Classification of Healthcare-Associated Staphylococcus aureus Bacteremia: Influence of Different Definitions on Prevalence, Patient Characteristics, and Outcome

2015 ◽  
Vol 37 (2) ◽  
pp. 208-211 ◽  
Author(s):  
Jesper Smit ◽  
Mette Søgaard ◽  
Henrik Carl Schønheyder ◽  
Henrik Nielsen ◽  
Reimar Wernich Thomsen
Keyword(s):  
Staphylococcus Aureus ◽  
Patient Characteristics ◽  
Infect Control Hosp ◽  
Healthcare Associated Infection ◽  
Staphylococcus Aureus Bacteremia ◽  
Healthcare Associated

We investigated whether different definitions of healthcare-associated infection influenced the prevalence, characteristics, and mortality of patients with Staphylococcus aureus bacteremia. With different definitions, the proportion of patients classified as having healthcare-associated S. aureus bacteremia varied substantially and the distribution of patient characteristics was influenced, whereas 30-day mortality remained robust.Infect. Control Hosp. Epidemiol. 2016;37(2):208–211

scholarly journals Classification of healthcare-associated infection: a systematic review 10 years after the first proposal

BMC Medicine ◽  
2014 ◽  
Vol 12 (1) ◽  
Author(s):  
Teresa Cardoso ◽  
Mónica Almeida ◽  
N Deborah Friedman ◽  
Irene Aragão ◽  
Altamiro Costa-Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

scholarly journals Phase II, Randomized, Double-Blind, Multicenter Study Comparing the Safety and Pharmacokinetics of Tefibazumab to Placebo for Treatment of Staphylococcus aureus Bacteremia

2006 ◽  
Vol 50 (8) ◽  
pp. 2751-2755 ◽  
Author(s):  
J. John Weems ◽  
James P. Steinberg ◽  
Scott Filler ◽  
John W. Baddley ◽  
G. Ralph Corey ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Primary Objective ◽  
Related Complication ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Adhesion Protein ◽  
Treatment Groups ◽  
Staphylococcus Aureus Bacteremia ◽  
Humanized Monoclonal Antibody ◽  
Healthcare Associated

ABSTRACT Tefibazumab (Aurexis), a humanized monoclonal antibody that binds to the surface-expressed adhesion protein clumping factor A, is under development as adjunctive therapy for serious Staphylococcus aureus infections. Sixty patients with documented S. aureus bacteremia (SAB) were randomized and received either tefibazumab at 20 mg/kg of body weight as a single infusion or a placebo in addition to an antibiotic(s). The primary objective of the study was determining safety and pharmacokinetics. An additional objective was to assess activity by a composite clinical end point (CCE). Baseline characteristics were evenly matched between groups. Seventy percent of infections were healthcare associated, and 57% had an SAB-related complication at baseline. There were no differences between the treatment groups in overall adverse clinical events or alterations in laboratory values. Two patients developed serious adverse events that were at least possibly related to tefibazumab; one hypersensitivity reaction was considered definitely related. The tefibazumab plasma half-life was 18 days. Mean plasma levels were <100 μg/ml by day 14. A CCE occurred in six patients (four placebo and two tefibazumab patients) and included five deaths (four placebo and one tefibazumab patient). Progression in the severity of sepsis occurred in four placebo and no tefibazumab patients. Tefibazumab was well tolerated, with a safety profile similar to those of other monoclonal antibodies. Additional trials are warranted to address the dosing range and efficacy of tefibazumab.

Seasonal Variation ofEscherichia coli,Staphylococcus aureus, andStreptococcuspneumoniaeBacteremia According to Acquisition and Patient Characteristics: A Population-Based Study

2016 ◽  
Vol 37 (8) ◽  
pp. 946-953 ◽  
Author(s):  
Kim Oren Gradel ◽  
Stig Lønberg Nielsen ◽  
Court Pedersen ◽  
Jenny Dahl Knudsen ◽  
Christian Østergaard ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Seasonal Variation ◽  
Patient Characteristics ◽  
Population Based ◽  
Danish Health ◽  
Hospital Registry ◽  
Healthcare Associated ◽  
Laboratory Information Systems ◽  
Hospital Acquired ◽  
The Impact

OBJECTIVESeasonal variation is a characteristic of many infectious diseases, but relatively little is known about determinants thereof. We studied the impact of place of acquisition and patient characteristics on seasonal variation of bacteremia caused by the 3 most common pathogens.DESIGNSeasonal variation analysis.METHODSIn 3 Danish health regions (2.3 million total inhabitants), patients with bacteremia were identified from 2000 through 2011 using information from laboratory information systems. Analyses were confined toEscherichia coli,Staphylococcus aureus, andStreptococcus pneumoniae. Additional data were obtained from the Danish National Hospital Registry for the construction of admission histories and calculation of the Charlson comorbidity index (CCI). Bacteremias were categorized as community acquired, healthcare associated (HCA), and hospital acquired. We defined multiple subgroups by combining the following characteristics: species, acquisition, age group, gender, CCI level, and location of infection. Assuming a sinusoidal model, seasonal variation was assessed by the peak-to-trough (PTT) ratio with a 95% confidence interval (CI).RESULTSIn total, we included 16,006E.coli, 6,924S.aureus, and 4,884S.pneumoniaebacteremia cases. ForE.coli, the seasonal variation was highest for community-acquired cases (PTT ratio, 1.24; 95% CI, 1.17–1.32), was diminished for HCA (PTT ratio, 1.14; 95% CI, 1.04–1.25), and was missing for hospital-acquired cases. No seasonal variation was observed forS.aureus.S.pneumoniaeshowed high seasonal variation, which did not differ according to acquisition (overall PTT ratio, 3.42; 95% CI, 3.10–3.83).CONCLUSIONSSeasonal variation was mainly related to the species although the place of acquisition was important forE.coli.Infect Control Hosp Epidemiol2016;37:946–953

scholarly journals Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

2012 ◽  
Vol 49 (4) ◽  
pp. 255-258 ◽  
Author(s):  
Helena Duarte ◽  
Carla Santos ◽  
Manuel Luís Capelas ◽  
Jorge Fonseca
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Antibiotic Prophylaxis ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Infection Rates ◽  
Healthcare Associated Infection ◽  
Methicillin Resistant ◽  
Endoscopic Gastrostomy ◽  
Peristomal Infection ◽  
Healthcare Associated

CONTEXT: Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates. OBJECTIVES: The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection. METHODS: Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0. RESULTS: A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%). Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3%) followed by Pseudomonas aeruginosa (30.6%). The incidence rate had been rising each year and differ from 4.65% in 2004/2007 to 17.9% in 2008/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6%) were detected in the first 10 days post procedure. There was no significant difference in age, body mass index values, mean survival time and duration of percutaneous endoscopic gastrostomy feeding between patients with and without periostomal infection. Institutional factors, namely global prevalence infection rates and the endemic character of Staphylococcus aureus methicillin resistant, play an important role in peristomal infection rates. Traditional antibiotic prophylaxis with cefazolin is not adequate due to the prevalence of resistant organisms. CONCLUSIONS: Peristomal infection is a frequent problem with clinical impact in percutaneous endoscopic gastrostomy patients and should be considered a healthcare associated infection. The antimicrobial prophylaxis regimens using cephalosporins are not adequate and need to be reviewed due to the high prevalence of Staphylococcus aureus methicillin resistant and other resistant organisms in hospitals and nursing homes.

scholarly journals Derivation and validation of clinical prediction rules for reduced vancomycin susceptibility in Staphylococcus aureus bacteraemia

2012 ◽  
Vol 141 (1) ◽  
pp. 165-173 ◽  
Author(s):  
J. H. HAN ◽  
W. B. BILKER ◽  
P. H. EDELSTEIN ◽  
K. B. MASCITTI ◽  
E. LAUTENBACH
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Prediction Rule ◽  
Clinical Prediction Rule ◽  
Clinical Prediction ◽  
Broth Microdilution ◽  
Healthcare Associated Infection ◽  
Final Model ◽  
Individualized Management ◽  
Healthcare Associated

SUMMARYReduced vancomycin susceptibility (RVS) may lead to poor clinical outcomes in Staphylococcus aureus bacteraemia. We conducted a cohort study of 392 patients with S. aureus bacteraemia within a university health system. The association between RVS, as defined by both Etest [vancomycin minimum inhibitory concentration (MIC) >1·0 μg/ml] and broth microdilution (vancomycin MIC ⩾1·0 μg/ml), and patient and clinical variables were evaluated to create separate predictive models for RVS. In total, 134 (34·2%) and 73 (18·6%) patients had S. aureus isolates with RVS by Etest and broth microdilution, respectively. The final model for RVS by Etest included methicillin resistance [odds ratio (OR) 1·51, 95% confidence interval (CI) 0·97–2·34], non-white race (OR 0·67, 95% CI 0·42–1·07), healthcare-associated infection (OR 0·56, 95% CI 0·32–0·96), and receipt of any antimicrobial therapy ⩽30 days prior to the culture date (OR 3·06, 95% CI 1·72–5·44). The final model for RVS by broth microdilution included methicillin resistance (OR 2·45, 95% CI 1·42–4·24), admission through the emergency department (OR 0·54, 95% CI 0·32–0·92), presence of an intravascular device (OR 2·24, 95% CI 1·30–3·86), and malignancy (OR 0·51, 95% CI 0·26–1·00). The availability of an easy and rapid clinical prediction rule for early identification of RVS can be used to help guide the timely and individualized management of these serious infections.

Laws Pertaining to Healthcare-Associated Infections: A Review of 3 Legal Requirements

2012 ◽  
Vol 33 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Julie Reagan ◽  
Carl Hacker
Keyword(s):  
Infect Control Hosp ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Legal Requirements ◽  
Us States ◽  
The Public ◽  
Data Submission ◽  
Legal Provisions ◽  
Healthcare Associated

We reviewed US state and territorial healthcare-associated infection (HAI) laws, specifically addressing 3 legal requirements: data submission, reporting of data to the public, and inclusion of facility identifiers in public reports. The majority of US states and territories have HAI laws. The 3 studied legal provisions are all commonly included in state HAI laws in varying forms; however, only a minority of states and territories specifically mandate all 3 legal requirements. The laws of the remaining states vary considerably.Infect Control Hosp Epidemiol 2012;33(1):75-80

Evaluation of International Classification of Diseases, Ninth Revision, Clinical Modification Codes for Reporting Methicillin-Resistant Staphylococcus aureus Infections at a Hospital in Illinois

2010 ◽  
Vol 31 (05) ◽  
pp. 463-468 ◽  
Author(s):  
Melissa K. Schaefer ◽  
Katherine Ellingson ◽  
Craig Conover ◽  
Alicia E. Genisca ◽  
Donna Currie ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
Diagnosis Codes ◽  
Classification Of Diseases ◽  
Mrsa Infection ◽  
Healthcare Associated

Background. States, including Illinois, have passed legislation mandating the use of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for reporting healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA). Objective. To evaluate the sensitivity of ICD-9-CM code combinations for detection of MRSA infection and to understand implications for reporting. Methods. We reviewed discharge and microbiology databases from July through August of 2005, 2006, and 2007 for ICD-9-CM codes or microbiology results suggesting MRSA infection at a tertiary care hospital near Chicago, Illinois. Medical records were reviewed to confirm MRSA infection. Time from admission to first positive MRSA culture result was evaluated to identify hospital-onset MRSA (HO-MRSA) infections. The sensitivity of MRSA code combinations for detecting confirmed MRSA infections was calculated using all codes present in the discharge record (up to 15); the effect of reviewing only 9 diagnosis codes, the number reported to the Centers for Medicare and Medicaid Services, was also evaluated. The sensitivity of the combination of diagnosis codes for detection of HO-MRSA infections was compared with that for community-onset MRSA (CO-MRSA) infections. Results. We identified 571 potential MRSA infections with the use of screening criteria; 403 (71%) were confirmed MRSA infections, of which 61 (15%) were classified as HO-MRSA. The sensitivity of MRSA code combinations was 59% for all confirmed MRSA infections when 15 diagnoses were reviewed compared with 31% if only 9 diagnoses were reviewed (P &lt; .001). The sensitivity of code combinations was 33% for HO-MRSA infections compared with 62% for CO-MRSA infections (P &lt; .001). Conclusions. Limiting analysis to 9 diagnosis codes resulted in low sensitivity. Furthermore, code combinations were better at revealing CO-MRSA infections than HO-MRSA infections. These limitations could compromise the validity of ICD-9-CM codes for interfacility comparisons and for reporting of healthcare-associated MRSA infections.

scholarly journals Healthcare-associated Staphylococcus aureus Bacteremia in Children

2016 ◽  
Vol 35 (3) ◽  
pp. 263-268 ◽  
Author(s):  
J. Chase McNeil ◽  
Eric Y. Kok ◽  
Andrea R. Forbes ◽  
Linda Lamberth ◽  
Kristina G. Hulten ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Staphylococcus Aureus Bacteremia ◽  
Healthcare Associated

Distribution of Central Line-Associated Bloodstream Infections Determined From Washington State’s Annual Reporting Validation Program, 2009–2013

2016 ◽  
Vol 38 (4) ◽  
pp. 489-492
Author(s):  
Jason M. Lempp ◽  
M. Jeanne Cummings ◽  
David W. Birnbaum
Keyword(s):  
Bloodstream Infection ◽  
Healthcare Quality ◽  
Bloodstream Infections ◽  
Central Line ◽  
Infect Control Hosp ◽  
Public Healthcare ◽  
Healthcare Associated Infection ◽  
Reporting Accuracy ◽  
Annual Reporting ◽  
Healthcare Associated

Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State’s validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure that hospital reporting accuracy is maintained. This paper details findings and costs from our experience.Infect Control Hosp Epidemiol 2017;38:489–492

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