scholarly journals Time-series modelling for the quantification of seasonality and forecasting antibiotic-resistant episodes: application to carbapenemase-producing Enterobacteriaceae episodes in France over 2010–20

2020 ◽  
Vol 76 (1) ◽  
pp. 226-232
Author(s):  
Jonathan Roux ◽  
Narimane Nekkab ◽  
Mélanie Colomb-Cotinat ◽  
Pascal Astagneau ◽  
Pascal Crépey
Keyword(s):  
Time Series ◽  
Prediction Interval ◽  
Healthcare Associated Infections ◽  
Antibiotic Resistant ◽  
Factors Associated ◽  
Time Series Modelling ◽  
Potential Factors ◽  
Healthcare Associated ◽  
The Impact ◽  
National Surveillance System

Abstract Background Carbapenemase-producing Enterobacteriaceae (CPE) cause resistant healthcare-associated infections that jeopardize healthcare systems and patient safety worldwide. The number of CPE episodes has been increasing in France since 2009, but the dynamics are still poorly understood. Objectives To use time-series modelling to describe the dynamics of CPE episodes from August 2010 to December 2016 and to forecast the evolution of CPE episodes for the 2017–20 period. Methods We used time series to analyse CPE episodes from August 2010 to November 2016 reported to the French national surveillance system. The impact of seasonality was quantified using seasonal-to-irregular ratios. Seven time-series models and three ensemble stacking models (average, convex and linear stacking) were assessed and compared with forecast CPE episodes during 2017–20. Results During 2010–16, 3559 CPE episodes were observed in France. Compared with the average yearly trend, we observed a 30% increase in the number of CPE episodes in the autumn. We noticed a 1 month lagged seasonality of non-imported episodes compared with imported episodes. Average stacking gave the best forecasts and predicted an increase during 2017–20 with a peak up to 345 CPE episodes (95% prediction interval = 124–1158, 80% prediction interval = 171–742) in September 2020. Conclusions The observed seasonality of CPE episodes sheds light on potential factors associated with the increased frequency of episodes, which need further investigation. Our model predicts that the number of CPE episodes will continue to rise in the coming years in France, mainly due to local dissemination, associated with bacterial carriage by patients in the community, which is becoming an immediate challenge with regard to outbreak control.

scholarly journals Group Electronic Monitoring of Hand Hygiene on Inpatient Units: A Multicenter Cluster Randomized Quality Improvement Study

2020 ◽  
Vol 41 (S1) ◽  
pp. s38-s39
Author(s):  
Jerome Leis ◽  
Jeff Powis ◽  
Allison McGeer ◽  
Daniel Ricciuto ◽  
Tanya Agnihotri ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Hand Hygiene ◽  
Electronic Monitoring ◽  
Current Approach ◽  
Antibiotic Resistant ◽  
Guide Unit ◽  
Cluster Randomized ◽  
Healthcare Associated ◽  
The Impact ◽  
Inpatient Units

Background: The current approach to measuring hand hygiene (HH) relies on human auditors who capture <1% of HH opportunities and rapidly become recognized by staff, resulting in inflation in performance. Our goal was to assess the impact of group electronic monitoring coupled with unit-led quality improvement on HH performance and prevention of healthcare-associated transmission and infection. Methods: A stepped-wedge cluster randomized quality improvement study was undertaken across 5 acute-care hospitals in Ontario, Canada. Overall, 746 inpatient beds were electronically monitored across 26 inpatient medical and surgical units. Daily HH performance as measured by group electronic monitoring was reported to inpatient units who discussed results to guide unit-led improvement strategies. The primary outcome was monthly HH adherence (%) between baseline and intervention. Secondary outcomes included transmission of antibiotic resistant organisms such as methicillin resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections. Results: After adjusting for the correlation within inpatient units, there was a significant overall improvement in HH adherence associated with the intervention (IRR, 1.73; 95% CI, 1.47–1.99; P < .0001). Monthly HH adherence relative to the intervention increased from 29% (1,395,450 of 4,544,144) to 37% (598,035 of 1,536,643) within 1 month, followed by consecutive incremental increases up to 53% (804,108 of 1,515,537) by 10 months (P < .0001). We identified a trend toward reduced healthcare-associated transmission of MRSA (0.74; 95% CI, 0.53–1.04; P = .08). Conclusions: The introduction of a system for group electronic monitoring led to rapid, significant, and sustained improvements in HH performance within a 2-year period.Funding: NoneDisclosures: None

Healthcare-associated infections in high-risk neonates: Temporal trends in a national surveillance system

2021 ◽  
pp. 105394
Author(s):  
Ralciane P. Menezes ◽  
Sávia G.O. Melo ◽  
Murilo B. Oliveira ◽  
Felipe F. Silva ◽  
Priscila G.V. Alves ◽  
...  
Keyword(s):  
High Risk ◽  
Surveillance System ◽  
Temporal Trends ◽  
Healthcare Associated Infections ◽  
National Surveillance ◽  
Healthcare Associated ◽  
National Surveillance System

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 The financial impact of improved hand hygiene on healthcare-associated infections in the UK

2020 ◽  
pp. 117-122
Author(s):  
Katie-Rose Cawthorne Cawthorne ◽  
Jason Dean ◽  
Richard PD Cooke
Keyword(s):  
Hand Hygiene ◽  
Financial Analysis ◽  
Cost Savings ◽  
Direct Costs ◽  
Healthcare Associated Infections ◽  
Financial Assessment ◽  
Paediatric Hospital ◽  
The Uk ◽  
Healthcare Associated ◽  
The Impact

Background: Though high hand hygiene (HH) levels significantly reduce the risk of healthcare-associated infections (HCAIs), the current cost of HCAIs and the impact of optimal HH practices on HCAIs are poorly defined. The last NHS England financial assessment was in 2009. Methods: The number of HCAIs per bed per year for NHS England were calculated and average costs were attributed using data from three sources; National Audit Office report, a commercially available calculator, and a financial analysis by a specialist paediatric hospital in England. Improved HH compliance for NHS England was based on a sustained rise in compliance rates from 50 to 80% combined with an HCAI reduction of at least 20%. The cost savings based on such improvements were then calculated. Results: In 2020, it is estimated that the number of HCAIs per bed per year ranges from 3.0 to 9.3, with a midpoint of 5.1. The direct costs of HCAI to NHS England were found to lie between £1.6 and £5 billion. Based on a 20% reduction in HCAI rates, this could lead to cost savings of between £322 million and £1 billion per year. Conclusion: Current direct costs of HCAIs consume approximately 1.3% to 4.1% of NHS England’s annual budget. Improving HH compliance among healthcare workers can lead to significant cost savings. There appears to be a strong financial argument for investment into innovative HH compliance technologies that have been historically perceived as too expensive.

Using social media to disseminate research in infection prevention, hospital epidemiology, and antimicrobial stewardship

2019 ◽  
Vol 40 (11) ◽  
pp. 1262-1268 ◽  
Author(s):  
Kelly A. Cawcutt ◽  
Jasmine R. Marcelin ◽  
Julie K. Silver
Keyword(s):  
Social Media ◽  
Best Practices ◽  
Antimicrobial Stewardship ◽  
Infection Prevention ◽  
Online Communication ◽  
Health Impact ◽  
Healthcare Associated Infections ◽  
Hospital Epidemiology ◽  
Healthcare Associated ◽  
The Impact

AbstractSocial media, prevention of healthcare-associated infections (HAIs) and antimicrobial stewardship (ASP) each impact every area of medicine. Independently, each have power to change medicine, however, synergistically, the impact could be transformative. Given the profound clinical, financial, and public health impact of infection prevention and antimicrobial stewardship combined with the incomplete uptake of best practices, multimodal strategies employing social media are critical to increase the speed and reach of research. This review discusses the strategic utilization of online communication platforms to increase the dissemination of critical publications.

scholarly journals Modeling Carbapenemase-producing Enterobacteriaceae episodes’ evolution in France over 2010-2020

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Roux ◽  
N Nekkab ◽  
P Astagneau ◽  
P Crépey
Keyword(s):  
Public Health ◽  
Time Series ◽  
Patient Safety ◽  
Healthcare Associated Infections ◽  
Time Series Modeling ◽  
National Healthcare ◽  
Response System ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Healthcare Associated

Abstract Background Incidence of Carbapenemase-Producing Enterobacteriaceae (CPE) episodes within hospitals is rising at an alarming rate and threaten health systems and patient safety worldwide. Their number is growing in France since 2009 associated with inter-regional dissemination and importation of international cases. This study aimed at describing the dynamics of CPE episodes in France over 2010-2016 and forecasting their evolution for 2017-2020. Methods Surveillance data of CPE episodes (imported and non-imported) from August 2010 to November 2016 were issued from the French national Healthcare-Associated Infections Early Warning and Response System. Impact of seasonality on the number of CPE episodes was analyzed using seasonal-to-irregular ratios. Seven models issued from time series analysis and three ensemble stacking models (average, convex and linear stacking) were used to describe and forecast CPE episodes. The model with the best forecasting’s quality was then trained on all available data (2010-2016) and used to predict CPE episodes over 2017-2020. Results Over 2010-2016, 3,559 CPE episodes were observed in France. Compared to the average yearly trend, we observed a 30% increase in the number of CPE episodes in September and October. On the opposite, a decrease of 20% was noticed in February compared to other months. We also noticed a 1-month lagged seasonality of non-imported episodes compared to imported ones. The number of non-imported episodes appeared to grow faster than imported ones starting from 2014. Average stacking gave the best forecasts and predicted an increase over 2017-2020 with a peak up to 345 CPE episodes (95% PI [124-1,158], 80% PI [171-742]) in September 2020. Conclusions The number of CPE episodes is predicted to rise in the next years in France because of non-imported episodes. These results could help public health authorities in the definition and evaluation of new containment strategies. Key messages Time series modeling predicts an increase in the number of CPE episodes in France in the next few years with a quicker rise of non-imported episodes. An increase of 30% in the number of CPE episodes was observed in September and October with a 1-month lagged seasonality impact of non-imported episodes compared to imported one.

scholarly journals Patients' Hand Hygiene at Home Predicts Their Hand Hygiene Practices in the Hospital

2014 ◽  
Vol 35 (5) ◽  
pp. 585-588 ◽  
Author(s):  
Anna Barker ◽  
Ajay Sethi ◽  
Emily Shulkin ◽  
Rachell Caniza ◽  
Sara Zerbel ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Intrinsic Value ◽  
Healthcare Associated Infections ◽  
Hospital Hygiene ◽  
Factors Associated ◽  
Hygiene Practices ◽  
Hospital Patients ◽  
Hospital Practices ◽  
Healthcare Associated ◽  
At Home

We examine factors associated with hand hygiene practices of hospital patients. Hygiene in the hospital decreased compared to that at home, and home practices were strongly associated with hospital practices. Understanding and leveraging the intrinsic value some patients associate with hand hygiene may be important for improving overall hospital hygiene and decreasing healthcare-associated infections.

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.

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