scholarly journals Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs

2017 ◽  
Author(s):  
Payal K Patel ◽  
Ashwin Gupta ◽  
Valerie M. Vaughn ◽  
Jason D. Mann ◽  
Jessica M. Ameling ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bloodstream Infection ◽  
Central Line

The Impact of 2015 NHSN Catheter-associated Urinary Tract Infection (CAUTI) Definition Change on Central Line-associated Bloodstream Infection (CLABSI) Rates and CLABSI Prevention Efforts at an Academic Medical Center

2018 ◽  
Vol 39 (07) ◽  
pp. 878-880 ◽  
Author(s):  
Sonali D. Advani ◽  
Rachael A. Lee ◽  
Martha Long ◽  
Mariann Schmitz ◽  
Bernard C. Camins
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bloodstream Infection ◽  
Medical Center ◽  
Academic Medical Center ◽  
Bloodstream Infections ◽  
Central Line ◽  
Academic Medical ◽  
The Impact

The 2015 changes in the catheter-associated urinary tract infection definition led to an increase in central line-associated bloodstream infections (CLABSIs) and catheter-related candidemia in some health systems due to the change in CLABSI attribution. However, our rates remained unchanged in 2015 and further declined in 2016 with the implementation of new vascular-access guidelines.Infect Control Hosp Epidemiol 2018;878–880

Centers for medicare and medicaid services hospital-acquired conditions policy for central line-associated bloodstream infection (CLABSI) and cather-associated urinary tract infection (CAUTI) shows minimal impact on hospital reimbursement

2018 ◽  
Vol 39 (8) ◽  
pp. 897-901 ◽  
Author(s):  
Michael S. Calderwood ◽  
Alison Tse Kawai ◽  
Robert Jin ◽  
Grace M. Lee
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bloodstream Infection ◽  
Acute Care ◽  
Central Line ◽  
Fee For Service ◽  
Hospital Reimbursement ◽  
Hospital Acquired Conditions ◽  
Hospital Acquired

ObjectiveIn 2008, the Centers for Medicare and Medicaid Services (CMS) stopped reimbursing for hospital-acquired conditions (HACs) not present on admission (POA). We sought to understand why this policy did not impact central line–associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) trends.DesignRetrospective cohort study.SettingAcute-care hospitals in the United States.ParticipantsFee-for-service Medicare patients discharged January 1, 2007, through December 31, 2011.MethodsUsing inpatient Medicare claims data, we analyzed billing practices before and after the HAC policy was implemented, including the use and POA designation of codes for CLABSI or CAUTI. For the 3-year period following policy implementation, we determined the impact on diagnosis-related groups (DRG) determining reimbursement as well as hospital characteristics associated with the reimbursement impact.ResultsDuring the study period, 65,205,607 Medicare fee-for-service hospitalizations occurred at 3,291 acute-care, nonfederal US hospitals. Based on coding, CLABSI and CAUTI affected 0.23% and 0.06% of these hospitalizations, respectively. In addition, following the HAC policy, 82% of the CLABSI codes and 91% of the CAUTI codes were marked POA, which represented a large increase in the use of this designation. Finally, for the small numbers of CLABSI and CAUTI coded as not POA, financial impacts were detected on only 0.4% of the hospitalizations with a CLABSI code and 5.7% with a CAUTI code.ConclusionsPart of the reason the HAC policy did not have its intended impact is that billing codes for CLABSI and CAUTI were rarely used, were commonly listed as POA in the postpolicy period, and infrequently impacted hospital reimbursement.

The Benefits and Harms of Antibiotic Prophylaxis for Urinary Tract Infection in Older Adults

2021 ◽  
Author(s):  
Bradley J Langford ◽  
Kevin A Brown ◽  
Christina Diong ◽  
Alex Marchand-Austin ◽  
Kwaku Adomako ◽  
...  
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Positive Culture ◽  
Clostridioides Difficile

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides  difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.

Infection Control in Surgical Practice

2017 ◽  
Author(s):  
Caroline E. Reinke ◽  
Rachel R. Kelz ◽  
Elizabeth A Bailey
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Clostridium Difficile ◽  
Tract Infection ◽  
Infection Control ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Site Infection ◽  
Preventive Strategies

Health care–associated infections (HAIs) are those that are acquired while patients are being treated for another condition in the health care setting. HAIs are associated with substantial morbidity and mortality, with 75,000 deaths attributable to HAIs each year. This review outlines the evolution of HAI as a quality metric and introduces key governmental and professional organization stakeholders. The role of the local infection control program is also discussed. Using the example of surgical site infection, we detail the multitude of factors that contribute to the occurrence of an HAI, evidence-based preventive strategies, and systems-based programs to reduce preventable infections. Specific diagnostic criteria and preventive strategies are also introduced for catheter-associated urinary tract infection, central line–associated bloodstream infection, ventilator-associated pneumonia, Clostridium difficile infection, and various multidrug-resistant organisms. This review contains 3 figures, 9 tables, and 74 references. Key words: catheter-associated urinary tract infection, central line–associated bloodstream infection, Clostridium difficile, hospital-acquired infection, infection, quality, surgical site infection, ventilator-associated pneumonia 

Infection Control in Surgical Practice

2017 ◽  
Author(s):  
Caroline E. Reinke ◽  
Rachel R. Kelz ◽  
Elizabeth A Bailey
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Clostridium Difficile ◽  
Tract Infection ◽  
Infection Control ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Site Infection ◽  
Preventive Strategies

Health care–associated infections (HAIs) are those that are acquired while patients are being treated for another condition in the health care setting. HAIs are associated with substantial morbidity and mortality, with 75,000 deaths attributable to HAIs each year. This review outlines the evolution of HAI as a quality metric and introduces key governmental and professional organization stakeholders. The role of the local infection control program is also discussed. Using the example of surgical site infection, we detail the multitude of factors that contribute to the occurrence of an HAI, evidence-based preventive strategies, and systems-based programs to reduce preventable infections. Specific diagnostic criteria and preventive strategies are also introduced for catheter-associated urinary tract infection, central line–associated bloodstream infection, ventilator-associated pneumonia, Clostridium difficile infection, and various multidrug-resistant organisms. This review contains 3 figures, 9 tables, and 74 references. Key words: catheter-associated urinary tract infection, central line–associated bloodstream infection, Clostridium difficile, hospital-acquired infection, infection, quality, surgical site infection, ventilator-associated pneumonia 

scholarly journals Population Pharmacokinetic and Pharmacokinetic/Pharmacodynamic Analyses of Cefiderocol, a Parenteral Siderophore Cephalosporin, in Patients with Pneumonia, Bloodstream Infection/Sepsis, or Complicated Urinary Tract Infection

2020 ◽  
Author(s):  
Nao Kawaguchi ◽  
Takayuki Katsube ◽  
Roger Echols ◽  
Toshihiro Wajima
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bloodstream Infection ◽  
Plasma Concentrations ◽  
Complicated Urinary Tract Infection ◽  
Population Pharmacokinetic ◽  
Dosing Regimen ◽  
Population Pk

Cefiderocol is a novel siderophore cephalosporin with antibacterial activity against Gramnegative bacteria including carbapenemresistant strains. The standard dosing regimen of cefiderocol is 2 g administered every 8 hours over 3 hours infusion in patients with creatinine clearance (CrCL) of 60 to 119 mL/min, and it is adjusted for patients with < 60 mL/min or ≥ 120 mL/min CrCL. A population pharmacokinetic (PK) model was constructed using 3427 plasma concentrations from 91 uninfected subjects and 425 infected patients with pneumonia, bloodstream infection/sepsis (BSI/sepsis), and complicated urinary tract infection (cUTI). Plasma cefiderocol concentrations were adequately described by the population PK model, and CrCL was the most significant covariate. No other factors including infection sites and mechanical ventilation were clinically relevant, although the effect of infection sites was identified as a statistically significant covariate in the population PK analysis. No clear pharmacokinetic/pharmacodynamic relationship was found for any of the microbiological outcome, clinical outcome, or vital status. This is because the estimated percentage of time for which free plasma concentrations exceed the minimum inhibitory concentration (MIC) over dosing interval (%fT>MIC) was 100% in most of the enrolled patients. The probability of target attainment (PTA) for 100% fT>MIC was > 90% against MICs ≤ 4 μg/mL for all infection sites and renal function groups except for BSI/sepsis patients with normal renal function (85%). These study results support adequate plasma exposure can be achieved at the cefiderocol recommended dosing regimen for the infected patients including the patients with augmented renal function, ventilation, and/or severe illness.

scholarly journals Surveilans Pasif dan Aktif Kejadian Infeksi Terkait Pelayanan Kesehatan di RSUD Provinsi NTB, 2017

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Eustachius Hagni Wardoyo ◽  
Edi Prasetyo Wibowo ◽  
I Gede Jayantika ◽  
I Gst Alit Rai Sudiadnya ◽  
Rolly Armand
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Ventilator Associated Pneumonia ◽  
Site Infection ◽  
Health Care Associated Infections

Pendahuluan: Surveilans Health-care Associated Infections (HAIs) atau kejadian infeksi terkait pelayanan kesehatan dapat dilakukan baik secara aktif maupun pasif sesuai sumber daya yang dimiliki. Penelitian ini bertujuan mengetahui insidensi dan perbandingan hasil surveilans pasif dan aktif 4 jenis HAIs di RSUD Provinsi Nusa Tenggara Barat periode Januari-Oktober 2017. Empat jenis HAIs tersebut adalah Ventilator-associated Pneumonia (VAP), Catheter-associated Urinary Tract Infection (CAUTI), Central Line-associated Blood Stream Infection (CLABSI) dan Surgical Site infection (SSI). Metode: Surveilans pasif menggunakan data sekunder dengan menelusuri rekam medis, sedangkan surveilans aktif berdasarkan laporan Tim Pencegahan dan Pengendalian Infeksi (PPI). Hasil: Tidak ada perbedaan indikator yang digunakan dalam form VAP dan CLABSI pada surveilans pasif dan aktif. Namun pada form CAUTI dan SSI tidak mencantumkan gejala infeksi dan gejala panas di lokasi infeksi pada surveilans aktif. Perbandingan hasil surveilans pasif dan aktif berturut-turut adalah VAP 24,9 dan 0 per 1.000 ventilator days, CAUTI 49 dan 12 per 1.000 catheter days, CLABSI 18 dan 9 per 1.000 central line days, serta SSI 1,9 dan 1,4%. Kesimpulan: Ada perbedaan insidensi keempat jenis HAIs pada surveilans pasif dan aktif, karena penggunaan metodologi yang berbeda.

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