Using data linkage methodologies to augment healthcare-associated infection surveillance data

2019 ◽  
Vol 40 (10) ◽  
pp. 1144-1150 ◽  
Author(s):  
Seungwon Lee ◽  
Paul Ronksley ◽  
John Conly ◽  
Stephanie Garies ◽  
Hude Quan ◽  
...  
Keyword(s):  
Data Linkage ◽  
Primary Objective ◽  
Biological Data ◽  
Surveillance Data ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
Data Types ◽  
Population Database ◽  
Hospitalization Period ◽  
Healthcare Associated

AbstractBackground and objectives:The landscape of antimicrobial resistance (AMR) surveillance is changing rapidly. The primary objective of this study was to assess the benefit of linking population-based infection prevention and control surveillance data on methicillin-resistant Staphylococcus aureus (MRSA) to hospital discharge abstract data (DAD). We assessed the value of this novel data linkage for the characterization of hospital-acquired (HA) and community-acquired MRSA (CA-MRSA) cases.Methods:Incident inpatient MRSA surveillance data for all adults (≥18 years) from 4 acute-care facilities in Calgary, Alberta, between April 1, 2011, and March 31, 2017, were linked to DAD. Personal health number (PHN) and gender were used to identify specific individuals, and specimen collection time-points were used to identify specific hospitalization records. A third common variable on admission date between these databases was used to validate the linkage process. Descriptive statistics were used to characterize HA-MRSA and CA-MRSA cases identified through the linkage process.Results:A total of 2,430 surveillance records (94.6%) were successfully linked to the correct hospitalization period. By linking surveillance and administrative data, we were able to identify key differences between patients with HA- and CA-MRSA. These differences are consistent with previously reported findings in the literature. Data linkage to DAD may be a novel tool to enhance and augment the details of base surveillance data.Conclusion and recommendations:This is the first Canadian study linking a frontline healthcare-associated infection AMR surveillance database to an administrative population database. This work represents an important methodological step toward complementing traditional AMR surveillance data practices. Data linkage to other data types, such as primary care, emergency, social, and biological data, may be the basis of achieving more precise data focused around AMR.

scholarly journals Variations in Identification of Healthcare-Associated Infections

2013 ◽  
Vol 34 (7) ◽  
pp. 678-686 ◽  
Author(s):  
Sara C. Keller ◽  
Darren R. Linkin ◽  
Neil O. Fishman ◽  
Ebbing Lautenbach
Keyword(s):  
Cross Sectional Study ◽  
Primary Objective ◽  
Research Network ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
Cross Sectional ◽  
Hospital Size ◽  
Clinical Vignettes ◽  
Healthcare Associated ◽  
Infection Preventionists

Objective.Little is known about whether those performing healthcare-associated infection (HAI) surveillance vary in their interpretations of HAI definitions developed by the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN). Our primary objective was to characterize variations in these interpretations using clinical vignettes. We also describe predictors of variation in responses.Design.Cross-sectional study.Setting.United States.Participants.A sample of US-based members of the Society for Healthcare Epidemiology of America (SHEA) Research Network.Methods.Respondents assessed whether each of 6 clinical vignettes met criteria for an NHSN-defined HAI. Individual- and institutional-level data were also gathered.Results.Surveys were distributed to 143 SHEA Research Network members from 126 hospitals. In total, 113 responses were obtained, representing at least 61 unique hospitals (30 respondents did not identify a hospital); 79.2% (84 of 106 nonmissing responses) were infection preventionists, and 79.4% (81 of 102 nonmissing responses) worked at academic hospitals. Among the 6 vignettes, the proportion of respondents correctly characterizing the vignettes was as low as 27.3%. Combining all 6 vignettes, the mean percentage of correct responses was 61.1% (95% confidence interval, 57.7%–63.8%). Percentage of correct responses was associated with presence of a clinical background (ie, nursing or physician degrees) but not with hospital size or infection prevention and control department characteristics.Conclusions.Substantial heterogeneity exists in the application of HAI definitions in this survey of infection preventionists and hospital epidemiologists. Our data suggest a need to better clarify these definitions, especially when comparing HAI rates across institutions.

scholarly journals Medicolegal Causation Investigation of Bacterial Endocarditis Associated with an Oral Surgery Practice Using the INFERENCE Approach

2021 ◽  
Vol 18 (14) ◽  
pp. 7530
Author(s):  
Putri Dianita Ika Meilia ◽  
Maurice P. Zeegers ◽  
Herkutanto ◽  
Michael D. Freeman
Keyword(s):  
Oral Surgery ◽  
Invasive Procedure ◽  
Bacterial Endocarditis ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
Department Of Health ◽  
The Individual ◽  
Healthcare Associated ◽  
And Control ◽  
Causation Analysis

Investigating causation is a primary goal in forensic/legal medicine, aiming to establish the connection between an unlawful/negligent act and an adverse outcome. In malpractice litigation involving a healthcare-associated infection due to a failure of infection prevention and control practices, the medicolegal causal analysis needs to quantify the individual causal probabilities to meet the evidentiary requirements of the court. In this paper, we present the investigation of the most probable cause of bacterial endocarditis in a patient who underwent an invasive procedure at a dental/oral surgical practice where an outbreak of bacterial endocarditis had already been identified by the state Department of Health. We assessed the probability that the patient’s endocarditis was part of the outbreak versus that it was an unrelated sporadic infection using the INFERENCE (Integration of Forensic Epidemiology and the Rigorous Evaluation of Causation Elements) approach to medicolegal causation analysis. This paper describes the step-by-step application of the INFERENCE approach to demonstrate its utility in quantifying the probability of causation. The use of INFERENCE provides the court with an evidence-based, transparent, and reliable guide to determine liability, causation, and damages.

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 2476. External and Internal Validation of the Healthcare-associated Infection Data in the Korean National Healthcare-associated Infectious Surveillance System (KONIS)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S857-S858
Author(s):  
Yee Gyung Kwak ◽  
Je Eun Song ◽  
Young Hwa Choi ◽  
Sung Ran Kim ◽  
Su Ha Han ◽  
...  
Keyword(s):  
Surveillance System ◽  
Bloodstream Infections ◽  
Surveillance Data ◽  
Healthcare Associated Infection ◽  
Continuous Training ◽  
Monitoring Method ◽  
Internal Validation ◽  
National Healthcare ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Background National surveillance data should be validated to identify data quality issues. This study tested the validity of healthcare-associated infection (HAI) data in the Korean National Healthcare-associated Infections Surveillance System (KONIS), intensive care unit (ICU) module. Methods The validation process consisted of external (EV) and internal (IV) validation phases. For the 10 hospitals that were selected based on the HAI rate, among the 193 participating hospitals between July 2016 and June 2017, both EV and IV were performed. For the EV, the validation team reviewed 295 medical records of 60 patients with reported HAIs, including 20 urinary tract infections (UTIs), 27 bloodstream infections (BSIs), and 13 cases of pneumonia (PNEU), and 235 patients with no reported HAI during 1-day visits conducted in November and December 2017. The reviewer’s diagnosis of HAI was regarded as the reference standard. IV was conducted by the staff of each hospital and evaluated whether UTI or BSI were present. Primary IV was performed for 279 patients who were subject to EV. Secondary IV was performed on 203 patients in another 11 selected participating hospitals that did not report HAIs to KONIS during the 1-year study period. Results In the EV, the diagnosis of UTI in the participating hospitals had a sensitivity of 72.0% and specificity of 99.3%. The sensitivity of BSI and PNEU was 63.2% and 70.6%, respectively, and specificity was 98.8% and 99.6%. The agreement (kappa) between the EV and primary IV was significant, with κ = 0.754 for UTI and κ = 0.674 for BSI. The results of the secondary IV showed that the hospitals that had no reports of HAI had few hospital beds and performed few blood or urine culture tests. In the secondary IV, eight UTIs and three BSIs were newly diagnosed in three hospitals, respectively. The reasons for not reporting the HAIs were presumed to be a lack of understanding of the surveillance standards and fear of the disadvantages of disclosing the HAI. Conclusion This study shows the need for ongoing validation and continuous training of surveillance personnel to maintain the accuracy of surveillance data. We also confirmed that IV can be used as an alternative monitoring method to examine validity and accuracy. Disclosures All authors: No reported disclosures.

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.

scholarly journals Analysis of The Implementation of Nosocomial Infection Prevention and Control in Hospitals (A Literature Study)

2021 ◽  
Vol 1 (1) ◽  
pp. 79-90
Author(s):  
Amira Mhuthia Adila ◽  
Nur Ramadhan ◽  
Puspa Nujulla ◽  
Putri Dwi Ardiyanti ◽  
Rina Oktavia ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Nosocomial Infections ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Reporting System ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
Literature Study ◽  
Healthcare Associated ◽  
And Control

Infections due to health services or Healthcare-Associated Infection (HAI) or known as nosocomial infections are infections that occur in patients during treatment in hospitals or other health facilities. The prevention and control of nosocomial infections is a worldwide challenge. This study aims to examine the literature, articles, or journals of research results regarding the implementation of prevention and control of nosocomial infections in hospitals. The method used is a literature review with 10 journals that were reviewed and written from 2015 to 2020, or written in the last 6 years with the keywords "Analysis of the Implementation of Nosocomial Infection Prevention and Control". The results obtained are 8 journals that have obstacles such as lack of Human Resources (HR), insufficient funds and infrastructure, there are still many officers who have not taken action according to Standard Operating Procedures (SOP), many officers have not received training, there is no incentive for officers. , there is an unbalanced workload, the reporting system is not maximized, the use of Personal Protective Equipment (PPE) is not optimal, and cough etiquette has not been carried out by officers. So it is necessary to add things that must be met such as training of officers, completing the needs (facilities and infrastructure) for officers, providing sanctions for officers when violating (not taking actions according to SOPs), providing incentives for officers, and even giving rewards for officers who obey comply SOP, especially given strict supervision from the hospital so that officers and patients do not transmit their disease to each other or other people.

scholarly journals HEALTHCARE-ASSOCIATED INFECTION IN NEUROSURGICAL PATIENTS IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2017-2019)

2021 ◽  
Vol 74 (8) ◽  
pp. 1945-1951
Author(s):  
Aidyn G. Salmanov ◽  
Dmytro V. Shchehlov ◽  
Oleh Svyrydiuk ◽  
Ihor M. Bortnik ◽  
Maryna Mamonova ◽  
...  
Keyword(s):  
Carbapenem Resistance ◽  
Surveillance Data ◽  
Healthcare Associated Infection ◽  
Surveillance Period ◽  
Multicenter Cohort Study ◽  
Mortality And Morbidity ◽  
Current Prevalence ◽  
Neurosurgical Patients ◽  
Enterococcus Spp ◽  
Healthcare Associated

The aim: To obtain the estimates of the current prevalence of healthcare-associated infection among neurosurgical patients and determine the antimicrobial resistance of responsible pathogens in Ukraine. Materials and methods: We performed a retrospective multicenter cohort study was based on surveillance data of HAIs among neurosurgical patients from 2017 to 2019 in 7 regional hospitals. Definitions of HAI were used from the CDC/ NHSN. Results: Of 9,711 neurosurgical patients, 1,031 (20.9%) HAIs were observed. The most frequently of HAI types were surgical site infection (53.2%), pneumonia (17.3%), urinary tract infection (15.1%) and bloodstream infection (14.4%). The overall prevalence of HAIs was 20.9% within three months and was 12.8% during one month surveillance period. Death during hospitalization was reported in 11.3% of HAI cases. Escherichia coli were most commonly reported, accounting for 24.3% of all organisms, followed by Staphylococcus aureus (15.9%), Enterococcus spp (14.6%), Pseudomonas aeruginosa (13.4%), and Klebsiella pneumoniae (9.8%). Meticillin resistance was 34.6% of S.aureus isolates. Vancomycin resistance was in 7.1% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 48.5% of K.pneumoniae and in 34.3% of E. coli isolates. Carbapenem resistance was reported in 11.7% of all included Enterobacteriaceae, also highest in K.pneumoniae, and in 32.4% of P.aeruginosa isolates and in 67.2% of Acinetobacter spp. isolates. Conclusions: Healthcare-associated infections are a cause for mortality and morbidity among hospitalized neurosurgical patients. This is due to increase emergence of antimicrobial-resistant pathogens. Routinely collected surveillance data are of great value as a basis for studying the consequences of HAIs.

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