Preventability of hospital onset bacteremia and fungemia: A pilot study of a potential healthcare-associated infection outcome measure

2019 ◽  
Vol 40 (3) ◽  
pp. 358-361 ◽  
Author(s):  
Raymund B. Dantes ◽  
Clare Rock ◽  
Aaron M. Milstone ◽  
Jesse T. Jacob ◽  
Sheri Chernetsky-Tejedor ◽  
...  
Keyword(s):  
Pilot Study ◽  
Outcome Measure ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Follow Up Studies ◽  
Potential Measure ◽  
Healthcare Associated

AbstractHospital-onset bacteremia and fungemia (HOB), a potential measure of healthcare-associated infections, was evaluated in a pilot study among 60 patients across 3 hospitals. Two-thirds of all HOB events and half of nonskin commensal HOB events were judged as potentially preventable. Follow-up studies are needed to further develop this measure.

scholarly journals RE: Preventability of hospital onset bacterermia and fungemia: A pilot study of potential healthcare-associated infection outcome measure, by Dantes et al (2019)

2019 ◽  
Vol 40 (10) ◽  
pp. 1209-1210
Author(s):  
Anna M. Civitarese ◽  
Eric Ruggieri ◽  
J. Mattias Walz ◽  
Deborah Ann Mack ◽  
Stephen O. Heard ◽  
...  
Keyword(s):  
Pilot Study ◽  
Outcome Measure ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

Mycobacteriosis as a Healthcare-Associated Infection: A Review of Epidemiologic Studies

2020 ◽  
pp. 37-41
Author(s):  
IV Petrov ◽  
TKh Amirova ◽  
LV Petrova ◽  
FS Petrova
Keyword(s):  
Skin Diseases ◽  
Nontuberculous Mycobacteria ◽  
Clinical Manifestations ◽  
Mycobacterial Infection ◽  
Epidemiologic Studies ◽  
Health Facilities ◽  
Water Supply Systems ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

Introduction: Healthcare-associated infections are of great socio-economic importance and are characterized by a large number of different pathogens. Nontuberculous mycobacteria are ubiquitous microorganisms that can circulate in a medical organization. The purpose of this review of epidemiologic studies was to establish the main features of mycobacteriosis as a healthcare-associated infection, taking into account the significance of the results and the compliance of the reviewed studies with the criteria of evidence-based medicine. Methods: We did a key word search for “nontuberculous mycobacteria”, “healthcare-associated infections”, and “mycobacteriosis” in several electronic bibliographic databases including Web of Science, PubMed, eLIBRARY, and ResearchGate and selected 127 out of 342 search results. Having analyzed the selected articles, we decided to include 34 of them in this study according to the topic of work. We established that nontuberculous mycobacteria can be found in various objects of health facilities, e.g. water supply systems, medical products and equipment. We also found that mycobacterial infection of nosocomial etiology could have various clinical manifestations (arthritis, keratitis, circulatory and skin diseases, etc.) determined by various aspects, such as heterogeneity of the group of nontuberculous mycobacteria, portals of entry (surgical procedures on various organs and systems of the human body, etc.), pathways of exposure and transmission factors. Resistance of nontuberculous mycobacteria to a number of disinfectants is a special question defining the importance of profound research in terms of ensuring sanitary and anti-epidemic (disinfection) safety within health facilities. Conclusions: Our findings indicate that mycobacterial infection can be considered as a healthcare-associated infection requiring an in-depth assessment from various perspectives including a microbiological monitoring of medical objects, statistical accounting of nosocomial infections, and clinical alertness in the diagnosis of mycobacteriosis by attending physicians and bacteriologists, etc.

scholarly journals Surveillance of healthcare-associated infections in a Tunisian university hospital

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H Hannachi ◽  
A Ben Cheikh ◽  
S Bhiri ◽  
H Ghali ◽  
S Khefacha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
University Hospital ◽  
Healthcare Associated Infections ◽  
Drug Resistant ◽  
Healthcare Associated Infection ◽  
Carbapenem Resistant ◽  
Independent Risk Factors ◽  
Healthcare Associated

Abstract Introduction Healthcare -associated infections has become a worldwide public health problem. The aim of this study was to estimate the incidence of healthcare- associated infections in a university hospital of Tunisia. Methods This was a cohort study conducted in six intensive care units in a university hospital of Tunisia during three months (from august to October 2018). Data was provided from patients’ files. Data entry and analysis was done using SPSS version 22. Multivariate analysis was used in order to identify independent risk factors for healthcare associated infection. Results A total of 202 patients were enrolled in this study. The incidence rate of healthcare-associated infections was 53,96%(109/202). The ratio infection/infected was estimated to 1.65(109/66). The incidence of multi-drug resistant pathogens was 21,28% (43/202). The most common resistant pathogens included pseudomonas aeruginosa resistant to cefdazidime in 13,76%(15/109) followed by those resistant to extended spectrum cephalosporin 11.92% (13/109), followed by carbapenem-resistant acinetobcater baumanii 6,42%(7/109) then by carbapenem resistant pathogens and enterococcus resistant to vancomycin 2.75%(3/109) and finally staphylococcus aureus resistant to methicillin 2.1%(2/1.83). The multivariate analysis showed that long duration of central line catheterisation (RR = 7.44; 95%CI[2.79-19.82]), tracheotomy(RR = 8.61;95%CI[2.09-35,39]) and length of stay (RR = 1.08; 95%CI[1.04-1.13]) were found as independent risk factors for healthcare -associated infection. Conclusions The emergence of mutli-drug resistant pathogens needs to be deeply studied and effective measures have to be taken in order to detect and prevent transmission of resistant strains and/or their resistance determinants, especially those with phenotypes having the fewest viable treatment options. Key messages The incidence of healthcare associated infection in the intensive care unit was high. Effective measures have to be taken in the intensive care unit to detect and prevent transmission of resistant pathogens.

scholarly journals Are Invasive Procedures and a Longer Hospital Stay Increasing the Risk of Healthcare-Associated Infections among the Admitted Patients at Hiwot Fana Specialized University Hospital, Eastern Ethiopia?

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Moti Tolera ◽  
Dadi Marami ◽  
Degu Abate ◽  
Merga Dheresa
Keyword(s):  
Cigarette Smoking ◽  
Hospital Stay ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Invasive Procedures ◽  
Healthcare Associated Infection ◽  
Eastern Ethiopia ◽  
Healthcare Associated ◽  
The Impact

Background. Healthcare-associated infection is a major public health problem, in terms of mortality, morbidity, and costs. Majorities of the cause of these infections were preventable. Understanding the potential risk factors is important to reduce the impact of these avoidable infections. The study was aimed to identify factors associated with healthcare-associated infections among patients admitted at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. Methods. A cross-sectional study was carried out among 433 patients over a period of five months at Hiwot Fana Specialized University Hospital. Sociodemographic and clinical data were obtained from a patient admitted for 48 hours and above in the four wards (surgical, medical, obstetrics/gynecology, and pediatrics) using a structured questionnaire. A multivariate logistic regression model was applied to identify predictors of healthcare-associated infections. A p value <0.05 was considered statistically significant. Results. Fifty-four (13.7%) patients had a history of a previous admission. The median length of hospital stay was 6.1 days. Forty-six (11.7%) participants reported comorbid conditions. Ninety-six (24.4%) participants underwent surgical procedures. The overall prevalence of healthcare-associated infection was 29 (7.4%, 95% CI: 5.2–10.6). Cigarette smoking (AOR: 5.18, 95% CI: 2.15–20.47), staying in the hospital for more than 4 days (AOR: 4.29, 95% CI: 2.31–6.15), and undergoing invasive procedures (AOR: 3.58, 95% CI: 1.11–7.52) increase the odds of acquiring healthcare-associated infections. Conclusion. The cumulative prevalence of healthcare-associated infections in this study was comparable with similar studies conducted in developing countries. Cigarette smoking, staying in the hospital for more than 4 days, and undergoing invasive procedures increase the odds of healthcare-associated infections. These factors should be considered in the infection prevention and control program of the hospital.

scholarly journals Locating Longitudinal Respondents After a 50-Year Hiatus

2014 ◽  
Vol 30 (2) ◽  
pp. 311-334 ◽  
Author(s):  
Celeste Stone ◽  
Leslie Scott ◽  
Danielle Battle ◽  
Patricia Maher
Keyword(s):  
Pilot Study ◽  
Cognitive Abilities ◽  
Original Sample ◽  
Chi Square ◽  
Administrative Records ◽  
Interaction Detection ◽  
Geographically Dispersed ◽  
Follow Up Studies ◽  
Study Participants

Abstract Many longitudinal and follow-up studies face a common challenge: locating study participants. This study examines the extent to which a geographically dispersed subsample of participants can be relocated after 37 to 51 years of noncontact. Relying mostly on commercially available databases and administrative records, the 2011-12 Project Talent Follow-up Pilot Study (PTPS12) located nearly 85 percent of the original sample members, many of whom had not participated in the study since 1960. This study uses data collected in the base year to examine which subpopulations were the hardest to find after this extended hiatus. The results indicate that females were located at significantly lower rates than males. As expected, sample members with lower cognitive abilities were among the hardest-to-reach subpopulations. We next evaluate the extent to which biases introduced during the tracking phase can be minimized by using the multivariate chi-square automatic interaction detection (CHAID) technique to calculate tracking loss adjustments. Unlike a 1995 study that found that these adjustments reduced statistical biases among its sample of located females, our results suggest that statistical adjustments were not as effective in PTPS12, where many participants had not been contacted in nearly 50 years and the tracking rates varied so greatly across subgroups.

scholarly journals Development of a nursing website for critical care regarding healthcare-associated infections

2021 ◽  
Vol 74 (suppl 5) ◽  
Author(s):  
Eliézer Farias de Mello ◽  
Bárbara Alessandra Tibério ◽  
Mitzy Tannia Reichembach ◽  
Letícia Pontes
Keyword(s):  
Development Process ◽  
Health Care Research ◽  
Product Development Process ◽  
Healthcare Associated Infections ◽  
Infection Rates ◽  
Healthcare Associated Infection ◽  
Computational Tools ◽  
Technological Production ◽  
Research And Education ◽  
Healthcare Associated

ABSTRACT Objective: to describe the development of a website about the main healthcare-associated infections and the respective bundles to prevent these diseases, oriented toward intensive care unit nursing. Methods: experience report describing the development of technological innovation by nurses, using computational tools and technological production methodological research and following the product development process. Results: nurses developed an educational website which can be accessed through computers, tablets, and smartphones at the electronic address irastis.com and focuses on healthcare-associated infections. Final considerations: digital technologies have contributed to fulfill demands in health care, research, and education. The developed website has the potential to support reduction in healthcare-associated infection rates, since it makes preventive measures for these infections available and refers users to publication environments that systematize the implementation of the bundles.

scholarly journals Implementation of the WHO Hand Hygiene Strategy in Faranah Regional Hospital, Guinea

2020 ◽  
Author(s):  
Sophie Alice Müller ◽  
Alpha Oumar Karim Diallo ◽  
Rebekah Wood ◽  
Mouctar Bayo ◽  
Tim Eckmanns ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Improve Patient Safety ◽  
Regional Hospital ◽  
Healthcare Associated Infections ◽  
Baseline Assessment ◽  
Improvement Strategy ◽  
Resource Limited ◽  
Comparison Results ◽  
Healthcare Associated

Abstract Background: Healthcare-associated infections are the most frequent adverse events in healthcare worldwide, with limited available evidence suggesting highest burden in resource-limited settings. Recent Ebola epidemics emphasize the disastrous impact that spread of infectious agents within healthcare facilities can have, accentuating the need for improvement of infection control practices. Hand hygiene (HH) measures are considered to be the most effective tool to prevent healthcare-associated infections. However, HH knowledge and compliance are low, especially in vulnerable settings such as Guinea. The aim of PASQUALE (Partnership to Improve Patient Safety and Quality of Care) was to assess knowledge and compliance with HH and improve HH by incorporating the WHO HH Strategy within the Faranah Regional Hospital (FRH), Guinea. Methods: In a participatory approach, a team of FRH staff and leadership was invited to identify priorities of the hospital prior to the start of PASQUALE. The local hygiene committee was empowered to increase its activities and take ownership of the HH improvement strategy. A baseline assessment of knowledge, perception and compliance was performed months before the intervention. The main intervention consisted of local alcohol-based-hand-rub (ABHR) production, with final product efficacy testing, in conjunction with a training adapted to the needs identified in the baseline assessment. A follow-up assessment was conducted directly after the training. Effectiveness of the intervention was assessed via uncontrolled before-and-after comparison. Results: Baseline knowledge score (13.0/25) showed a significant increase to 19.0/25 in follow-up. Baseline-Compliance was 23.7% and increased significantly to 71.5% in follow-up. Compliance rose significantly across all professional groups except for midwifes and in all indications for HH, with the largest in the indication “Before aseptic tasks”. The increase in compliance was associated with the intervention and remained significant after adjusting for confounders. The local pharmacy successfully supplies the entire hospital. The local supply resulted in a ten-fold increase of monthly hospital disinfectant consumption. Conclusion: The WHO HH strategy is an adaptable and effective method to improve HH knowledge and compliance in a resource-limited setting. Local production is a feasible method for providing self-sufficient supply of ABHR to regional hospitals like the FRH. Participatory approaches like hygiene committee ownership builds confidence of sustainability.

scholarly journals Impact on mortality of a bundle for the management of enterococcal bloodstream infection

2019 ◽  
Author(s):  
Michele Bartoletti ◽  
Sara Tedeschi ◽  
Luigia Scudeller ◽  
Renato Pascale ◽  
Elena Rosselli Del Turco ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Blood Cultures ◽  
Healthcare Associated Infections ◽  
Hospital Acquired Infection ◽  
Enterococcus Spp ◽  
Quasi Experimental ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
Post Period

Abstract BACKGROUND In this study we evaluated the effectiveness of a management bundle for Enterococcus spp BSI (E-BSI). METHODS This was a single-center quasi-experimental (pre/post) study. In the “pre” phase (January 2014 to December 2015) patients with monomicrobial E-BSI were retrospectively enrolled. During the “post” or “intervention” phase (January 2016 to December 2017), all patients with incident E-BSI were prospectively enrolled in a non-mandatory intervention arm consisting in infectious disease consultation, echocardiography, follow-up blood cultures and early targeted antibiotic treatment. Patients were followed-up to 1 year after E-BSI. The primary outcome was 30-day mortality. RESULTS Overall, 368 patients were enrolled, 173 in the “pre” phase and 195 in the “post” phase. The entire bundle was applied in 15% and 61% patients during the “pre” and “post” phase, respectively (P<0.001). Patients enrolled in the post-phase had a significant lower 30-day mortality rate (20% vs 32%, P=0.0042). At multivariate analysis, factors independently associated to mortality were age [HR 1.03 (95%CI 1.00-1.05)], ICU admission [HR 2.51 (95%CI 1.18-3.89)] healthcare associated [HR 2.32 (95%CI 1.05-5.16)] and hospital-acquired infection [HR 2.85 (95%CI 1.34-4.76)] whereas being enrolled in the “post” period [HR 0.49 (95%CI 0.32-0.75)] was associated with improved survival. Results were consistent also in the subgroups with severe sepsis [HR 0.37 (95%CI 0.16-0.90)] or healthcare-associated infections [HR 0.53 (95%CI 0.31-0.93)]. A significative lower 1-year mortality was observed in patients enrolled in the “post” period (50% vs 68%,p<0.001). CONCLUSION The introduction of a bundle for the management of E-BSI was associated with improved 30-day and 1-year survival.

Clinical and Molecular Epidemiology of Healthcare-Associated Infections Due to Extended-Spectrumβ-Lactamase (ESBL)–Producing Strains ofEscherichia coliandKlebsiella pneumoniaeThat Harbor Multiple ESBL Genes

2008 ◽  
Vol 29 (11) ◽  
pp. 1026-1034 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Pattarachai Kiratisin ◽  
Linda M. Mundy
Keyword(s):  
Confidence Interval ◽  
Antimicrobial Therapy ◽  
Odds Ratio ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Middle Income ◽  
E Coli ◽  
Esbl Gene ◽  
Empirical Antimicrobial Therapy ◽  
Healthcare Associated

Objectives.To characterize healthcare-associated infections due to extended-spectrumβ-lactamase (ESBL)-producing strains ofEscherichia coliandKlebsiella pneumoniaethat harbor multiple ESBL genes, as opposed to a single ESBL gene.Methods.All patients with a confirmed healthcare-associated infection due to an ESBL-producing strain ofE. coliorK. pneumoniaewere enrolled in the study. Molecular typing of isolates was performed, and the comparative risks and outcomes of patients were analyzed.Results.Among 71 patients with healthcare-associated infection due to an ESBL-producing strain ofE. coliorK. pneumoniae, the gene for CTX-M, with or without other ESBL genes, was identified in all 51 (100%) of the patients infected with anE. colistrain and in 18 (90%) of the 20 patients infected with aK. pneumoniaestrain. Of these 71 patients, 17 (24%) met the definition of healthcare-associated infection due to an ESBL-producing strain that harbored multiple genes; in multivariate analysis, previous exposure to 3 or more classes of antibiotics (adjusted odds ratio, 4.5 [95% confidence interval, 1.7-75.2]) was the sole risk factor for healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes. Isolates recovered from patients with healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes were more resistant to various antibiotic classes, and, compared with patients with healthcare-associated infection due to an ESBL-producing strain that harbored a single ESBL gene, they were more likely to have ineffective initial empirical antimicrobial therapy (52% vs 94%; odds ratio, 5.1 [95% confidence interval, 1.04-14.5]).Conclusions.CTX-M ESBL is highly prevalent in Thailand. Patients with healthcare-associated infection due to an ESBL-producing strain that harbored multiple ESBL genes were more likely to have had ineffective initial empirical antimicrobial therapy, and, given that antibiotic selection pressure was the only associated risk, we suggest focused antimicrobial stewardship programs to limit the emergence and spread of healthcare-associated infection due to ESBL-producing strains in this middle-income country.

scholarly journals Indirect Versus Direct Standardization Methods for Reporting Healthcare-Associated Infections: An Analysis of Central Line–Associated Bloodstream Infections in Maryland

2017 ◽  
Vol 38 (8) ◽  
pp. 989-992 ◽  
Author(s):  
Lyndsay M. O’Hara ◽  
Max Masnick ◽  
Surbhi Leekha ◽  
Sarah S. Jackson ◽  
Natalia Blanco ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Acute Care ◽  
Bloodstream Infections ◽  
Acute Care Hospitals ◽  
Central Line ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated ◽  
Direct Standardization ◽  
Standardization Methods

Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line–associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 methods generate different hospital rankings with payment implications.Infect Control Hosp Epidemiol 2017;38:989–992

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