Correcting for bias when estimating the cost of hospital-acquired infection: an analysis of lower respiratory tract infections in non-surgical patients

2005 ◽  
Vol 14 (7) ◽  
pp. 755-761 ◽  
Author(s):  
Nicholas Graves ◽  
Diana Weinhold ◽  
Jennifer A. Roberts
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Surgical Patients ◽  
Lower Respiratory Tract Infections ◽  
Hospital Acquired Infection ◽  
Tract Infections ◽  
The Cost ◽  
Hospital Acquired

scholarly journals Effect of the “Normalized Epidemic Prevention and Control Requirements” on hospital-acquired and community-acquired infections in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Caiyun Chen ◽  
Ping Zhu ◽  
Yongxiang Zhang ◽  
Bo Liu
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Prevention And Control ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections ◽  
Hospital Acquired ◽  
And Control ◽  
Over Time

Abstract Background No studies have yet reported the effect of prevention and control measures, which were implemented to combat COVID-19, on the prevention and control of common HAIs. We aimed to examine the effect of the “Normalized Epidemic Prevention and Control Requirements” (implemented in May 2020) by comparison of hospital-acquired infections (HAIs) and community-acquired infections (CAIs) in China during 2018, 2019, and 2020. Methods Data of inpatients before and after implementation of new requirements were retrospectively analyzed, including infection rate, use of alcohol-based hand cleaner, anatomical sites of infections, pathogen species, infection by multi-drug resistant species, and use of different antibiotics. Results The HAI rate was significantly higher in 2020 than in 2018 and 2019 (P < 0.05), and the CAI rate was significantly higher in 2019 and 2020 than in 2018 (P < 0.001). Lower respiratory tract infections were the most common HAI during all years, with no significant changes over time. Lower respiratory tract infections were also the most common CAI, but were significantly more common in 2018 and 2019 than 2020 (P < 0.001). There were no changes in upper respiratory tract infections among HAIs or CAIs. Most HAIs and CAIs were from Gram-negative bacteria, and the percentages of fungal infections were greater in 2019 and 2020 than 2018. MRSA infections were more common in 2020 than in 2018 and 2019 (P < 0.05). The utilization rate and usage days of antibiotics decreased over time (P < 0.001) and the culture rate of microbial specimens before antibiotic usage increased over time (P < 0.001). Conclusions The new prevention and control requirements provided important benefits during the COVID-19 pandemic. However, their effects on HAIs were not obvious.

scholarly journals Practical Comparison of the BioFire FilmArray Pneumonia Panel to Routine Diagnostic Methods and Potential Impact on Antimicrobial Stewardship in Adult Hospitalized Patients with Lower Respiratory Tract Infections

2020 ◽  
Vol 58 (7) ◽  
Author(s):  
Blake W. Buchan ◽  
Sam Windham ◽  
Joan-Miquel Balada-Llasat ◽  
Amy Leber ◽  
Amanda Harrington ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Diagnostic Methods ◽  
Lower Respiratory Tract Infections ◽  
Percent Agreement ◽  
Tract Infections ◽  
Hospital Acquired ◽  
The Impact ◽  
Antibiotic Agents

ABSTRACT Lower respiratory tract infections, including hospital-acquired and ventilator-associated pneumonia, are common in hospitalized patient populations. Standard methods frequently fail to identify the infectious etiology due to the polymicrobial nature of respiratory specimens and the necessity of ordering specific tests to identify viral agents. The potential severity of these infections combined with a failure to clearly identify the causative pathogen results in administration of empirical antibiotic agents based on clinical presentation and other risk factors. We examined the impact of the multiplexed, semiquantitative BioFire FilmArray Pneumonia panel (PN panel) test on laboratory reporting for 259 adult inpatients submitting bronchoalveolar lavage (BAL) specimens for laboratory analysis. The PN panel demonstrated a combined 96.2% positive percent agreement (PPA) and 98.1% negative percent agreement (NPA) for the qualitative identification of 15 bacterial targets compared to routine bacterial culture. Semiquantitative values reported by the PN panel were frequently higher than values reported by culture, resulting in semiquantitative agreement (within the same log10 value) of 43.6% between the PN panel and culture; however, all bacterial targets reported as >105 CFU/ml in culture were reported as ≥105 genomic copies/ml by the PN panel. Viral targets were identified by the PN panel in 17.7% of specimens tested, of which 39.1% were detected in conjunction with a bacterial target. A review of patient medical records, including clinically prescribed antibiotics, revealed the potential for antibiotic adjustment in 70.7% of patients based on the PN panel result, including discontinuation or de-escalation in 48.2% of patients, resulting in an average savings of 6.2 antibiotic days/patient.

scholarly journals Effect of The “Normalized Epidemic Prevention And Control Requirements” On Hospital-Acquired And Community-Acquired Infections In China

2021 ◽  
Author(s):  
Caiyun Chen ◽  
Ping Zhu ◽  
Yongxiang Zhang ◽  
Bo Liu
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Prevention And Control ◽  
Respiratory Tract Infections ◽  
Antibiotic Use ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections ◽  
Hospital Acquired ◽  
And Control ◽  
Over Time

Abstract Background: No studies have yet reported the effect of prevention and control measures, which were implemented to combat COVID-19, on the prevention and control of common HAIs. We aimed to examine the effect of the “Normalized Epidemic Prevention and Control Requirements” (implemented in May 2020) by comparison of hospital-acquired infections (HAIs) and community-acquired infections (CAIs) in China during 2018, 2019, and 2020.Methods: Data of inpatients before and after implementation of new requirements were retrospectively analyzed, including infection rate, use of alcohol-based hand cleaner, anatomical sites of infections, pathogen species, infection by multi-drug-resistant species, use of different antibiotics, and antibiotic use density. Results: The HAI rate was significantly higher in 2020 than in 2018 and 2019 (P<0.05), and the CAI rate was significantly higher in 2019 and 2020 than in 2018 (P<0.001). Lower respiratory tract infections were the most common HAI during all years, with no significant changes over time. Lower respiratory tract infections were also the most common CAI, but were significantly more common in 2018 and 2019 than 2020 (P<0.001). There were no changes in upper respiratory tract infections among HAIs or CAIs. Most HAIs and CAIs were from Gram-negative bacteria, and the percentages of fungal infections were greater in 2019 and 2020 than 2018. MRSA infections were more common in 2020 than in 2018 and 2019 (P<0.05). The utilization rate and usage days of antibiotics decreased over time (P<0.001), the culture rate of microbial specimens before antibiotics usage increased over time (P<0.001), but antibiotic use density remained steady over time. Conclusions: The new prevention and control requirements provided important benefits during the COVID-19 pandemic. However, their effects on HAIs were not obvious.

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