1
|
Hernández-Aceituno A, Vega-Costa V, Ruiz-Álvarez M, Figuerola-Tejerina A, Méndez-Hernández R, Ramasco-Rueda F. Effectiveness of a bundle of measures for reducing central line-associated bloodstream infections. ACTA ACUST UNITED AC 2020; 67:227-236. [PMID: 32216956 DOI: 10.1016/j.redar.2019.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 10/21/2019] [Accepted: 11/08/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Catheter-associated infections are the main cause of nosocomial bacteremia. The main objective of this study was to demonstrate a possible decrease in CLABSI rates in perioperative environment after the implementation of a bundle of measures. Secondary objective was to determine which factors were associated with an increased risk of CLABSI, after the implementation of the bundle. METHODS Insertion bundle consisted of: subclavian vein as access of choice, disinfection with alcoholic 2% chlorhexidine, central-line full body drapes, sterile ultrasound probe-cable covers and insertion check-list. Cumulative Incidence (CI) and Incidence Density Rate (IR) of CLABSIs were compared before and after the intervention. Associations between patient or CVC characteristic and CLABSI were summarized with odds ratios and 95% confidence interval, obtained from multiple logistic regression, adjusting for age, sex, comorbidities and days with CVC. RESULTS Before implementing the bundle, from January to November 2016, CI of CLABSI was 5.05% and IR was 5.17 ‰. In the same period of 2018, CI of CLABSI was 2.28% and IR was 2.27 ‰, which means a reduction of 54.8% in CI (P=.072) and of 56% in IR (P=.068) In multivariable analyses, replacement of CVC was associated with a higher risk of CLABSI (OR 11.01, 95%CI 2.03-59.60, P=.005), as well as 2 or more catheterizations (OR 10.05, 95%CI 1.77-57.16, P=.009), and parenteral nutrition (OR 23.37, 95%CI 4.37-124.91, P<.001). CONCLUSIONS CLABSI rates decreased after the implementation of the insertion bundle. CVC replacement, 2 or more catheterizations and parenteral nutrition were associated with CLABSI after bundle implementation.
Collapse
Affiliation(s)
- A Hernández-Aceituno
- Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario de La Princesa, Madrid, España.
| | - V Vega-Costa
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de La Princesa, Madrid, España
| | - M Ruiz-Álvarez
- Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario de La Princesa, Madrid, España
| | - A Figuerola-Tejerina
- Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario de La Princesa, Madrid, España
| | - R Méndez-Hernández
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de La Princesa, Madrid, España
| | - F Ramasco-Rueda
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario de La Princesa, Madrid, España
| |
Collapse
|
2
|
Sánchez Villar I, Lorenzo Sellares V. ¿Se infectan más los catéteres tunelizados para hemodiálisis cuando los pacientes ingresan en el hospital? ENFERMERÍA NEFROLÓGICA 2019. [DOI: 10.4321/s2254-28842019000300005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
La infección de los catéteres para hemodiálisis constituye una de las causas de mayor morbimortalidad. La hipótesis intuitiva de que los catéteres se infectan más durante la hospitalización no ha sido verificada en la literatura.
Objetivo: Conocer si la hospitalización es un factor de riesgo de bacteriemia relacionada con catéter.
Material y Método: Análisis retrospectivo de las bacteriemias asociadas a catéter durante un período de 4 años de un centro periférico extrahospitalario de hemodiálisis dependiente de un Servicio de Nefrología de un hospital de tercer nivel durante el período 2014-2017.
Se recogieron los tiempos de empleo de catéteres y las bacteriemias relacionadas con catéter divididos en 2 escenarios: Hospital y centro periférico.
Se aplicó el Modelo de Regresión de Poisson para comparar las bacteriemias Hospital vs centro periférico. Un mismo paciente pudo padecer bacteriemia más de una vez y en los dos escenarios.
Resultados: Se emplearon 361 catéteres en 174 pacientes con tiempo total de uso 91.491 días, con 103 episodios de bacteriemia.Tasas de bacteriemias: hospitalizado 7,81/1000 días/catéter y centro periférico 0,81/1000 días/catéter.
El riesgo de sufrir bacteriemia se multiplicó por 9,6 durante la hospitalización vs centro periférico (p
Collapse
|
3
|
Díaz E, Turégano C. Daily skin antisepsis and hygiene in the critically ill patient. Med Intensiva 2018; 43 Suppl 1:13-17. [PMID: 30482557 DOI: 10.1016/j.medin.2018.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/08/2018] [Accepted: 09/20/2018] [Indexed: 11/26/2022]
Abstract
Hygiene and skin care of patients admitted to the Intensive Care Unit (ICU) are part of basic care. For some years there has been evidence of skin colonization by multiresistant gramnegative and grampositive pathogens. The increase in nosocomial infections due to multiresistant microorganisms has led to evaluation of the role of the use of antiseptics, mainly chlorhexidine, as a strategy for reducing the number of such infections. This article reviews the current situation of this strategy, as well as the positioning of the authors in relation to the spreading of its use in ICUs. This article is part of a supplement entitled "Antisepsis in the critical patient", which is sponsored by Becton Dickinson.
Collapse
Affiliation(s)
- E Díaz
- Servicio de Medicina Intensiva, Hospital Universitari Parc Taulí, Sabadell, Barcelona, España.
| | - C Turégano
- Servicio de Medicina Intensiva, Hospital Universitari Parc Taulí, Sabadell, Barcelona, España
| |
Collapse
|
4
|
Hernández-Tejedor A, Peñuelas O, Sirgo Rodríguez G, Llompart-Pou J, Palencia Herrejón E, Estella A, Fuset Cabanes M, Alcalá-Llorente M, Ramírez Galleymore P, Obón Azuara B, Lorente Balanza J, Vaquerizo Alonso C, Ballesteros Sanz M, García García M, Caballero López J, Socias Mir A, Serrano Lázaro A, Pérez Villares J, Herrera-Gutiérrez M. Recommendations of the Working Groups from the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) for the management of adult critically ill patients. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.medine.2017.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
5
|
Recommendations of the Working Groups from the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) for the management of adult critically ill patients. Med Intensiva 2017; 41:285-305. [PMID: 28476212 DOI: 10.1016/j.medin.2017.03.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/25/2017] [Accepted: 03/11/2017] [Indexed: 12/14/2022]
Abstract
The standardization of the Intensive Care Medicine may improve the management of the adult critically ill patient. However, these strategies have not been widely applied in the Intensive Care Units (ICUs). The aim is to elaborate the recommendations for the standardization of the treatment of critical patients. A panel of experts from the thirteen working groups (WG) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) was selected and nominated by virtue of clinical expertise and/or scientific experience to carry out the recommendations. Available scientific literature in the management of adult critically ill patients from 2002 to 2016 was extracted. The clinical evidence was discussed and summarised by the experts in the course of a consensus finding of every WG and finally approved by the WGs after an extensive internal review process that was carried out between December 2015 and December 2016. A total of 65 recommendations were developed, of which 5 corresponded to each of the 13 WGs. These recommendations are based on the opinion of experts and scientific knowledge, and are intended as a guide for the intensivists in the management of critical patients.
Collapse
|
6
|
Llauradó-Serra M, Güell-Baró R, Castanera-Duro A, Sandalinas I, Argilaga E, Fortes-Del Valle ML, Jiménez-Herrera MF, Bordonado-Pérez L, Fuentes-Pumarola C. [Barriers and motivations of nurses for conducting research in Intensive Care Units and Emergency Medical Service]. ENFERMERIA INTENSIVA 2016; 27:146-154. [PMID: 27542686 DOI: 10.1016/j.enfi.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 05/09/2016] [Accepted: 05/24/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The implementation of evidence based practice is essential in clinical practice. However, it is still a challenge in critical care patients. AIM To identify the barriers for conducting research that nursing professionals perceive in intensive care and medical emergency departments, as well as to investigate the areas of interest and motivations to carry out research projects. METHOD Cross-sectional and multicentre study carried out in 4 intensive care units and in one Medical Emergency Department emergency pre-hospital carein Catalonia on 2014. The instrument used was The Barriers to Research Utilization Scale which had been previously validated into Spanish. A descriptive and bivariate analysis was performed. A statistical significance of P<.05 was assumed. RESULTS One hundred seventy-two questionnaires were obtained (69.9% response). Of the total, 135 were from critical care, 27 to pre-hospital care, and 10 from both. Just over half (57.3%) had research experience, although 44.4% had related training. The questionnaire dimension considered most relevant was organisational characteristics. The most important barriers were: there is not enough time at work [3.11 (SD 1.21)], physicians do not collaborate in its implementation [2.99 (SD 1.22)], and nurses are isolated with respect to other professionals [2.86 (SD 1.32)]. Significant differences were observed in the barriers according to research experience and work place. The main motivation was to be updated in critical patient care. CONCLUSIONS The main barriers perceived are related to the organisation. There are differences in the barriers according to research experience and work place.
Collapse
Affiliation(s)
- M Llauradó-Serra
- Departament d'Infermeria, Universitat Rovira i Virgili, Tarragona, España
| | - R Güell-Baró
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, España; Unidad de Cuidados Intensivos, Hospital Universitari Joan XXIII de Tarragona, Tarragona, España
| | - A Castanera-Duro
- Unidad de Cuidados Intensivos, Hospital Universitari Dr. Josep Trueta de Girona, Girona, España; Departament d'Infermeria, Universitat de Girona, Girona, España
| | - I Sandalinas
- Unidad de Cuidados Intensivos, Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, España
| | - E Argilaga
- Unidad de Cuidados Intensivos, Hospital Universitari de Bellvitge, L' Hospitalet de Llobregat, Barcelona, España
| | - M L Fortes-Del Valle
- Unidad de Cuidados Intensivos, Hospital Universitari Joan XXIII de Tarragona, Tarragona, España
| | | | - L Bordonado-Pérez
- Unidad de Cuidados Intensivos, Hospital Universitari Joan XXIII de Tarragona, Tarragona, España
| | | | | |
Collapse
|
7
|
Cuzco Cabellos C, Guasch Pomés N. [Application and evalauation of care plan for patients admitted to Intensive Care Units]. ENFERMERIA INTENSIVA 2015; 26:137-43. [PMID: 26340906 DOI: 10.1016/j.enfi.2015.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 06/15/2015] [Accepted: 07/05/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Assess whether the use of the nursing care plans improves outcomes of nursing care to patients admitted to the intensive care unit (ICU). METHODS The study was conducted in a University Hospital of Barcelona in Spain, using a pre- and post-study design. A total of 61 patient records were analysed in the pre-intervention group. A care plan was applied to 55 patients in the post-intervention group. Specific quality indicators in a medical intensive care unit to assess the clinical practice of nursing were used. Fisher's exact test was used to compare the degree of association between quality indicators in the two groups. RESULTS A total of 116 records of 121 patients were evaluated: 61 pre-intervention and 55 post-intervention. Fisher test: The filling of nursing records, p=.0003. Checking cardiorespiratory arrest equipment, p <.001. Central vascular catheter related bacteraemia (B-CVC) p=.622. Ventilator associated pneumonia (VAP) p=.1000. Elevation of the head of the bed more than 30° p=.049, and the pain management in non-sedated patients p=.082. CONCLUSIONS The implementation of nursing care plans in patients admitted to the intensive care area may contribute to improvement in the outcomes of nursing care.
Collapse
Affiliation(s)
- C Cuzco Cabellos
- Diplomada en Enfermería, Máster Oficial Enfermo Crítico y Emergencias, Área de Vigilancia Intensiva, Hospital Clínic de Barcelona, Barcelona, España.
| | - N Guasch Pomés
- Coordinadora Asistencial de Enfermería, Máster Oficial Enfermo Crítico y Emergencias, Área de Vigilancia Intensiva Hospital Clínic de Barcelona, Barcelona, España
| |
Collapse
|
8
|
Abstract
The nationwide Bacteremia Zero (BZ) Project consists in the simultaneous implementation of measures to prevent central venous catheter-related bacteremia (CVC-B) in critically ill patients and in the development of an integral safety plan. The objective is to present the results obtained after the implementation of the BZ project in the ICUs of the Autonomous Community of Catalonia, Spain. All patients admitted to ICUs in Catalonia participating in the ENVIN-HELICS registry between January 2009 and June 2010 were included. Information was provided by 36 (92.3%) of the total possible 39 ICUs. A total of 281 episodes of CVC-B were diagnosed (overall rate of 2.53 episodes per 1000 days of CVC). The rates have varied significantly between ICUs that participated in the project for more or less than 12 months (2.17 vs. 4.27 episodes per 1000 days of CVC, respectively; p<.0001). The implementation of the BZ Project in Catalonia has been associated with a decrease greater than 40% in the CVC-B rates in the ICUs of this community, which is much higher than the initial objective of 4 episodes per 1000 days of CVC).
Collapse
|
9
|
A Prevalence Survey of Intravascular Catheter use in a General Hospital. J Vasc Access 2014; 15:524-8. [DOI: 10.5301/jva.5000272] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 11/20/2022] Open
Abstract
Purpose Survey of intravascular catheter management is an essential step in the control and prevention of catheter-related infection. In recent years, most surveillance studies only included catheters from intensive care units (ICUs). Data regarding the level of care and adherence to international guidelines in a whole general institution are scarce. Our objective was to evaluate the care situation of intravascular catheters in our adult units of a General Hospital. Methods We surveyed adults hospitalized in non-psychiatric/maternity wards. In a week, a nurse visited all the adult hospitalized patients. Data were registered in a protocol that included variables, such as no. of catheters, location of catheter, type of catheter, date of placement and the need of an indication of each catheter in the visit day. Results We included in the study a total of 753 adult patients. Of them, 653 (86.7%) had one or more inserted catheters at the moment of the study visit (total: 797 catheters). Of all the catheters, 144 (18.0%) were central venous catheters and 653 (81.9%) were peripheral lines. The hospitalization units where the patients were admitted were ICU, 52 (6.9%); and non-ICU, 601 (92.0%). There were 183 (22.9%) catheters with no need to remain in place in the day of the study. Overall, we found 464 (71.0%) patients with one or more opportunities for catheter care improvement. Conclusions A rapid survey of the care situation of intravascular catheters is feasible and easy to do with our methodology. The data show great opportunity for improvement, mainly in the non-ICU areas.
Collapse
|
10
|
Pérez-Granda MJ, Barrio JM, Muñoz P, Hortal J, Rincón C, Rabadán PM, Pernia MS, Bouza E. Ethanol lock therapy (E-Lock) in the prevention of catheter-related bloodstream infections (CR-BSI) after major heart surgery (MHS): a randomized clinical trial. PLoS One 2014; 9:e91838. [PMID: 24675993 PMCID: PMC3967996 DOI: 10.1371/journal.pone.0091838] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 02/14/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Lock-therapy with antimicrobials has been used for the treatment and prevention of catheter-related bloodstream infections (CR-BSI). Experiences with Ethanol-Locks (E-locks) have included therapeutic interventions with variable results. Patients undergoing Major Heart Surgery (MHS) are a high-risk population for CR-BSI.The aim of this study was to assess the efficacy and tolerance to E-Locks in the prevention of CR-BSI of patients undergoing MHS. METHODS AND FINDINGS This is an academic, prospective, randomized, non-blinded and controlled clinical trial assessing the incidence of CR-BSI of patients with E-locks (E-lock) and the tolerance to the procedure in comparison with patients receiving conventional catheter-care (CCC). Patients undergoing MHS with intravascular catheters for more than 48 hours were randomly assigned into treatment or control group by a computer-generated list of randomly assigned numbers. In the treatment group, all their catheter lumens were locked with an ethanol solution at 70% for two hours, every three days (E-Locks). The control group received conventional catheter-care (CCC). Overall, 200 patients with 323 catheters were included in the study, which was stopped after 10 months due to adverse events. Of them, 179 catheters (113 patients) had E-Locks and 144 catheters (87 patients) were CCC. Euroscore Surgical Risk in both groups was 4.04 vs 4.07 p = 0.94 respectively. The results for the E-Locks and CCC were as follows: Incidence of CR-BSI/1000 days of exposure 2.1 vs 5.2 (p = 0.33), catheter tip colonization 14 (7.8%) vs 6 (4.2%) patients (p = 0.17), median length of hospital stay, 15 vs 16 days (p = 0.77). Seven patients (6.19%), all in the ethanol branch, had to discontinue the trial due to intolerance or adverse events. CONCLUSIONS We do not recommend prophylaxis of CR-BSI with ethanol-lock on a routine basis in patients undergoing Major Heart Surgery. TRIAL REGISTRATION Clinical Trials.gov NCT01229592.
Collapse
Affiliation(s)
- María Jesús Pérez-Granda
- Department of Anesthesiology, School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
- * E-mail: (MJPG); (PM)
| | - José María Barrio
- Department of Anesthesiology, School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| | - Patricia Muñoz
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Universidad Complutense, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
- * E-mail: (MJPG); (PM)
| | - Javier Hortal
- Department of Anesthesiology, School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| | - Cristina Rincón
- Department of Anesthesiology, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Pablo Martin Rabadán
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Universidad Complutense, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| | - Maria Sagrario Pernia
- Department of Pharmacy, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Universidad Complutense, Madrid, Spain
- Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain
- Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain
| |
Collapse
|
11
|
Terapia secuencial con medicamentos. Conversión de la vía intravenosa a la vía oral. ¿Una buena estrategia para disminuir la bacteriemia relacionada con catéter? Med Intensiva 2014; 38:99-103. [DOI: 10.1016/j.medin.2013.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 09/11/2013] [Accepted: 09/14/2013] [Indexed: 11/23/2022]
|
12
|
Curiel Balsera E, Joya Montosa C, Trujillo García E, Martinez Gonzalez MC, Molina Diaz H. [Daily evaluation of the FASTHUG protocol and short-term outcomes]. Med Intensiva 2013; 38:393-4. [PMID: 24199990 DOI: 10.1016/j.medin.2013.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 08/27/2013] [Accepted: 09/04/2013] [Indexed: 12/21/2022]
Affiliation(s)
- E Curiel Balsera
- Unidad de Cuidados Críticos y Urgencias, Hospital Regional Universitario Carlos Haya, Málaga, España.
| | - C Joya Montosa
- Unidad de Cuidados Críticos y Urgencias, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - E Trujillo García
- Unidad de Cuidados Críticos y Urgencias, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - M C Martinez Gonzalez
- Unidad de Cuidados Críticos y Urgencias, Hospital Regional Universitario Carlos Haya, Málaga, España
| | - H Molina Diaz
- Unidad de Cuidados Críticos y Urgencias, Hospital Regional Universitario Carlos Haya, Málaga, España
| |
Collapse
|
13
|
Catéteres de arteria y de vena femoral: complicaciones relacionadas con su inserción y alternativas técnicas para evitarlas. Med Intensiva 2013; 37:369-71. [DOI: 10.1016/j.medin.2013.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 03/22/2013] [Indexed: 11/19/2022]
|
14
|
Pemán J, Salavert M. [Epidemiology and prevention of nosocomial invasive infections by filamentous fungi and yeasts]. Enferm Infecc Microbiol Clin 2013; 31:328-41. [PMID: 23561595 DOI: 10.1016/j.eimc.2013.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 02/05/2013] [Indexed: 10/27/2022]
Abstract
Knowledge of the epidemiology of invasive fungal diseases in health care settings helps to establish the action levels necessary for its prevention. A first step is to identify groups of patients at high risk of invasive fungal diseases, establish accurate risk factors, observing the periods of greatest risk, and analyze the epidemiological profile in genera and species, as well as the patterns of antifungal resistance. Secondly, mechanisms to avoid persistent exposure to potential fungal pathogens must be established, protecting areas and recommending measures, such as the control of the quality of the air and water inside and outside the hospital, and determining and promoting appropriate architectural designs of health institutions. Finally, apart from the correct implementation of these measures, the use of antifungal prophylaxis should be considered in selected patients at very high risk, following the guidelines published.
Collapse
Affiliation(s)
- Javier Pemán
- Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | | |
Collapse
|
15
|
Pujol M, Limón E. Epidemiología general de las infecciones nosocomiales. Sistemas y programas de vigilancia. Enferm Infecc Microbiol Clin 2013; 31:108-13. [DOI: 10.1016/j.eimc.2013.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 01/08/2013] [Indexed: 01/04/2023]
|
16
|
|
17
|
Padrón Ruiz OM, Ojeda Betancor N, Morales López L, Rodríguez Pérez A. [Venous catheter-related infections]. ACTA ACUST UNITED AC 2012; 60:215-25. [PMID: 23141206 DOI: 10.1016/j.redar.2012.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 09/04/2012] [Indexed: 11/15/2022]
Abstract
Central venous catheter-related infections can lead to a substantial increase in morbidity and mortality in patients. Nowadays, with the increase in multi-resistant bacteria, the recent appearance of new antibiotics, and the development of new treatment guidelines, means that this has to be constantly reviewed. The objective of this review is to briefly define the epidemiological and pathogenic concepts and to look in detail at the preventive and therapeutic measures of this type of infection. Practical aspects are presented of different clinical situations such as, antibiotic-lock of the central venous catheter, and the withdrawal or maintenance of the catheter.
Collapse
Affiliation(s)
- O M Padrón Ruiz
- Servicio de Anestesiología, Reanimación y Terapia del dolor, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, España
| | | | | | | |
Collapse
|
18
|
Lorente L. [Conservative methods for diagnosing catheter-associated bacteremia]. Med Intensiva 2012; 36:163-8. [PMID: 22386333 DOI: 10.1016/j.medin.2011.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 12/25/2011] [Indexed: 11/18/2022]
|
19
|
García Araguas T, Irigoyen Aristorena I, Zazpe Oyarzun C, Baztán Madoz B, Barado Hugalde J. Evaluación de un programa de prevención de neumonía asociada a ventilación mecánica (NAVM): resultados al año. ENFERMERIA INTENSIVA 2012; 23:4-10. [DOI: 10.1016/j.enfi.2011.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 12/11/2011] [Accepted: 12/13/2011] [Indexed: 11/29/2022]
|