Protection of Intraluminal Pathway with Zero Fluid Displacement Connector Reduces Catheter-Related Bloodstream Infections in a Comprehensive Cancer Center

2012 ◽  
Vol 17 (2) ◽  
pp. 86-89 ◽  
Author(s):  
Brenda Caillouet
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Infusion Therapy ◽  
Oncology Patient ◽  
Fluid Displacement ◽  
Positive Displacement ◽  
Project Description

Abstract Background/Purpose: Although annual rates of catheter-related bloodstream infections (CR-BSI) in a comprehensive cancer center were below the national average, further reductions were sought. Research indicates that contamination of a catheter's intraluminal pathway is a major cause of CR-BSI. Connectors are the gateway to the intraluminal pathway and studies link positive displacement, negative displacement, and split septum connectors to CR-BSI. Project Description: The infusion therapy team piloted a zero fluid displacement (ZFD) connector based on the design of the ZFD, which appeared uniquely suited to CR-BSI prevention. A product trial was performed in intensive care units to compare the CR-BSI rates associated with the current split septum connector to the ZFD connector. The design was quantitative and quasiexperimental. Results: During the trial, CR-BSI rates decreased from 4.2 (2,331 catheter days) with the split septum connector, to 0.4 (2,477 catheter days) with the ZFD connector. Six months after institutional implementation of the ZFD connector there were zero CR-BSI in the intensive care units across 4,424 catheter days, despite the complexity and acuity of a largely immunocompromised oncology patient population. The previous 6 months with the split septum the CR-BSI rate was 2.24 across 4,920 catheter days. Conclusions: Our institution's success suggests that protecting the intraluminal pathway with a properly designed connector may be more crucial to the prevention bundle than is widely understood or practiced. Other hospitals may achieve comparable results by implementing a similar device.

scholarly journals Impact of a Rapid Diagnostic for Bloodstream Infections with Antimicrobial Stewardship Intervention at a Comprehensive Cancer Center

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S625-S626
Author(s):  
Brian Buss ◽  
Timothy Baures ◽  
Minkyoung Yoo ◽  
Kim Hanson ◽  
Donald Alexander ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Bloodstream Infections ◽  
Comprehensive Cancer Center ◽  
Cancer Center

scholarly journals The national rate of intensive care units-acquired infections, one-year retrospective study in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Neda Izadi ◽  
Babak Eshrati ◽  
Yadollah Mehrabi ◽  
Korosh Etemad ◽  
Seyed-Saeed Hashemi-Nazari
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Increased Risk ◽  
Neonatal Icu ◽  
Mortality Causes ◽  
One Year ◽  
Multi Center Study

Abstract Background Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran. Methods For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of “hospital-ward-month”), and then, the last observation carried forward method was used to replace the missing data. Results The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran’s hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83% of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area. Conclusions HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier.

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.

Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study

2018 ◽  
Vol 57 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ferhat Arslan ◽  
Hulya Caskurlu ◽  
Sema Sarı ◽  
Hayriye Cankar Dal ◽  
Sema Turan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Absolute Risk ◽  
Subsequent Development ◽  
Bloodstream Infections ◽  
Case Control ◽  
Prior Exposure ◽  
Control Study

Abstract Candida bloodstream infections are associated with high mortality among critically ill patients in intensive care units (ICUs). Studies that explore the risk factors for candidemia may support better patient care in intensive care units. We conducted a retrospective, multicenter case-control study to investigate the risk factors for noncatheter-related Candida bloodstream infections (CBSI) in adult ICUs. Participants selected controls randomly on a 1:1 basis among all noncase patients stayed during the same period in ICUs. Data on 139 cases and 140 controls were deemed eligible. Among the controls, 69 patients died. The stratified Fine-Gray model was used to estimate the subdistribution Hazard ratios. The subdistribution hazards and 95% confidence intervals for final covariates were as follows: prior exposure to antimycotic agents, 2.21 (1.56–3.14); prior exposure to N-acetylcysteine, 0.11 (0.03–0.34) and prior surgical intervention, 1.26 (0.76–2.11). Of the patients, those exposed to antimycotic drugs, 87.1% (54/62) had breakthrough candidemia. Serious renal, hepatic, or hematologic side effects were comparable between patients those exposed and not-exposed to systemic antimycotic drugs. Untargeted administration of antimycotic drugs did not improve survival among candidemic patients (not-exposed, 63.6% [49/77]; exposed % 66.1 [41/62]; P = .899). This study documented that exposure to an antifungal agent is associated with increased the risk of subsequent development of CBSIs among nonneutropenic adult patients admitted to the ICU. Only two centers regularly prescribed N-acetylcysteine. Due to the limited number of subjects, we interpreted the positive effect of N-acetylcysteine on the absolute risk of CBSIs with caution.

Analysis of Central Line–Associated Bloodstream Infections in the Intensive Care Unit after Implementation of Central Line Bundles

2010 ◽  
Vol 31 (05) ◽  
pp. 551-553 ◽  
Author(s):  
Emily K. Shuman ◽  
Laraine L. Washer ◽  
Jennifer L. Arndt ◽  
Christy A. Zalewski ◽  
Robert C. Hyzy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Central Line ◽  
Line Bundles ◽  
Blood Samples ◽  
Central Lines ◽  
Definition Of ◽  
Contaminated Blood

Central line-associated bloodstream infections (CLABSIs) have been reduced in number but not eliminated in our intensive care units with use of central line bundles. We performed an analysis of remaining CLABSIs. Many bloodstream infections that met the definition of CLABSI had sources other than central lines or represented contaminated blood samples.

scholarly journals Trends and outcome of 1121 nosocomial bloodstream infections in intensive care units in a Brazilian hospital, 1999–2003

2008 ◽  
Vol 12 (6) ◽  
pp. e145-e146 ◽  
Author(s):  
E. Girão ◽  
A.S. Levin ◽  
M. Basso ◽  
S. Gobara ◽  
L.B. Gomes ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Bloodstream Infections

scholarly journals Bloodstream infections among patients using central venous catheters in intensive care units

2007 ◽  
Vol 15 (3) ◽  
pp. 453-459 ◽  
Author(s):  
Eni Rosa Aires Borba Mesiano ◽  
Edgar Merchán-Hamann
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Analytical Study ◽  
Hospital Costs ◽  
Bloodstream Infections ◽  
Federal District ◽  
Central Venous Catheters ◽  
Central Venous ◽  
Catheter Group ◽  
The Right

Central Venous Catheters (CVC), widely used in Intensive Care Units (ICU) are important sources of bloodstream infections (BSI). This prospective cohort epidemiological analytical study, aimed to infer the incidence of BSI, the risk factors associated and evaluate the care actions related to the use of these catheters in seven ICU in the Federal District - Brasília, Brazil. From the 630 patients using CVC, 6.4% developed BSI (1.5% directly related to the catheter and 4.9% clinic BSI). The hospitalization term was 3.5 times greater among these patients. Different modalities of catheter insertion and antiseptic substances use were observed. Time of CVC permanence was significantly associated to infection incidence (p<1x10-8) as well as the right subclavian access and double-lumen catheters. Patients with neurological disorders and those submitted to tracheotomy were the most affected. We suggest the organization of a "catheter group" aiming to standardize procedures related to the use of catheters in order to reduce the hospitalization term and hospital costs.

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