Nosocomial Infections In Patients Research Articles

Phenotypic and Genotypic Detection of Carbapenem Resistant Organism Causing Nosocomial Infection in Patients Attending Tertiary Care Hospital

Aims: Nosocomial infections are the leading cause of mortality. ESKAPE organisms are the primary causes of nosocomial infection as these organisms are more or less carbapenem resistant. This study aimed to isolate and identify the etiological agents responsible for causing nosocomial infection and determine the carbapenemase producing organism by phenotypic and genotypic detection.
 Study Design: The study design is cross-sectional study.
 Place and Duration of Study: The study was conducted in the Department of Microbiology, at Index Medical College, Indore, between January 2020 and January 2022.
 Methodology: Total of 246 samples was collected from the patients who develop symptoms after 48- 72 hrs of hospitalization. Samples were processed for identification of etiological agents. Gram negative organisms were selected and further identified for carbapenemase enzyme. Screening was done by Kirby Bauer disc diffusion test and further confirmed by Modified Hodge test, Combined Disc test, Double Disc Synergy Diffusion test and Carbapenem Inactivation method. Genotypic detection was done by using multiplex polymerase chain reaction for KPC, NDM and OXA-48 gene.
 Results: Out of 107-gram-negative organisms, 19 (17.75%) were carbapenem resistant. Among 19 carbapenem resistant GNR, 13% MHT, 15% CCDT, 17% DDST and 17% mCIM were positive. The sensitivity and specificity of MHT, CCDT, DDST, mCIM were 74%/100, 84%/100,95%/100 and 95%/100respectively. The genotypic detection shows highest percentage of blaNDM 74% which is followed by bla OXA-48 31% and blaKPC 26%.
 Conclusion: Hospitals have become the hotspot for various microorganism causing nosocomial infections and are getting carbapenem resistance due to irrational use of antibiotics. Antimicrobial stewardship is one of the effective measures that minimize the resistance. Proper universal precaution can also minimize, spread of resistance in organism. If the last resort drug gets resistant, then it could be challenging for the clinician to treat their patients. Hospitals should have regular HAI meeting and release of antibiogram to know the pattern of these notorious organisms invading infection.

Effect of early achievement of energy target by different nutritional support strategies on nosocomial infections in patients undergoing major abdominal surgery: a secondary analysis of two randomized clinical trials.

The effect of early achievement of energy targets (EAETs) using different nutritional support strategies in patients undergoing major abdominal surgery is unclear. This study determined the impact of EAETs on the incidence of nosocomial infections in patients undergoing major abdominal surgery. This was a secondary analysis of two open-label randomized clinical trials. Patients from the general surgery department of 11 academic hospitals in China undergoing major abdominal surgery and at nutritional risk (Nutritional risk screening 2002≥3) were divided into two groups based on whether they met the 70% energy targets, the EAET (521 EAET and non-achievement of energy target (114 NAET) groups. The primary outcome was the incidence of nosocomial infections between postoperative day 3 and discharge, and the secondary outcomes were actual energy and protein intake, postoperative noninfectious complications, intensive care unit admission, mechanical ventilation, and hospital stay. Overall, 635 patients [mean (SD) age, 59.5 (11.3) years] were included. The EAET group received more mean energy between days 3 and 7 than the NAET group (22.7±5.0 vs. 15.1±4.8kcal/kg/d; P <0.001). The EAET group had significantly fewer nosocomial infections than the NAET group [46/521(8.8%) vs. 21/114(18.4%); risk difference, 9.6%; 95% CI, 2.1-17.1%; P =0.004]. A significant difference was found in the mean (SD) number of noninfectious complications between the EAET and NAET groups [121/521(23.2%) vs. 38/114(33.3%); risk difference, 10.1%; 95% CI, 0.7-19.5%; P =0.024]. The nutritional status of the EAET group was significantly improved at discharge compared with the NAET group ( P <0.001), and other indicators were comparable between groups. EAETs was associated with fewer nosocomial infections and improved clinical outcomes, regardless of the nutritional support strategy (early enteral nutrition alone or combined with early supplemental parenteral nutrition).

Prevalence of nosocomial infection Pre- and Post-COVID 19 Pandemic in a Tertiary Care Hospital in Karachi.

Objective: To evaluate the role of the COVID-19 pandemic in the prevalence of nosocomial infections in patients admitted to the Ziauddin University Hospital, Clifton Campus, Karachi. Study Design: Retrospective Cross-sectional study. Setting: Ziauddin University Hospital, Clifton Campus, Karachi. Period: Pre-COVID: Feb 1, 2019 – Jan 31, 2019 Post-COVID: May 1 2020- Apr 30, 2021. Material &amp; Methods: Clinicians retrospectively reviewed all Infectious Disease Department medical records for a list of all patients who developed a NI after 48 hours of admission to the hospital. The diagnosis of NI had been formulated by clinicians on the basis of clinical, radiological and microbiological findings. Results: We found an increase in certain types of NIs, and stability in the infection rate for many other organisms, which may be due to improved infection control practices during COVID. This information will lead to a better understanding of infection control practices in the future, and will better guide clinical decision making. Conclusion: The strict and proper implementation of infection control protocols during the COVID-19 outbreak has reduced the rate of NIs. It has been evident that NIs can be minimized by creating a positive attitude, improving awareness and staff hygiene practices and behaviours, and the provision of facilities to comply with the of infection control protocols’ standards.

Nosocomial infections in patients requiring short-term mechanical circulatory support: characteristics, risk factors and prognosis

Abstract Funding Acknowledgements Type of funding sources: None. Background The use of short-term mechanical circulatory support (MCS) has been increasing in recent years. Infection is a frequent complications and seems to contribute to increased morbidity and mortality. Purpose Our objective was to describe the profile of infections in patients with short-term MCS, as well as factors related to their appearance and their prognostic influence. Methods Retrospective analysis of consecutive cases of venoarterial extracorporeal membrane oxygenator (VA-ECMO) or Impella CP® implantation in a referral center. We characterized the infections during the entire hospitalization and analyzed their relationship with different variables and survival. Infection as microbiological isolation (no colonization) or clinical suspicion that motivates antimicrobial therapy with therapeutic intent. Results 232 patients between 2014-sep 2022 (Table). A total of 104 (56.5%) patients presented infection, respiratory tract (other than pneumonia) (23.3%) was the most prevalent. The most frequently isolated microorganisms were Gram-negative bacteria and Staphylococcus aureus, with 8.2% multidrug-resistant bacteria (Figure). Infection appeared during MCS in 25% of patients, 13% after its removal, 11% at both times, and 6.1% of patients were already infected at MCS implant. Baseline characteristics and admission evolution depending on the presence of infection are described in table. Infections were significantly more frequent in cardiogenic shock indication and bridge to recovery intention, and non-percutaneous access. We observed a non-statistically significant trend towards more infections under VA-ECMO vs Impella CP® device. The following factors were associated with the appearance of infection: a longer time under MCS, endotracheal intubation (especially out-of-hospital), longer invasive mechanical ventilation (MV) and tracheostomy, right ventricular dysfunction, the need for vasoactive drugs, and corticosteroids treatment during more than 3 days. The appearance of infection was significantly associated with other complications (Table). At multivariate analysis a longer time under MCS (HR 1.15, IC95% 1.06-1.26, p=0.002) and MV (HR 1.06, IC95% 1.02-1.09, p=0,001) were independently related to infections. Overall in-hospital mortality was 59.8% (n=137), 3.9% due to infection. No direct relationship was observed between in-hospital mortality and the presence of infection (57.4% in infected patients vs 61.7% without infection, p=0.587). Patient already infected at MCS implantation had higher mortality (87.7% vs 57% during MCS vs 41.9% after MCS, p=0.030). Conclusions Infections in patients under short-term SCM are frequent, highlighting the upper respiratory tract infection. Longer support and ventilation time were independently related to infections. The development of infection was associated with other complications, but not with higher in-hospital mortality. Short-term MCS in already infected patients was related to high mortality.

Nosocomial Infections in Adult Patients Supported by Extracorporeal Membrane Oxygenation in a Cardiac Intensive Care Unit.

The use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in-hospital mortality due to nosocomial infections in patients with ECMO admitted to a single coronary intensive care unit between July 2013 and March 2019 treated with VA-ECMO for >48 h. From 69 patients treated with VA-ECMO >48 h, (median age 58 years), 29 (42.0%) patients developed 34 episodes of infections with an infection rate of 0.92/1000 ECMO days. The most frequent were ventilator-associated pneumonia (57.6%), tracheobronchitis (9.1%), bloodstream infections (9.1%), skin and soft tissue infections (9.1%), and cytomegalovirus reactivation (9.1%). In-hospital mortality was 47.8%, but no association with nosocomial infections was found (p = 0.75). The number of days on ECMO (OR 1.14, 95% CI 1.01-1.30, p = 0.029) and noninfectious complications were higher in the infected patients (OR: 3.8 95% CI = 1.05-14.1). A higher baseline creatinine value (OR: 8.2 95% CI = 1.12-60.2) and higher blood lactate level at 4 h after ECMO initiation (OR: 2.0 95% CI = 1.23-3.29) were significant and independent risk factors for mortality. Conclusions: Nosocomial infections in medical patients treated with VA-ECMO are very frequent, mostly Gram-negative respiratory infections. Preventive measures could play an important role for these patients.

Clinical Characteristics and Nomogram Model of Nosocomial Infection in Patients with Newly Diagnosed Multiple Myeloma

To explore the clinical characteristics of nosocomial infection in newly diagnosed multiple myeloma(NDMM) patients, and establish a predictive nomogram model. The clinical data of 164 patients with MM who were treated in Shanxi Bethune Hospital from January 2017 to December 2021 were retrospectively analyzed. The clinical characteristics of infection were analyzed. Infections were grouped as microbiologically defined infections and clinically defined infections. Univariate and multivariate regression models were used to analyze the risk factors of infection. A nomogram was established. 164 patients with NDMM were included in this study, and 122 patients (74.4%) were infected. The incidence of clinically defined infection was the highest (89 cases, 73.0%), followed by microbial infection (33 cases, 27.0%). Among 122 cases of infection, 89 cases (73.0%) had CTCAE grade 3 or above. The most common site of infection was lower respiratory in 52 cases (39.4%), upper respiratory tract in 45 cases (34.1%), and urinary system in 13 cases (9.8%). Bacteria(73.1%) were the main pathogens of infection. Univariate analysis showed that ECOG ≥2, ISS stage Ⅲ, C-reactive protein ≥10 mg/L, serum Creatinine ≥177 μmol/L had higher correlation with nosocomial infection in patients with NDMM. Multivariate regression analysis showed that C-reactive protein ≥10 mg/L (P＜0.001), ECOG ≥2 (P=0.011) and ISS stage Ⅲ （P=0.024） were independent risk factors for infection in patients with NDMM. The nomogram model established based on this has good accuracy and discrimination. The C-index of the nomogram was 0.779（95%CI: 0.682-0.875）. Median follow-up time was 17.5 months, the median OS of the two groups was not reached (P=0.285). Patients with NDMM are prone to bacterial infection during hospitalization. C-reactive protein ≥10 mg/L, ECOG ≥2 and ISS stage Ⅲ are the risk factors of nosocomial infection in NDMM patients. The nomogram prediction model established based on this has great prediction value.

Risk factors of nosocomial infection in patients underwent artificial liver support system: a retrospective case-control study.

Although nosocomial infection is one of the most discussed problems in patients undergoing artificial liver support system (ALSS) treatment, only few solutions have been proposed so far. This study aimed to explore the risk factors of nosocomial infection in patients treated with ALSS in order to aid in the development of future preventive measures. This retrospective case-control study included patients treated with ALSS at the Department of Infectious Diseases, First Affiliated Hospital of xxx Medical University between January 2016 and December 2021. One hundred seventy-four patients were included. There were 57 patients in the nosocomial infection group and 117 patients in the non-nosocomial infection group, of them 127 males (72.99%) and 47 females (27.01%) with an average age of 48.15 ± 14.19 years old. Multivariate logistic regression analysis revealed that total bilirubin [odds ratio (OR) = 1.004; 95% confidence interval (CI), 1.001-1.007; P = 0.020], number of invasive procedures (OR = 2.161; 95% CI, 1.500-3.313; P < 0.001), blood transfusion (OR = 2.526; 95% CI, 1.312-4.864; P = 0.006) were independent risk factors and haemoglobin (Hb) (OR = 0.973; 95% CI, 0.953-0.994; P = 0.011) was a protective factor for nosocomial infection in patients treated with ALSS. The total bilirubin, transfusion of blood products and higher number of invasive operations were independent risk factors for nosocomial infection in patients treated with ALSS, while higher Hb was a protective factor.

Environmental Contamination With SARS-CoV-2 in a Hospital Setting.

Background The coronavirus disease 2019 (COVID-19) pandemic is a global concern and has changed the way we practice medicine in acute hospital settings. This is particularly true with regard to patient triage, patient risk assessment, use of personal protective equipment, and environmental disinfection. Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily through inhalation of respiratory droplets generated through talking, coughing, or sneezing. There is, however, a potential risk that respiratory droplets settling on inanimate surfaces and objects in the hospital environment could provide a reservoir for nosocomial infections in patients and pose a healthcare risk to medical staff. Indeed, there have been previous reports of healthcare-associated outbreaks in hospitals. Several authors have argued that the risk of transmission via fomites may be insignificant. It is, however, not clear what proportion of SARS-CoV-2 infections are attributable to direct contact with fomites; a few reports have indicated possible transmission via this route. Environmental contamination with SARS-CoV-2 in healthcare institutions has been shown to vary according to the function or service provided by a unit or department. Information that identifies hospital areas that have a propensity for higher environmental burden may improve the practice of infection control and environmental cleaning and decontamination in healthcare institutions. This study aimed to investigate environmental SARS-CoV-2 contamination in the clinical areas of patients with COVID-19 infection. Methodology We conducted a cross-sectional study performing swabbing of frequently touched surfaces, equipment, and ventilation ducts in five specific clinical areas of Peterborough City Hospital which is part of the North West Anglia NHS Foundation Trust. The five clinical areas that were chosen for swabbing were the Emergency Department (ED), Intensive Care Unit (ICU), Isolation Ward, Respiratory Ward, and a Gastroenterology Ward that was serving as a receiving ward at the height of the second COVID-19 infection wave in the United Kingdom. Surfaces to be swabbed were divided into the patient zone, doctor zone, and nursing zone. Swabs from the chosen surfaces were collected on two consecutive days. A total of 158 surface swabs were collected during the second wave of the COVID-19 pandemic. SARS-CoV-2 RNA was detected by reverse transcription polymerase chain reaction. Results The most contaminated clinical areas were the three receiving wards where 12% (11/96) of the swabs were positive. Inside the patient rooms, these surfaces included bed rails and controls, bedside tables, television screens, remote control units, and the room ventilation system. Outside the patient room, these surfaces included mobile computers and computer desk surfaces in the doctors' offices. All swabs taken from the ED and ICU were found to be negative. Conclusions Our study confirms the potential infection risks posed by environmental contamination with the SARS-CoV-2 virus. This highlights the importance of adequate environmental cleaning for proper infection control and prevention in healthcare settings.

The Risk of Exposure to Infectious Bacterial Bioaerosols in Different Hospital Wards: A Case Study

Background: Biological aerosol particles smaller than 10 microns in diameter are among the health concerns in hospitals since they remain in the air for a long time and are infectious and easily transported. We aimed to investigate the concentration of Escherichia coli and Staphylococcus aureus bioaerosols and evaluate their risk in the indoor environment of different wards of Khatam al-Anbia hospital, Jask, Iran, in 2020. Methods: This descriptive-analytical study was performed by collecting and analyzing 50 samples from seven different hospital wards. The active sampling of bioaerosols was performed according to the standard method of the National Organization for Occupational Health and Safety and by a pump with a flow rate of 28.3 L/min for 10 minutes. Blood agar and eosin methylene blue were used to detect bacteria. Then, the Monte Carlo simulation technique was used to assess the microbial risk. Results: The concentration of S. aureus in different wards of the hospital was 4.81 to 18.11 CFU/m3 . The lowest and highest concentrations of S. aureus were in the operating room and general emergency wards, respectively, while the highest and lowest concentrations of E. coli were in the inpatient wards (0 CFU/m3 ) and infectious emergency ward (21.22 CFU/m3 ), respectively. The highest and lowest daily risk of S. aureus was observed in the neonatal and general emergency wards (8.03×10-4 and 3.02×10-4), respectively. Moreover, the lowest and highest daily risk of E. coli was found in the neonatal and male inpatient wards (zero and 7.21×10-3), respectively. Conclusion: In some hospital wards, the concentration and infection risk of E. coli and S. aureus were found to be higher than the acceptable value. Since high concentrations of airborne bacteria can play an important role in producing nosocomial infections in patients and staff, it is necessary for hospital officials to take corrective measures in equipment control, use proper ventilation systems in the wards, and closely monitor the disinfection process.

Densidade de incidência de pneumonia associada à ventilação mecânica em dois hospitais

Ventilator-associated pneumonia (VAP) is the main nosocomial infection in patients admitted to the intensive care unit. A strategy to avoid VAP are preventive measures (bundles), which are performed by intensive care professionals. One of the recommendations of the bundles is the oral hygiene protocol for the intubated patient, performed by the nursing technician, which can minimize the incidence of VAP in the ICUs, but which could be better performed by the insertion of the dental surgeon (CD) in the team. The aim of the study was to compare the density of the incidence of VAP (AVIP) in the Intensive Care Units (ICUs) of two private hospitals, named A and B. In hospital A, patients were not followed up by a CD (group 1). In hospital B, there were two collections, one related to patients without DH follow-up (group 2), and another collection of patients who received dental care from a DH (group 3). The incidence densities in groups 1, 2 and 3 were respectively 13.76; 11.96 and 3.63. Although there was no statistical difference between the three groups (p = 0.33), group 3 of patients in hospital B had a considerably lower incidence. The present study concludes by pointing to the importance of including the dentist within the medical-hospital care team for patients using mechanical ventilation, as it contributes to infection control and prevention of searchable diseases that can have consequences on general health.

A model for microbial interactions and metabolomic alterations in Candida glabrata-Staphylococcus epidermidis dual-species biofilms.

The fungus Candida glabrata and the bacterium Staphylococcus epidermidis are important biofilm-forming microorganisms responsible of nosocomial infections in patients. In addition to causing single-species disease, these microorganisms are also involved in polymicrobial infections leading to an increased antimicrobial resistance. To expand knowledge about polymicrobial biofilms, in this study we investigate the formation of single- and dual-species biofilms of these two opportunistic pathogens employing several complementary approaches. First, biofilm biomass, biofilm metabolic activity and the microbial composition in single- and dual-species biofilms were assessed and compared. Then, the expression of three genes of C. glabrata and three genes of S. epidermidis positively related to the process of biofilm formation was evaluated. Although S. epidermidis is a stronger biofilm producer than C. glabrata, both biological and genetic data indicate that S. epidermidis growth is inhibited by C. glabrata which dominates the dual-species biofilms. To better understand the mechanisms of the interactions between the two microorganisms, a broad GC-MS metabolomic dataset of extracellular metabolites for planktonic, single- and dual-species biofilm cultures of C. glabrata and S. epidermidis was collected. As demonstrated by Partial Least Squares Discriminant Analysis (PLS-DA) of GC-MS metabolomic data, planktonic cultures, single- and dual-species biofilms can be sharply differentiated from each other by the nature and levels of an assortment of primary and secondary metabolites secreted in the culture medium. However, according to our data, 2-phenylethanol (secreted by C. glabrata) and the synergistically combined antifungal activity of 3-phenyllactic acid and of the cyclic dipeptide cyclo-(l-Pro-l-Trp) (secreted by S. epidermidis) play a major role in the race of the two microorganisms for predominance and survival.

Impact of the COVID-19 Pandemic on the Prevalence of Nosocomial Infections in Patients Hospitalized in the Clinical Department of Hematology in Cracow, Poland

The COVID-19 outbreak has diametrically changed the epidemiological situation worldwide. Measures to reduce the spread of SARS-CoV-2 had an impact on the incidence of other infections, including nosocomial infections (NIs). The aim of this study was to investigate the impact of COVID-19 on the prevalence of NIs among patients with hematologic malignancies hospitalized in our Department. This population constitutes a specific group of patients due to secondary immunodeficiency resulting from underlying disorders and administered treatment. Consequently, these patients were particularly protected against infections before the emergence of SARS-CoV-2. For this reason, the analysis of NIs prevalence in the pre-pandemic and pandemic time appears to be interesting. To the best of our knowledge, it is the first scientific report to analyze NIs in terms of pandemic and simultaneously strictly devoted to hematologic conditions. This is a retrospective analysis of patients treated at the Clinical Department of Hematology in Cracow, Poland, from March to May 2019 (pre-pandemic) compared to the same period in 2020 (pandemic). The hospital information system collected patient characteristics and data on NIs (clinical manifestation, laboratory findings, microbiological test results). All analyzes were performed with STATISTICA, version 13.3. Categorical variables were compared between the pandemic and the pre-pandemic era with χ2-test and its modifications, if appropriate. The normally distributed continuous variables were compared using a t-test and the non-normally distributed using the Mann-Whitney U test. The statistical significance level was chosen as .05. A p-value of less than .1 but not reaching .05 was considered marginally significant. We analyzed 109 hospitalizations (96 patients) before and 121 (83 patients) during the pandemic. The cohorts did not differ significantly in terms of sex and age at admission, but more deaths and a lower age at death were observed before the pandemic (p = .062 and .052, respectively). The most common cause of death was pneumonia (5/18 patients in total). Although the duration of hospitalization was similar between periods (p = .767), there were more first-time admissions in 2019 (p = .002). This observation suggests a decrease in the proportion of patients who present to healthcare units during the pandemic. The number of fever episodes and their duration were comparable between both periods (p = .136 and .184, respectively). In post hoc analysis, we found that lymphoid neoplasm cases were positively related to the number of fevers and their duration (p = .019 and .064, respectively). The same trend was observed if management was based on immunotherapy, mainly anti-CD20 monoclonal antibodies (p = .031 and .068, respectively). The inflammation markers (white blood cell count, C-reactive protein, and procalcitonin concentration) investigated on the first day of fever were similar (p = .649, .977, and .911, respectively) between the compared periods. Symptomatic infections mostly affected the respiratory system (pre-pandemic: 6% hospitalizations, pandemic: 5%) and urinary tract (pre-pandemic: 3% hospitalizations, pandemic: 2%). The duration of antibacterial treatment was significantly longer before the pandemic (p = .012). In this period, fewer hospitalizations were also associated with the administration of chemoimmunotherapy (p = .000), which is a proven risk factor for infectious complications. During the pandemic, more microorganisms were isolated from the samples (p = .036). In 2020, there were more hospitalizations with a positive rectal swab and urine culture (p = .011 and .000, respectively). However, more pathogens were isolated from nasal swabs, blood, and CVC cultures in 2019 (p = .044, .033, and .001, respectively). Furthermore, the samples revealed a higher proportion of drug-resistant strains before the pandemic (p = .000), especially regarding urine culture and pharyngeal swab (p = .025 and .055, respectively). Our study suggests that the applied COVID-19 prevention strategy impacted the prevalence and severity of NIs in our material. We demonstrated that strict isolation and extensive use of personal protective equipment could reduce the number of infections caused by pathogens with antimicrobial resistance, the duration of antibiotic therapy, and the number of deaths due to NIs in younger immunocompromised patients. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Vitamin D and nosocomial infection in patients undergoing major abdominal surgery

Vitamin D and nosocomial infection in patients undergoing major abdominal surgery

Probiotic as an adjuvant preventive treatment for ventilator associated pneumonia: an evidence-based case report

Background and objectives : Ventilator-associated pneumonia (VAP) is one of the most frequent nosocomial infections in patients requiring mechanical ventilation. It leads to prolonged duration of mechanical ventilation and ICU stay that is associated with a high rate of mortality, and the increase of healthcare burden. There have been various attempts to reduce the incidence of VAP including the use of antibiotics, but neither of these has conclusively shown to be beneficial. Probiotics have preventive effects in VAP through the suppression of pathogenic bacteria, enhancement of innate immunity, and promotion of epithelial barrier function. This study aimed to find out the efficacy of probiotic as adjuvant preventive treatment in patients with high risk of VAP.

S1244 Reduction in Nosocomial Infections in Patients With Cirrhosis During the COVID-19 Era Compared to Pre-COVID-19 Era: Impact of Masking and Restricting Visitation?

S1244 Reduction in Nosocomial Infections in Patients With Cirrhosis During the COVID-19 Era Compared to Pre-COVID-19 Era: Impact of Masking and Restricting Visitation?

Assessment of Microbiological Environment and the Level of Antibiotic Resistance in a Multidisciplinary Hospital

The objective: to determine the incidence and drug sensitivity of the main pathogens causing community-acquired and nosocomial infections in patients staying in a multidisciplinary hospital.Subjects and Methods: a retrospective study of the microbiological population in patients of a multidisciplinary hospital was carried out. The period over 3 years was assessed. 3,954 samples of biological materials from various sites were studied.Results: gram-positive bacteria prevailed in the general structure of microbial environment of patients – Staphylococcus aureus (28%), and Enterococcus faecalis (10%), as well as gram-negative – Escherichia coli (26%), and Klebsiella pneumoniae (13%). The majority of non-fermenting gram-negative microorganisms isolated from patients in the intensive care unit demonstrated multiple resistance and quantitatively prevailed over those in surgery units. The spectrum of antibiotic susceptibility of microorganisms of the same species isolated from patients of therapy and surgery departments differed.

Study on the effect of nursing management in operating room on the prevention and control of nosocomial infection in patients with gastrointestinal cancer.

article: Study on the effect of nursing management in operating room on the prevention and control of nosocomial infection in patients with gastrointestinal cancer - Minerva Gastroenterology 2022 Sep 23 - Minerva Medica - Journals

Prevalence, Clinical Profile and Risk Factors of Nosocomial Infection in Ayder Pediatric Intensive Care Unit, Tigray, Ethiopia.

BackgroundHospital-acquired infection (HAI) is a significant cause of increased morbidity and mortality amongst hospitalized patients and represents a considerable health and economic burden worldwide. However, evidence about HAI in pediatric ICU is limited.ObjectiveTo identify the prevalence of hospital-acquired infection (HAI), clinical profile, and its risk factors for nosocomial infection in patients admitted to the pediatric intensive care unit (PICU).MethodologyFrom a two-year retrospective chart review admitted from 2019 to 2020 to the PICU, 223 patients were selected by systematic random sampling. Data were analyzed in SPSS version 23.0. P-values <0.05 were considered significant for all tests.ResultsForty-five (20.2%) patients developed nosocomial infection (NI). The median age was 4 years with 25–50th IQR of (0.6–9). About invasive procedures done, the most common was nasogastric tube (57%), followed by mechanical ventilation (17.9%) and urinary catheter (13.9%). The main focus of the infection was chest (53.3%), followed by bloodstream infection (22%) and gastrointestinal infection (9%). The odds of HAI were 3.3 times higher among under-five compared to those aged between 5 and 18 years (AOR: 3.3, 95% CI = 1.4–8.0, p = 0.008). The odds of HAI were also 4.1 times higher in those who stayed for more than two weeks compared to those who stayed in the pediatric ICU 2 to 14 days (AOR: 4.1, 95% CI = 2.0–8.6, p < 0.001). The mean duration of mechanical ventilation in those patients with and without NI was 1.65 days and 13.96 days, respectively (AOR = 3.46, 95% CI = 1.44–9.81, p = 0.02). Patients who started antibiotics at admission and patients who were on nasogastric tube feeding were also statistically significant risk factors for developing NI (AOR = 2.67, 95% CI = 1.37–9.64, p = 0.02; AOR = 2.45, 95% CI = 1.64–6.53, p = 0.03).ConclusionThe rate of infection in this study was higher compared to some developing countries. Younger age and prolonged length of hospital stay were found to be significant risk factors for HAI.

Investigation of Air Quality in Medical Centers in Different Places in Basra Province, South of Iraq

To prevent nosocomial infection in patients, maintaining acceptable indoor air quality (IAQ) in medical centers (MCs) is crucial. The properties of IAQ in several medical centers were investigated in this study. The aim of this was to focus on some indoor air pollutants in different medical clinics. Models of air samples were measured inside several medical clinics in Basra province. The results of TVOC, CH2O, and PM2.5 were distributed between exceeding the standard limits and others within the standard. The results in the urban (center of Basra city) were within the legal limits for TVOC and CH2O, but the rural areas were above the legal limits in those areas. PM2.5 were above legal limits but urban sites had the highest. Healthcare workers and patients are exposed to a variety of chemicals that vary with the activities and products used. The presence and exposure of VOCs, CH2O, and PM2.5 may lead to health effects on the patient people. Variation between rural and urban sites in pollutants concentration was clear.

Development of a nomogram for predicting nosocomial infections among patients after cardiac valve replacement surgery.

To construct a predictive nomogram of the risk of nosocomial infections among patients after cardiac valve replacement surgery. Nosocomial infections are a standout challenge that worsens the prognosis of patients after valve replacement surgery. However, studies on the nomogram of nosocomial infections in these patients have remained scarce. A retrospective cohort study. Patients (n=720) following valve replacement surgery from 2018 to 2019 were selected. LASSO regression and multivariate logistic regression were utilised to ascertain predictors of nosocomial infections. The predictive performance of the nomogram was appraised by calibration and discrimination. Decision and impact curves were used to assess the clinical utility. Internal validation was implemented via 1000 bootstrap samples to mitigate overfitting. TRIPOD guidelines were used in this study. One hundred and fifty one patients (20.97%) experienced nosocomial infections following valve replacement surgery. Heart failure, preoperative anaemia, valve material, American Society of Anesthesiologists score ≥ IV, prolonged duration of surgery, duration of mechanical ventilation ≥ 24 h and indwelling nasogastric tube were predictors of nosocomial infections. Using these variables, we developed a predictive nomogram of the occurrence of nosocomial infections and the internal validation results demonstrated good discrimination and calibration of the nomogram. The clinical decision and impact curve revealed significant clinical utility. The present study constructed a nomogram for predicting the risk of nosocomial infections in patients following cardiac valve replacement surgery. This nomogram may strengthen the effective screening of patients at high risk of nosocomial infections. This risk warning tool can assist clinical staff in making decisions and providing individualised infection control measures for patients, which has a significant reference value for clinical practice. The data for this study were obtained from the hospital database, and the entire process of the study did not involve patient participation.