Knowledge and attitudes toward preventing hospital-acquired infections among nurses and residents at a university hospital

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

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Transmission of ESBL-producing Enterobacteriaceae and their mobile genetic elements—identification of sources by whole genome sequencing: study protocol for an observational study in Switzerland

BMJ Open ◽

10.1136/bmjopen-2018-021823 ◽

2018 ◽

Vol 8 (2) ◽

pp. e021823 ◽

Cited By ~ 12

Author(s):

Tanja Stadler ◽

Dominik Meinel ◽

Lisandra Aguilar-Bultet ◽

Jana S Huisman ◽

Ruth Schindler ◽

...

Keyword(s):

Observational Study ◽

Whole Genome Sequencing ◽

Genome Sequencing ◽

Bacterial Species ◽

Mobile Genetic Elements ◽

University Hospital ◽

Whole Genome ◽

Hospital Acquired Infections ◽

Genetic Elements ◽

Hospital Acquired

IntroductionExtended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae were first described in relation with hospital-acquired infections. In the 2000s, the epidemiology of ESBL-producing organisms changed as especially ESBL-producingEscherichia coliwas increasingly described as an important cause of community-acquired infections, supporting the hypothesis that in more recent years ESBL-producing Enterobacteriaceae have probably been imported into hospitals rather than vice versa. Transmission of ESBL-producing Enterobacteriaceae is complicated by ESBL genes being encoded on self-transmissible plasmids, which can be exchanged among the same and different bacterial species. The aim of this research project is to quantify hospital-wide transmission of ESBL-producing Enterobacteriaceae on both the level of bacterial species and the mobile genetic elements and to determine if hospital-acquired infections caused by ESBL producers are related to strains and mobile genetic elements predominantly circulating in the community or in the healthcare setting. This distinction is critical in prevention since the former emphasises the urgent need to establish or reinforce antibiotic stewardship programmes, and the latter would call for more rigorous infection control.Methods and analysisThis protocol presents an observational study that will be performed at the University Hospital Basel and in the city of Basel, Switzerland. ESBL-producing Enterobacteriaceae will be collected from any specimens obtained by routine clinical practice or by active screening in both inpatient and outpatient settings, as well as from wastewater samples and foodstuffs, both collected monthly over a 12-month period for analyses by whole genome sequencing. Bacterial chromosomal, plasmid and ESBL-gene sequences will be compared within the cohort to determine genetic relatedness and migration between humans and their environment.Ethics and disseminationThis study has been approved by the local ethics committee (Ethikkommission Nordwest-und Zentralschweiz) as a quality control project (Project-ID 2017–00100). The results of this study will be published in peer-reviewed medical journals, communicated to participants, the general public and all relevant stakeholders.

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The accuracy and validity of a weekly point-prevalence survey for evaluating the trend of hospital-acquired infections in a university hospital in Turkey

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2011.05.010 ◽

2011 ◽

Vol 15 (10) ◽

pp. e684-e687 ◽

Cited By ~ 6

Author(s):

Cemal Ustun ◽

Salih Hosoglu ◽

Mehmet Faruk Geyik ◽

Zafer Parlak ◽

Celal Ayaz

Keyword(s):

Point Prevalence ◽

University Hospital ◽

Prevalence Survey ◽

Hospital Acquired Infections ◽

Point Prevalence Survey ◽

Hospital Acquired

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Evaluation of the Quality of Medico-technical Equipment Sterilization in National University Hospital of Cotonou in Benin in 2013

The Open Public Health Journal ◽

10.2174/1874944501609010053 ◽

2016 ◽

Vol 9 (1) ◽

pp. 53-64 ◽

Cited By ~ 1

Author(s):

Edgard-Marius D. Ouendo ◽

Cyriaque Dégbey ◽

Sossa J. Charles ◽

Judith Sègnon ◽

Jacques Saizonou ◽

...

Keyword(s):

Nosocomial Infections ◽

Medical Equipment ◽

Health Workers ◽

University Hospital ◽

National Committee ◽

Technical Equipment ◽

Hospital Acquired Infections ◽

National University ◽

Hospital Acquired

Backgrounds: In low income countries, hospital-acquired infections continue to develop in hospitalized patients, and may also affect medical staff. Medico-technical equipment sterilization is critical for prevention and safety care of nosocomial infections. Objective: To assess the quality of medico-technical equipment sterilization at the National University Hospital of Cotonou in 2013. Method: This cross-sectional and evaluative study was conducted at the National University Hospital of Cotonou from 10th June to 04th July 2013. A sample of 51 health workers involved in the of medico-technical equipment sterilization system, two (02) administrative authorities, the responsible of National Committee for the Fight against nosocomial infections in the hospital, 41 sterilized instruments and compresses were assessed in the study. Health workers were observed in their work environment before undergoing an individual interview as well as the administrative authorities and the Responsible of the National Committee for the Fight against nosocomial infections. Sterilized instruments are analyzed in microbiology laboratory. Results: More than half of the participants were male (52.9%). The average age of respondents was 41 ± 7.5 years. The sterilization unit of the hospital was managed by common surgical department of the hospital and its mission was to provide sterile medico-technical equipment. The sterilization unit did not meet the standard architecture of sterilization environment. Equipment sterilization procedure did not meet standards of quality assurance. There was no preventive maintenance procedure for autoclave and poupinel that were used for sterilization of instruments. No indoor cleaning and air sterilization of the service of sterilization were planned. However, equipment sterilization supplies were available, and 13.72% of workers surveyed were well-skilled. Microbiological tests showed that 48.8% of sterilized medical equipment was contaminated by Staphylococcus aureus, Pseudomonas aeruginosa and Enterobacter cloacae. Conclusion: The quality of instrument sterilization system in the HKM National University hospital of Cotonou was poor. Sterilized equipment was contaminated by pathogens. Medical equipment sterilization process needs improvement to prevent hospital-acquired infections.

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Use of single-bed rooms may decrease the incidence of hospital-acquired infections in geriatric patients: A retrospective cohort study in Central Denmark region

Journal of Health Services Research & Policy ◽

10.1177/1355819621994866 ◽

2021 ◽

pp. 135581962199486

Author(s):

Merete Gregersen ◽

Anders Mellemkjær ◽

Catherine H Foss ◽

Sif Blandfort

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

University Hospital ◽

Electronic Patient Records ◽

X Ray ◽

Hospital Acquired Infections ◽

Comorbidity Index ◽

Discharge From Hospital ◽

Hospital Acquired

Objective Patients accommodated in single-bed rooms may have a reduced risk of hospital-acquired infections (HAIs) compared to those in multi-bed rooms. This study aimed to examine the effect of single-bed accommodation on HAIs in older patients admitted to a geriatric ward. Methods A retrospective cohort study of patients admitted to geriatric wards in a university hospital in Central Denmark Region linked to a move to a newly built hospital, involving all consecutively admitted patients aged 65 years and over from 15 September to 19 December 2016 and a similar cohort admitted in the same three months in 2017. We compared the incidence of HAIs in patients in single-bed accommodation to those in multi-bed accommodation using retrospective review of electronic patient records, with all infections verified microbiologically or by X-ray with onset between 48 hours after admission to 48 hours after discharge from hospital. Results In total 446 patients were included. The incidence of HAIs in multi-bed accommodation was 30% compared to 20% in single-bed accommodation. The hazard ratio was 0.62 (95% Confidence Interval 0.43–0.91, p = 0.01) for single-bed accommodation. This finding remained robust after adjustment for age, sex, infection at admission, risk of sepsis, use of catheter, treatment with prednisone or methotrexate, and comorbidity index. Conclusion Accommodation in single-bed rooms appeared to reduce HAIs compared to multi-bed rooms in two geriatric wards. This finding should be considered as hypothesis-generating and be examined further using an experimental design.

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Use of 16s rRNA to identify non-lactose-fermenting bacilli and molecular detection of ESBL resistance genes associated with hospital-acquired infection in Soba University Hospital, Sudan

F1000Research ◽

10.12688/f1000research.22541.1 ◽

2020 ◽

Vol 9 ◽

pp. 1311

Author(s):

Wissam Ahmed Al Hag ◽

Hana Elbadawi ◽

Muzamil Mahdi Abdel Hamid

Keyword(s):

Pseudomonas Aeruginosa ◽

16S Rrna ◽

Resistance Genes ◽

University Hospital ◽

16S Rrna Genes ◽

Rrna Genes ◽

Biochemical Tests ◽

Gram Negative ◽

Hospital Acquired Infections ◽

Hospital Acquired

Background: Non-lactose-fermenting gram-negative bacilli (NLFGNB) have become significant nosocomial pathogens and often exhibit intrinsic multidrug resistance. Sequencing of 16s rRNA genes could be utilized for robust identification of NLFGNB. This study aimed to identify resistant NLFGNB associated with hospital-acquired infections using 16s rRNA sequencing and to detect the extended-spectrum β-lactamase (ESBL) genes of isolates in Soba Hospital, Khartoum State, Sudan. Methods: A prospective, cross-sectional, laboratory-based study was conducted from October 2017 to March 2018 at the Microbiology Department of Soba University Hospital. A total of 100 randomly selected NLFGNB samples were isolated from blood and urine during the time of the study. All the isolates were identified using standard biochemical tests and antimicrobial sensitivity testing, 16s rRNA gene sequencing, and bioinformatics techniques. Results: The biochemical tests revealed that, out of the 100 NLFGNB isolates, the Pseudomonas species was predominant (57 isolates), followed by gram-negative bacilli (33 isolates), Coccobacilli (9 isolates) and Coliform (1 isolate) species. Sequencing of 16s rRNA genes identified all the resistant isolates at the species level: Pseudomonas aeruginosa (26%), Acinetobacter baumannii (22%), Burkholderia cepacia (13%), Stenotrophomonas maltophilia (10%), Enterococcus species (E. faecalis, E. faecium) (10%), and other GNB (Acinetobacter variabilis, Klebsiella pneumoniae, Morganella morganii, Escherichia fergusonii, Enterobacter hormaechei and Pseudomonas stutzeri) (19%). The antimicrobial susceptibility tests indicated that 31 isolates were resistant to at least three classes of antibiotics and contain the highest level of ESBL resistance genes. Conclusions: Pseudomonas aeruginosa and Acinetobacter baumannii were the most widely recognized NLFGNB identified from hospital-acquired infections in Soba hospital. Among the NLFGNB, antimicrobial resistance and ESBL resistance genes were observed at a high frequency.

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Prevalence of Hospital-Acquired Infections During Successive Surveillance Surveys Conducted at a University Hospital in The Netherlands

Infection Control and Hospital Epidemiology ◽

10.1086/512640 ◽

2007 ◽

Vol 28 (4) ◽

pp. 459-465 ◽

Cited By ~ 21

Author(s):

T. E. M. Hopmans ◽

H. E. M. Blok ◽

A. Troelstra ◽

M. J. M. Bonten

Keyword(s):

University Hospital ◽

Infection Rates ◽

Total Cost ◽

Surgical Department ◽

Hospital Acquired Infections ◽

Orthopedic Procedure ◽

High Prevalence ◽

Cheap Method ◽

Control And Prevention ◽

Hospital Acquired

Objective.To monitor hospital-wide trends in the prevalence of hospital-acquired infections (HAIs) in order to identify areas where the risk of infection is increasing.Methods.Successive surveillance surveys were conducted twice yearly, from November 2001 until May 2004, to determine the prevalence of HAIs at 2 Dutch hospitals, using Centers for Disease Control and Prevention criteria.Results.In all, 340 HAIs were observed in 295 (11.1%) of 2,661 patients surveyed. The overall prevalence per survey varied from 10.2% to 15.6%, with no significant differences between successive surveys. In the surgical department, the prevalence of HAIs increased from 10.8 cases per 100 surgeries in November 2001 to 20.4 cases per 100 surgeries in May 2002. Further analysis revealed a high prevalence of surgical site infection among patients who had an orthopedic procedure performed. In the neurology-neurosurgery department, the prevalence increased from 13.0 cases per 100 patients in May 2002 to 26.6 cases per 100 patients in May 2003 and involved several types of infection. Further analysis retrieved exceptionally high incidences of infections associated with cerebrospinal fluid drainage. Specific infection control interventions were developed and implemented in both departments. The total cost of the surveys was estimated to be €9,100 per year.Conclusion.Successive performance of surveillance surveys is a simple and cheap method to monitor the prevalence of infection throughout the hospital and appeared instrumental in identifying 2 departments with increased infection rates.

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HOSPITAL-ACQUIRED INFECTIONS I. SURVEILLANCE IN A UNIVERSITY HOSPITAL

American Journal of Epidemiology ◽

10.1093/oxfordjournals.aje.a112223 ◽

1976 ◽

Vol 103 (3) ◽

pp. 251-260 ◽

Cited By ~ 130

Author(s):

RICHARD P. WENZEL ◽

CHARLES A. OSTERMAN ◽

KATHRYN J. HUNTING ◽

JACK M. GWALTNEY

Keyword(s):

University Hospital ◽

Hospital Acquired Infections ◽

Hospital Acquired

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Surveillance for Hospital-Acquired Infections on Surgical Wards in a Dutch University Hospital

Infection Control and Hospital Epidemiology ◽

10.1086/502258 ◽

2003 ◽

Vol 24 (8) ◽

pp. 584-590 ◽

Cited By ~ 8

Author(s):

Titia E. M. Kamp-Hopmans ◽

Hetty E. M. Blok ◽

Annet Troelstra ◽

Ada C. M. Gigengack-Baars ◽

Annemarie J. L. Weersink ◽

...

Keyword(s):

Medical Center ◽

University Hospital ◽

Incidence Density ◽

Gynecologic Surgery ◽

Prospective Surveillance ◽

Oncologic Surgery ◽

Prevalence Survey ◽

Hospital Acquired Infections ◽

Tract Infections ◽

Hospital Acquired

AbstractObjectives:To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections.Methods:Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and vascular, thoracic, orthopedic, and general gynecologic and gynecologic-oncologic surgery of the University Medical Center Utrecht, the Netherlands. Data were collected from patients with and without infections, using criteria of the Centers for Disease Control and Prevention.Results:The infection control team recorded 648 hospital-acquired infections affecting 550 (14%) of 3,845 patients. The incidence density was 17.8 per 1,000 patient-days. Patients with hospital-acquired infections were hospitalized for 19.8 days versus 7.7 days for patients without hospital-acquired infections.Prolongation of stay among patients with hospital-acquired infections may have resulted in 664 fewer admissions due to unavailable beds. Different specialties were associated with different infection rates at different sites, requiring a tailor-made approach. Interventions were recommended for respiratory tract infections in the thoracic surgery ward and for surgical-site infections in the orthopedic and gynecologic surgery wards.Conclusions:Surveillance in four surgical wards showed that each had its own prominent infection, risk factors, and indications for specific recommendations. Because prospective surveillance requires extensive resources, we considered a modified approach based on a half-yearly point-prevalence survey of hospital-acquired infections in all wards of our hospital. Such surveillance can be extended with procedure-specific prospective surveillance when indicated.

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