Common Type Of Healthcare-associated Infection Research Articles

Surveillance and Prediction of Risk Factors for Central Line-Associated Bloodstream Infections in Saudi Arabia.

Although central line-associated bloodstream infection (CLABSI) is the most common type of healthcare-associated infection among patients with inserted devices, few studies have comprehensively evaluated the related risk factors. This retrospective study analyzed the risk factors, predictors, causative organisms, and impact of CLABSI on clinical outcomes mortality, and length of stay (LOS) in older adults. We included 36 patients diagnosed with CLABSI according to the Centers for Disease Control and Prevention criteria at King Abdulaziz University Hospital during 2013-2014 casesand 375 control patients controls. Risk factors were evaluated using a multivariate logistic regression analysis. Cases and controls did not differ significantly in age or sex distribution. However, cases had a significantly longer LOS than controls 78 vs. 19 days, p < 0.001. One-third of 12/36 CLABSI cases were admitted to the medical intensive care unit (MICU). Most had renal disease, acute coronary syndrome, and used steroids. Additionally, 34 cases (94.4%) and 2 cases (5.6%) presented with primary and secondary infections, respectively, and hypotension was the most prevalent symptom (12/36).The internal jugular vein was the most common insertion site, and the nasogastric tube and mechanical ventilator were the most common insertion devices. Seven cases died, and three deaths were attributed to bloodstream infection (BSI). The most common cause of blood infection was Staphylococcus epidermidis, followed by Klebsiella pneumoniae. The present study reveals age, LOS, total parenteral nutrition/partial parenteral nutrition (TPN/PPN), and transplantation as the independent risk factors/predictors of CLABSI.

Urinary Catheterization and Care of Urinary Catheter

Catheter-associated urinary tract infection (CAUTI) is usually defined as a UTI in a patient with current urinary tract catheterization or who has been catheterized in the past 48 hours. Urinary tract infections are the most common type of healthcare-associated infection, accounting for more than 30% of infections reported by acute care hospitals. National data from NHSN acute care hospitals in 2006 showed a range of pooled mean CAUTI rates of 3.1- 7.5 infections per 1000 catheter-days. Urinary catheters increase the risk of acquiring CAUTI; thus health care personnel must take special care to minimize that risk. Health care workers should follow evidence-based guidelines, including using aseptic technique for site preparation and supplies and limiting use and duration of the placement of urinary catheters.

Evaluation of Infectious Agents, Species, and Resistance Profiles of Healthcare-Associated Infections

Evaluation of Infectious Agents, Species, and Resistance Profiles of Healthcare-Associated Infections

Biophysical and molecular characterization of the immobilization of biomimetic peptide-polymer conjugates as building blocks for antimicrobial catheter surfaces to prevent infectious diseases.

Catheter-associated urinary tract infections (CAUTIs) are the most common type of healthcare-associated infection. The World Health Organization recently reported that patients with a catheter had a 5% greater probability of acquiring a urinary tract infection per day of being catheterized and in a month this probability increased up to a 100%. This work explores the catheter surface immobilization and characterization of the MH5C modified with acysteine (MH5C-Cys) and coupled to polyethylene glycol to serve as a surface protective coating. First, purification method by size exclusion chromatography (SEC) was performed followed by analytical SEC and SDS-PAGE and MALDI-ToF to confirm the reaction. Also, we immobilized on the catheter surface the MH5C-Cys-PEG and it was confirmed by the appearance of the characteristic peaks of 3,264 cm−1for N-H stretching, 1,532 cm−1for N-H bending and 1,157 cm−1for C-N stretching at the FTIR spectrum of the catheter with the immobilized peptide. Additionally, for this study, we have performed a Circular Dichroism (CD) technique for evaluating the secondary structure of the peptide-polymer conjugates. The CD spectra illustrated that conjugates possessed α-helical structures. Subsequently, we evaluated the efficacy of MH5C-Cys-PEG conjugate via scanning electron microscopy, minimum biofilm inhibition concentration (MBIC), assays to evaluate their ability to prevent the biofilms. Interestingly, this work demonstrated a critical PEG polymer weight of 5 kDa as ideal when coupled to the MH5C-Cysto achieve inhibition and eradication of the biofilm formation in Escherichia coli. According to theMBICs (300 μM), we can conclude that MH5C-Cys-PEG has an action that prevents the formation of biofilms. This type of study serves to improve progress toward new methods to counteract antimicrobial resistance of many of the bacteria known to cause CAUTIs.

Reducing Indwelling Urinary Catheter Utilization Results in Reduction of Associated Urinary Tract Infections

<h3>Background</h3> Catheter Associated Urinary tract infections (CAUTIs) are the fifth most common type of healthcare-associated infection (HAI), resulting in increased morbidity/mortality. The most important risk factor for developing a CAUTI is prolonged use of indwelling urinary catheters (IUCs). One of the strategies to prevent a CAUTI is to reduce IUC utilization. During the 12-month period from July 2019 through June 2020, the CAUTI Standard Infection Ratio (SIR) for our Medical Center was 1.86 with 21 observed cases. The Standard Utilization Ratio (SUR) was 0.89. <h3>Methods</h3> A Plan Do Study Act (PDSA) cycle was used in this performance improvement project. In order to address high CAUTI incidences, a multi-disciplinary performance improvement task force composed of nursing directors, physicians, infection prevention, and the supply chain was initiated in August 2020. The Chief Medical Officer, Chief Nursing Officer and Chief Operating Officer highlighted the gravity of the situation at every team meeting. One action taken was the initiation of the "Holy Moley Remove That Foley" campaign. The purpose of the campaign was to review appropriateness of IUCs during daily multi-disciplinary rounds using "IUC appropriateness checklist" and complete the "IUC insertion checklist" prior each IUC insertion house-wide including the Emergency Department. Bladder scans were encouraged to assess for retention and to follow a nurse driven protocol to use external urinary devices. The hospital's education department provided education and ongoing competency evaluations during this campaign. <h3>Results</h3> The actions above resulted in SIR of 0.58, SUR of 0.71 and 7 incidences during July 2020 through June 2021. This is a statistically significant SIR reduction with two-tailed t test, p value of 0.0049. <h3>Conclusions</h3> By engaging a multi-disciplinary team that includes non-nursing departments, a significant reduction in CAUTIs was achieved. This project highlights that the involvement of several disciplines is needed to prevent HAIs.

To Assess the Incidence of Catheter Associated Urinary Tract Infection and Evaluate the Effectiveness of Evidence based Practice Protocol for Prevention of Catheter-associated Urinary Tract Infections (CAUTI) in Adult Critical Care Patients

Background: UTIs are the most common type of healthcare-associated infection. Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. The most important risk factor for developing a CAUTI is prolonged use of the urinary catheter. Therefore, catheters should only be used for appropriate indications and should be removed as soon as they are no longer needed. Aim: The aim of the study is to prevent CAUTIs in adult critical care patients, by using evidence based practice protocol. Materials and Methods: A Quasi Experimental one group pretest posttest research design was used. 200 staff nurses were selected from hospitals by using purposive sampling technique. Biophysical measures like signs and symptoms of CAUTI and urine culture was done to assess the incidence of CAUTIs in adult critical care patients before administration of evidence based practice protocol. Result: The overall incidence rate of CAUTI in adult critical care patients was 11.1%. A Comparison of Pre and Post test level of Knowledge of Staff Nurse’s regarding CAUTIs shows that 46(23.0%) had poor knowledge before intervention and it was reduced 2(1.0%) after intervention. None of the staff nurse had excellent knowledge before intervention and was increased 12(6.0%) after intervention, 23(11.5%) had pre test good knowledge and was increased to 122(61.0%) in post test. Pre test mean knowledge of staff nurse regarding CAUTIs was 13.68 whereas post test knowledge score was 16.5 and was statistically significant with p-value &lt;0.0001. Conclusion: This approach shows for reduction of CAUTIs in critical care settings. The same type of protocol or education programme might be adopted for the other health care associated infections.

Epidemiology and Risk Factors of Healthcare-Associated Infections in Critically Ill Patients in a Tertiary Care Teaching Hospital in Nepal: A Prospective Cohort Study

Background:Healthcare-associated infection (HAI) is an important public health problem, particularly in intensive care units (ICUs). We aimed to examine the epidemiology and risk factors of HAIs in our ICUs and study their microbiological profile.Methods:We evaluated 100 consecutive patients in 3 medical and surgical ICUs of a tertiary care teaching hospital daily starting in January 2016 using the Centers for Disease Control and Prevention definitions and methods. We determined the incidence and sites of HAIs, identified the causative microorganism, and studied their antibiotic sensitivity profiles. We investigated risk factors for the development of an HAI using a multiple logistic regression model.Results:Of 300 patients, 129 patients (43%) developed HAIs (55.96 HAI events per 1000 ICU-days). Pneumonia was the most common type of HAI (57, 41%). Escherichia coli was the most frequently isolated microorganism (20, 29%) and 74% of the pathogens isolated were multi-drug resistant. The presence of an invasive device (Odds Ratio, 4.29; 95% Confidence Interval, 2.52-7.51) and use of sedation (Odds Ratio, 2.24; 95% Confidence Interval, 1.31-3.87) were the statistically significant risk factors for HAIs.Conclusions:We found a high incidence of HAIs in our ICUs and a high burden of multidrug-resistant microorganisms highlighting the importance of infection control and antibiotic stewardship.

CAUTI: A Journey of Micturition at MICU Since 2014

Background: Catheter-associated urinary tract infections (CAUTIs) have gained popularity in recent years for increasing morbidity and mortality in multiple healthcare settings. In fact, they are the most common type of healthcare-associated infection (HAI) in US hospitals, and they account for ~35% of HAIs. Objectives: At our institution, CAUTI rates were higher than the national average; therefore, various preventative protocols were implemented. Southeast Health’s Medical ICU (MICU) has taken many measures to decrease the CAUTI incidence. Methods: We conducted an observational study with a retrospective analysis of the data beginning in 2014 after a poor performance at prevention of CAUTIs as noted in the Leapfrog Hospital Survey. As part of improving prevention measures in MICU, we started a lean project in 2015 that primarily focused on systems-based practices and improvements in the existing nurse protocols. Results: We were successful in this endeavor and in August 2018 the Alabama Department of Public Health (ADPH) reported that we still lower than the national average in prevention of CAUTIs. This finding led us to tighten the protocols and to appoint 2 infection preventionists in the MICU. With the assistance of the infection preventionists, we were able to actively decrease indwelling catheter and device days with daily multidisciplinary rounds to access the necessity for catheter use. We also set monthly attainable targets and reinforced nurse driven protocols with educational in-service programs. One of the most significant additions was the introduction of female external catheters (Purewick) in December 2019 and male external catheters (Liberty) in May, 2019. Our results showed a significant reduction in the number of CAUTIs divided by number of Foley catheter days in the MICU from 32 of 7,435 in 2014 to 1 of 5,934 in 2019. We are excited to see reduction in the CAUTIs with our above measures. We will continue our measures to reach our target of 0 CAUTIs, and we plan to remain above the national average.Funding: NoneDisclosures: None

1160. CAUTIs are the Most Common Type of Healthcare-Associated Infection. In an Effort to Decrease CAUTI Rates Through Proactive Prevention, We Sought to Develop a Weighted Model of CAUTI Risk Factors. The Final Set of Risk Factors Jointly Predicting CAUTI Were ADL Dependent, CVA, Catheter Replacement Within 7 days, and Catheterization Duration ≥5. We Have Defined Contemporary Weighted Risk Factors

BackgroundCatheter-associated urinary tract infections (CAUTI) are the most common type of healthcare-associated infection. In an effort to decrease CAUTI rates through proactive prevention, we sought to develop a weighted model of CAUTI risk factors in our patient population.MethodsA retrospective case–control study was conducted to identify potential CAUTI risk factors in a 401-bed, acute care, tertiary academic facility. Data were collected through chart review of CAUTI cases between January 2014 and June 2018. Controls were catheterized patients who did not develop a CAUTI, and were selected based on the corresponding case event date (±7 days) and location. The case to control ratio was 1:2. A multivariable logistic regression was used to identify CAUTI risk factors by stepwise selection. All tests were 2-sided at a 0.05 significance level. All statistical analyses were performed using SAS 9.4.ResultsWe reviewed 501 patients. The mean age was 62.7 years and 51% were female. The most common organisms in CAUTI cases (n = 167) were Escherichia coli (28.7%) and Pseudomonas aeruginosa (18.6%). Median catheterization duration for cases and controls was 8 and 5 days, respectively. Univariate logistic regression analyses revealed the following statistically significant risk factors: female, catheterization duration ≥5 days, ADL-dependent, cerebrovascular disease (CVA), nonoperating room procedure, catheter placement in operating room and history of malignancy. The final set of risk factors jointly predicting CAUTI included ADL-dependent (OR 1.69), CVA (OR 7.3), catheter replacement within 7 days (OR 1.85), and catheterization duration ≥5 (OR 2.1). The final model’s AUC was 0.72. Risk factors were scored using β coefficient from the final model. The highest score attainable was 20 with CVA receiving the maximum weight. The risk score’s ability to classify infection was measured by AUC of 0.60.ConclusionIn our study, we have defined contemporary weighted risk factors associated with CAUTI. We intend to utilize these findings to deploy a tiered approach where patients with risk factors will receive ‘advanced’ in addition to ‘basic’ preventive efforts. Additionally, our risk score model will allow for prioritizing efforts.Disclosures All authors: No reported disclosures.

2426. Performance of Statistical Process Control Charts for Detecting Clinically-Significant Increases in Clostridium difficile Infection Rates

Background Clostridium difficile infections (CDIs) are the most common type of healthcare-associated infection in the United States, with an estimated annual incidence of 500,000 cases and excess healthcare costs of $5 billion per year. The prevalence and severity of CDIs have been increasing in recent years, making it of vital importance to detect outbreaks sufficiently early to minimize negative health outcomes. Statistical process control (SPC) methods have proven to be a versatile tool in healthcare, enabling near real-time monitoring of adverse events rates and thereby improving patients’ health. The aim of this study was to investigate the performance of SPC in detecting clinically significant increases in CDI rates.MethodsWe retrospectively analyzed monthly CDI rates at 6 community hospitals in the Duke Infection Control Outreach Network from 2009–2017. Detected CDIs were stratified by surveillance system (LabID or traditional), infection source, recurrence type, and diagnostic test (nucleic acid amplification or enzyme-linked immunosorbent assay). Recurrent and community-associated CDIs were excluded from all analyses. Several variations of Shewhart and exponentially-weighted moving average (EWMA) u-charts were applied to each hospital (Figure 1), including using different baseline types (global, fixed, or rolling) and baseline data streams (hospital or network-wide). To help assess chart performance, epidemiologists determined the clinical relevance (yes/no) of 167 statistical signals generated using earlier iterations of these charts. Performance was quantified via sensitivity, specificity, and accuracy.ResultsEWMA u-charts with global network-wide baselines performed the best (Figure 2), detecting the largest number of clinically relevant signals (56% sensitivity) with high specificity (96%). Charts utilizing network-wide baselines were generally more accurate than those using local hospital data for that purpose (accuracy of 46–72% vs. 43–45%). Similarly, charts with fixed baselines performed better than those with rolling ones (accuracy of 43–62% vs. 43–47%).ConclusionSPC charts are easily applicable to CDI surveillance; however, their parameters would need to be optimized to maximize utility. Disclosures All authors: No reported disclosures.

Reinforcing a Catheter-Associated Urinary Tract Infection (CAUTI) Bundle Compliance Decreases Overall Catheter Days and CAUTIs

BACKGROUND Catheter-associated urinary tract infections (CAUTI) are the most common type of healthcare-associated infection. The key risk factor for CAUTIs is prolonged indwelling catheter use, and therefore their use should be minimized when possible. The objectives of this initiative were to decrease CAUTIs by reinforcing bundle compliance and to decrease the use of indwelling catheters by utilizing more external catheters. METHODS Intervention began January 2017 when a bundle device compliance form with a daily catheter goal was introduced. This form ensured that proper procedures were followed, with a focus on the pericare process, with the most important step being the glove change after wiping the patient and prior to wiping the catheter. Bundle compliance was reviewed daily by unit managers and checked weekly by infection control, which resulted in an increase in bundle compliance, however the daily catheter goal was still not met. In January 2018 an external female catheter was introduced, and in June 2018 another type of external male?catheter was introduced in order to meet the daily catheter goal. RESULTS During the pre-intervention period (2016) a total of 32 CAUTIs were reported with 19,890 catheter days. Implementation of bundle compliance in 2017 led to a 9.3% reduction in CAUTIs and a 7.5% reduction in catheter days. Introduction of external catheters during 2018 further improved these numbers, leading to a total reduction of 59.3% in CAUTIs and 26.5% in catheter days compared to the pre-intervention period. CONCLUSIONS This initiative demonstrates that reinforcing bundle device rounds leads to moderate reductions in CAUTIs and catheter days. The initiative also showed that increased use of external catheters leads to even larger decreases in CAUTIs and catheter days. Implementing both of these measures met the goals for reductions in CAUTIs and catheter days and has led to an increase in patient safety.

Using Nursing Digital Technology to Reduce the Rates of Catheter-Associated and Non-Catheter-Associated Urinary Tract Infection

Urinary tract infection (UTI), the most common type of healthcare-associated infection, may result from negligence of care regardless of the presence or absence of catheterization. The UTI rate in our unit was .069%, which was the highest among all of the wards in the hospital. This project aimed to reduce the UTI rate to 0.37%. In order to achieve this goal, we amended the SOPs and audit table of catheterization, enhanced access to catheterization and perineal-wash-related instructional videos using quick response (QR) codes, encouraged and reminded patients to drink plenty of water, maintained the urinary drainage system free to avoid the growth of bacterial colonies, revised related healthcare education pamphlets and posters, and organized on-the-job training sessions for nursing staff. The UTI rate fell from .069% to 0.030%. Moreover, patients and their families responded well to the QR code method of accessing relevant videos, which enhanced technical knowledge and made the new information easy to learn. The use of QR code scanning enabled patients and their families to easily and conveniently watch videos on catheterization and perineal washing on demand. Nurses may employ QR codes in health education more frequently in order to provide higher quality nursing care.

Catheter-Associated Urinary Tract Infections: Diagnosis, Treatment, and Prevention

The most common type of healthcare-associated infection (HAI) is a urinary tract infection (UTI), and 80 percent of these are associated with the use of indwelling urinary catheters (IUCs). These are termed catheter-associated urinary tract infections (CAUTIs). It has been estimated that about 25 percent of all hospitalized patients have an IUC placed during their hospital stay. In addition to the morbidity and mortality that may be associated with a CAUTI, there are also financial consequences. This is particularly true since as of October 1, 2008, the Centers for Medicare and Medicaid Services stopped reimbursing hospitals for several types of infections acquired during a hospital stay, including CAUTIs. In United States (U.S.) the estimated annual cost of treating these CAUTIs is $350 million. It has been proposed that a large percentage of CAUTIs should be preventable. This article will discuss the diagnosis, treatment, and prevention of CAUTIs

MP23-09 COMPARISON OF POSTOPERATIVE CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI) RATES IN THE UROLOGIC PATIENT WITH A SUPRAPUBIC CATHETER VERSUS TRANSURETHRAL CATHETER

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2018MP23-09 COMPARISON OF POSTOPERATIVE CATHETER-ASSOCIATED URINARY TRACT INFECTION (CAUTI) RATES IN THE UROLOGIC PATIENT WITH A SUPRAPUBIC CATHETER VERSUS TRANSURETHRAL CATHETER Jason Warncke, Brittan Sutphin, John Hohenmeyer, E. David Crawford, and Brian Flynn Jason WarnckeJason Warncke More articles by this author , Brittan SutphinBrittan Sutphin More articles by this author , John HohenmeyerJohn Hohenmeyer More articles by this author , E. David CrawfordE. David Crawford More articles by this author , and Brian FlynnBrian Flynn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.741AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary tract infections (UTIs) are the most common type of healthcare-associated infection. Among UTIs acquired in the hospital, 75% are catheter-associated urinary tract infections (CAUTI). CAUTI has gained much attention, as in 2008 Medicare regulations ceased reimbursement for costs related to nosocomial CAUTIs. Traditional teaching has been that suprapubic catheters (SPC) are associated with less risk of CAUTI than transurethral catheters (TUC). However, studies directly comparing the CAUTI rate in patients with SPC versus TUC are lacking, particularly in the postoperative Urologic patient. Thus, in this study we aim to compare the CAUTI rate with SPC versus TUC in the postoperative Urologic patient. METHODS We retrospectively reviewed and compared the medical records of 354 patients over a 5-yr period that underwent Urologic surgery. The SPC group consisted of patients that underwent SPC placement at the time of concomitant autologous rectus fascia pubovaginal sling (PVS) by a single surgeon (BJF). SPC placement was accomplished using the T-Spec device from Swan Valley Medical. The TUC group consisted of patients that underwent TUC placement using an 18 Fr Foley at the time of open radical prostatectomy (RP) by a single surgeon (EDC). Patients without a SPC or TUC and patients with both were excluded from the study. The primary outcome of comparison was the CAUTI rate (defined by the 2017 CDC guidelines) between the SPC and TUC cohorts. A Fisher’s exact test was performed to determine if the difference in CAUTI rate between the two cohorts was statistically significant (p<0.05). RESULTS 252 patients were included, including 145 (57.6%) in the SPC group and 107 (42.5%) in the TUC group, mean age 54.5 and 61.5 yrs, respectively. The mean catheter duration at the time of CAUTI for the SPC and TUC groups were 21.3 and 16.0 days, respectively (p=0.79). The mean catheter duration for the TUC group with and without CAUTI was 25.4 and 14.7 days, respectively (p=0.14). The overall CAUTI rate when catheter duration was less than 15 days compared to greater than 15 days was 3.3% and 5.0%, respectively (p=0.39). The CAUTI rate for the SPC group was 2.1% versus the TUC group 7.5% (p=0.039; OR 3.82). CONCLUSIONS In this study of postoperative Urologic patients, SPC was found to have a statistically significant lower rate of CAUTI when compared to TUC. This information may help guide providers when choosing the appropriate bladder drainage modality for their patients, particularly in the postoperative Urologic setting. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e284 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jason Warncke More articles by this author Brittan Sutphin More articles by this author John Hohenmeyer More articles by this author E. David Crawford More articles by this author Brian Flynn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Candiduria in catheterized Menoufia patients: emerging microbiological trends

Objective The present study aimed to assess the prevalence of different Candida spp. as a cause of infections in the urinary tract infection (UTI) among catheterized patients and to test the susceptibility of Candida isolate to antifungal agents. Background UTIs are tied with pneumonia as the second-most common type of healthcare-associated infection. Catheter-associated UTI occurs because urethral catheters inoculate organisms into the bladder and promote colonization by providing a surface for bacterial adhesion and thus causing mucosal irritation. Candida spp. accounts for almost 10–15% of the nosocomial UTIs. Patients and methods The study was conducted on 200 catheterized inpatients from ICU. The urine specimens were examined for Candida by using CHROMagar and Integral System Yeasts Plus. Results The API system is highly effective in diagnosing fungal infections. Candida infection was the highest among the age group more than 45 years and in females. The most sensitive antifungal drug for Candida infection was flucytosmine and the least sensitive were nystain and micoconazole. Conclusion There is a strong relationship between host risk factors (old age, antibiotic use, catheterization, female sex, ICU stay, diabetes mellitus, hospitalization) and the expression of various virulence factors of Candida spp. causing candiduria and their resistance to antifungals.

ANALYSIS CATHETER ASSOCIATED URINARY TRACT INFECTION IN CHILDREN: THE EDIMO STUDY

Ponte Academic JournalMar 2017, Volume 73, Issue 3 ANALYSIS CATHETER ASSOCIATED URINARY TRACT INFECTION IN CHILDREN: THE EDIMO STUDYAuthor(s): Putri Eyanoer ,Rosmayanti Syafriani Siregar, Putri Chairani Eyanoer, Rafita RamayatiJ. Ponte - Mar 2017 - Volume 73 - Issue 3 doi: 10.21506/j.ponte.2017.3.28 Abstract:Catheter-associated urinary tract infection (CAUTI) is the most common type of healthcare-associated infection. Education-implementation and monitoring (EDIMO) study was one of project to decrease CAUTI rate in our hospital. We evaluate the effect of EDIMO targeted on modifiable risk factors on CAUTI rates. This study was cohort prospective between January 1st, 2015 and September 30th, 2016. Urinary tract infection was defined as if patients with an indwelling urinary catheter (in place for more 2 calender days) have at least 1 of the following sign or symptoms. Compliance was assessed as all or none, meaning that each patient�s event had to comply with all elements of the bundle to be considered compliant. Bacteria were identified by using an ATB kit, and the antibiotic sensitivities were tested by using the Kirby-Bauer method. There were 354 children enrolled in EDIMO study and 165 CAUTI episodes occurred among 153 children. Eschericia coli (27.9%) and Enterobacter (26.1%) predominated for CAUTI infection. Compliance with education (RR,0.68; 95% CI,0.50-0.84), implementation (RR,0.69; 95% CI,0.51-0.83) and monitoring (RR,0.39; 95% CI,0.33-0.82) was independently associated with a lower risk of CAUTI. Compliance with standardized practices for EDIMO study was associated with lower risk of CAUTI infection in pediatric patients.\\\\r\\\\n\\\\r\\\\nKey words: catheter urine, infection , pediatric, education, implementation and monitoring Download full text:Check if you have access through your login credentials or your institution Username Password

Proportion of Surgical Site Infections Occurring after Hospital Discharge: A Systematic Review.

Surgical site infection (SSI) is the most common type of healthcare-associated infection, contributing to substantial annual morbidity, costs, and deaths. In the United States it is the number one reason for hospital re-admission after surgery. Relatively little attention has been paid to the proportion of SSIs that occur after discharge. This paper systematically reviews two decades of publications to characterize better the proportion of SSIs that are identified after discharge and the need for better early detection and treatment. A restricted systematic literature search was conducted in PubMed to identify English-language studies published after 1995 that include the occurrence of pre-discharge and post-discharge SSIs. The data abstracted were the date of publication, country of origin, procedure, study design, surveillance system, population size, follow-up rate, and SSI counts and proportions. Descriptive statistics and forest plots were used to characterize the data set, represent the overall proportion of SSIs occurring after discharge, and assess the heterogeneity of the studies. A total of 55 articles met the inclusion criteria, with data from 1,432,293 operations and 141,347 SSIs based on studies from 15 countries. The overall proportion of operations leading to SSI was 9.9%. Of the 141,347 infections, 84,984 (60.1%) appeared after discharge. The proportion of SSIs after discharge differed among studies, from 13.5 to 94.8, and was heterogeneous for all studies and for most individual surgery types. Post-discharge SSIs constitute the majority of these infections and pose a substantial disease burden for surgical patients globally and for different surgery types. Further examination is warranted to determine the methodologic and clinical factors moderating the proportion of post-discharge SSIs.

Diagnosis, Treatment and Prevention of Catheter-Associated Urinary Tract Infections

Diagnosis, Treatment and Prevention of Catheter-Associated Urinary Tract Infections The most common type of healthcare-associated infection (HAI) is a urinary tract infection (UTI), and 80 percent of these are associated with the use of indwelling urinary catheters (IUCs). These are termed catheter-associated urinary tract infections (CAUTIs).

Local application of gentamicin collagen implants in the prophylaxis of surgical site infections following gastrointestinal surgery: a review of clinical experience.

BackgroundSurgical site infection (SSI) is a common type of healthcare-associated infection in gastrointestinal (GI) surgical procedures, which often has major consequences for patient recovery and increased healthcare costs due to prolonged hospital stay. This article provides an overview of the efficacy and safety of prophylactic application of resorbable gentamicin-containing collagen implants (GCI) in the prevention of SSI following high-risk GI surgical procedures.MethodNine publications were identified using the PubMed online database and search terms ‘gentamicin collagen implant’ plus ‘surgical site infection’, ‘wound infection’ and ‘gastrointestinal surgery’.ResultsData from 483 patients treated prophylactically have demonstrated that GCI can reduce the wound infection rate in high-risk GI surgical procedures and improve wound healing after pilonidal sinus excision. In a study of 221 patients who underwent colorectal surgery, the wound infection rate was reduced to 5.6% in the GCI group compared to 18.4% in the control group (P < 0.01). GCI also positively influences the post-operative course for patients undergoing particularly risky procedures e.g. abdominoperineal resection (APR) combined with neoadjuvant radiotherapy. In one such patient series, GCI reduced the wound infection rate by over 70% and the length of hospital stay by 40%. Few side effects of GCI were noted in the 9 clinical studies.ConclusionsThis review demonstrates that GCI can have a positive effect on wound infection rates in high-risk GI surgery and can also improve wound healing after pilonidal sinus excision.

Health-associated infections in a pediatric nephrology unit in China

Health care-associated infection (HAI) in children is associated with morbidity and mortality, prolonged hospital stay, and increased health care costs. We report the prevalence of HAIs in children admitted to the pediatric nephrology unit of a large tertiary care pediatric hospital in China between 2000 and 2008. A prospective infection control surveillance program led by physicians identified HAIs in admitted patients and sent monthly summary data to the hospital's Nosocomial Infections Committee. Infections at any body site meeting the Center for Disease Control and Prevention's former National Nosocomial Infection Surveillance System definitions were eligible for inclusion. Over the study period, various infection prevention and control strategies were introduced, including education on hand hygiene, measures to ensure appropriate antimicrobial prophylaxis for patients, and a guideline for antibiotic use. Of the 971 patients admitted, 81 had a total of 89 episodes of HAI (9.16%; 89/971); 75 patients (92.6%) had one HAI. The percentage of children acquiring HAI decreased from 12% to 6% over the observation period, representing a statistically significant linear trend. The most common type of HAI was respiratory tract infection (65.16%; n = 58), followed by gastrointestinal tract infection (11.24%; n = 10), skin and soft tissue infection (8.99% (n = 8), bloodstream infection (7.87%; n = 7), and urinary tract infection (6.74%; n = 6). The incidence of HAI in a pediatric nephrology ward decreased over an 8-year period, associated with a surveillance program and education directed at hand hygiene and appropriate antibiotic use. Despite a strict visitor policy, respiratory tract infection was the most common HAI seen.