Success of an Infection Control Program to Reduce the Spread of Carbapenem-Resistant Klebsiella pneumoniae

2009 ◽  
Vol 30 (5) ◽  
pp. 447-452 ◽  
Author(s):  
Sandeep Kochar ◽  
Timothy Sheard ◽  
Roopali Sharma ◽  
Alan Hui ◽  
Elaine Tolentino ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Infection Control ◽  
Control Program ◽  
Control Measures ◽  
Infection Control Program ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
The Mean ◽  
Vancomycin Resistant

Objective.To assess the effect of enhanced infection control measures with screening for gastrointestinal colonization on limiting the spread of carbapenem-resistant Klebsiella pneumoniae in a New York City hospital endemic for this pathogen.Design.Retrospective observational study with pre- and postinterventional phases.Methods.Beginning in 2006, a comprehensive infection control program was instituted in a 10-bed medical and surgical intensive care unit at a university-based medical center. In addition to being placed in contact isolation, all patients colonized or infected with carbapenem-resistant gram-negative bacilli, vancomycin-resistant Enterococcus, or methicillin-resistant Staphylococcus aureus were cohorted to one end of the unit. Improved decontamination of hands and environmental surfaces was encouraged. In addition, routine rectal surveillance cultures were screened for the presence of carbapenem-resistant pathogens. The number of patients per quarter with clinical cultures positive for carbapenem-resistant K. pneumoniae was compared during the approximately 2-year periods before and after the intervention.Results.The mean number ( ± SD) of new patients per 1,000 patient-days per quarter with cultures yielding carbapenem-resistant K. pneumoniae decreased from 9.7 ± 2.2 before the intervention to 3.7 ± 1.6 after the intervention (P< .001 ). There was no change in the mean number of patient-days or the mean number of patients per quarter with cultures yielding methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, or carbapenem-resistant Acinetobacter baumannii or Pseudomonas aeruginosa after the intervention. There was no association between antibiotic usage patterns and carbapenem-resistant K. pneumoniae.Conclusions.The comprehensive intervention that combined intensified infection control measures with routine rectal surveillance cultures was helpful in reducing the incidence of carbapenem-resistant K. pneumoniae in an intensive care unit where strains producing the carbapenemase KPC were endemic.

scholarly journals Cross-infection and infection control in dental clinics in Nablus and Tulkarm districts

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wafaa Menawi ◽  
Areej Sabbah ◽  
Lubna Kharraz
Keyword(s):  
Infection Control ◽  
Positive Response ◽  
Statistical Significance ◽  
Reliability And Validity ◽  
Control Program ◽  
Health Care Facilities ◽  
Control Measures ◽  
Infection Control Program ◽  
Infection Control Measures ◽  
Dental Clinics

Abstract Background Infection control had many developments in the COVID 19 (Coronavirus Disease 2019) pandemic, despite this, there were many complications in different health care facilities as well as dentists’ clinics due to the lack of infection control knowledge and compliance failure. This study aimed to assess the level of knowledge and compliance with the infection control measures in the dental clinics in the Nablus and Tulkarm districts. Results The results showed that the total positive response regard all infection control domains were (70.0 %). Whereas the participants gave the highest positive response for personnel protective equipment i.e. gloving was (96.10 %). They gave the instruments related to controls the lowest responses, i.e. instruments sterilization was (59.40 %). The analyzed data showed significant statistical differences in the compliance with infection control measures between Nablus and Tulkarm districts “p < 0.05” in the interest of dentists from Tulkarm. Conclusions In conclusion, the findings of this study showed that there is moderate compliance to infection control protocol in Nablus and Tulkarm dental clinics. Thus, there is a need to strengthen adherence to infection control measures. Method A universal sampling was used to assess the infection control program at the dental clinics in Nablus and Tulkarm Districts. The study sample involved 265 dentists. Data was collected using a questionnaire which has been sent via email between July and August 2020. Descriptive statistics, Chi-square test, One-way ANOVA and Post-Hock tests have been used. Statistical significance was set at ″P <0.05″. Cronbach’s alpha has been conducted to ensure the reliability and validity of the questionnaire.

scholarly journals Infection control measures to reduce hospital infection rates in the medical city burn center

2019 ◽  
Vol 60 (4) ◽  
pp. 191-194
Author(s):  
Mohannad Albermani ◽  
Waleed A. Salman ◽  
Gulala K. Hamad ◽  
Eman A. Hadi
Keyword(s):  
Infection Control ◽  
Control Program ◽  
Control Measures ◽  
Burn Patients ◽  
Burn Wound ◽  
Infection Control Program ◽  
Burn Center ◽  
Infection Control Measures ◽  
Medical City ◽  
Burn Units

Background: The most serious problem in burn units is nosocomial infection (NI). In extensive burn patients, sepsis is considered the main cause of death; infection control program will help to lower NI and its subsequent high mortality rate. Objective: To achieve the lowering of NI in burn units, by effect of infection control measures (ICMs). Patients and methods: This is a prospective study conducted on patients admitted in Burn Center/Medical City in Baghdad from May 2012 to April 2015. A total of 1977 hospitalized patients were included in this study. This center receives burn patients with different severity. In around April 2012 an infection control program was started in the center by the infection control team ICT.Results: The rate of NI was reduced; the mortality rates declined, and mean hospital stay of NI patients decreased. The number of cases with burn wound infection (BWI), bacteremia sepsis and subsequent mortality were decreased. Conclusion: ICMs helped to reduce NIs in the burn center .Rational usage of antibiotic and baths, new dressing, early excision and grafting are vital and recommended.

Costs and Savings Associated With Infection Control Measures That Reduced Transmission of Vancomycin-Resistant Enterococci in an Endemic Setting

2001 ◽  
Vol 22 (7) ◽  
pp. 437-442 ◽  
Author(s):  
Marisa A. Montecalvo ◽  
William R. Jarvis ◽  
Jane Uman ◽  
David K. Shay ◽  
Coleen Petrullo ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Strategies ◽  
Control Measures ◽  
Antimicrobial Use ◽  
Mixed Effect ◽  
Infection Control Program ◽  
Endemic Setting ◽  
Vancomycin Resistant Enterococci ◽  
Number Of Patients ◽  
Vancomycin Resistant

AbstractObjective:To determine the costs and savings of a 15-component infection control program that reduced transmission of vancomycin-resistant enterococci (VRE) in an endemic setting.Design:Evaluation of costs and savings, using historical control data.Setting:Adult oncology unit of a 650-bed hospital.Participants:Patients with leukemia, lymphoma, and solid tumors, excluding bone marrow transplant recipients.Methods:Costs and savings with estimated ranges were calculated. Excess length of stay (LOS) associated with VRE bloodstream infection (BSI) was determined by matching VRE BSI patients with VRE-negative patients by oncology diagnosis. Differences in LOS between the matched groups were evaluated using a mixed-effect analysis of variance linear-regression model.Results:The cost of enhanced infection control strategies for 1 year was $116,515. VRE BSI was associated with an increased LOS of 13.7 days. The savings associated with fewer VRE BSI ($123,081), fewer patients with VRE colonization ($2,755), and reductions in antimicrobial use ($179,997) totaled $305,833. Estimated ranges of costs and savings for enhanced infection control strategies were $97,939 to $148,883 for costs and $271,531 to $421,461 for savings.Conclusion:The net savings due to enhanced infection control strategies for 1 year was $189,318. Estimates suggest that these strategies would be cost-beneficial for hospital units where the number of patients with VRE BSI is at least see to nine patients per year or if the savings from fewer VRE BSI patients in combination with decreased antimicrobial use equalled $100,000 to $150,000 per year.

Molecular Epidemiology of an Outbreak ofSerratia marcescensin a Neonatal Intensive Care Unit

2001 ◽  
Vol 22 (10) ◽  
pp. 630-634 ◽  
Author(s):  
Paolo Villari ◽  
Margherita Crispino ◽  
Alessandra Salvadori ◽  
Alda Scarcella
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Neonatal Intensive Care Unit ◽  
Genomic Dna ◽  
Neonatal Intensive Care ◽  
Control Program ◽  
Control Measures ◽  
Infection Control Program ◽  
Multiresistant Bacteria

AbstractObjective:To investigate and control a biphasic outbreak ofSerratia marcescensin a neonatal intensive care unit (NICU).Design:Epidemiological and laboratory investigation of the outbreak.Setting:The NICU of the 1,470-bed teaching hospital of the University “Federico II,” Naples, Italy.Patients:The outbreak involved 56 cases of colonization by Smarcescensover a 15-month period, with two epidemic peaks of 6 and 3 months, respectively. Fourteen (25%) of the 56 colonized infants developed clinical infections, 50% of which were major (sepsis, meningitis, or pneumonia).Methods:Epidemiological and microbiological investigations, analysis of macrorestriction pattern of genomic DNA through pulsed-field gel electrophoresis (PFGE) of clinical and environmental isolates, and institution of infection control measures.Results:Analysis of macrorestriction patterns of genomic DNA by PFGE demonstrated that the vast majority of Smarcescensisolates, including three environmental strains isolated from two handwashing disinfectants and the hands of a nurse, were of the same clonal type. The successful control of the outbreak was achieved through cohorting of noncolonized infants, isolation of Smarcescens-infectedand -colonized infants, and an intense educational program that emphasized the need for adherence to glove use and handwashing policies. The NICU remained open to new admissions.Conclusions:Outbreaks caused by Smarcescensare very difficult to eradicate. An infection control program that includes molecular typing of microorganisms and the proper dissemination among staff members of the typing results is likely to be very effective in reducing NICU-acquired infections and in controlling outbreaks caused by Smarcescens,as well as other multiresistant bacteria.

scholarly journals Cross-Infection and Infection Control in Dental Clinics In Nablus and Tulkarm Districts

2021 ◽  
Author(s):  
Wafaa Menawi ◽  
Areej Sabbah ◽  
Lubna Kharraz
Keyword(s):  
Infection Control ◽  
Positive Response ◽  
Statistical Significance ◽  
Reliability And Validity ◽  
Control Program ◽  
Health Care Facilities ◽  
Control Measures ◽  
Infection Control Program ◽  
Infection Control Measures ◽  
Dental Clinics

Abstract Background: Infection control had many developments in the COVID 19 pandemic, despite this, there were many complications in different health care facilities as well as dentists’ clinics due to the lack of infection control knowledge and compliance failure.Aim: To assess the level of knowledge and compliance with the infection control measures in the dental clinics in Nablus and Tulkarm districts.Method: A universal Sampling was used to assess the infection control program at the dental clinics in Nablus and Tulkarm District. The study sample involved 265 dentists. Data was collected using a questionnaire which has been sent via email between July and August 2020. Descriptive statistics, Chi-square test, One-way ANOVA and Post-Hock tests have been used. Statistical significance was set at ″P <0.05″. Cronbach's alpha has been conducted to ensure the reliability and validity of the questionnaire.Findings: The results showed that the total positive response regard all infection control domains were (70.0%). Whereas the participants gave the highest positive response for personnel protective equipment i.e gloving (96.10%), they gave the instruments related controls the lowest responses i.e instruments sterilization were (59.40%). The analyzed data showed significant statistical differences in the compliance with infection control measures between Nablus and Tulkarm districts “p < 0.05” in the interest of dentists from Tulkarm.Conclusion: The findings of this study showed that there is a moderate compliance to infection control protocol in Nablus and Tulkarm dental clinics. Thus, there is a need to strengthen the adherence to infection control measures.

Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility—A qualitative analysis

2021 ◽  
pp. 1-7
Author(s):  
Katharina R. Rynkiewich ◽  
Jinal Makhija ◽  
Mary Carl M. Froilan ◽  
Ellen C. Benson ◽  
Alice Han ◽  
...  
Keyword(s):  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Healthcare Personnel ◽  
Skilled Nursing ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Resident Care ◽  
Semistructured Interviews ◽  
Self Protection

Abstract Objective: Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. Design: A qualitative study involving semistructured interviews. Setting: One vSNF in the Chicago, Illinois, metropolitan region. Participants: The study included 17 healthcare personnel representing management, nursing, and nursing assistants. Methods: We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. Results: Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were ‘invisible’ and potentially ‘threatening.’ Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. Conclusions: Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.

Infection Control in El Salvador: The Hospital Rosales Experience

1987 ◽  
Vol 8 (12) ◽  
pp. 495-500 ◽  
Author(s):  
José A. Marinero Càceres ◽  
Yolanda de Sotello
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Infection Control ◽  
El Salvador ◽  
Control Program ◽  
Infection Control Program ◽  
San Salvador ◽  
Duration Of Hospitalization ◽  
The Mean ◽  
Open Wards ◽  
Partial Correction

AbstractWe describe circumstances at the Hospital Rosales, located in San Salvador, El Salvador, and some salient observations from an infection control program begun in 1978. Findings include overuse of antibiotics, especially of penicillin and chloramphenicol; a predominance of gram-negative rod infections, especially Pseudomonas aeruginosa; a relative infrequency of Staphylococcus aureus infections; an apparent doubling of the mean duration of hospitalization for patients with nosocomial infections compared with other patients (22.1 days versus 11.0 days); documentation and partial correction of deficiencies in aseptic and antiseptic practices; an outbreak of Pseudomonas aeruginosa endophthalmitis traced to the hospital's factory for the manufacturing of intravenous fluids; and attitudinal problems such as the care of patients with rabies on open wards. Prevalence surveys conducted during 1981 and 1986 suggest a dramatic increase in the recent incidence of surgical wound infection (44% v 28%, P < 0.001). This latter observation suggests a direct relationship between infection rates and the hardships imposed by poverty and civil war.

scholarly journals The effectiveness of a Comprehensive Device Associated Healthcare-Associated Infections Prevention and Control Program: results of a 3-year program in the Republic of Cyprus

2019 ◽  
Author(s):  
Stelios Iordanou ◽  
Nicos Middleton ◽  
Elizabeth Papathanassoglou ◽  
Lakis Palazis ◽  
VASILIOS RAFTOPOULOS
Keyword(s):  
Infection Control ◽  
Prevention And Control ◽  
Control Program ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Second Phase ◽  
Infection Control Program ◽  
The Republic ◽  
Republic Of Cyprus ◽  
And Control

Abstract Background: Device-associated health care-associated infections (DA-HAIs) are a major threat to patient safety, particularly in the Intensive Care Unit (ICU). The aim of this study was to evaluate the effectiveness of a bundle of infection control measures to reduce DA-HAIs in the ICU of a General Hospital in the Republic of Cyprus, over a three-year period. Methods: We studied 599 ICU patients with length of stay (LOS) for at least 48 hours. Our prospective cohort study was divided into three surveillance phases. VAP, CLABSI, and CAUTI incidence rates, LOS and mortality were calculated before, during and after the infection prevention and control program. Results: There was a statistically significant reduction in the number of DA-HAI events during the surveillance periods, associated with DA-HAIs prevention efforts. In 2015 (prior to program implementation), the baseline DA-HAIs instances were 43: 16 VAP (10.1/1000 Device Days), 21 (15.9/1000DD) CLABSIs and 6 (2.66/1000DD) CAUTIs, (n=198). During the second phase (2016), CLABSIs prevention measures were implemented and the number of infections were 24: 14 VAP (12.21/1000DD), 4 (4.2/1000DD) CLABSIs & 6 (3.22/1000DD) CAUTIs, (n=184). During the third phase (2017), VAP and CAUTI prevention measure were again implemented and the rates were 6: (3 VAP: 12.21/1000DD), 2 (1.95/1000DD) CLABSIs & 1 (0.41/1000DD) CAUTIs, (n=217). There was an overall reduction of 87% in the total number of DA-HAIs instances for the period 01/01/15 to 31/12/17. Conclusions: The significant overall reduction in DA-HAI rates, indicates that a comprehensive infection control program can affect DA-HAI rates.

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