scholarly journals Diminishing Surgical Site Infections in Australia: Time Trends in Infection Rates, Pathogens and Antimicrobial Resistance Using a Comprehensive Victorian Surveillance Program, 2002–2013

2015 ◽  
Vol 36 (4) ◽  
pp. 409-416 ◽  
Author(s):  
Leon J. Worth ◽  
Ann L. Bull ◽  
Tim Spelman ◽  
Judith Brett ◽  
Michael J. Richards
Keyword(s):  
Risk Reduction ◽  
Time Trends ◽  
Artery Bypass ◽  
Surgical Site Infections ◽  
Surveillance Program ◽  
Healthcare Associated Infection ◽  
Surveillance Strategy ◽  
Healthcare Facilities ◽  
Surgical Antibiotic Prophylaxis ◽  
Healthcare Associated

OBJECTIVETo evaluate time trends in surgical site infection (SSI) rates and SSI pathogens in Australia.DESIGNProspective multicenter observational cohort study.SETTINGA group of 81 Australian healthcare facilities participating in the Victorian Healthcare Associated Infection Surveillance System (VICNISS).PATIENTSAll patients underwent surgeries performed between October 1, 2002, and June 30, 2013. National Healthcare Safety Network SSI surveillance methods were employed by the infection prevention staff at the participating hospitals.INTERVENTIONProcedure-specific risk-adjusted SSI rates were calculated. Pathogen-specific and antimicrobial-resistant (AMR) infections were modeled using multilevel mixed-effects Poisson regression.RESULTSA total of 183,625 procedures were monitored, and 5,123 SSIs were reported. Each year of observation was associated with 11% risk reduction for superficial SSI (risk ratio [RR], 0.89; 95% confidence interval [CI], 0.88–0.90), 9% risk reduction for deep SSI (RR, 0.91; 95% CI, 0.90–0.93), and 5% risk reduction for organ/space SSI (RR, 0.95; 95% CI, 0.93–0.97). Overall, 3,318 microbiologically confirmed SSIs were reported. Of these SSIs, 1,174 (35.4%) were associated with orthopedic surgery, 827 (24.9%) with coronary artery bypass surgery, 490 (14.8%) with Caesarean sections, and 414 (12.5%) with colorectal procedures. Staphylococcus aureus was the most frequently identified pathogen, and a statistically significant increase in infections due to ceftriaxone-resistant Escherichia coli was observed (RR, 1.37; 95% CI, 1.10–1.70).CONCLUSIONSStandardized SSI surveillance methods have been implemented in Victoria, Australia. Over an 11-year period, diminishing rates of SSIs have been observed, although AMR infections increased significantly. Our findings facilitate the refinement of recommended surgical antibiotic prophylaxis regimens and highlight the need for a more expansive national surveillance strategy to identify changes in epidemiology.Infect Control Hosp Epidemiol 2015;00(0): 1–8

scholarly journals Building an Interactive Geospatial Visualization Application for National Healthcare-Associated Infection Surveillance (Preprint)

2020 ◽  
Author(s):  
Shuai Zheng ◽  
Jonathan R. Edwards ◽  
Margaret A. Dudeck ◽  
Prachi Patel ◽  
Lauren Wattenmaker ◽  
...  
Keyword(s):  
Quality Measurement ◽  
Healthcare Facility ◽  
The United States ◽  
Surveillance Program ◽  
Development Effort ◽  
Healthcare Associated Infection ◽  
Healthcare Facilities ◽  
National Healthcare ◽  
State And Local ◽  
Healthcare Associated

BACKGROUND The Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) is the most widely used healthcare-associated infection (HAI) and antimicrobial use and resistance (AUR) surveillance program in the United States. Over 37,000 healthcare facilities participate in the program and submit a large volume of HAI and AUR surveillance data. These data are used by the facilities themselves, CDC, and other agencies and organizations for a variety of purposes, including infection prevention, antimicrobial stewardship, and clinical quality measurement. Among the summary metrics made available by NHSN are standardized infection ratios (SIRs), which are used to identify HAI prevention needs and measure progress at the national, regional, state and local levels. OBJECTIVE To extend the use of geospatial methods and tools to NHSN data, and in turn to promote and inspire new uses of the rendered data for analysis and prevention purposes, we developed a web-enabled system that enables integrated visualization of HAI metrics and supporting data. METHODS We leveraged geocoding and visualization technologies that are readily available and in current use to develop a web-enabled system designed to support visualization and interpretation of data submitted to NHSN from geographically dispersed sites. The server-client model-based system enables users to access the application via a web-browser. RESULTS We integrated multiple datasets into a single page dashboard designed to enable users to navigate across different HAI event types, choose specific healthcare facility or geographic locations for data displays, and scale across time units within identified time periods. We launched the system for internal CDC use in January 2019. CONCLUSIONS CDC NHSN statisticians, data analysts, and subject matter experts identified opportunities to extend the use of geospatial methods and tools to NHSN data and provided the impetus to develop NHSNViz. The development effort proceeded iteratively, with the developer adding or enhancing functionality and including additional data sets in a series of prototype versions, each of which incorporated user feedback. The initial production version of NHSNViz provides a new geospatial analytic resource built in accordance with CDC user requirements and extensible to additional users and uses in subsequent versions.

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.

scholarly journals The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network

2021 ◽  
pp. 1-14 ◽  
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Vaishnavi Pattabiraman ◽  
Rebecca Y. Konnor ◽  
Prachi R. Patel ◽  
Emily Wong ◽  
...  
Keyword(s):  
State Level ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Objectives: To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infection (HAI) incidence in US hospitals, national- and state-level standardized infection ratios (SIRs) were calculated for each quarter in 2020 and compared to those from 2019. Methods: Central–line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), select surgical site infections, and Clostridioides difficile and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia laboratory-identified events reported to the National Healthcare Safety Network for 2019 and 2020 by acute-care hospitals were analyzed. SIRs were calculated for each HAI and quarter by dividing the number of reported infections by the number of predicted infections, calculated using 2015 national baseline data. Percentage changes between 2019 and 2020 SIRs were calculated. Supporting analyses, such as an assessment of device utilization in 2020 compared to 2019, were also performed. Results: Significant increases in the national SIRs for CLABSI, CAUTI, VAE, and MRSA bacteremia were observed in 2020. Changes in the SIR varied by quarter and state. The largest increase was observed for CLABSI, and significant increases in VAE incidence and ventilator utilization were seen across all 4 quarters of 2020. Conclusions: This report provides a national view of the increases in HAI incidence in 2020. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics.

Outbreak of Healthcare-Associated Infection and Colonization With Multidrug-ResistantSalmonella entericaSerovar Senftenberg in Florida

2007 ◽  
Vol 28 (7) ◽  
pp. 805-811 ◽  
Author(s):  
Robyn S. Kay ◽  
Alexander G. Vandevelde ◽  
Paul D. Fiorella ◽  
Rebecca Crouse ◽  
Carina Blackmore ◽  
...  
Keyword(s):  
Infection Control ◽  
Chronically Ill ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Healthcare Associated Infection ◽  
Healthcare Facilities ◽  
Infection Control Measures ◽  
Healthcare Associated ◽  
Chronically Ill Patients

Background.In July 1999, a rare strain of multidrug-resistantSalmonella entericaserovar Senftenberg was isolated from the sputum of a trauma patient. Over a 6-year period (1999-2005) in northeast Florida, thisSalmonellaserovar spread to 66 other patients in 16 different healthcare facilities as a result of frequent transfers of patients among institutions. To our knowledge, this is the first outbreak of healthcare-associated infection and colonization with a fluoroquinolone-resistant strain of S. Senftenberg in the United States.Objectives.To investigate an outbreak of infection and colonization with an unusual strain of S. Senftenberg and assist with infection control measures.Design.A case series, outbreak investigation, and microbiological study of all samples positive forS.Senftenberg on culture.Setting.Cases ofS.Senftenberg infection and colonization occurred in hospitals and long-term care facilities in 2 counties in northeast Florida.Results.The affected patients were mostly elderly persons with multiple medical conditions. They were frequently transferred between healthcare facilities. ThisSalmonellaserovar was capable of long-term colonization of chronically ill patients. AllS.Senftenberg isolates tested shared a similar pulsed-field gel electrophoresis (PFGE) pattern.Conclusion.A prolonged outbreak of infection and colonization with multidrug-resistantS.Senftenberg was identified in several healthcare facilities throughout the Jacksonville, Florida, area and became established when infection control measures failed. The bacterial agent was capable of long-term colonization in chronically ill patients. Because the dispersal pattern of this strain suggested a breakdown of infection control practices, a multipronged intervention approach was undertaken that included intense education of personnel in the different institutions, interinstitutional cooperation, and transfer paperwork notification.

Public Disclosure of Healthcare-Associated Infections: The Role of the Society for Healthcare Epidemiology of America

2005 ◽  
Vol 26 (2) ◽  
pp. 210-212 ◽  
Author(s):  
Edward S. Wong ◽  
Mark E. Rupp ◽  
Leonard Mermel ◽  
Trish M. Perl ◽  
Suzanne Bradley ◽  
...  
Keyword(s):  
Health Planning ◽  
Healthcare Providers ◽  
Public Disclosure ◽  
Healthcare Associated Infection ◽  
Healthcare Facilities ◽  
The Public ◽  
Disclosure Laws ◽  
The Right ◽  
Healthcare Associated ◽  
Healthcare Epidemiology

Prior to 2004, only two states, Pennsylvania and Illinois, had enacted legislation requiring healthcare facilities to collect nosocomial or healthcare-associated infection (HAI) data intended for public disclosure. In 2004, two additional states, Missouri and Florida, passed disclosure laws. Currently, several other states are considering similar legislation. In California, Senate Bill 1487 requiring hospitals to collect HAI data and report them to the Office of Statewide Health Planning was passed by the legislature, but was not signed into law by Governor Schwarzenegger, effectively vetoing it. The impetus for these laws is complex. Support comes from consumer advocates, who argue that the public has the right to be informed, and from others who view HAI as preventable and hope that public disclosure would provide an incentive to healthcare providers and institutions to improve their care.

scholarly journals Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017

2019 ◽  
Vol 16 (6) ◽  
pp. 911 ◽  
Author(s):  
Małgorzata Kołpa ◽  
Marta Wałaszek ◽  
Anna Różańska ◽  
Zdzisław Wolak ◽  
Jadwiga Wójkowska-Mach
Keyword(s):  
General Condition ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Incidence Rates ◽  
Surveillance Program ◽  
Physical Status Classification ◽  
Neurosurgical Patients ◽  
American Society ◽  
Infection Types ◽  
Healthcare Associated

Introduction: The objective of the analysis was to determine the epidemiology of healthcare-associated infections (HAIs) in neurosurgical patients, paying special attention to two time points, 2003 and 2017, in order to evaluate the effectiveness of a surveillance program introduced in 2003 and efforts to reduce infection rates. Materials and methods: Continuous surveillance during 2003–2017 carried out using the HAI-Net methodology allowed us to detect 476 cases of HAIs among 10,332 patients staying in a 42-bed neurosurgery unit. The intervention in this before–after study (2003–2017) comprised standardized HAI surveillance with regular analysis and feedback. Results: The HAI incidence during the whole study was 4.6%. Surgical site infections (SSIs) accounted for 33% of all HAIs with an incidence rate of 1.5%. The remaining infections were pneumonia (1.1%) and bloodstream infections (0.9%). The highest SSI incidence concerned spinal fusion (FUSN, 2.2%), craniotomy (1.9%), and ventricular shunt (5.1%) while the associated total HAI incidence rates were 4.1%, 8.0%, and 18.6%, respectively. A significant reduction was found in HAI incidence between 2003 and 2017 in regard to the most common surgery types: laminectomy (4.5% vs. 0.8%); FUSN (11.8% vs. 0.8%); and craniotomy (10.1% vs. 0.4%). Significant changes were also achieved in selected elements of the unit’s work: pre-hospitalization duration, hospital stay, and surgery length reductions. Simultaneously, the general condition of patients became significantly worse: there was an increase in patients’ age and decreases in their general condition as expressed by ASA scores (The American Society of Anesthesiologists physical status classification system). Conclusions: HAI epidemiology changed substantially during the study period. Among the main types of HAI, SSIs were slightly predominant, but non-surgical HAIs accounted for almost two thirds of all infections; this indicates the need for surveillance of infection types other than SSIs in surgical patients. The implementation of active surveillance based on regular analysis and feedback led to a significant reduction in HAI incidence.

scholarly journals Can National Healthcare-Associated Infections (HAIs) Data Differentiate Hospitals in the United States?

2017 ◽  
Vol 38 (10) ◽  
pp. 1167-1171 ◽  
Author(s):  
Max Masnick ◽  
Daniel J. Morgan ◽  
John D. Sorkin ◽  
Mark D. Macek ◽  
Jessica P. Brown ◽  
...  
Keyword(s):  
United States ◽  
Secondary Analysis ◽  
Surgical Site Infections ◽  
The United States ◽  
Geographic Region ◽  
Data Availability ◽  
Healthcare Associated Infection ◽  
Hospital Referral ◽  
Geographic Regions ◽  
Healthcare Associated

OBJECTIVETo determine whether patients using the Centers for Medicare and Medicaid Services (CMS) Hospital Compare website (http://medicare.gov/hospitalcompare) can use nationally reported healthcare-associated infection (HAI) data to differentiate hospitals.DESIGNSecondary analysis of publicly available HAI data for calendar year 2013.METHODSWe assessed the availability of HAI data for geographically proximate hospitals (ie, hospitals within the same referral region) and then analyzed these data to determine whether they are useful to differentiate hospitals. We assessed data for the 6 HAIs reported by hospitals to the Centers for Disease Control and Prevention (CDC).RESULTSData were analyzed for 4,561 hospitals representing 88% of registered community and federal government hospitals in the United States. Healthcare-associated infection data are only useful for comparing hospitals if they are available for multiple hospitals within a geographic region. We found that data availability differed by HAI.Clostridium difficileinfections (CDI) data were most available, with 82% of geographic regions (ie, hospital referral regions) having >50% of hospitals reporting them. In contrast, 4% of geographic regions had >50% of member hospitals reporting surgical site infections (SSI) for hysterectomies, which had the lowest availability. The ability of HAI data to differentiate hospitals differed by HAI: 72% of hospital referral regions had at least 1 pair of hospitals with statistically different risk-adjusted CDI rates (SIRs), compared to 9% for SSI (hysterectomy).CONCLUSIONSHAI data generally are reported by enough hospitals to meet minimal criteria for useful comparisons in many geographic locations, though this varies by type of HAI. CDI and catheter-associated urinary tract infection (CAUTI) are more likely to differentiate hospitals than the other publicly reported HAIs.Infect Control Hosp Epidemiol2017;38:1167–1171

scholarly journals Identification of Antibiotic-Resistant Bacteria in the Primary Health Center in Bandung (Qualitative study in Puskesmas Ibrahim Adjie)

2020 ◽  
Vol 148 ◽  
pp. 04003
Author(s):  
Mayrina Firdayati ◽  
Anindrya Nastiti ◽  
Marlia Singgih ◽  
Elin Julianti ◽  
Muhammad Azhari ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Pathogenic Bacteria ◽  
Pseudomonas Stutzeri ◽  
Opportunistic Pathogen ◽  
Resistant Bacteria ◽  
Healthcare Associated Infection ◽  
Healthcare Facilities ◽  
Primary Health ◽  
Healthcare Associated

The world is currently facing a serious health threat resulting from antimicrobial resistance (AMR). It is estimated that the global mortality related to AMR is roughly 700,000 per year and is expected to rise to 10 million annually by 2050. Healthcare facilities are among the main contributors of antimicrobial resistance. This study aims to identify the existence of antibiotic resistance bacteria in the air environment of the primary health facility (Puskesmas). Ten samples were collected in 4 different places of indoor environment in Puskesmas Ibrahim Adjie, Bandung, West Java. Antibiotic resistance bacteria (ARB) first selected by growing in 5 different selective media. There are 265 colonies which then selected and identified respectively by using Kirby-Bauer Method with Amoxicillin and Microgen Biochemical Identification. Three dominant bacteria Stenotrophomonas (Xanthomonas) maltophilia, Pseudomonas stutzeri and Serratia marcescens, were found. Those bacteria are not the main pathogenic bacteria but recently recognized as opportunistic pathogen combining a propensity for healthcare-associated infection and antimicrobial resistance.

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