Infections in Australian Aged-Care Facilities: Evaluating the Impact of Revised McGeer Criteria for Surveillance of Urinary Tract Infections

2016 ◽  
Vol 37 (5) ◽  
pp. 610-612 ◽  
Author(s):  
Noleen J. Bennett ◽  
Sandra A. Johnson ◽  
Michael J. Richards ◽  
Mary A. Smith ◽  
Leon J. Worth
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Aged Care ◽  
Infect Control Hosp ◽  
Healthcare Associated Infections ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Our survey of 112 Australian aged-care facilities demonstrated the prevalence of healthcare-associated infections to be 2.9%. Urinary tract infections (UTIs) defined by McGeer criteria comprised 35% of all clinically defined UTIs. To estimate the infection burden in these facilities where microbiologic testing is not routine, modified surveillance criteria for UTIs are necessary.Infect Control Hosp Epidemiol 2016;37:610–612

scholarly journals Urinary Tract Infection Management in Elderly People : Approach Beyond the Pills and Needles

2017 ◽  
Vol 16 (1) ◽  
pp. 3-6
Author(s):  
Abhijit Chowdhury ◽  
Jannatul Ferdoush ◽  
Mokhlesur Rahman ◽  
Binayok Das ◽  
Prasenjit Sarker
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Treatment Strategies ◽  
Aged Care ◽  
Psychosocial Needs ◽  
Care Facilities ◽  
Aged Care Facilities ◽  
Tract Infections

This review article focuses on critical analyses of the approach towards the management of older adults suffering from urinary tract infections. The article sheds light on the better scopes of management for these patients beyond the conventional treatment strategies to deal with the disease complexities with a goal to achieve patient satisfaction as well as fulfilling their psychosocial needs. Medline (1946) Scopus, Embase,CINAHL and PsycINFO were searched for articles published from 1980 to 2015 using the keywords Urinary Tract Infection, Older Adults, Elderly, Aged and Aged Care Facilities. The reference lists of the selected publications were also reviewed. Articles published only in English have been chosen.Chatt Maa Shi Hosp Med Coll J; Vol.16 (1); Jan 2017; Page 3-6

scholarly journals Catheter-Associated Urinary Tract Infections in Adults: Diagnosis, Treatment, and Prevention

2019 ◽  
Vol 15 (9) ◽  
pp. 552-556 ◽  
Author(s):  
Karen Clarke ◽  
Casey L Hall ◽  
Zanthia Wiley ◽  
Sheri Chernetsky Tejedor ◽  
James S Kim ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Patient Outcomes ◽  
Urinary Tract Infections ◽  
Urinary Catheter ◽  
Financial Impact ◽  
Healthcare Associated Infections ◽  
Incentive Program ◽  
Treatment And Prevention ◽  
Tract Infections ◽  
Healthcare Associated

Urinary tract infections (UTIs) are among the most common healthcare-associated infections, and 70%-80% are catheter-associated urinary tract infections (CAUTIs). About 25% of hospitalized patients have an indwelling urinary catheter placed during their hospital stay, and therefore, are at risk for CAUTIs which have been associated with worse patient outcomes. Additionally, hospitals face a significant financial impact since the Centers for Medicare and Medicaid Services incentive program penalizes hospitals with higher than expected CAUTIs. Hospitalists care for many patients with indwelling urinary catheters and should be aware of and engage in processes that reduce the rate of CAUTIs. This article will discuss the diagnosis, treatment, and prevention of CAUTIs in adults.

scholarly journals 1469. Effect of Treatment Duration on Outcomes in Septic Patients Admitted for Urinary Tract Infections from Extended Care Facilities

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S536-S537
Author(s):  
Annelise Jongekrijg ◽  
Jamie George ◽  
Pramodini Kale-Pradhan ◽  
Leonard B Johnson
Keyword(s):  
Urinary Tract ◽  
Hospital Mortality ◽  
Urinary Tract Infections ◽  
Categorical Variables ◽  
Extended Care ◽  
Care Facilities ◽  
Antibiotic Duration ◽  
Tract Infections ◽  
The Impact

Abstract Background Adults in extended care facilities (ECFs) are at an increased risk of urinary tract infections (UTIs) with sepsis and there are little data on effective antibiotic duration. The purpose of this project was to assess the impact of inpatient antibiotic duration on clinical outcomes in these patients. Methods A single-center, retrospective study of adult, ECF, septic UTI patients from 5/1/16 to 4/30/18 were included. In-hospital mortality, 30-day readmission rate, and length-of-stay (LOS) were compared based on the effective antibiotic duration of short- and long-term therapies (≤ 5 and > 5 days, respectively). Pregnant and asymptomatic bacteriuria patients were excluded. Demographics, Charlson Weighted Index of Comorbidity (CWIC), presence of indwelling catheter, SIRS criteria, microbiologic results and antibiotic regimen were collected. Continuous variables were analyzed using Student’s t-test and categorical variables with Chi-square test. Results 105 of 1,158 ECF patients met the inclusion criteria. 38 patients received ≤ 5 days of effective antibiotic therapy, and 67 received > 5 days. Baseline demographics were similar, except the ≤ 5 days group were older and less likely to have fever (see table). In-hospital mortality was 18.4% in the short-term antibiotic group and 6.0% in the long-term group. Overall 30-day readmission was not significantly different. LOS was significantly greater in the > 5 day overall and non-bacteremia group. Conclusion Duration of antibiotics (≤ 5 and > 5 days) did not significantly affect 30-day readmission and in-hospital mortality; however, LOS was significantly longer in the > 5 days group. Further studies are needed to confirm these findings. Disclosures All authors: No reported disclosures.

scholarly journals Targeted Assessment for Prevention of Healthcare-Associated Infections: A New Prioritization Metric

2015 ◽  
Vol 36 (12) ◽  
pp. 1379-1384 ◽  
Author(s):  
Minn M. Soe ◽  
Carolyn V. Gould ◽  
Daniel Pollock ◽  
Jonathan Edwards
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Healthcare Associated Infections ◽  
Healthcare Facilities ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Infection Reduction ◽  
Tract Infections ◽  
Healthcare Associated

OBJECTIVETo develop a method for calculating the number of healthcare-associated infections (HAIs) that must be prevented to reach a HAI reduction goal and identifying and prioritizing healthcare facilities where the largest reductions can be achieved.SETTINGAcute care hospitals that report HAI data to the Centers for Disease Control and Prevention’s National Healthcare Safety Network.METHODSThe cumulative attributable difference (CAD) is calculated by subtracting a numerical prevention target from an observed number of HAIs. The prevention target is the product of the predicted number of HAIs and a standardized infection ratio goal, which represents a HAI reduction goal. The CAD is a numeric value that if positive is the number of infections to prevent to reach the HAI reduction goal. We calculated the CAD for catheter-associated urinary tract infections for each of the 3,639 hospitals that reported such data to National Healthcare Safety Network in 2013 and ranked the hospitals by their CAD values in descending order.RESULTSOf 1,578 hospitals with positive CAD values, preventing 10,040 catheter-associated urinary tract infections at 293 hospitals (19%) with the highest CAD would enable achievement of the national 25% catheter-associated urinary tract infection reduction goal.CONCLUSIONThe CAD is a new metric that facilitates ranking of facilities, and locations within facilities, to prioritize HAI prevention efforts where the greatest impact can be achieved toward a HAI reduction goal.Infect. Control Hosp. Epidemiol. 2015;36(12):1379–1384

scholarly journals Frequency of Healthcare-Associated Infections in the Elderly Patient Hospitalized

2021 ◽  
Author(s):  
Aria Rahmani ◽  
Alireza Namazi Shabestari ◽  
Maryam Sadeh ◽  
Reza Bidaki ◽  
Saeidreza Jamalimoghadamsiahkli ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Hospital Stay ◽  
Urinary Tract Infections ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Tract Infections ◽  
Healthcare Associated

Introduction: Healthcare- Associated Infections (HAI) are known to be one of the most important health issues in developed and developing countries. The most common infections include central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated pneumonia and surgical site infection. The aim of this study was to investigate the incidence of nosocomial infections in the elderly patients. Methods: In this cross-sectional study, 1279 patients were 60 years of age or older. Patients who had been admitted for more than 48 hours in the hospital and had no signs of infection at the time of admission, were entered into the study. It was evaluated four most common HAI, according to CDC include bacteremia, central line-associated blood stream infections, urinary tract infections, and ventilator-associated pneumonia. Infections may also occur at surgery sites, known as surgical site infections. The Chi-square and T- test or analysis of variance was used for data analysis. Results: Of the total patients, 93 (7.3%) developed HAI at duration admission. The highest rate of infection was bacteremia, which was 48.4 % and then urinary tract infection 21.5%. The prevalence of HAI among patients with cardiovascular diseases was relatively higher than underlying diseases. The frequency of length of hospital stay was significant in patients > 7 days with 68.8% in the HAI group. Conclusion: Our findings showed that patients with cardiovascular, renal and pulmonary disease are more susceptible to HAIs. Due to the increased length of hospital stay increases the risk of infection, it is recommended to discharge patients as soon as possible.

Incidence of healthcare-associated infections in patients with fever during the first 48 hours after decannulation from veno-venous extracorporeal membrane oxygenation

Perfusion ◽  
2020 ◽  
pp. 026765912094842
Author(s):  
Emily C Esposito ◽  
KM Jones ◽  
SM Galvagno ◽  
DJ Kaczorowski ◽  
MA Mazzeffi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Extracorporeal Membrane Oxygenation ◽  
Urinary Tract Infections ◽  
Blood Stream ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Blood Stream Infections ◽  
Membrane Oxygenation ◽  
Tract Infections ◽  
Healthcare Associated

Introduction: Fevers following decannulation from veno-venous extracorporeal membrane oxygenation often trigger an infectious workup; however, the yield of this workup is unknown. We investigated the incidence of post-veno-venous extracorporeal membrane oxygenation decannulation fever as well as the incidence and nature of healthcare-associated infections in this population within 48 hours of decannulation. Methods: All patients treated with veno-venous extracorporeal membrane oxygenation for acute respiratory failure who survived to decannulation between August 2014 and November 2018 were retrospectively reviewed. Trauma patients and bridge to lung transplant patients were excluded. The highest temperature and maximum white blood cell count in the 24 hours preceding and the 48 hours following decannulation were obtained. All culture data obtained in the 48 hours following decannulation were reviewed. Healthcare-associated infections included blood stream infections, ventilator-associated pneumonia, and urinary tract infections. Results: A total of 143 patients survived to decannulation from veno-venous extracorporeal membrane oxygenation and were included in the study. In total, 73 patients (51%) were febrile in the 48 hours following decannulation. Among this cohort, seven healthcare-associated infections were found, including five urinary tract infections, one blood stream infection, and one ventilator-associated pneumonia. In the afebrile cohort (70 patients), four healthcare-associated infections were found, including one catheter-associated urinary tract infection, two blood stream infections, and one ventilator-associated pneumonia. In all decannulated patients, the majority of healthcare-associated infections were urinary tract infections (55%). No central line–associated blood stream infections were identified in either cohort. When comparing febrile to non-febrile cohorts, there was a significant difference between pre- and post-decannulation highest temperature (p < 0.001) but not maximum white blood cell count (p = 0.66 and p = 0.714) between the two groups. Among all positive culture data, the most commonly isolated organism was Klebsiella pneumoniae (41.7%) followed by Escherichia coli (33%). Median hospital length of stay and time on extracorporeal membrane oxygenation were shorter in the afebrile group compared to the febrile group; however, this did not reach a statistical difference. Conclusion: Fever is common in the 48 hours following decannulation from veno-venous extracorporeal membrane oxygenation. Differentiating infection from non-infectious fever in the post-decannulation veno-venous extracorporeal membrane oxygenation population remains challenging. In our febrile post-decannulation cohort, the incidence of healthcare-associated infections was low. The majority were diagnosed with a urinary tract infection. We believe obtaining cultures in febrile patients in the immediate decannulation period from veno-venous extracorporeal membrane oxygenation has utility, and even in the absence of other clinical suspicion, should be considered. However, based on our data, a urinalysis and urine culture may be sufficient as an initial work up to identify the source of infection.

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