scholarly journals Nosocomial Infection in an Iranian Neonatal Intensive Care Unit: Hospital Epidemiology and Risk Factors

2020 ◽  
Vol 8 (4) ◽  
Author(s):  
Farhad Choobdar ◽  
Zahra Vahedi ◽  
Nastaran Khosravi ◽  
Nasrin Khalesi ◽  
Asma Javid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Hospital Stay ◽  
Neonatal Intensive Care ◽  
Infected Group ◽  
Control Group ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Hospital Infection Control ◽  
Hospital Acquired

Background: Hospital-acquired infection is one of the main concerns in Neonatal Intensive Care Units (NICUs), leading to increased mortality, hospital stay, and costs. Objectives: This study aimed to investigate the risk factors of hospital-acquired infection in NICUs. Methods: A descriptive, cross-sectional, prospective study was conducted in the NICU of Ali Asghar Children Hospital for one year. All admitted newborns were sampled on a simple basis. The criteria for the diagnosis of hospital-acquired infection were based on the definitions of the CDC and the NNIS system. Risk factors such as days of fully catheters usage, nurse-to-patient ratio, history of surgery, prematurity, and mechanical ventilation were considered as variables. The data collection tools consisted of a patient information questionnaire, the monthly report of the hospital infection control committee based on the NNIS system, a daily schedule of all risk factors for each infant, and the monthly nurse-to-patient ratio in the NICU. The STATA software was used for data analysis. Results: In our study, 654 newborns were enrolled. The rate of hospital-acquired infections was 13.5%. Moreover, 80.7% of the cases exhibited sepsis (72.7% diagnosed based on clinical findings and 8% based on positive blood culture). Statistical analysis showed 9% pneumonia cases, 8% surgical site infection cases, and 2.3% urinary tract infection cases. The average time to the occurrence of hospital-acquired infection was 13.5 days after admission. All risk factors were significantly higher in the infected group than in the control group (P = 0.0001). Furthermore, surgical interventions were significantly more in the infected group than in the non-infected group (34.1% vs. 6.7%, respectively, P = 0.0001). The prevalence rates in different weight ranges (less than 1000 g, 1001 to 1500 g, 1501 to 2500, and above 2501 g) were 2.6%, 6.9%, 21.4%, and 69.1%, respectively, in the infected group, which were significantly different from those of the non-infected group (P = 0.0001). The most common etiologic microorganism was Acinetobacter baumannii. Conclusions: Factors such as surgery, the presence of a central venous catheter, and the increased length of hospital stay significantly increased the hospital-acquired infections. Reducing invasive procedures, maintenance of full catheters, and providing optimal nursing care can help control hospital-acquired infections.

Epidemiology, antimicrobial resistance, and incremental medical costs of hospital-acquired infections in the Intensive Care Unit: 2-year experience from Serbia

2019 ◽  
Author(s):  
Aleksa Jovan Despotovic ◽  
Branko Milosevic ◽  
Ivana Milosevic ◽  
Andja Cirkovic ◽  
Snezana D Jovanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Length Of Stay ◽  
Fold Increase ◽  
Antimicrobial Treatment ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Resistance Rates ◽  
Hospital Acquired

Abstract Background: Hospital-acquired infections are a major complication of hospital treatment. The growing presence of multidrug-resistant pathogens contributes to increased mortality and costs, particularly in intensive care units where patients are predisposed to numerous risk factors. Comprehensive data about hospital-acquired infections from Serbian intensive care units is scarce. The aim of this study was to determine the presence of hospital-acquired infections among intensive care unit patients and look into the patterns of antimicrobial resistance, risk factors, and incremental costs of diagnosis and antimicrobial treatment. Methods: This retrospective study included 355 patients over a two-year period. Etiology, antimicrobial resistance patterns, and incremental costs of diagnosis and antimicrobial treatment were examined. Risk factors for infection acquisition, as well as length of stay, were statistically analyzed using Pearson’s chi-square tests and logistic regression analysis. Results: At least one hospital-acquired infection was identified in 32.7% of patients. A total of 204 infection episodes were documented, the most common type being urinary tract infections (36.3%). Clostridium difficile , Klebsiella spp. , and Acinetobacter baumanii were the most common isolates. Antimicrobial resistance rates < 20% were observed for linezolid (0%), colistin (9%), and tigecycline (14%). Resistance rates > 50% were seen in all other tested antibiotic agents. Mortality rates were not higher in patients who acquired only one hospital-acquired infection (p=0.09), but were significantly higher for patients in whom more than one episode occurred (p=0.038). Length of stay > 20 days carried a 7.5-fold increase in odds of acquiring an infection (CI 4.4-12.7, p<0.001), whereas length of stay > 30 days carried a 10-fold increase (CI 5.5-16.1, p<0.001). During the study period, over 37,000 EUR was incrementally spent on diagnosis and antimicrobial treatment for hospital-acquired infections. Conclusion: Our results suggest a high prevalence of hospital-acquired infections and very high antimicrobial resistance rates compared to most European countries. Together with the first published results regarding incremental costs from Serbia, our observations require large-scale prospective follow-up studies in order to obtain a deeper insight into the actual burden of hospital-acquired infections.

Effectiveness of Chlorhexidine Wipes for the Prevention of Multidrug-Resistant Bacterial Colonization and Hospital-Acquired Infections in Intensive Care Unit Patients: A Randomized Trial in Thailand

2015 ◽  
Vol 37 (3) ◽  
pp. 245-253 ◽  
Author(s):  
Adhiratha Boonyasiri ◽  
Peerapat Thaisiam ◽  
Chairat Permpikul ◽  
Tepnimitr Judaeng ◽  
Bordeesuda Suiwongsa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hospital Stay ◽  
Bacterial Colonization ◽  
Controlled Trial ◽  
Multidrug Resistant ◽  
Control Group ◽  
Open Label ◽  
Skin Reactions ◽  
Hospital Acquired Infection ◽  
Hospital Acquired

OBJECTIVETo determine the effectiveness of daily bathing with 2% chlorhexidine-impregnated washcloths in preventing multidrug-resistant (MDR) gram-positive bacterial colonization and bloodstream infection.METHODSA randomized, open-label controlled trial was conducted in 4 medical intensive care units (ICUs) in Thailand from December 2013 to January 2015. Patients were randomized to receive cleansing with non-antimicrobial soap (control group) or 2% chlorhexidine-impregnated washcloths used to wipe the patient’s body once daily (chlorhexidine group). Swabs were taken from nares, axilla, antecubital, groin, and perianal areas on admission and on day 3, 5, 7, and 14. The 5 outcomes were (1) favorable events ( all samples negative throughout ICU admission, or initially positive samples with subsequent negative samples); (2) MDR bacteria colonization-free time; (3) hospital-acquired infection; (4) length of ICU and hospital stay; (5) adverse skin reactions.RESULTSA total of 481 patients were randomly assigned to the control group (241) or the chlorhexidine group (240). Favorable events at day 14 were observed in 34.8% of patients in the control group and 28.6% in the chlorhexidine group (P=.79). Median MDR bacteria colonization-free times were 5 days in both groups. The incidence rate of hospital-acquired infection and the length of the ICU and hospital stay did not differ significantly between groups. The incidence of adverse skin reactions in the chlorhexidine group was 2.5%.CONCLUSIONThe effectiveness of 2% chlorhexidine-impregnated washcloths for the prevention of MDR gram-negative bacteria colonization and hospital-acquired infection in adult patients in ICU was not proven.TRIAL REGISTRATIONClinicalTrials.gov identifier: NCT01989416.Infect. Control Hosp. Epidemiol. 2016;37(3):245–253

scholarly journals Hospital-Acquired Infections among Adult Patients Admitted for COVID-19

2021 ◽  
pp. 1-15
Author(s):  
Leigh Smith ◽  
Sara M Karaba ◽  
Joe Amoah ◽  
George Jones ◽  
Robin Avery ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Antibiotic Exposure ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Multicenter Cohort ◽  
Hospital Acquired

Abstract In a multicenter cohort of 963 adults hospitalized due to COVID-19, 5% had a proven hospital-acquired infection (HAI) and 21% had a proven/probable or possible HAI. Risk factors for proven/probable HAIs included intensive care unit admission, dexamethasone use, severe COVID-19, heart failure and antibiotic exposure upon admission.

scholarly journals Analysis of the Risk Factors Associated with Hearing Loss of Infants Admitted to a Neonatal Intensive Care Unit: A 13-Year Experience in a University Hospital in Korea

2020 ◽  
Vol 17 (21) ◽  
pp. 8082
Author(s):  
Kyu Young Choi ◽  
Bum Sang Lee ◽  
Hyo Geun Choi ◽  
Su-Kyoung Park
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Significant Risk ◽  
University Hospital ◽  
Control Group ◽  
Brainstem Response

Early detection of hearing loss in neonates is important for normal language development, especially for infants admitted to the neonatal intensive care unit (NICU) because the infants in NICU have a higher incidence of hearing loss than healthy infants. However, the risk factors of hearing loss in infants admitted to the NICU have not been fully acknowledged, especially in Korea, although they may vary according to the circumstances of each country and hospital. In this study, the risk factors of hearing loss in NICU infants were analyzed by using the newborn hearing screening (NHS) and the diagnostic auditory brainstem response (ABR) test results from a 13-year period. A retrospective chart review was performed using a list of NICU infants who had performed NHS from 2004 to 2017 (n = 2404) in a university hospital in Korea. For the hearing loss group, the hearing threshold was defined as 35 dB nHL or more in the ABR test performed in infants with a ‘refer’ result in the NHS. A four multiple number of infants who had passed the NHS test and matched the age and gender of the hearing loss group were taken as the control group. Various patient factors and treatment factors were taken as hearing loss related variables and were analyzed and compared. From the 2404 infants involved, the prevalence of hearing loss was 1.8% (n = 43). A comparison between the hearing loss group (n = 43) and the control group (n = 172) revealed that history of sepsis, peak total bilirubin, duration of vancomycin use, days of phototherapy, and exposure to loop-inhibiting diuretics were significantly different, and can be verified as significant risk factors for hearing loss in NICU infants.

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