Nosocomial Bacteremia in Children: A 15-Year Experience at a General Hospital in Mexico

2007 ◽  
Vol 28 (4) ◽  
pp. 418-422 ◽  
Author(s):  
Luis Fernando Pérez-González ◽  
Juana María Ruiz-González ◽  
Daniel E. Noyola
Keyword(s):  
General Hospital ◽  
Bloodstream Infection ◽  
Active Surveillance ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Coagulase Negative Staphylococci ◽  
Hospital Acquired Infection ◽  
Nosocomial Bacteremia ◽  
Laminar Air Flow ◽  
Hospital Acquired

Objective.To describe the incidence and etiology of nosocomial bloodstream infections in children at a general hospital.Design.Review of nosocomial bloodstream infections detected in children during 1991-2005. Data were prospectively gathered through active surveillance. Annual rates of infection were compared.Setting.A public general hospital in San Luis Potosi, Mexico.Patients.Children younger than 15 years of age admitted to pediatric wards and subjected to prospective surveillance for nosocomial infection.Interventions.Measures instituted to decrease the incidence of hospital-acquired infection during the 15-year study period included establishing active surveillance for hospital-acquired infection, reinforcing compliance with handwashing recommendations, decreasing the degree of crowding on wards, establishing guidelines for the management of intravenous catheters and solutions, preparing parenteral nutrition and intravenous solutions under a laminar air-flow hood, and increasing nursing personnel.Results.There were 868 nosocomial bloodstream infections detected in 29,273 subjects (overall rate, 2.94 episodes per 100 discharges). Infection rates were greatest among children admitted to the neonatal intensive care unit and lowest for those admitted to the school-age ward and the infectious diseases ward. There was a significant decrease in rates of nosocomial bacteremia in all of the wards. The organisms isolated most commonly were Klebsiella pneumoniae, Candida species, and coagulase-negative staphylococci. Mortality rates were higher for children with a gram-negative bacterial bloodstream infection (45.2%) and lower for children with a gram-positive bacterial infection (19.2%).Conclusions.Rates of nosocomial bloodstream infection decreased over the past 15 years at our hospital but continue to cause significant mortality. Continuing efforts to decrease the frequency of and mortality due to bloodstream infection are warranted.

National Bloodstream Infection Surveillance in Switzerland 2008–2014: Different Patterns and Trends for University and Community Hospitals

2016 ◽  
Vol 37 (9) ◽  
pp. 1060-1067 ◽  
Author(s):  
Niccolò Buetti ◽  
Jonas Marschall ◽  
Andrew Atkinson ◽  
Andreas Kronenberg ◽  
Keyword(s):  
Bloodstream Infection ◽  
Bloodstream Infections ◽  
Community Hospitals ◽  
University Hospitals ◽  
Coagulase Negative Staphylococci ◽  
E Coli ◽  
Infection Surveillance ◽  
Laboratory Surveillance ◽  
Predominant Pathogen ◽  
Hospital Acquired

OBJECTIVETo characterize the epidemiology of bloodstream infections in Switzerland, comparing selected pathogens in community and university hospitals.DESIGNObservational, retrospective, multicenter laboratory surveillance study.METHODSData on bloodstream infections from 2008 through 2014 were obtained from the Swiss infection surveillance system, which is part of the Swiss Centre for Antibiotic Resistance (ANRESIS). We compared pathogen prevalences across 26 acute care hospitals. A subanalysis for community-acquired and hospital-acquired bloodstream infections in community and university hospitals was performed.RESULTSA total of 42,802 bloodstream infection episodes were analyzed. The most common etiologies were Escherichia coli (28.3%), Staphylococcus aureus (12.4%), and polymicrobial bloodstream infections (11.4%). The proportion of E. coli increased from 27.5% in 2008 to 29.6% in 2014 (P = .04). E. coli and S. aureus were more commonly reported in community than university hospitals (34.3% vs 22.7%, P<.001 and 13.9% vs 11.1%, P<.001, respectively). Fifty percent of episodes were community-acquired, with E. coli again being more common in community hospitals (41.0% vs 32.4%, P<.001). The proportion of E. coli in community-acquired bloodstream infections increased in community hospitals only. Community-acquired polymicrobial infections (9.9% vs 5.6%, P<.001) and community-acquired coagulase-negative staphylococci (6.7% vs 3.4%, P<0.001) were more prevalent in university hospitals.CONCLUSIONSThe role of E. coli as predominant pathogen in bloodstream infections has become more pronounced. There are distinct patterns in community and university hospitals, potentially influencing empirical antibiotic treatment.Infect Control Hosp Epidemiol 2016;37:1060–1067

scholarly journals Genomic Analysis of Multiresistant Staphylococcus capitis Associated with Neonatal Sepsis

2018 ◽  
Vol 62 (11) ◽  
Author(s):  
Glen P. Carter ◽  
James E. Ussher ◽  
Anders Gonçalves Da Silva ◽  
Sarah L. Baines ◽  
Helen Heffernan ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Genomic Analysis ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Comparative Genomic ◽  
Coagulase Negative Staphylococci ◽  
Content Type ◽  
Staphylococcus Capitis ◽  
Hospital Infection Control

ABSTRACT Coagulase-negative staphylococci (CoNS), such as Staphylococcus capitis, are major causes of bloodstream infections in neonatal intensive care units (NICUs). Recently, a distinct clone of S. capitis (designated S. capitis NRCS-A) has emerged as an important pathogen in NICUs internationally. Here, 122 S. capitis isolates from New Zealand (NZ) underwent whole-genome sequencing (WGS), and these data were supplemented with publicly available S. capitis sequence reads. Phylogenetic and comparative genomic analyses were performed, as were phenotypic assessments of antimicrobial resistance, biofilm formation, and plasmid segregational stability on representative isolates. A distinct lineage of S. capitis was identified in NZ associated with neonates and the NICU environment. Isolates from this lineage produced increased levels of biofilm, displayed higher levels of tolerance to chlorhexidine, and were multidrug resistant. Although similar to globally circulating NICU-associated S. capitis strains at a core-genome level, NZ NICU S. capitis isolates carried a novel stably maintained multidrug-resistant plasmid that was not present in non-NICU isolates. Neonatal blood culture isolates were indistinguishable from environmental S. capitis isolates found on fomites, such as stethoscopes and neonatal incubators, but were generally distinct from those isolates carried by NICU staff. This work implicates the NICU environment as a potential reservoir for neonatal sepsis caused by S. capitis and highlights the capacity of genomics-based tracking and surveillance to inform future hospital infection control practices aimed at containing the spread of this important neonatal pathogen.

Eradication of Methicillin-ResistantStaphylococcus AureusFrom a Neonatal Intensive Care Unit by Active Surveillance and Aggressive Infection Control Measures

2005 ◽  
Vol 26 (7) ◽  
pp. 616-621 ◽  
Author(s):  
Jad Khoury ◽  
Marilyn Jones ◽  
Autumn Grim ◽  
Wm. Michael Dunne ◽  
Vicky Fraser
Keyword(s):  
Active Surveillance ◽  
Neonatal Intensive Care ◽  
Control Measures ◽  
Multiple Gestation ◽  
Infection Control Measures ◽  
Contact Isolation ◽  
Increased Risk ◽  
Mrsa Infection ◽  
Hospital Acquired ◽  
Mrsa Colonization

AbstractObjectives:To describe an outbreak of hospital-acquired MRSA in a NICU and to identify the risk factors for, outcomes of, and interventions that eliminated it.Setting:An 18-bed, level III-IV NICU in a community hospital.Methods:Interventions to control MRSA included active surveillance, aggressive contact isolation, and cohorting and decolonization of infants and HCWs with MRSA. A case–control study was performed to compare infants with and without MRSA.Results:A cluster of 6 cases of MRSA infection between September and October 2001 represented an increased attack rate of 21.2% compared with 5.3% in the previous months. Active surveillance identified unsuspected MRSA colonization in 6 (21.4%) of 28 patients and 6 (5.5%) of 110 HCWs screened. They were all successfully decolonized. There was an increased risk of MRSA colonization and infection among infants with low birth weight or younger gestational age. Multiple gestation was associated with an increased risk of colonization (OR, 37.5; CI95, 3.9–363.1) and infection (OR, 5.36; CI95, 1.37–20.96). Gavage feeding (OR, 10.33; CI95, 1.28–83.37) and intubation (OR, 5.97; CI95, 1.22–29.31) were associated with increased risk of infection. Infants with MRSA infection had a significantly longer hospital stay than infants without MRSA (51.83 vs 21.46 days;P= .003). Rep-PCR withmectyping and PVL analysis confirmed the presence of a single common strain of hospital-acquired MRSA.Conclusion:Active surveillance, aggressive implementation of contact isolation, cohorting, and decolonization effectively eradicated MRSA from the NICU for 2½ years following the outbreak. (Infect Control Hosp Epidemiol 2005;26:616-621)

scholarly journals Emergence of Azole Resistant Candida Glabrata as an Important Cause of Hospital Acquired Infection: Its Risk Factors and Impact

2020 ◽  
Vol 3 (2) ◽  
pp. 141-146
Author(s):  
Sarkar T
Keyword(s):  
Candida Glabrata ◽  
Acquired Resistance ◽  
Human Microbiome ◽  
Bloodstream Infections ◽  
Candida Spp ◽  
Mortality And Morbidity ◽  
Hospital Acquired Infection ◽  
The Usa ◽  
Proportional Increase ◽  
Hospital Acquired

Candida spp. colonizes the human host and coexists with members of the human microbiome. Candida glabrata are aggressive pathogens, have many virulence factors that lead to serious recurrent candidiasis. Their ability to form a complex biofilm, inability to form hyphae, and inability to secrete hydrolase lead to antifungal resistance. Candidemia is the fourth most common bloodstream infection [1]. Candidemia remains a major source of mortality and morbidity. Mortality among patients with invasive candidiasis is as high as 40%, even when patients receive antifungal therapy [2]. More than 90% of invasive diseases are caused by the 5 most common Candida spp. C. albicans, C. glabrata, C. tropicalis, C. parapsilosis, and C. krusei [3]. The distribution of Candida species has been changing over the last decade, with a decrease in the proportion of C. albicans and an increase in C. glabrata and C. parapsilosis. More than 50% of bloodstream infections are caused by non-albicans Candida [2,4]. The largest proportional increase in the USA is in C. glabrata, which accounts for one third or more of all candidemia isolates [5-7]. C.glabrata are associated with high mortality. Candida glabrata develop acquired resistance following exposure to antifungal agents [8]. 50% of C. glabrata are resistant to fluconazole [9,10]. Furthermore, 9% of C. glabrata that are resistant to fluconazole are also resistant to the echinocandins [8,11].

scholarly journals The Standardization of Hospital-Acquired Infection Rates Using Prediction Models in Iran: Observational Study of National Nosocomial Infection Registry Data

10.2196/33296 ◽  
2021 ◽  
Vol 7 (12) ◽  
pp. e33296
Author(s):  
Neda Izadi ◽  
Koorosh Etemad ◽  
Yadollah Mehrabi ◽  
Babak Eshrati ◽  
Seyed Saeed Hashemi Nazari
Keyword(s):  
Internal Medicine ◽  
Infectious Disease ◽  
Prediction Models ◽  
Scientific Evidence ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Rates ◽  
Hospital Acquired Infection ◽  
Tract Infections ◽  
Hospital Acquired

Background Many factors contribute to the spreading of hospital-acquired infections (HAIs). Objective This study aimed to standardize the HAI rate using prediction models in Iran based on the National Healthcare Safety Network (NHSN) method. Methods In this study, the Iranian nosocomial infections surveillance system (INIS) was used to gather data on patients with HAIs (126,314 infections). In addition, the hospital statistics and information system (AVAB) was used to collect data on hospital characteristics. First, well-performing hospitals, including 357 hospitals from all over the country, were selected. Data were randomly split into training (70%) and testing (30%) sets. Finally, the standardized infection ratio (SIR) and the corrected SIR were calculated for the HAIs. Results The mean age of the 100,110 patients with an HAI was 40.02 (SD 23.56) years. The corrected SIRs based on the observed and predicted infections for respiratory tract infections (RTIs), urinary tract infections (UTIs), surgical site infections (SSIs), and bloodstream infections (BSIs) were 0.03 (95% CI 0-0.09), 1.02 (95% CI 0.95-1.09), 0.93 (95% CI 0.85-1.007), and 0.91 (95% CI 0.54-1.28), respectively. Moreover, the corrected SIRs for RTIs in the infectious disease, burn, obstetrics and gynecology, and internal medicine wards; UTIs in the burn, infectious disease, internal medicine, and intensive care unit wards; SSIs in the burn and infectious disease wards; and BSIs in most wards were >1, indicating that more HAIs were observed than expected. Conclusions The results of this study can help to promote preventive measures based on scientific evidence. They can also lead to the continuous improvement of the monitoring system by collecting and systematically analyzing data on HAIs and encourage the hospitals to better control their infection rates by establishing a benchmarking system.

scholarly journals Prevalence of central venous catheter salvage in newborn with staphylococcal bloodstream infection

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Izabela Linha Secco ◽  
Mitzy Tannia Reichembach ◽  
Higor Pacheco Pereira ◽  
Regina Paula Guimarães Vieira Cavalcante da Silva
Keyword(s):  
Blood Culture ◽  
Central Venous Catheter ◽  
Antibiotic Therapy ◽  
Bloodstream Infection ◽  
Neonatal Intensive Care ◽  
Venous Catheter ◽  
Cross Sectional Study ◽  
Central Venous ◽  
Coagulase Negative Staphylococci ◽  
Cross Sectional

ABSTRACT Objectives: to establish the prevalence of salvage of central venous catheters in newborns with bloodstream infection caused by coagulase-negative staphylococci. Methods: retrospective cross-sectional study with 136 newborns admitted to the Neonatal Intensive Care Unit between 2011 and 2017. The total of 143 infection events undergoing antibiotic therapy were evaluated. Results: among the 143 infection events, 39 catheters in which antibiotic therapy was used were saved and in 69 cases, the device was removed. Positive central blood culture and single lumen catheter were factors associated with salvage failure. The probability of salvage decreased with infections diagnosed from 15 days of using the catheter. Negative blood culture raised the chance of salvage by fourfold. Conclusions: the use of antibiotic therapy in the treatment of infections resulted in a low prevalence of salvage of the central venous catheter. The probability of salvage was associated with variables of the device.

scholarly journals Combination Therapy with Aminoglycoside in Bacteremiasdue to ESBL-Producing Enterobacteriaceae in ICU

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 777
Author(s):  
Lucie Benetazzo ◽  
Pierre-Yves Delannoy ◽  
Marion Houard ◽  
Frederic Wallet ◽  
Fabien Lambiotte ◽  
...  
Keyword(s):  
Death Rate ◽  
Distress Syndrome ◽  
Bloodstream Infections ◽  
Observational Cohort Study ◽  
Icu Patients ◽  
Hospital Acquired Infection ◽  
History Of ◽  
Observational Cohort ◽  
Hospital Acquired ◽  
Retrospective Observational Cohort Study

Objectives: Evaluation of the efficacy of empirical aminoglycoside in critically ill patients with bloodstream infections caused by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E BSI). Methods: Patients treated between 2011 and 2018 for ESBL-E BSI in the ICU of six French hospitals were included in a retrospective observational cohort study. The primary endpoint was mortality on day 30. Results: Among 307 patients, 169 (55%) were treated with empirical aminoglycoside. Death rate was 40% (43% with vs. 39% without aminoglycoside, p = 0.55). Factors independently associated with death were age ≥70 years (OR: 2.67; 95% CI: 1.09–6.54, p = 0.03), history of transplantation (OR 5.2; 95% CI: 1.4–19.35, p = 0.01), hospital acquired infection (OR 8.67; 95% CI: 1.74–43.08, p = 0.008), vasoactive drugs >48 h after BSI onset (OR 3.61; 95% CI: 1.62–8.02, p = 0.001), occurrence of acute respiratory distress syndrome (OR 2.42; 95% CI: 1.14–5.16, p = 0.02), or acute renal failure (OR 2.49; 95% CI: 1.14–5.47, p = 0.02). Antibiotherapy appropriateness was more frequent in the aminoglycoside group (91.7% vs. 77%, p = 0.001). Rate of renal impairment was similar in both groups (21% vs. 24%, p = 0.59). Conclusions: In intensive care unit (ICU) patients with ESBL-E BSI, empirical treatment with aminoglycoside was frequent. It demonstrated no impact on mortality, despite increasing treatment appropriateness.

scholarly journals Comparison of Total Hospital-Acquired Bloodstream Infections to Central Line–Associated Bloodstream Infections and Implications for Outcome Measures in Infection Control

2013 ◽  
Vol 34 (9) ◽  
pp. 984-986 ◽  
Author(s):  
Surbhi Leekha ◽  
Shanshan Li ◽  
Kerri A. Thom ◽  
Michael Anne Preas ◽  
Brian S. Caffo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Outcome Measures ◽  
Bloodstream Infections ◽  
Central Line ◽  
Total Hospital ◽  
Prevention Intervention ◽  
Hospital Acquired

The validity of the central line-associated bloodstream infection (CLABSI) measure is compromised by subjectivity. We observed significant decreases in both CLABSIs and total hospital-acquired bloodstream infections (BSIs) following a CLABSI prevention intervention in adult intensive care units. Total hospital-acquired BSIs could be explored as an adjunct, objective CLABSI measure.

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