Changing infection control measures to reduce MRSA infection rates after fracture surgery

2006 ◽  
Vol 10 (2) ◽  
pp. 95-97
Author(s):  
Feroz Dinah ◽  
Ajeya Adhikari
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Infection Rates ◽  
Infection Control Measures ◽  
Mrsa Infection ◽  
Fracture Surgery

scholarly journals Retrospective Study on Personal Protective Equipment During Pandemic Link to Outbreak of Carbpenem-Resistant Enterobacteriace

2021 ◽  
Vol 1 (S1) ◽  
pp. s9-s10
Author(s):  
Kenisha Evans ◽  
Jennifer LeRose ◽  
Angela Beatriz Cruz ◽  
Lavina Jabbo ◽  
Teena Chopra
Keyword(s):  
Retrospective Study ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Horizontal Transmission ◽  
Control Measures ◽  
Protective Equipment ◽  
Local Health ◽  
Infection Rates ◽  
Infection Control Measures ◽  
The Impact

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None

scholarly journals Preparing for future waves and pandemics: a global hospital survey on infection control measures and infection rates in COVID-19

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Simon Matoori ◽  
Daniel R. Kuritzkes ◽  
Yonggeng Goh ◽  
Swee Tian Quek ◽  
Liang Wang ◽  
...  
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Infection Rate ◽  
Health Care Workers ◽  
Control Measures ◽  
Infection Rates ◽  
Infection Control Measures ◽  
Care Workers

AbstractA survey of hospitals on three continents was performed to assess their infection control preparedness and measures, and their infection rate in hospital health care workers during the COVID-19 pandemic. All surveyed hospitals used similar PPE but differences in preparedness, PPE shortages, and infection rates were reported.

scholarly journals Implementation of an infection prevention bundle and increased physician awareness improves surgical outcomes and reduces costs associated with spine surgery

2018 ◽  
Vol 29 (1) ◽  
pp. 108-114 ◽  
Author(s):  
Nitin Agarwal ◽  
Prateek Agarwal ◽  
Ashley Querry ◽  
Anna Mazurkiewicz ◽  
Zachary J. Tempel ◽  
...  
Keyword(s):  
Infection Control ◽  
Infection Rate ◽  
Spine Surgery ◽  
Infection Prevention ◽  
Cost Savings ◽  
Control Measures ◽  
Control Group ◽  
Infection Rates ◽  
Infection Control Measures ◽  
Physician Awareness

OBJECTIVEPrevious studies have demonstrated the efficacy of infection prevention protocols in reducing infection rates. This study investigated the effects of the development and implementation of an infection prevention protocol that was augmented by increased physician awareness of spinal fusion surgical site infection (SSI) rates and resultant cost savings.METHODSA cohort clinical investigation over a 10-year period was performed at a single tertiary spine care academic institution. Preoperative infection control measures (chlorohexidine gluconate bathing, Staphylococcus aureus nasal screening and decolonization) followed by postoperative infection control measures (surgical dressing care) were implemented. After the implementation of these infection control measures, an awareness intervention was instituted in which all attending and resident neurosurgeons were informed of their individual, independently adjudicated spinal fusion surgery infection rates and rankings among their peers. During the course of these interventions, the overall infection rate was tracked as well as the rates for those neurosurgeons who complied with the preoperative and postoperative infection control measures (protocol group) and those who did not (control group).RESULTSWith the implementation of postoperative surgical dressing infection control measures and physician awareness, the postoperative spine surgery infection rate decreased by 45% from 3.8% to 2.1% (risk ratio 0.55; 95% CI 0.32–0.93; p = 0.03) for those in the protocol cohort, resulting in an estimated annual cost savings of $291,000. This reduction in infection rate was not observed for neurosurgeons in the control group, although the overall infection rate among all neurosurgeons decreased by 54% from 3.3% to 1.5% (risk ratio 0.46; 95% CI 0.28–0.73; p = 0.0013).CONCLUSIONSA novel paradigm for spine surgery infection control combined with physician awareness methods resulted in significantly decreased SSI rates and an associated cost reduction. Thus, information sharing and physician engagement as a supplement to formal infection control measures result in improvements in surgical outcomes and costs.

The Hygienic Situation in 56 German, 33 Austrian, and 25 Belgian Intensive Care Units

1987 ◽  
Vol 8 (9) ◽  
pp. 376-379 ◽  
Author(s):  
H. Benzer ◽  
P. Brühl ◽  
W. Dietzel ◽  
J. Kilian ◽  
F. Lackner ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Infection Rate ◽  
Control Measures ◽  
Teaching Hospitals ◽  
Infection Rates ◽  
Small Unit ◽  
Infection Control Measures ◽  
Life Saving ◽  
High Standards

The intensive care unit (ICU) creates the unique situation of subjecting highly susceptible patients to a variety of invasive procedures that are concentrated in a small unit. Effectively providing life-saving care is considered more important than other measures, such as infection control. Nevertheless, it is frustrating to lose a patient due to a sepsis that could have been prevented by simple hygienic arrangements, the application of aseptic techniques, and infection control measures. There is some confusion about the necessity and efficacy of many of these prescriptions, and some of them must certainly be considered rituals: only controlled studies demonstrating the influence of the specific measure on the infection rate will give a decisive answer about usefulness. Most factors determining the occurrence and transmission of infections lie with the patient's resistance and treatment, but technical, diagnostic, and curative measures may also influence the infection rate. Facilities, techniques followed, and prescribed procedures may differ from hospital to hospital. If we want to draw a conclusion from the comparison of infection rates in different ICUs, it is desirable to compare not only the different preventive measures in nursing procedures and techniques, but also the organization and structure of the units. Therefore, our committee decided to study the hygienic situation of ICUs before elaborating a practicable and valuable system for the registration of nosocomial infections. The study was not limited to the small group of interested teaching hospitals with high standards, but rather, was extended to all Austrian (A) ICUs and a significative sample of German (D) and Belgian (B) ICUs.

Relationship between the Prevalence of Methicillin-ResistantStaphylococcus aureusInfection and Indicators of Nosocomial Infection Control Measures A Population-Based Study in French Hospitals

2009 ◽  
Vol 30 (9) ◽  
pp. 861-869 ◽  
Author(s):  
Leslie Grammatico-Guillon ◽  
Jean-Michel Thiolet ◽  
Pascale Bernillon ◽  
Bruno Coignard ◽  
Babak Khoshnood ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Population Based ◽  
Mean Value ◽  
Control Measures ◽  
Prevalence Survey ◽  
Infection Control Measures ◽  
Mrsa Infection ◽  
The Mean ◽  
National Prevalence

Objective.To assess whether infection control indicators are associated with the prevalence of methicillin-resistantStaphylococcus aureus(MRSA) infection in French hospitals.Methods.We linked the database for the 2006 national prevalence survey of nosocomial infection with the database of infection control indicators (comprised of ICALIN, an indicator of infection control organization, resources, and action, and ICSHA, an indicator of alcohol-based handrub consumption) recorded from hospitals by the Ministry of Health. Data on MRSA infection were obtained from the national prevalence survey database and included the site and origin of infection, the microorganism responsible, and its drug resistance profile. Because the prevalence of MRSA infection was low and often nil, especially in small hospitals, we restricted our analysis to hospitals with at least 300 Patients. We used a multilevel logistic regression model to assess the joint effects of patient-level variables (eg, age, sex, or infection) and hospital-level variables (infection control indicators).Results.Two hundred two hospitals had at least 300 patients, for a total of 128,631 Patients. The overall prevalence of MRSA infection was 0.34% (95% confidence interval [CI], 0.29%-0.39%). The mean value for ICSHA was 7.8 L per 1,000 patient-days (median, 6.1 L per 1,000 patient-days; range, 0-33 L per 1,000 patient-days). The mean value for ICALIN was 92 of a possible 100 points (median, 94.5;range, 67-100). Multilevel analyses showed that ICALIN scores were associated with the prevalence of MRSA infection (odds ratio for a score change of 1 standard deviation, 0.80;95% CI, 0.69-0.93). We found no association between prevalence of MRSA infection and ICSHA. Other variables significantly associated with the prevalence of MRSA infection were sex, vascular or urinary catheter, previous surgery, and the McCabe score.Conclusions.We found a significant association between the prevalence of MRSA infection and ICALIN that suggested that a higher ICALIN score may be predictive of a lower prevalence of MRSA infection.

scholarly journals The Prevalence, Risk, and Management of Methicillin-Resistant Staphylococcus aureus Infection in Diverse Populations across Canada: A Systematic Review

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 393 ◽  
Author(s):  
Elena Mitevska ◽  
Britney Wong ◽  
Bas G. J. Surewaard ◽  
Craig N. Jenne
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Control Measures ◽  
Diverse Populations ◽  
Methicillin Resistant ◽  
Infection Control Measures ◽  
Mrsa Infection

Methicillin-resistant Staphylococcus aureus (MRSA) first emerged after methicillin was introduced to combat penicillin resistance, and its prevalence in Canada has increased since the first MRSA outbreak in the early 1980s. We reviewed the existing literature on MRSA prevalence in Canada over time and in diverse populations across the country. MRSA prevalence increased steadily in the 1990s and 2000s and remains a public health concern in Canada, especially among vulnerable populations, such as rural, remote, and Indigenous communities. Antibiotic resistance patterns and risk factors for MRSA infection were also reported. All studies reported high susceptibility (>85%) to trimethoprim-sulfamethoxazole, with no significant resistance reported for vancomycin, linezolid, or rifampin. While MRSA continues to have susceptibility to several antibiotics, the high and sometimes variable resistance rates to other drugs underscores the importance of antimicrobial stewardship. Risk factors for high MRSA infection rates related to infection control measures, low socioeconomic status, and personal demographic characteristics were also reported. Additional surveillance, infection control measures, enhanced anti-microbial stewardship, and community education programs are necessary to decrease MRSA prevalence and minimize the public health risk posed by this pathogen.

Significance of Nosocomial Infection Rates in the Era of DRGs

1986 ◽  
Vol 7 (10) ◽  
pp. 506-507 ◽  
Author(s):  
Peter C. Fuchs ◽  
Marie E. Gustafson
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Infection Rate ◽  
Control Measures ◽  
Infection Rates ◽  
Important Data ◽  
Medical Practices ◽  
Control Programs ◽  
Infection Control Measures ◽  
False Sense

Nosocomial infection rates, as determined by either incidence or prevalence methods, are considered important data in infection control programs. Many factors besides infection control measures affect infection rates— eg, illness acuity of the patient population. However, there is evidence that when these factors remain constant, a lowering of the infection rate can be the result of infection control efforts. We wish to illustrate how a dramatic drop in infection rate may mislead infection control personnel into a false sense of accomplishment, when in reality it is an effect of changing medical practices.

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