scholarly journals Airborne and Surface-Bound Microbial Contamination in Two Intensive Care Units of a Medical Center in Central Taiwan

2013 ◽  
Vol 13 (3) ◽  
pp. 1060-1069 ◽  
Author(s):  
Ping-Yun Huang ◽  
Zhi-Yuan Shi ◽  
Chi-Hao Chen ◽  
Walter Den ◽  
Hui-Mei Huang ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Microbial Contamination ◽  
Medical Center ◽  
Central Taiwan

Microbial epidemiology of candidaemia in neonatal and paediatric intensive care units at the Children's Medical Center, Tehran

Mycoses ◽  
2017 ◽  
Vol 61 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Arezu Charsizadeh ◽  
Hossein Mirhendi ◽  
Bahram Nikmanesh ◽  
Hamid Eshaghi ◽  
Koichi Makimura
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medical Center ◽  
Paediatric Intensive Care ◽  
Paediatric Intensive Care Units

Abstract 301: Differential Outcomes for Geriatric Patients in Cardiac Intensive Care Unit Compared to Medical Intensive Care Unit

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Caroline Ong ◽  
Albert Lui ◽  
John A Dodson ◽  
Jordan B Strom ◽  
Carlos Alviar
Keyword(s):  
Older Adults ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Medical Center ◽  
Older Age ◽  
Icu Mortality ◽  
Differential Outcomes ◽  
Medical Intensive Care ◽  
Cardiac Intensive Care

Background: The number of older adults admitted to cardiac intensive care units (CICU) have been increasing over the past decade, but it is not known if outcomes vary between CICU and medical intensive care units (MICU). We aimed to describe survival and length of stay (LOS) in older adults admitted to CICU and MICU. Methods: All patients admitted to the CICU or MICU at Beth Israel Deaconess Medical Center from 2001-2012 were identified from MIMIC-III, a large single-center critical care database containing deidentified clinical data for 38,597 patients. Our primary outcomes were ICU mortality and ICU LOS. Regression analyses were performed adjusting for age, gender, ICU setting and Oxford Acute Severity of Illness Score (OASIS), a severity score developed and validated in critically ill patients for ICU mortality. Results: We included 21,088 MICU patients (48.3% female) and 7,726 CICU patients (42% female). Unadjusted mortality was 13.7% in MICU and 12.5% in CICU (p=0.11). When adjusted for age, gender and OASIS, there was no difference in mortality between MICU and CICU (OR 0.62, 95% CI 0.34-1.13, p=0.15). However, we found a significant interaction between older age and type of ICU with mortality (p=0.03) but not with ICU LOS (p=0.15). In patients >75 years (6,837 in MICU and 3,161 in CICU), each 5-year interval of older age was associated with higher mortality when adjusted for gender and OASIS in the CICU (OR 1.05, 95% CI 1.02-1.08 p=0.002), but not in the MICU (OR 1.01, 95% CI 0.99-1.03, p=0.15, Figure). Conclusion: Older adults admitted to the CICU had higher adjusted mortality by age group after age 75, as opposed to older MICU patients in whom mortality was high but remained unchanged after age 75.

Clinical Incidence of Methicillin-Resistant Staphylococcus aureus (MRSA) Colonization or Infection as a Proxy Measure for MRSA Transmission in Acute Care Hospitals

2011 ◽  
Vol 32 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Pei-Jean I. Feng ◽  
Alexander J. Kallen ◽  
Katherine Ellingson ◽  
Robert Muder ◽  
Rajiv Jain ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Medical Center ◽  
Correlation Coefficients ◽  
Veterans Affairs ◽  
Proxy Measure ◽  
Trends Over Time ◽  
Mrsa Colonization

Background.The incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection has been used as a proxy measure for MRSA transmission, but incidence calculations vary depending on whether active surveillance culture (ASC) data are included.Objective.To evaluate the relationship between incidences of MRSA colonization or infection calculated with and without ASCs in intensive care units and non-intensive care units.Setting.A Veterans Affairs medical center.Methods.From microbiology records, incidences of MRSA colonization or infection were calculated with and without ASC data. Correlation coefficients were calculated for the 2 measures, and Poisson regression was used to model temporal trends. A Poisson interaction model was used to test for differences in incidence trends modeled with and without ASCs.Results.The incidence of MRSA colonization or infection calculated with ASCs was 4.9 times higher than that calculated without ASCs. Correlation coefficients for incidences with and without ASCs were 0.42 for intensive care units, 0.59 for non-intensive care units, and 0.48 hospital-wide. Trends over time for the hospital were similar with and without ASCs (incidence rate ratio with ASCs, 0.95 [95% confidence interval, 0.93-0.97]; incidence rate ratio without ASCs, 0.95 [95% confidence interval, 0.92-0.99]; P = .68). Without ASCs, 35% of prevalent cases were falsely classified as incident.Conclusions.At 1 Veterans Affairs medical center, the incidence of MRSA colonization or infection calculated solely on the basis of clinical culture results commonly misclassified incident cases and underestimated incidence, compared with measures that included ASCs; however, temporal changes were similar. These findings suggest that incidence measured without ASCs may not accurately reflect the magnitude of MRSA transmission but may be useful for monitoring transmission trends over time, a crucial element for evaluating the impact of prevention activities.

Microbial Air Contamination in an Intensive Care Unit

2015 ◽  
Vol 4 (3) ◽  
pp. 145
Author(s):  
Chih-Yi Chang ◽  
Liang Tseng ◽  
Lung-Shih Yang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Center ◽  
Statistical Significance ◽  
Incidence Density ◽  
Air Contamination ◽  
Care Services ◽  
Air Sampler ◽  
Significant Difference ◽  
Central Taiwan

Unit layout affects every aspect of intensive care services, including patient safety. A previous study has shown that patients admitted to beds adjacent to the sink and to the door of a large bayroom had the highest number of positive blood cultures and the highest blood culture incidence density, respectively. The present study measures microbial air contamination in a medical intensive care unit of a medical center in central Taiwan. Of the 17 rooms, 8 rooms with distinct physical environmental characteristics were selected. Sampling tests were conducted between December 2013 and February 2014 with a microbial air sampler (MAS-100NT). TSA was used for bacteria collection and DG18 for fungi collection. The overall average bacterial and fungal concentrations were 83CFU/m<sup>3</sup> and 69CFU/m<sup>3</sup>, respectively. The ranges were between 8-354 CFU/m<sup>3</sup> and 0-1468 CFU/m<sup>3</sup>, respectively. A significant difference was found in the bacterial concentration (p=.005) between different room locations. The highest concentration was found in the rooms located at the front end of the circulation (99 CFU/m<sup>3</sup>), while the lowest was found in the rooms located at the rear end of the circulation (55CFU/m<sup>3</sup>). Differences in fungal concentrations for different room locations did not reach statistical significance. In addition, differences in bacterial and fungal concentrations for rooms with different sink locations did not reach statistical significance. Even though the microbial concentrations generally complied with standards, the results may help designers and hospital administrators develop a healthier environment for patients.

The impact of formulary restriction on the relative consumption of carbapenems in intensive care units at an academic medical center

2019 ◽  
Vol 40 (9) ◽  
pp. 1056-1058
Author(s):  
Jacob W. Pierce ◽  
Andrew Kirk ◽  
Kimberly B. Lee ◽  
John D. Markley ◽  
Amy Pakyz ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medical Center ◽  
Academic Medical Center ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Surgical Intensive Care ◽  
Academic Medical ◽  
The Impact ◽  
Formulary Restriction

AbstractAntipseudomonal carbapenems are an important target for antimicrobial stewardship programs. We evaluated the impact of formulary restriction and preauthorization on relative carbapenem use for medical and surgical intensive care units at a large, urban academic medical center using interrupted time-series analysis.

scholarly journals Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series

BMJ ◽  
2020 ◽  
pp. m1996 ◽  
Author(s):  
Michael G Argenziano ◽  
Samuel L Bruce ◽  
Cody L Slater ◽  
Jonathan R Tiao ◽  
Matthew R Baldwin ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
New York City ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Symptom Onset ◽  
Medical Center ◽  
Kidney Injury ◽  
Bimodal Distribution ◽  
Presenting Symptoms

Abstract Objective To characterize patients with coronavirus disease 2019 (covid-19) in a large New York City medical center and describe their clinical course across the emergency department, hospital wards, and intensive care units. Design Retrospective manual medical record review. Setting NewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center in New York City. Participants The first 1000 consecutive patients with a positive result on the reverse transcriptase polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented to the emergency department or were admitted to hospital between 1 March and 5 April 2020. Patient data were manually abstracted from electronic medical records. Main outcome measures Characterization of patients, including demographics, presenting symptoms, comorbidities on presentation, hospital course, time to intubation, complications, mortality, and disposition. Results Of the first 1000 patients, 150 presented to the emergency department, 614 were admitted to hospital (not intensive care units), and 236 were admitted or transferred to intensive care units. The most common presenting symptoms were cough (732/1000), fever (728/1000), and dyspnea (631/1000). Patients in hospital, particularly those treated in intensive care units, often had baseline comorbidities including hypertension, diabetes, and obesity. Patients admitted to intensive care units were older, predominantly male (158/236, 66.9%), and had long lengths of stay (median 23 days, interquartile range 12-32 days); 78.0% (184/236) developed acute kidney injury and 35.2% (83/236) needed dialysis. Only 4.4% (6/136) of patients who required mechanical ventilation were first intubated more than 14 days after symptom onset. Time to intubation from symptom onset had a bimodal distribution, with modes at three to four days, and at nine days. As of 30 April, 90 patients remained in hospital and 211 had died in hospital. Conclusions Patients admitted to hospital with covid-19 at this medical center faced major morbidity and mortality, with high rates of acute kidney injury and inpatient dialysis, prolonged intubations, and a bimodal distribution of time to intubation from symptom onset.

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