Incidence Of Healthcare-associated Infections Research Articles

Epidemiology of healthcare-associated infections and outcomes among open and robotic pancreatoduodenectomy: A retrospective study from 2013 to 2022.

Healthcare-associated infections (HAIs) after pancreaticoduodenectomy (PD) are one of the common postoperative complications. This study aims to investigate the epidemiology of postoperative HAIs in patients with open pancreaticoduodenectomy (OPD) and robotic pancreaticoduodenectomy (RPD). This retrospective cohort study described the trend of HAIs in patients undergoing PD from January 2013 to December 2022 at a tertiary hospital. Patients were divided into OPD and RPD, and the HAIs and outcomes were compared. Among 2632 patients who underwent PD, 230 (8.7%, 95% confidence interval [CI] 7.7-9.9%) were diagnosed with HAIs, with a decreasing trend from 2013 to 2022 (P<0.001 for trend). The incidence of postoperative HAIs was significantly higher in patients with OPD than RPD (9.6% vs 5.8%; P=0.003). The incidence of HAIs for patients with OPD showed a decreasing trend (P=0.001 for trend), and the trend for RPD was not significant (P=0.554 for trend). Logistic regression showed that RPD was significantly associated with postoperative HAIs after adjusting for covariates (adjusted odds ratio=0.654; 95% CI 0.443-0.965; P=0.032), especially in the subgroup of patients without preoperative biliary drainage (adjusted odds ratio=0.486; 95% CI 0.292-0.809; P=0.006). Regarding clinical outcomes, RPD has a shorter length of stay and a more expensive charge than OPD (all P<0.05). Postoperative HAIs in patients with PD showed a decreasing trend in recent years, especially in OPD. RPD was significantly associated with reduced postoperative HAIs and length of stay, although the charge is more expensive. Attention should be paid to postoperative HAIs in OPD, and it is imperative to continue reducing the costs of RPD.

Novel scores relevant to antimicrobial resistance and hospital-acquired infections developed with data from a multi-hospital consortium in the Parisian region of France

Indicators for comparing and understanding differences in antimicrobial resistance (AMR) and healthcare-associated infections (HAIs) for benchmarking are essential to identify priorities for hospitals. This study measured the incidence of hospital-acquired or resistant Gram-negative bacilli bloodstream infections (GNB-BSIs) in a large public healthcare consortium in the Parisian region of France. Within each hospital, there was a strong positive correlation between the incidence of GNB-BSIs due to resistant GNB and the incidence of hospital-acquired GNB-BSIs. Two scores measuring AMR and HAI rates by combining different GNB-BSI incidence rates were developed as indicators. These scores were highly variable within the hospital consortium. On multi-variate analysis, AMR and HAI scores were significantly associated with the proportion of surgical beds, staff absenteeism and the consumption of alcohol-based hand rub, with the latter two characteristics being amenable to interventions. Carbapenem use was also linked to AMR, but this may be because carbapenems are the preferred drug for treating resistant infections. These results shed light on the incidence of HAIs and AMR in the study hospitals, and suggest possibilities for targeted interventions at healthcare facility level.

Risk factors and prediction of bacterial complications in liver transplantation

Aim. To conduct a systems analysis of clinical and epidemiological risk factors of bacterial complications associated with liver transplantation, to evaluate the effectiveness of their prevention algorithm.Materials and methods. The authors analyzed the treatment outcomes of 1000 recipients who underwent liver transplantation from April 2008 to April 2023. The study involved analysis of correlation between infections associated with health care and main risk factors, including contamination of different loci and preservation solution.Results. The incidence of healthcare-associated infections accounted for 22.2%. The cumulative incidence of donor organ and recipient contamination was 9.85%. Transmission of infection occurred in 29% of cases. Sepsis developed in 8% of all recipients with healthcare-associated infection. The mortality rate was 70% in cases of sepsis. After liver transplantation, in-hospital mortality was 9.3%. Urgent transplantation was required in 10.7% of observations. Univariate regression analysis shows the highest risk contribution to healthcare-associated infection for the MELD score, contamination of preservation solution with multidrug-resistant flora, severe early graft dysfunction, blood loss, and warm ischemia time.Conclusion. Contamination of preservation solution increases the risk of bacterial complications associated with liver transplantation. The resistance profile affects the development time, structure and outcome of these complications. Timely diagnosis and infection control measures are fundamental to preventing the infectious complications.

Assessment of Healthcare Associated Infections in a Medical Intensive Care Unit

Objective: This study was undertaken to assess the current status of healthcare associated infections (HAIs) in our institution during a 2-year period in relation to causative agents and their distribution, use and duration of invasive mechanical ventilation, and infection rate and incidence in comparison with national data.&#x0D; Methods: Patients admitted to Medical ICUs of Meram State Hospital between 1st Jan 2019 and 31st Dec 2020 wereincluded. During a 2-year period a total of 47 patients were diagnosed with HAIs based on Centers for Disease Control and Prevention (CDC) and National Nosocomial Infection Surveillance Network (NNISN) criteria.&#x0D; Results: During 6041 follow-up days for 922 patients admitted to ICU, a total of 47 HAIs cases were detected. The most common types of HAIs included healthcare-associated pneumonia in 21 patients (45.6%) and other infections of the respiratory system in 12 patients (26.1%). The most common causative agent was Acinetobacter baumannii, which was found in 27 patients (50.9%).&#x0D; Conclusion: HAIs is an unavoidable condition in ICUs owing to a number of factors such as frequent use of invasive devices, prolonged length of admission, and increased number of complications. One of the major health targets in healthcare facilities is to control an manage HAIs. Avoidance from unnecessary catheterizations, timely removal of invasive catheters, increased adherence to infection control measures, prevention of inappropriate antibiotic use, compliance with isolation procedures, and initiation of appropriate antibiotherapy based on documentation of causative organisms will significantly reduce HAIs incidence.

Antimicrobial Resistance of the Genus Enterococcus in Cantonal Hospital of Zenica, Bosnia and Herzegovina

Among Enterococcus spp, only the virulence gene harboring strains of Enterococcus faecalis and E. faecium are associated with human infections, including urinary tract infections (UTI), pelvic, blood, intraabdominal, and skin and soft tissue infections (SSTI). Over the past decades, enterococcal antimicrobial resistance has escalated in many regions of the world, leading to ominous outcomes. The rising incidence of Healthcare-Associated Infections (HCAIs) secondary to Vancomycin-resistant strain (VRE) resulted in high morbidity and mortality, as well as substantial challenges in control, prevention, and management). The aim of this study is to examine the antimicrobial resistance of E. faecalis and E. faecium species in different human samples. The study included 184 clinical samples over a period of 6 months. E. faecalis was identified in 95.65% and E. faecium in 4.35% of cases. E. faecalis isolates showed resistance to gentamicin in 40.9% of cases and to ampicillin in 1.7% of cases. Resistance to nitrofurantoin and ciprofloxacin was observed in 6.1% and 35.7% of E. faecalis isolates. VRE was isolated in 1.1% of E. faecalis isolates tested for this antibiotic. Resistance of E. faecium isolates to ampicillin and gentamicin was observed in 87.5% of cases in both antibiotics. All urinary isolates of E. faecium were resistant to ciprofloxacin. All E. faecium isolates were sensitive to vancomycin. Based on the results of our study, the growing importance of Enterococcus spp. as a causative agent of hospital infections and infections in the general population, and its antimicrobial resistance to various drugs were observed.

Healthcare-associated infections and antimicrobial resistance in severe acquired brain injury: a retrospective multicenter study.

Recent studies underscore that healthcare-associated infections (HAIs) and multidrug-resistant (MDR) HAIs affect rehabilitation outcomes and hospital length of stay (LOS) for severe acquired brain injury (sABI). This study aimed to estimate HAI incidence in different sABI rehabilitation settings and determine risk factors and HAI impact on neuromotor and cognitive recovery. We conducted a retrospective multicenter study in two semi-intensive units (SICUs), two high-specialty post-acute units (PAUs), and one long-term care (LTC) rehabilitation facility. Data extraction was performed by experienced clinicians, using a structured Excel file and they agreed upon criteria for case definitions of healthcare. The main outcome measures were the HAI and MDR HAI incidence and the LOS, the functional recovery was measured using the Level of Cognitive Functioning and Disability Rating Scale. There were 134 sABI participants. The calculation of the probability level was adjusted for three pairwise comparisons among settings (0.05/3 = 0.017). The HAI and MDR HAI incidences were significantly higher in SICU (3.7 and 1.3 per 100 person-days) than in other settings (LTC: 1.9, p = 0.034 and 0.5, p = 0.026; PAU: 1.2, p < 0.001 and 0.3, p < 0.001). HAI and MDR HAI risk variables included older age, an increased number of devices, and carbapenemase-producing Enterobacteriaceae (CPE) colonization, while a high prealbumin plasma value seemed to have a protective effect. HAIs are related to longer LOS, and colonization is associated with poor prognosis and poor functional outcomes with reduced ability to achieve the cognitive capacity of self-care, employability, and independent living. The need to ensure the protection of non-colonized patients, especially those with severe disabilities on admission, is highlighted.

Revisiting the personal protective equipment components of transmission-based precautions for the prevention of COVID-19 and other respiratory virus infections in healthcare.

The COVID-19 pandemic highlighted some potential limitations of transmission-based precautions. The distinction between transmission through large droplets vs aerosols, which have been fundamental concepts guiding infection control measures, has been questioned, leading to considerable variation in expert recommendations on transmission-based precautions for COVID-19. Furthermore, the application of elements of contact precautions, such as the use of gloves and gowns, is based on low-quality and inconclusive evidence and may have unintended consequences, such as increased incidence of healthcare-associated infections and spread of multidrug-resistant organisms. These observations indicate a need for high-quality studies to address the knowledge gaps and a need to revisit the theoretical background regarding various modes of transmission and the definitions of terms related to transmission. Further, we should examine the implications these definitions have on the following components of transmission-based precautions: (i) respiratory protection, (ii) use of gloves and gowns for the prevention of respiratory virus infections, (iii) aerosol-generating procedures and (iv) universal masking in healthcare settings as a control measure especially during seasonal epidemics. Such a review would ensure that transmission-based precautions are consistent and rationally based on available evidence, which would facilitate decision-making, guidance development and training, as well as their application in practice.

The intertwining of healthcare-associated infections and COVID-19 in Italian intensive care units: an analysis of the SPIN-UTI project from 2006 to 2021

Although healthcare-associated infections (HAIs) pose an extraordinary burden on public health, the impact of coronavirus disease 2019 (COVID-19) is still a matter of debate. To describe trends of HAIs in Italian intensive care units (ICUs) from 2006 to 2021, and to compare characteristics and outcomes of patients with or without COVID-19. We evaluated patients participating in the 'Italian Nosocomial Infections Surveillance in Intensive Care Units' (SPIN-UTI) project, who were admitted to ICUs for more than 48h. Data regarding diagnosis, clinical conditions, therapies, treatments and outcomes of COVID-19 patients were also collected. From a total of 21,523 patients from 2006 to 2021, 3485 (16.2%) presented at least one HAI. We observed an increasing trend for both the incidence of patients with HAI and the incidence density of HAIs (P-trend <0.001). Compared with the pre-pandemic period, the incidence density of HAIs increased by about 15% in 2020-2021, with pneumoniae being the greatest contributors to this increase (P-trend <0.001). Moreover, incidence of HAIs was higher in ICUs dedicated to COVID-19 patients (P<0.001), who showed a greater risk of HAIs and death than patients without COVID-19 (P-values <0.001). Accordingly, the mortality in ICUs increased over the years and doubled during the pandemic (P-trend <0.001). Notably, co-infected patients had higher mortality (75.2%) than those with COVID-19 (66.2%) or HAI (39.9%) alone, and those without any infection (23.2%). Our analysis provides useful insight into whether and how the COVID-19 pandemic influenced HAI incidence and death in Italian ICUs, highlighting the need for evaluation of the long-term effects of the pandemic.

Bacterial Contamination of Mobile Phones Used by Healthcare Workers in Critical Care Units: A Cross-Sectional Study from Saudi Arabia.

Healthcare-associated infections (HAIs) present a formidable challenge for healthcare institutions, resulting in heightened mortality, morbidity, and economic burden. Within healthcare settings, various equipment and materials, including mobile phones, can potentially act as sources of infection. This study sought to examine the occurrence of bacterial contamination on mobile phones utilized by healthcare workers (HCWs) in intensive care units (ICUs), pediatric intensive care units (PICUs), neonatal intensive care units (NICUs), and cardiac care units (CCUs) within a central hospital (CH) and two peripheral hospitals (PHs) situated in the southwestern province of Saudi Arabia. We collected a total of 157 samples from mobile phones utilized by HCWs across all ICUs in the CH and PHs. These samples underwent bacteriological analysis to evaluate the degree of bacterial contamination. We found that 45 out of 55 samples from physicians (81.81%) and 58 out of 77 samples from nurses (75.32%) showed bacterial contamination. Contamination rates on HCWs' mobile phones in the ICU, PICU, and NICU departments of the CH were observed at 69.56%, 80.95%, and 70.27%, respectively. Furthermore, the overall contamination rates in the ICUs, NICUs, and CCUs of the PHs were 78.26%, 88.88%, and 66.66%, respectively. The overall contamination rates of mobile phones in the CH and PHs were 72.11% and 81.13%, respectively. These findings underscore the necessity of routinely disinfecting the mobile phones of HCWs to mitigate the risk of cross-contamination. Implementing robust disinfection protocols can significantly contribute to curtailing the propagation of bacterial pathogens and reducing the incidence of HAIs in healthcare settings.

IMPACT OF ENVIRONMENTAL CLEANING AND DISINFECTION PRACTICES ON INFECTION CONTROL OUTCOMES IN SAUDI ARABIAN HEALTHCARE SETTINGS: A SYSTEMATIC REVIEW AND META-ANALYSIS

IMPACT OF ENVIRONMENTAL CLEANING AND DISINFECTION PRACTICES ON INFECTION CONTROL OUTCOMES IN SAUDI ARABIAN HEALTHCARE SETTINGS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Health Care–Associated Infection in Elderly Patients With Cerebrovascular Disease in Intensive Care Units: A Retrospective Cohort Study in Taizhou, China

Cerebrovascular diseases are associated with high incidence of health care-associated infections (HAIs) and poor prognosis in elderly patients. This study aimed to investigate the incidence and clinical characteristics of HAIs in elderly patients with cerebrovascular disease in the intensive care unit (ICU). Patients admitted with cerebrovascular disease, aged≥65 years, were included. The clinical data of the patients were retrospectively analyzed to determine the risk factors, infection type, distribution, and pathogenic characteristics of HAIs in the context of cerebrovascular diseases. Out of 381 ICU inpatients monitored, 79 (20.73%) developed HAIs. Risk analysis revealed number of ventilator days as significant risk factors for HAIs in elderly patients with cerebrovascular diseases in the comprehensive ICU. In the HAI group, 56 patients (70.89%) had respiratory tract infection (RTI). Sixty-five patients (82.28%) were infected with Gram-negative bacteria (GNB), and 42 (53.16%) with multi-drug-resistant organism (MDRO). The length of hospitalization days, ventilator days, and overall hospitalization costs were higher in the HAI group than in the non-HAI group (P < 0.05), but there was no significant difference between groups in the treatment outcome of patients. Patients with MDRO infection had longer duration and higher cost of hospitalization than those infected with non-MDRO (P < 0.05), but there was no significant difference between the groups in the treatment outcome of patients. HAIs occurred mostly due to RTI and GNB infection. The hospitalization cost and duration, as well as the length of ventilator days, were higher for cerebrovascular patients with HAIs than for non-HAIs patients.

Multi-Model Strategies for Prevention of Infection Caused by Certain Multi-Drug Resistant Organisms in A Rehabilitation Unit: A Semi-Experimental Study.

Objective: To assess the effectiveness of multi-model strategies on healthcare-associated infections (HAIs) caused by multi-drug resistant organisms (MDROs) in rehabilitation units. Methods: A semi-experimental study was conducted in a rehabilitation unit with 181 beds from January 2021 to December 2022 in a teaching hospital with 4300 beds in China. In 2021, many basic prevention and control measures were conducted routinely. Based on the basic measures, strengthening multi-model strategies for the prevention and control of MDROs was pursued year-round since 1 January 2022. Results: A total of 6206 patients were enrolled during the study period. The incidence density of HAIs caused by MDROs decreased from 1.22 (95% CI, 0.96~1.54) cases/1000 patient-days in the pre-intervention period to 0.70 (95% CI, 0.50~0.95) cases/1000 patient-days (p = 0.004). Similarly, the incidence of HAIs in the intervention period was 50.85% lower than that in the pre-intervention period (2.02 (95% CI, 1.50~2.72) vs. 4.11 (95% CI, 3.45-4.85) cases/100 patients, p < 0.001). The rate of MDROs isolated from the environment decreased by 30.00%, although the difference was not statistically significant (p = 0.259). Conclusion: Multi-model strategies can reduce the incidence of HAIs and HAIs caused by certain MDROs in the rehabilitation unit.

The incidence of nosocomial bloodstream infection and urinary tract infection in Australian hospitals before and during the COVID-19 pandemic: an interrupted time series study

BackgroundThe COVID-19 pandemic has had a significant impact on healthcare including increased awareness of infection prevention and control (IPC). The aim of this study was to explore if the heightened awareness of IPC measures implemented in response to the pandemic influenced the rates of healthcare associated infections (HAI) using positive bloodstream and urine cultures as a proxy measure.MethodsA 3 year retrospective review of laboratory data from 5 hospitals (4 acute public, 1 private) from two states in Australia was undertaken. Monthly positive bloodstream culture data and urinary culture data were collected from January 2017 to March 2021. Occupied bed days (OBDs) were used to generate monthly HAI incidence per 10,000 OBDs. An interrupted time series analysis was undertaken to compare incidence pre and post February 2020 (the pre COVID-19 cohort and the COVID-19 cohort respectively). A HAI was assumed if positive cultures were obtained 48 h after admission and met other criteria.ResultsA total of 1,988 bloodstream and 7,697 urine positive cultures were identified. The unadjusted incident rate was 25.5 /10,000 OBDs in the pre-COVID-19 cohort, and 25.1/10,000 OBDs in the COVID-19 cohort. The overall rate of HAI aggregated for all sites did not differ significantly between the two periods. The two hospitals in one state which experienced an earlier and larger outbreak demonstrated a significant downward trend in the COVID-19 cohort (p = 0.011).ConclusionThese mixed findings reflect the uncertainty of the effect the pandemic has had on HAI’s. Factors to consider in this analysis include local epidemiology, differences between public and private sector facilities, changes in patient populations and profiles between hospitals, and timing of enhanced IPC interventions. Future studies which factor in these differences may provide further insight on the effect of COVID-19 on HAIs.

Healthcare-associated infections in adult intensive care units: A multisource study examining nurses’ safety attitudes, quality of care, missed care, and nurse staffing

ObjectivesThis study examined the association between safety attitudes, quality of care, missed care, nurse staffing levels, and the rate of healthcare-associated infection (HAI) in adult intensive care units (ICUs). MethodsA cross-sectional study was conducted in five hospitals. Nurses completed a validated survey on safety attitudes, quality of care, missed care, nurse staffing levels, and the frequency of HAIs. Secondary data were collected on the incidence of central line–associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) in participating units. Descriptive analysis and generalized linear models were performed. ResultsA total of 314 nurses from eight ICUs participated in this study. The mean safety culture score was 60.85 (SD = 3.53). ICUs with strong job satisfaction had lower incidence and nurse-reported frequency of CLABSI, CAUTI, and VAP. Missed care was common, with 73.11% of nurses reporting missing at least one required care activity on their last shift. The mean patient-to-nurse ratio was 1.95. Increased missed care and higher workload were associated with higher HAIs. Nurses’ perceptions of CLABSI and VAP frequency were positively associated with the actual occurrence of CLABSI and VAP in participating units. ConclusionPositive safety culture and better nurse staffing levels can lower the rates of HAIs in ICUs. Improvements to nurse staffing will reduce nursing workloads, which may reduce missed care, increase job satisfaction, and, ultimately, reduce HAIs. Implications for clinical practiceHigher levels of job satisfaction among ICU nurses, lower proportions of missed nursing care and higher nurse staffing are associated with lower rates of HAIs. Nurse-reported HAI frequency was positively associated with the incidence of HAIs; therefore, nurses provide reliable data on infection control outcomes in ICU settings.

Effects of COVID-19 pandemic on healthcare-associated infections, antibiotic resistance and consumption rates in intensive care units.

This paper aimed to evaluate the effects of the COVID-19 pandemic on healthcare-associated infections (HAIs), antibiotic resistance and consumption rates in intensive care units (ICUs) of a tertiary care university hospital. Between 1 January 2018 and 31 December 2021, adult patients diagnosed with HAIs in ICUs were investigated retrospectively. Patients were divided into pre-pandemic (2018-2019) and pandemic periods (2020-2021). Antibiotic consumption index was calculated via using the formula of (total dose (grams)/defined daily dose (DDD) x total patient days) x1000. A p value below 0.05 was accepted as statistically significant. The incidence of HAIs (per 1000 patient days) in the ICU of COVID-19 patients was 16.59, while it was 13.42 in the other ICUs during the pandemic period (p=0.107). The bloodstream infection (BSI) incidence was 3.32 in the pre-pandemic period and 5.41 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p<0.001). In the pandemic period, the BSI incidence rate was significantly higher in the ICU of COVID-19 patients than in the other ICUs (14.26 vs 5.41, p<0.001). Central venous catheter bloodstream infections incidence rate was 4.72 in the pre-pandemic and 7.52 in the pandemic period in ICUs other than the ICU of COVID-19 patients (p=0.0019). During the pandemic period, the bacteraemia episode rates of Acinetobacter baumannii (5.375 vs 0.984, p<0.001), Enterococcus spp. (1.635 vs 0.268, p<0.001) and Stenotrophomonas maltophilia (3.038 vs 1.297, p=0.0086) in the ICU of COVID-19 patients were significantly found higher than others. The extended-spectrum beta-lactamase (ESBL) positivity rates for Klebsiella pneumoniae and Escherichia coli were 61% and 42% in the pre-pandemic period; 73% and 69% in the pandemic period in ICUs other than the ICU of COVID-19 patients (p>0.05). In the pandemic period, the ESBL positivity rates for K. pneumoniae and E. coli were 83% and 100% in the ICU of COVID-19 patients, respectively. Meropenem (p<0.001), teicoplanin (p<0.001) and ceftriaxone (p<0.001) consumptions were increased while ciprofloxacin (p=0.003) consumption was decreased in all ICUs after the pre-pandemic period. BSI and CVCBSI incidence rates were significantly increased in all ICUs after the COVID-19 pandemic in our hospital. Bacteraemia episode rates of A. baumannii, Enterococcus spp. and S. maltophilia in ICU of COVID-19 patients were significantly found higher than others. In addition, meropenem, teicoplanin and ceftriaxone consumptions were increased in all ICUs after the COVID-19 pandemic.

The structure of ESKAPE pathogens isolated from patients of the neonatal intensive care unit at the National Hospital of Pediatrics in Hanoi, the Socialist Republic of Vietnam

Introduction. The incidence of healthcare-associated infections is a major public health problem worldwide, affecting all countries regardless of their economic status. The main agents of these infections are pathogens belonging to the ESKAPE group.&#x0D; The aim of the study was to explore the structure, molecular and antigenic characteristics of the ESKAPE pathogens isolated from oral and anal mucosa of patients of the neonatal intensive care unit (NICU), and to assess their etiological significance in occurrence of healthcare-associated infections.&#x0D; Materials and methods. Samples from a total of 49 children were tested, including 40 newborns patients of NICU at the National Hospital of Pediatrics in Hanoi. Collection and processing of biomaterial (oropharyngeal swabs, rectal swabs) and isolation of bacterial cultures were performed using conventional bacteriological methods. Mass spectrometry was used for identification of isolates. Klebsiella pneumoniae strains were analyzed using the whole-genome sequencing method.&#x0D; Results. The group of gram-positive ESKAPE pathogens identified in oral mucosa was represented by isolates Enterococcus faecium and Staphylococcus aureus. The isolates of the family Enterobacteriaceae included K. pneumoniae, Escherichia coli, Enterobacter cloacae; the group of nonfermenting gram-negative bacteria was represented by Pseudomonas aeruginosa, Acinetobacter baumannii. The structure of ESKAPE pathogens persistent in anal mucosa was characterized by dominance of Enterococcus spp., E. coli, K. pneumoniae and P. aeruginosa bacteria. The whole-genome sequencing of K. pneumoniae isolates revealed 7 clusters and 8 sequence types. ST14 and ST1741 prevailed, accounting for 25%, respectively, of the total number of the studied strains. The molecular serotyping showed that by the O antigen, strains belonged mainly to serotypes O1v1, O1/ O2v2, O5; by the presence of the capsular antigen to serotypes KL2, KL104, KL60.&#x0D; Conclusion. The analysis of the structure of the ESKAPE pathogens isolated from the oral and anal mucosa of patients of NICU at the National Hospital of Pediatrics in Hanoi identified etiologically significant agents of bacterial infections: S. aureus, K. pneumoniae, E. coli, E. cloacae, P. aeruginosa, A. baumannii. The molecular and genetic analysis of K. pneumoniae strains co-circulating in mucous membranes of several patients of the unit revealed their homology, thus confirming healthcare-associated contamination of children with nosocomial strains.

Reducing the number of catheter-associated urinary tract infections at an inpatient rehabilitation facility: A quality improvement project.

During the coronavirus disease 2019 (COVID-19) pandemic, the incidence of healthcare-associated infections (HAIs), including catheter-associated urinary tract infections (CAUTIs), increased significantly across the country. This report describes a quality improvement project aimed at reducing the incidence of CAUTIs at an inpatient rehabilitation facility.

Impact of the COVID-19 pandemic on the incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar.

Healthcare-associated infections (HAIs) in critical patients affect the quality and safety of patient care and increase patient morbidity and mortality. During the COVID-19 pandemic, an increase in the incidence of HAIs, particularly device-associated infections (DAIs), was reported worldwide. In this study, we aimed to estimate the incidence of HAIs in an intensive care unit (ICU) during a 10-year period and compare HAI incidence during the preCOVID-19 and COVID-19 periods. A retrospective, observational study of HAIs in the medical-surgical ICU at The Cuban Hospital was conducted. DAIs included central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and ventilator-associated pneumonia (VAP). Data included the annual incidence of HAIs, etiology, and antimicrobial resistance, using definitions provided by the Centers for Disease Control and Prevention, except for other respiratory tract infections (RTIs). 155 patients with HAI infections were reported, from which 130 (85.5%) were identified during the COVID-19 period. The frequencies of DAIs and non-DAIs were higher during the COVID-19 period, except for Clostridium difficile infections. Species under Enterobacter, Klebsiella, and Pseudomonas dominated in both periods, and higher frequencies of Acinetobacter, Enterococcus, Candida, Escherichia coli, Serratia marcescens, and Stenotrophoma maltophila were noted during COVID-19 period. Device utilization ratio increased to 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19 pandemic, with risks for CLABSI, VAP, and CAUTI increased by 2.79 (95% confidence interval, 0.93-11.21; p<0.0050), 15.31 (2.53-625.48), and 3.25 (0.68-31.08), respectively. The incidence of DAIs increased during the pandemic period, with limited evidence of antimicrobial resistance observed. The infection control program should evaluate strategies to minimize the impact of the pandemic on HAIs.

Ten-year incidence and impact of coronavirus infections on incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar.

Healthcare-associated infections (HAI) in critical patients affect the quality and safety of patient care as they impact morbidity and mortality. During the COVID-19 pandemic, an increase in the incidence rate was reported worldwide. We aim to describe the incidence of HAI in the intensive care unit (ICU) during a 10-year follow-up period and compare the incidence during the pre-COVID-19 and COVID-19 periods. A retrospective observational study of HAI in the medical-surgical ICU at The Cuban Hospital was conducted. The data collected include the annual incidence of HAI, its etiology, and antimicrobial resistance, using the Centers for Disease Control and Prevention definitions, except for other respiratory tract infections (RTIs). A total of 155 patients had HAI, of which 130 (85.5%) were identified during COVID-19. The frequency of device-associated infections (DAI) and non-DAI was higher during COVID-19, except for Clostridium difficile infections. Etiology was frequently related to species of Enterobacter, Klebsiella, and Pseudomonas in both periods, and a higher frequency of Acinetobacter, Enterococcus, Candida, Escherichia coli, Serratia marcescens, and Stenotrophomonas maltophilia was noted during the COVID-19 period. Device utilization ratio increased by 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19, with a 2.79 higher risk of infection (95% CI: 0.93-11.21; p < 0.0050), 15.31 (2.53-625.48), and 3.25 (0.68-31.08) for CLABSI, VAP, and CAUTI, respectively. The incidence of DAI increased during the pandemic period as compared to the pre-pandemic period, and limited evidence of the impact on antimicrobial resistance was observed. The infection control program should evaluate strategies to minimize the impact of pandemics on HAI.

Effect of serious infectious threat response initiative (SITRI) during the coronavirus disease 2019 (COVID-19) pandemic at the Veterans Affairs North Texas Health Care System

Health care-associated infections (HAIs) increased worldwide as health care facilities struggled through the pandemic. We describe our methods in the implementation of a programmatic initiative called serious infectious threat response initiative (SITRI) that was conceptualized to support our staff, to facilitate day-to-day clinical operations related to COVID-19 and to shield our infection prevention and control program (IPC) from excessive COVID-19 work burden to the extent possible to retain routine prevention focused efforts. Post implementation, we sought to understand and quantify the workload and utility of SITRI, IPC burnout and HAI incidence during the implementation period. We correlated the number of weekly phone calls with inpatient COVID-19 census, assessed types of calls, staff feedback, IPC burnout, pre- and postpandemic HAI incidence, and the cost. There was significant correlation between SITRI calls and the weekly average COVID-19 census (P=.00026). IPC burnout evaluation indicated improvement in scores for exhaustion and reduced achievement and worsening in score for depersonalization. HAI incidence did not increase. SITRI's cost was $360,000. Staff solicited SITRI's support in tandem with the COVID-19 burden. Our HAI during the pandemic did not increase while SITRI was operational in contrast to what is published in literature.