scholarly journals Healthcare-Associated Infections Among Neonates in Brazil

2004 ◽  
Vol 25 (9) ◽  
pp. 772-777 ◽  
Author(s):  
Carmem Lúcia Pessoa-Silva ◽  
Rosana Richtmann ◽  
Roseli Calil ◽  
Rosana Maria Rangel Santos ◽  
Maria Luiza M. Costa ◽  
...  
Keyword(s):  
Perinatal Care ◽  
Venous Catheter ◽  
Incidence Density ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Maternal Origin ◽  
Central Venous ◽  
Prospective Surveillance ◽  
Coagulase Negative Staphylococci ◽  
Healthcare Associated

AbstractObjective:To describe the epidemiology of healthcare-associated infections (HAIs) among neonates.Design:Prospective surveillance of HAIs was conducted during 2 years. Infections beginning within 48 hours of birth were defined as HAIs of maternal origin. Death occurring during an active episode of HAI was considered related to HAI.Setting:Seven neonatal units located in three Brazilian cities.Patients:All admitted neonates were included and observed until discharge.Results:Twenty-two percent of 4,878 neonates had at least one HAI. The overall incidence density was 24.9 per 1,000 patient-days, and 28.1% of all HAIs were maternally acquired. HAI rates ranged from 12.3% in the group with a birth weight (BW) of more than 2,500 g to 51.9% in the group with a BW of 1,000 g or less. The main HAIs were bloodstream infection (BSI) and pneumonia. Coagulase-negative staphylococci, Enterobacter species, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens. Forty percent of all deaths were related to HAI. Central venous catheter (CVC)-associated BSIs per 1,000 CVC-days ranged from 17.3 (BW, 1,501 to 2,500 g; device utilization [DU], 0.11) to 34.9 (BW, ≤ 1,000 g; DU, 34.92). Ventilator-associated pneumonia per 1,000 ventilator-days ranged from 7.0 (BW, ≤ 1,000 g; DU, 0.34) to 9.2 (BW, 1,001 to 1,500 g; DU, 0.14).Conclusions:The high proportion of HAIs of maternal origin highlights perinatal care issues in Brazil and the need to improve the diagnosis of neonatal HAIs. The very low BW group and device-associated infections should be priorities for prevention strategies in this population.

scholarly journals Presence of Invasive Devices and Risks of Healthcare-Associated Infections and Sepsis

2018 ◽  
Vol 07 (04) ◽  
pp. 188-195
Author(s):  
John VanBuren ◽  
Richard Holubkov ◽  
Susan Bratton ◽  
Erin Bennett
Keyword(s):  
Intensive Care Unit ◽  
Retrospective Cohort ◽  
Urinary Catheter ◽  
Pediatric Intensive Care ◽  
Venous Catheter ◽  
Healthcare Associated Infections ◽  
Central Venous ◽  
Endotracheal Tubes ◽  
Daily Risk ◽  
Healthcare Associated

AbstractThe present study evaluated the daily risk of healthcare-associated infections and sepsis (HAIS) events in pediatric intensive care unit patients with invasive devices. This was a retrospective cohort study. Invasive devices were associated with significant daily risk of HAIS (p < 0.05). Endotracheal tubes posed the greatest risk of HAIS (hazard ratio [HR]: 4.39, confidence interval [CI]: 2.59–7.46). Children with both a central venous catheter (CVC) and urinary catheter (UC) had over 2.5-fold increased daily risk (HR: 2.59, CI: 1.18–5.68), in addition to daily CVC risk (HR: 3.06, CI: 1.38–6.77) and daily UC risk (HR: 8.9, CI: 3.62–21.91). We conclude that a multistate hazard model optimally predicts daily HAIS risk.

National Survey of Practices to Prevent Healthcare-Associated Infections in Thailand: The Role of Safely Culture and Collaboratives

2012 ◽  
Vol 33 (7) ◽  
pp. 711-717 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
M. Todd Greene ◽  
Edward H. Kennedy ◽  
Thana Khawcharoenporn ◽  
Sarah Krein ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Venous Catheter ◽  
Central Line ◽  
Hospital Characteristic ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infection ◽  
Central Venous ◽  
Healthcare Associated ◽  
Hospital Characteristics

Objective.To evaluate hospital characteristics and practices used by Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP), the 3 most common types of healthcare-associated infection (HAI) in Thailand.Design.Survey.Setting.Thai hospitals with an intensive care unit and 250 or more hospital bedsMethods.Between January 1, 2010, and October 31, 2010, research nurses collected data from all eligible hospitals. The survey assessed hospital characteristics and practices to prevent CAUTI, CLABSI, and VAP. Ordinal logistic regression was used to assess relationships between hospital characteristics and use of prevention practices.Results.A total of 204 (80%) of 256 hospitals responded. Most hospitals (93%) reported regularly using alcohol-based hand rub. The most frequently reported prevention practice by infection was as follows: for CAUTI, condom catheters in men (47%); for CLABSI, avoiding routine central venous catheter changes (85%); and for VAP, semirecumbent positioning (84%). Hospitals with peripherally inserted central catheter insertion teams were more likely to regularly use elements of the CLABSI prevention bundle. Greater safety scores were associated with regular use of several VAP prevention practices. The only hospital characteristic associated with increased use of at least 1 prevention practice for each infection was membership in an HAI collaborative.Conclusions.While reported adherence to hand hygiene was high, many of the prevention practices for CAUTI, CLABSI, and VAP were used infrequently in Thailand. Policies and interventions emphasizing specific infection prevention practices, establishing a strong institutional safety culture, and participating in collaboratives to prevent HAI may be beneficial.

scholarly journals Incidence Rates of Healthcare-Associated Infection in a Pediatric Home Healthcare Service

2012 ◽  
Vol 33 (8) ◽  
pp. 845-848 ◽  
Author(s):  
André Ricardo Araujo da Silva ◽  
Cristina Vieira de Souza ◽  
Mario Eduardo Viana Guimarães ◽  
Guilherme Sargentelli ◽  
Marisa Zenaide Ribeiro Gomes
Keyword(s):  
Healthcare Service ◽  
Incidence Rates ◽  
Home Healthcare ◽  
Incidence Density ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Healthcare Associated

We describe the incidence rates of home healthcare-associated infections (HHAIs) in a pediatric home healthcare service (PHHCS). The overall incidence density of HHAIs was 11.1 infections per 1,000 patient-days. Average incidence density of ventilator-associated pneumonia (VAP) was 6.8 per 1,000 ventilator-days. Strategies for control of VAP should be prioritized in PHHCSs.

A systematic review and meta-analysis of risk factors associated with acquisition of waterborne healthcare-associated infection or colonization in high-risk units

2019 ◽  
pp. 1-4
Author(s):  
Lina M. Parra ◽  
Mireia Cantero ◽  
Juliana Sierra ◽  
Ángel Asensio ◽  
Fernando J. García
Keyword(s):  
Meta Analysis ◽  
Adult Population ◽  
Venous Catheter ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Central Venous ◽  
Factors Associated ◽  
Standardized Mean Difference ◽  
Healthcare Associated

Abstract In this meta-analysis, central venous catheter exposure (pooled odds ratio, 8.02; 95% confidence interval [CI], 2.19–29.31; P < .01) in neonates and length of stay (standardized mean difference, 0.65; 95% CI, 0.26–1.05; P = .01) in an adult population were associated with acquisition of waterborne healthcare-associated infections or colonization in ICUs. The quality of evidence was low.

scholarly journals Partnership among hospitals to reduce healthcare associated infections: a quasi-experimental study in Brazilian ICUs

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ladjane Santos Wolmer de Melo ◽  
Maria Verônica Monteiro de Abreu ◽  
Bernuarda Roberta de Oliveira Santos ◽  
Maria das Graças Washington Casimiro Carr ◽  
Maria Fernanda Aparecida Moura de Souza ◽  
...  
Keyword(s):  
Experimental Study ◽  
Length Of Stay ◽  
Public Hospitals ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Collaborative Project ◽  
Quasi Experimental ◽  
Tract Infections ◽  
Healthcare Associated ◽  
Over Time

Abstract Background Healthcare-associated infections (HAIs) are relevant in developing countries where frequencies can be at least 3 times higher than in developed countries. The purpose of this research was to describe the intervention implemented in intensive care units (ICUs) to reduce HAIs through collaborative project and analyze the variation over 18 months in the incidence density (ID) of the three main HAIs: ventilator associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs) and catheter-related urinary tract infections (CAUTIs) and also the length of stay and mortality in these ICUs. Methods A quasi-experimental study in five public adult clinical-surgical ICUs, to reduce HAIs, through interventions using the BTS-IHI “Improvement Model”, during 18 months. In the project, promoted by the Ministry of Health, Brazilian philanthropic hospitals certified for excellence (HE), those mostly private, certified as excellence and exempt from security contributions, regularly trained and monitored public hospitals in diagnostics, data collection and in developing cycles to improve quality and to prevent HAIs (bundles). In the analysis regarding the length of stay, mortality, the IDs of VAP, CLABSIs and CAUTIs over time, a Generalized Estimating Equation (GEE) model was applied for continuous variables, using the constant correlation (exchangeable) between assessments over time. The model estimated the average difference (β coefficient of the model) of the measures analyzed during two periods: a period in the year 2017 (prior to implementing the project) and in the years 2018 and 2019 (during the project). Result A mean monthly reduction of 0.427 in VAP ID (p = 0.002) with 33.8% decrease at the end of the period and 0.351 in CAUTI ID (p = 0.009) with 45% final decrease. The mean monthly reduction of 0.252 for CLABSIs was not significant (p = 0.068). Length of stay and mortality rates had no significant variation. Conclusions Given the success in reducing VAP and CAUTIs in a few months of interventions, the achievement of the collaborative project is evident. This partnership among public hospitals/HE may be applied to other ICUs including countries with fewer resources.

scholarly journals Effectiveness of Antimicrobial Filter Placement in ICU Taps to Prevent the Occurrence of HAIs by Pseudomonas aeruginosa (12-Months)

2020 ◽  
Vol 41 (S1) ◽  
pp. s206-s207
Author(s):  
Pablo Chico-Sánchez ◽  
Sandra Canovas-Javega ◽  
Natali J. Jimenez-Sepulveda ◽  
Edith Leutscher-Vasen ◽  
Cesar O. Villanueva-Ruiz ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Critical Care ◽  
Etiologic Agent ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Open Label ◽  
Filter Placement ◽  
Critical Care Units ◽  
Definition Of ◽  
Healthcare Associated

Background:Pseudomonas aeruginosa, is the third etiologic agent of healthcare associated infections, and the most frequent pathogen in ventilator-associated pneumonia (VAP). In critical care units is associated with high mortality, long hospital stay, and high healthcare-associated costs. We evaluated the effectiveness of filter placement in the water taps in critical care units to prevent the occurrence of healthcare-associated infections (HAIa) by Pseudomonas aeruginosa. Methods: This experimental study was both cross-over and open-label in nature. We included patients admitted for >24 hours in critical care units over 24 months. The study was divided into 4 periods of 6 months each. We divided the study into 2 groups: patients in units with filters and patients in units without filters. We compared the incidence density of P. aeruginosa HAIs (number of cases divided by the number of person days) according the ECDC definition of case criteria between the groups. The 2 test was used, and the magnitude of the association was calculated as a rate ratio with a 95% confidence interval, adjusted using a Poisson regression model. Results: Overall, 1,132 patients were included in the study: 595 in units with water tap filters and 537 in units without water tap filters. HAI incidence among patients in units with water tap filters was 5.3 per 1,000 person days stay; without water tap filters, HAI incidence was 4.7 per 1,000 person days stay (HR, 0.94; 95% CI, 0.47–1.90). Conclusions: The preliminary results of this study indicate a a lower incidence of P. aeruginosa HAIs in units with filters placed in water taps than in units without filters.Disclosures: NoneFunding: None

Burden of healthcare-associated infections among hospitalized children within community hospitals participating in an infection control network

2021 ◽  
pp. 1-3
Author(s):  
Ibukunoluwa C. Akinboyo ◽  
Rebecca R. Young ◽  
Michael J. Smith ◽  
Sarah S. Lewis ◽  
Becky A. Smith ◽  
...  
Keyword(s):  
Infection Control ◽  
Bloodstream Infections ◽  
Central Line ◽  
Control Network ◽  
Hospitalized Children ◽  
Healthcare Associated Infections ◽  
Community Hospitals ◽  
Prospective Surveillance ◽  
Healthcare Associated ◽  
Pediatric Healthcare

Abstract We describe the frequency of pediatric healthcare-associated infections (HAIs) identified through prospective surveillance in community hospitals participating in an infection control network. Over a 6-year period, 84 HAIs were identified. Of these 51 (61%) were pediatric central-line–associated bloodstream infections, and they often occurred in children <1 year of age.

scholarly journals Impact of Healthcare-Associated Infections Connected to Medical Devices—An Update

2021 ◽  
Vol 9 (11) ◽  
pp. 2332
Author(s):  
Nitin Chandra Teja Dadi ◽  
Barbora Radochová ◽  
Jarmila Vargová ◽  
Helena Bujdáková
Keyword(s):  
Medical Devices ◽  
Surgical Site Infections ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Care Bundles ◽  
Planktonic Form ◽  
Novel Approaches ◽  
Healthcare Associated ◽  
The Impact

Healthcare-associated infections (HAIs) are caused by nosocomial pathogens. HAIs have an immense impact not only on developing countries but also on highly developed parts of world. They are predominantly device-associated infections that are caused by the planktonic form of microorganisms as well as those organized in biofilms. This review elucidates the impact of HAIs, focusing on device-associated infections such as central line-associated bloodstream infection including catheter infection, catheter-associated urinary tract infection, ventilator-associated pneumonia, and surgical site infections. The most relevant microorganisms are mentioned in terms of their frequency of infection on medical devices. Standard care bundles, conventional therapy, and novel approaches against device-associated infections are briefly mentioned as well. This review concisely summarizes relevant and up-to-date information on HAIs and HAI-associated microorganisms and also provides a description of several useful approaches for tackling HAIs.

scholarly journals Increased Involvement of Klebsiellapneumoniae and Enterococcusfaecium in Healthcare-Associated Infections of Intensive Care Units in Taiwan

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1349
Author(s):  
Yu-Ren Lin ◽  
Yen-Yue Lin ◽  
Chia-Peng Yu ◽  
Ya-Sung Yang ◽  
Chun-Gu Cheng ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Intensive Care Units ◽  
Enterococcus Faecium ◽  
Healthcare Providers ◽  
Incidence Density ◽  
Healthcare Associated Infections ◽  
Chi Square ◽  
Control Protocols ◽  
Healthcare Associated

Background: Healthcare-associated infections (HAIs) cause increases in length of stay, mortality, and healthcare costs. A previous study conducted in Taiwan obtained similar results to those reported in Korea and Japan in 2015. Changes in microorganisms have been noted in recent years. Understanding the recent condition of HAIs in intensive care units (ICUs) can enable healthcare providers to develop effective infection control protocols to reduce HAIs. Methods: We used the Taiwan Nosocomial Infection Surveillance System to evaluate the incidence densities of HAIs, the proportions of causative pathogens, and the proportions of antimicrobial resistance (AMR). The Poisson regression model was constructed to incidence density, and the chi-square test was used to assess proportion. Results: The incidence density of HAIs decreased 5.7 to 5.4 per 1000 person-days. However, the proportions of Klebsiella pneumoniae and Enterococcus faecium significantly increased. In addition, the proportions of carbapenem-resistant K. pneumoniae and vancomycin-resistant Enterococcus faecium significantly increased over time. Conclusion: Analysis of the microorganisms involved in HAIs in ICUs showed elevated proportions of K. pneumoniae and E. faecium with AMR. Infection control protocols have been implemented for several years and require improvements regarding environmental cleanliness and medical staff prevention.

scholarly journals Molecular epidemiology of catheter-related bloodstream infections caused by coagulase-negative staphylococci in haematological patients with neutropenia

2004 ◽  
Vol 132 (5) ◽  
pp. 921-925 ◽  
Author(s):  
M. MÜLLER-PREMRU ◽  
P. ČERNELČ
Keyword(s):  
Blood Culture ◽  
Staphylococcus Epidermidis ◽  
Clinical Signs ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Blood Cultures ◽  
Peripheral Vein ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Haematological Patients

Catheter-related bloodstream infection (CRBSI) caused by coagulase-negative staphylococci (CNS) is common in haematological patients with febrile neutropenia. As the clinical signs of CRBSI are usually scarce and it is difficult to differentiate from blood culture contamination, we tried to confirm CRBSI by molecular typing of CNS isolated from paired blood cultures (one from a peripheral vein and another from the central venous catheter hub). Blood cultures were positive in 59 (36%) out of 163 patients. CNS were isolated in 24 (40%) patients; in 14 from paired blood cultures (28 isolates) and in 10 from a single blood culture. CNS from paired blood cultures were identified as Staphylococcus epidermidis. Antimicrobial susceptibility was determined and bacteria were typed by pulsed-field gel electrophoresis (PFGE) of bacterial genomic DNA. In 13 patients, the antibiotic susceptibility of isolates was identical. The PFGE patterns from paired blood cultures were identical or closely related in 10 patients, thus confirming the presence of CRBSI. In the remaining four patients they were unrelated, and suggested a mixed infection or contamination. Since CNS isolates from three patients had identical PFGE patterns, they were probably nosocomially spread amongst them.

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