HEALTHCARE-ASSOCIATED INFECTIONS IN INTENSIVE CARE UNITS

2019 ◽  
Vol 72 (5) ◽  
pp. 963-969
Author(s):  
Aidyn Salmanov ◽  
Viktor Litus ◽  
Sergiy Vdovychenko ◽  
Oleksandr Litus ◽  
Lena Davtian ◽  
...  

Introduction: Healthcare-associated infections (HAIs) remain a major public health problem and patient safety threat worldwide. Scant information is available on the occurrence HAI and antimicrobial susceptibility of responsible pathogens in Ukrainian intencive care units (ICUs). The aim: To evaluate the prevalence of HAIs and antimicrobial resistance of the responsible pathogens. Materials and methods: The study included 642 patients and 262 samples isolated from patients with microbiologically proven HAI. The identification and antimicrobial susceptibility of the cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby — Bauer antibiotic testing. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute. Results: Among 642 patients, 148 HAIs were observed (23.1%). Death during hospitalization was reported in 20.1% HAI cases. Pneumonia (47.3%), blood stream infection (21.6%), and urinary tract infection (14.9) together accounted for 83.8% of all HAIs reported. Most cases of these infections were device-associated. Considering all HAI types together, Klebsiella pneumoniae were most commonly reported, accounting for 21.8% of all organisms, followed by Acinetobacter baumanni (14.3%), Pseudomonas aeruginosa (12.4%) and Escherichia coli (9.4%). 59.8% and 6.6% of Staphylococcus aureus were oxacillin and teicoplanin resistant, respectively. Third-generation cephalosporins resistancewas found in 53.8% of K.pneumoniae and 32.1% of E.coli isolates; and carbapenem resistance in 78.6% of A. baumanni and 29.3% of K. pneumoniae isolates. Conclusions: Infection control priorities in intensive care units should include preventing nosocomial pneumonia, blood stream infection, urinary tract infection and of deviceassociated infections.

2015 ◽  
Vol 36 (10) ◽  
pp. 1139-1147 ◽  
Author(s):  
Hajime Kanamori ◽  
David J. Weber ◽  
Lauren M. DiBiase ◽  
Emily E. Sickbert-Bennett ◽  
Rebecca Brooks ◽  
...  

OBJECTIVETargeted surveillance has focused on device-associated infections and surgical site infections (SSIs) and is often limited to healthcare-associated infections (HAIs) in high-risk areas. Longitudinal trends in all HAIs, including other types of HAIs, and HAIs outside of intensive care units (ICUs) remain unclear. We examined the incidences of all HAIs using comprehensive hospital-wide surveillance over a 12-year period (2001–2012).METHODSThis retrospective observational study was conducted at the University of North Carolina (UNC) Hospitals, a tertiary care academic facility. All HAIs, including 5 major infections with 14 specific infection sites as defined using CDC criteria, were ascertained through comprehensive hospital-wide surveillance. Generalized linear models were used to examine the incidence rate difference by infection type over time.RESULTSA total of 16,579 HAIs included 6,397 cases in ICUs and 10,182 cases outside ICUs. The incidence of overall HAIs decreased significantly hospital-wide (−3.4 infections per 1,000 patient days), in ICUs (−8.4 infections per 1,000 patient days), and in non-ICU settings (−1.9 infections per 1,000 patient days). The incidences of bloodstream infection, urinary tract infection, and pneumonia in hospital-wide settings decreased significantly, but the incidences of SSI and lower respiratory tract infection remained unchanged. The incidence of Clostridium difficile infection (CDI) increased remarkably. The outcomes were estimated to include 700 overall HAIs prevented, 40 lives saved, and cost savings in excess of $10 million.CONCLUSIONSWe demonstrated success in reducing overall HAIs over a 12-year period. Our data underscore the necessity for surveillance and infection prevention interventions outside of the ICUs, for non–device-associated HAIs, and for CDI.Infect Control Hosp Epidemiol 2015;36(10):1139–1147


2010 ◽  
Vol 4 (3) ◽  
pp. 142-150 ◽  
Author(s):  
Ihnsook Jeong ◽  
Soonmi Park ◽  
Jae Sim Jeong ◽  
Duck Sun Kim ◽  
Young Sun Choi ◽  
...  

2015 ◽  
Vol 43 (6) ◽  
pp. 592-599 ◽  
Author(s):  
Heather E. Hsu ◽  
Erica S. Shenoy ◽  
Douglas Kelbaugh ◽  
Winston Ware ◽  
Hang Lee ◽  
...  

2016 ◽  
Vol 38 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Barbara W. Trautner ◽  
M. Todd Greene ◽  
Sarah L. Krein ◽  
Heidi L. Wald ◽  
Sanjay Saint ◽  
...  

OBJECTIVETo assess knowledge about infection prevention among nursing home personnel and identify gaps potentially addressable through a quality improvement collaborative.DESIGNBaseline knowledge assessment of catheter-associated urinary tract infection, asymptomatic bacteriuria, antimicrobial stewardship, and general infection prevention practices for healthcare-associated infections.SETTINGNursing homes across 14 states participating in the national “Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infection.”PARTICIPANTSLicensed (RNs, LPNs, APRNs, MDs) and unlicensed (clinical nursing assistants) healthcare personnel.METHODSEach facility aimed to obtain responses from at least 10 employees (5 licensed and 5 unlicensed). We assessed the percentage of correct responses.RESULTSA total of 184 (78%) of 236 participating facilities provided 1 response or more. Of the 1,626 respondents, 822 (50.6%) were licensed; 117 facilities (63.6%) were for-profit. While 99.1% of licensed personnel recognized the definition of asymptomatic bacteriuria, only 36.1% knew that pyuria could not distinguish a urinary tract infection from asymptomatic bacteriuria. Among unlicensed personnel, 99.6% knew to notify a nurse if a resident developed fever or confusion, but only 27.7% knew that cloudy, smelly urine should not routinely be cultured. Although 100% of respondents reported receiving training in hand hygiene, less than 30% knew how long to rub hands (28.5% licensed, 25.2% unlicensed) or the most effective agent to use (11.7% licensed, 10.6% unlicensed).CONCLUSIONSThis national assessment demonstrates an important need to enhance infection prevention knowledge among healthcare personnel working in nursing homes to improve resident safety and quality of care.Infect. Control Hosp. Epidemiol. 2016;1–6


2016 ◽  
Vol 38 (2) ◽  
pp. 239-241 ◽  
Author(s):  
Ana Cecilia Bardossy ◽  
Rachna Jayaprakash ◽  
Anjali C. Alangaden ◽  
Patricia Starr ◽  
Odaliz Abreu-Lanfranco ◽  
...  

Application of the new 2015 NHSN definition of catheter-associated urinary tract infection (CAUTI) in intensive care units reduced CAUTI rates by ~50%, primarily due to exclusion of candiduria. This significant reduction in CAUTI rates resulting from the changes in the definition must be considered when evaluating effectiveness of CAUTI prevention programs.Infect Control Hosp Epidemiol2017;38:239–241


2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Shima Sadat Lesani ◽  
Mohammad Soleimani ◽  
Pegah Shakib ◽  
Mohammad Reza Zolfaghari

Background: Escherichia coli is considered as one of the causes of opportunistic infections. Nowadays, due to the increase in drug resistance, the treatment of these infections has become very difficult and they are recognized as the main causes of death in hospitalized patients. Objectives: The aim of this study was to determine the prevalence of blaTEM, blaSHV, and blaCTX-M genes in E. coli strains isolated from the urinary tract infection in patients in Intensive Care Units of three different hospitals in Qom, Iran. Methods: This study was conducted in three months from October to December 2014. A total of 200 E. coli samples were taken from the patients with urinary tract infections in Intensive Care units of Qom hospital. The disc diffusion method was used to determine the susceptibility pattern of antibiotic and phenotypic confirmatory tests for screening of the expanded spectrum beta-lactamase (ESBL) isolates. The presence of blaTEM, blaSHV, and blaCTX-M genes was evaluated by the polymerase chain reaction (PCR) assay. Results: Of 200 samples, ampicillin (96%) and nitrofurantoin (19.5%) showed the highest and lowest drug resistance, respectively. A total of 156 isolates (78%) were identified as ESBLs using the phenotypic method. Moreover, 76 (38%), 90 (45%), and 123 (61.5%) isolates consisted of blaCTX-M, blaSHV, and blaTEM, respectively. Conclusions: Overall, the findings of this study showed that blaTEM was the most common gene with a frequency of 61.5% in ESBL E. coli.


2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S249-S250
Author(s):  
Anupama Neelakanta ◽  
Sarit Sharma ◽  
Vishnu Priya Kesani ◽  
Madiha Salim ◽  
Amina Pervaiz ◽  
...  

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