 year of age.

Healthcare-associated Infections in Pediatric Cardiovascular Surgery Intensive Care Unit between 2016-2020

2021 ◽  
Author(s):  
Mehmet Emirhan Işık ◽  
Ergin Arslanoğlu ◽  
Ömer Faruk Şavluk ◽  
Hakan Ceyran
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiovascular Surgery ◽  
Heart Diseases ◽  
Bloodstream Infections ◽  
Healthcare Associated Infections ◽  
Developmental Problems ◽  
Pediatric Cardiovascular Surgery ◽  
Tract Infections ◽  
Healthcare Associated

Objectives: Healthcare-associated infections are the most common problem in intensive care unit worldwide. Children with congenital heart diseases have many complications such as developmental problems, respiratory tract infections, endocarditis,pneumonia and after long-term hospital and intensive care stays and surgeries patients become vulnerable to healthcare-associated infections. Patients and Methods: The study presents the frequency of infection, microorganisms in patients hospitalized at SBÜ Koşuyolu High Spesialization Research and Training Hospital pediatric cardiovascular surgery intensive care unit between 2016-2020. Results: One hundred-eight HAI episodes were seen in 83 of 1920 patients hospitalized in pediatric cardiovascular surgery intensive care unit between 2016-2020.HAI rates varied between 4.8% and 7.77%. In the 5-year period,a total of 118 different microorganisms were detected.Among all microorganisms, Candida species (n: 43, 36.4%) ranked first. central line-associated bloodstream infections (CLABSI) 53 (49%), ventilator-associated pneumonia (VAP)40 (37%), surgical site infection (SSI) 8 (6.5%), catheter -associated urinary tract infection (CAUTI) 7 (6%) Conclusion: Healthcare-associated infections are require special attention in pediatric cardiovascular intensive care units. In order to prevent, innovations such as bundle applications should be implemented as well as personnel training.

scholarly journals 2476. External and Internal Validation of the Healthcare-associated Infection Data in the Korean National Healthcare-associated Infectious Surveillance System (KONIS)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S857-S858
Author(s):  
Yee Gyung Kwak ◽  
Je Eun Song ◽  
Young Hwa Choi ◽  
Sung Ran Kim ◽  
Su Ha Han ◽  
...  
Keyword(s):  
Surveillance System ◽  
Bloodstream Infections ◽  
Surveillance Data ◽  
Healthcare Associated Infection ◽  
Continuous Training ◽  
Monitoring Method ◽  
Internal Validation ◽  
National Healthcare ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Background National surveillance data should be validated to identify data quality issues. This study tested the validity of healthcare-associated infection (HAI) data in the Korean National Healthcare-associated Infections Surveillance System (KONIS), intensive care unit (ICU) module. Methods The validation process consisted of external (EV) and internal (IV) validation phases. For the 10 hospitals that were selected based on the HAI rate, among the 193 participating hospitals between July 2016 and June 2017, both EV and IV were performed. For the EV, the validation team reviewed 295 medical records of 60 patients with reported HAIs, including 20 urinary tract infections (UTIs), 27 bloodstream infections (BSIs), and 13 cases of pneumonia (PNEU), and 235 patients with no reported HAI during 1-day visits conducted in November and December 2017. The reviewer’s diagnosis of HAI was regarded as the reference standard. IV was conducted by the staff of each hospital and evaluated whether UTI or BSI were present. Primary IV was performed for 279 patients who were subject to EV. Secondary IV was performed on 203 patients in another 11 selected participating hospitals that did not report HAIs to KONIS during the 1-year study period. Results In the EV, the diagnosis of UTI in the participating hospitals had a sensitivity of 72.0% and specificity of 99.3%. The sensitivity of BSI and PNEU was 63.2% and 70.6%, respectively, and specificity was 98.8% and 99.6%. The agreement (kappa) between the EV and primary IV was significant, with κ = 0.754 for UTI and κ = 0.674 for BSI. The results of the secondary IV showed that the hospitals that had no reports of HAI had few hospital beds and performed few blood or urine culture tests. In the secondary IV, eight UTIs and three BSIs were newly diagnosed in three hospitals, respectively. The reasons for not reporting the HAIs were presumed to be a lack of understanding of the surveillance standards and fear of the disadvantages of disclosing the HAI. Conclusion This study shows the need for ongoing validation and continuous training of surveillance personnel to maintain the accuracy of surveillance data. We also confirmed that IV can be used as an alternative monitoring method to examine validity and accuracy. Disclosures All authors: No reported disclosures.

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