1
|
Baral R, Tuladhar R, Manandhar S, Singh A, Sherchan S. Detection of bla KPC gene among carbapenemase producing Klebsiella pneumoniae isolated from different clinical specimens at tertiary care hospital of Nepal. BMC Microbiol 2024; 24:144. [PMID: 38664608 PMCID: PMC11044503 DOI: 10.1186/s12866-024-03301-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Klebsiella pneumoniae infections have become a major cause of hospital acquired infection worldwide with the increased rate of acquisition of resistance to antibiotics. Carbapenem resistance mainly among Gram negative is an ongoing problem which causes serious outbreaks dramatically limiting treatment options. This prospective cross-sectional study was designed to detect blaKPC gene from carbapenem resistant K. pneumoniae. MATERIALS AND METHODS A totally of 1118 different clinical specimens were screened and confirmed for KPC producing K. pneumoniae phenotypically using Meropenem (10 μg) disc. The blaKPC gene was amplified from the isolates of K. pneumoniae to detect the presence of this gene. RESULT Of the total samples processed, 18.6% (n = 36) were K. pneumoniae and among 36 K. pneumoniae, 61.1% (n = 22/36) were meropenem resistant. This study demonstrated the higher level of MDR 91.7% (n = 33) and KPC production 47.2% (n = 17) among K. pneumoniae isolates. The blaKPC gene was detected in 8.3% (n = 3) of meropenem resistant isolates. CONCLUSION Since the study demonstrates the higher level of MDR and KPC producing K. pneumoniae isolates that has challenged the use of antimicrobial agents, continuous microbiology, and molecular surveillance to assist early detection and minimize the further dissemination of blaKPC should be initiated. We anticipate that the findings of this study will be useful in understanding the prevalence of KPC-producing K. pneumoniae in Nepal.
Collapse
Affiliation(s)
- Rakshya Baral
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.
- Department of Biology, Morgan State University, Baltimore, USA.
| | - Reshma Tuladhar
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Sarita Manandhar
- Department of Microbiology, Tri-Chandra Multiple Campus, Tribhuvan University, Kathmandu, Nepal
| | - Anjana Singh
- Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal
| | - Samendra Sherchan
- Department of Biology, Morgan State University, Baltimore, USA
- Department of Environmental Health Sciences, Tulane University, New Orleans, USA
| |
Collapse
|
2
|
Weerakoon BS, Chandrasiri NR. Knowledge and practice of infection control during radiology procedures among radiography undergraduates in Sri Lanka. J Med Imaging Radiat Sci 2023; 54:620-626. [PMID: 37516554 DOI: 10.1016/j.jmir.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/08/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION Sufficient knowledge and adherence to infection control measures are essential for healthcare workers to effectively combat healthcare-associated infections (HCAIs). Radiography undergraduates should stay updated and proficient in their infection control practice. This study aimed to assess knowledge and practice of infection control measures during radiological procedures among radiography undergraduates in Sri Lanka. METHOD A web-based, descriptive, self-administered, cross-sectional study was conducted. The questionnaire collected data on demographic, knowledge and practice related to infection control measures from radiography undergraduates. RESULTS A total of 167 radiography undergraduates returned the completed questionnaire. The majority (88%) have never participated in infection control programs. The mean knowledge and practice scores were 58% and 41.1%, indicating moderate and poor levels, respectively. A significant difference was observed in the overall knowledge of infection control when considering the academic year (p = 0.001) and the duration of clinical exposure (p = 0.01). There was no significant difference between practice and gender, age, ethnicity, academic year and duration of clinical exposure (p > 0.05). CONCLUSIONS The results of this study indicate that knowledge of nosocomial infection was moderate and practice was inadequate among most of the radiography students surveyed. This highlights the need to reassess the educational components of radiography programs to incorporate practical and comprehensive teaching, learning and monitoring of infection control measures.
Collapse
Affiliation(s)
- Bimali Sanjeevani Weerakoon
- Department of Radiography/ Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka.
| | - Nishadi Rangana Chandrasiri
- Department of Radiography/ Radiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| |
Collapse
|
3
|
Konno A, Okubo T, Enoeda Y, Uno T, Sato T, Yokota SI, Yano R, Yamaguchi H. Human pathogenic bacteria on high-touch dry surfaces can be controlled by warming to human-skin temperature under moderate humidity. PLoS One 2023; 18:e0291765. [PMID: 37729194 PMCID: PMC10511134 DOI: 10.1371/journal.pone.0291765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
Healthcare-associated infections have become a major health issue worldwide. One route of transmission of pathogenic bacteria is through contact with "high-touch" dry surfaces, such as handrails. Regular cleaning of surfaces with disinfectant chemicals is insufficient against pathogenic bacteria and alternative control methods are therefore required. We previously showed that warming to human-skin temperature affected the survival of pathogenic bacteria on dry surfaces, but humidity was not considered in that study. Here, we investigated environmental factors that affect the number of live bacteria on dry surfaces in hospitals by principal component analysis of previously-collected data (n = 576, for CFU counts), and experimentally verified the effect of warming to human-skin temperature on the survival of pathogenic bacteria on dry surfaces under humidity control. The results revealed that PCA divided hospital dry surfaces into four groups (Group 1~4) and hospital dry surfaces at low temperature and low humidity (Group 3) had much higher bacterial counts as compared to the others (Group 1 and 4) (p<0.05). Experimentally, warming to human-skin temperature (37°C with 90% humidity) for 18~72h significantly suppressed the survival of pathogenic bacteria on dry surfaces, such as plastic surfaces [p<0.05 vs. 15°C (Escherichia coli DH5α, Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumannii, and blaNDM-5 E. coli)] or handrails [p<0.05 vs. 15~25°C (E. coli DH5α, S. aureus, P. aeruginosa, A. baumannii)], under moderate 55% humidity. Furthermore, intermittent heating to human-skin temperature reduced the survival of spore-forming bacteria (Bacillus subtilis) (p<0.01 vs. continuous heating to human-skin temperature). NhaA, an Na+/H+ antiporter, was found to regulate the survival of bacteria on dry surfaces, and the inhibitor 2-aminoperimidine enhanced the effect of warming at human-skin temperature on the survival of pathogenic bacteria (E. coli DH5α, S. aureus, A. baumannii) on dry surfaces. Thus, warming to human-skin temperature under moderate humidity is a useful method for impairing live pathogenic bacteria on high-touch surfaces, thereby helping to prevent the spread of healthcare-associated infections.
Collapse
Affiliation(s)
- Ayano Konno
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Torahiko Okubo
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Yoshiaki Enoeda
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Tomoko Uno
- Department of Nursing, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan
- Faculty of Health Sciences, Department of Fundamental Nursing, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Toyotaka Sato
- Department of Microbiology, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan
- Faculty of Veterinary Medicine, Laboratory of Veterinary Hygiene, Hokkaido University, Kita-ku, Sapporo, Japan
- Graduate School of Infectious Diseases, Hokkaido University, Kita-ku, Sapporo, Japan
- One Health Research Center, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Shin-ichi Yokota
- Department of Microbiology, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan
| | - Rika Yano
- Faculty of Health Sciences, Department of Fundamental Nursing, Hokkaido University, Kita-ku, Sapporo, Japan
| | - Hiroyuki Yamaguchi
- Faculty of Health Sciences, Department of Medical Laboratory Science, Hokkaido University, Kita-ku, Sapporo, Japan
| |
Collapse
|
4
|
Sukumar S, Saha S, Dkhar W, Panakkal NC, Nair VT, Bommasamudram T, Vaishali K, Nagaraja R, Ravichandran S, Kadavigere R. Knowledge of Medical Imaging Professionals on Healthcare-Associated Infections: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4326. [PMID: 36901340 PMCID: PMC10001984 DOI: 10.3390/ijerph20054326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Healthcare-associated infections (HCAIs) are a significant concern for both healthcare professionals and patients. With recent advances in imaging modalities, there is an increase in patients visiting the radiology department for diagnosis and therapeutic examination. The equipment used for the investigator is contaminated, which may result in HCAIs to the patients and healthcare professionals. Medical imaging professionals (MIPs) should have adequate knowledge to overcome the spread of infection in the radiology department. This systematic review aimed to examine the literature on the knowledge and precaution standard of MIPs on HCIAs. This study was performed with a relative keyword using PRISMA guidelines. The articles were retrieved from 2000 to 2022 using Scopus, PubMed, and ProQuest databases. The NICE public health guidance manual was used to assess the quality of the full-length article. The search yielded 262 articles, of which Scopus published 13 articles, PubMed published 179 articles, and ProQuest published 55 articles. In the present review, out of 262 articles, only 5 fulfilled the criteria that reported MIPs' knowledge of Jordan, Egypt, Sri Lanka, France, and Malawi populations. The present review reported that MIPs have moderate knowledge and precautionary standards regarding HCIAs in the radiology department. However, due to the limited studies published in the literature, the current review limits the application of the outcome in the vast MIPs population. This review recommended further studies to be conducted among the MIPs worldwide to know the actual knowledge and precaution standards regarding HCIAs.
Collapse
Affiliation(s)
- Suresh Sukumar
- Department of Medical Imaging Technology, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Shovan Saha
- Department of Occupational Therapy, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Winniecia Dkhar
- Department of Medical Imaging Technology, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Nitika C. Panakkal
- Department of Medical Imaging Technology, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Visakh Thrivikraman Nair
- Department of Medical Imaging Technology, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Tulasiram Bommasamudram
- Department of Exercise and Sports Sciences, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - K Vaishali
- Department of Physiotherapy, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Ravishankar Nagaraja
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi 110021, India
| | - Sneha Ravichandran
- Department of Medical Imaging Technology, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| | - Rajagopal Kadavigere
- Department of Radiodiagnosis and Imaging, Kasturba Medical College (KMC), Manipal Academy of Higher Education (MAHE), Manipal 576104, India
| |
Collapse
|
5
|
Healthcare-Associated Infections (HAIs): Challenges and Measures Taken by the Radiology Department to Control Infection Transmission. Vaccines (Basel) 2022; 10:vaccines10122060. [PMID: 36560470 PMCID: PMC9781912 DOI: 10.3390/vaccines10122060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Infections contracted during healthcare delivery in a hospital or ambulatory setting are collectively referred to as healthcare-associated infections (HAIs). Healthcare workers and patients alike are vulnerable to serious problems as a result of the risk of HAIs. In the healthcare system, HAIs are considered among the most common and serious health problems. However, the occurrence of HAIs differs between different types of clinical departments within the hospital. Recently, the risk of HAIs has been increasing in radiology departments globally due to the central role of radiology in guiding clinical decisions for the diagnosis, treatment, and monitoring of different diseases from almost all medical specialties. The radiology department is particularly vulnerable to HAIs because it serves as a transit hub for infected patients, non-infected patients, and healthcare workers. Furthermore, as the number of patients referred to radiology and the length of patient contact time has increased, thanks to modern imaging techniques such as computed tomography and magnetic resonance imaging, the risk of HAIs has also increased significantly. With the increasing use of interventional radiological procedures, patients and healthcare workers face a potentially greater risk of contracting HAIs due to the invasive nature of such procedures. Although not exhaustive, we attempted through a literature search to provide a general overview of infection prevention and control practices, address HAIs in the radiology departments, and highlight the challenges and measures taken to control infection transmission in the radiology departments.
Collapse
|
6
|
Bastos LR, Almeida MM, Marques EA, Leão RS. Colonização pré-operatória por Staphylococcus aureus e as bactérias não suscetíveis à cefalosporina, em pacientes com fratura proximal do fêmur. Rev Bras Ortop 2022; 57:726-733. [PMID: 36226207 PMCID: PMC9550373 DOI: 10.1055/s-0041-1735546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/07/2021] [Indexed: 11/30/2022] Open
Abstract
Objective
To estimate the frequency of
Staphylococcus aureus
and cephalosporin nonsusceptible bacteria colonization in patients with proximal femoral fracture during preoperative hospitalization.
Methods
Prevalence and incidence assessment in 63 hospitalized patients over 1 year. The median time of pretreatment hospitalization was 12 days. Samples were collected from the nostrils, groin skin and anal mucosa during the pretreatment hospitalization and were tested by the disc-diffusion technique.
Results
The hospital colonization incidence and the prevalence of positive results were 14.3 and 44.4% for
S. aureus
; 3.2 and 6.4% for meticillin-resistant
S. aureus
; 28.6 and 85.7% for meticillin-resistant coagulase-negative
Staphylococcus
; 28.6 and 61.9% for cefazolin nonsusceptible
Enterobacteriaceae
(KFNSE); and 20.6 and 28.6% for cefuroxime nonsusceptible
Enterobacteriaceae
(CXNSE). In addition, factors such as to the duration of the pretreatment hospitalization period, being non-walker before fracture, antimicrobial use, American Society of Anesthesiologists (ASA) 4 surgical risk, and previous hospitalization, were related to an increase in the incidence of hospital acquisition and prevalence of colonization by the evaluated strains. The prevalence of colonization by KFNSE was three times higher than by CXNSE on admission, and twice as high at the time of fracture treatment.
Conclusion
There was a high incidence of hospital colonization and prevalence of colonization by all strains studied, which may guide the indication of prophylactic measures for infection.
Collapse
Affiliation(s)
- Leonardo R. Bastos
- Seção de Ortopedia e Traumatologia, Hospital Geral de Fortaleza/Exército Brasileiro, Fortaleza, CE, Brasil
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
| | - Mila M. Almeida
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
| | - Elizabeth A. Marques
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
| | - Robson Souza Leão
- Departamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ, Brasil
- Laboratórios de Bacteriologia e Micobactérias, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
7
|
Kultanova E, Severo M, Turmukhambetova A. Knowledge And Judgments About Standard Precautions For Nosocomial Infection: Comparative Analysis Of Medical Vs. Non-Medical Students. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background — Nosocomial infection (NI) is among the most common and serious challenges in a healthcare system. Health workers and medical students play an important role in prevention of NI. Despite advances in the field of medicine in Kazakhstan, low detection rate of NIs remains unchanged, which could be due to a lack of awareness of the standard precautions for infection control among medical students and health workers. This study is aimed at examining knowledge and judgments on NIs among medical and non-medical students. Material and Methods — We conducted a cross-sectional paper-based survey to examine the knowledge and judgments about the standard precautions for NI among medical and non-medical students. Data collection took place between September 21 and December 20, 2017. Results — The study enrolled 2,817 students. The mean overall score (±SD) was 2.045±1.29. Medical students had a better mean overall score (2.113) than non-medical students (1.785; p<0.001). Awareness of the standard preventive measures was increasing with a year of study, but still just one-third of year 5 medical students were aware of standard prevention (36.3% vs. 17.4% for non-medical students; p<0.001). Conclusion — The overall score of our survey indicated inadequate knowledge and awareness of the guidelines on infection prevention and control among both medical and non-medical students. In order to improve patient safety and welfare, the courses on infection control should be introduced into the curricular of medical universities in Kazakhstan.
Collapse
|
8
|
Barchitta M, Maugeri A, Favara G, Riela PM, Gallo G, Mura I, Agodi A. A machine learning approach to predict healthcare-associated infections at intensive care unit admission: findings from the SPIN-UTI project. J Hosp Infect 2021; 112:77-86. [PMID: 33676936 DOI: 10.1016/j.jhin.2021.02.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/27/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Identifying patients at higher risk of healthcare-associated infections (HAIs) in intensive care units (ICUs) represents a major challenge for public health. Machine learning could improve patient risk stratification and lead to targeted infection prevention and control interventions. AIM To evaluate the performance of the Simplified Acute Physiology Score (SAPS) II for HAI risk prediction in ICUs, using both traditional statistical and machine learning approaches. METHODS Data for 7827 patients from the 'Italian Nosocomial Infections Surveillance in Intensive Care Units' project were used in this study. The Support Vector Machines (SVM) algorithm was applied to classify patients according to sex, patient origin, non-surgical treatment for acute coronary disease, surgical intervention, SAPS II at admission, presence of invasive devices, trauma, impaired immunity, and antibiotic therapy in 48 h preceding ICU admission. FINDINGS The performance of SAPS II for predicting HAI risk provides a receiver operating characteristic curve with an area under the curve of 0.612 (P<0.001) and accuracy of 56%. Considering SAPS II along with other characteristics at ICU admission, the SVM classifier was found to have accuracy of 88% and an AUC of 0.90 (P<0.001) for the test set. The predictive ability was lower when considering the same SVM model but with the SAPS II variable removed (accuracy 78%, AUC 0.66). CONCLUSIONS This study suggested that the SVM model is a useful tool for early prediction of patients at higher risk of HAIs at ICU admission.
Collapse
Affiliation(s)
- M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI (Italian Study Group of Hospital Hygiene), Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - A Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI (Italian Study Group of Hospital Hygiene), Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - G Favara
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - P M Riela
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - G Gallo
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - I Mura
- GISIO-SItI (Italian Study Group of Hospital Hygiene), Italian Society of Hygiene, Preventive Medicine and Public Health, Italy; Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; GISIO-SItI (Italian Study Group of Hospital Hygiene), Italian Society of Hygiene, Preventive Medicine and Public Health, Italy.
| | | |
Collapse
|
9
|
Barchitta M, Maugeri A, Favara G, Riela PM, La Mastra C, La Rosa MC, San Lio RM, Gallo G, Mura I, Agodi A. Cluster analysis identifies patients at risk of catheter-associated urinary tract infections in intensive care units: findings from the SPIN-UTI Network. J Hosp Infect 2020; 107:57-63. [PMID: 33017617 DOI: 10.1016/j.jhin.2020.09.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/01/2020] [Accepted: 09/26/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although preventive strategies have been proposed against catheter-associated urinary tract infections (CAUTIs) in intensive care units (ICUs), more efforts are needed to control the incidence rate. AIM To distinguish patients according to their characteristics at ICU admission, and to identify clusters of patients at higher risk for CAUTIs. METHODS A two-step cluster analysis was conducted on 9656 patients from the Italian Nosocomial Infections Surveillance in Intensive Care Units project. FINDINGS Three clusters of patients were identified. Type of admission, patient origin and administration of antibiotics had the greatest weight on the clustering model. Cluster 1 comprised more patients with a medical type of ICU admission who came from the community. Cluster 2 comprised patients who were more likely to come from other wards/hospitals, and to report administration of antibiotics 48 h before or after ICU admission. Cluster 3 was similar to Cluster 2 but was characterized by a lower percentage of patients with administration of antibiotics 48 h before or after ICU admission. Patients in Clusters 1 and 2 had a longer duration of urinary catheterization [median 7 days, interquartile range (IQR) 12 days for Cluster 1; median 7 days, IQR 11 days for Cluster 2] than patients in Cluster 3 (median 6 days, IQR 8 days; P<0.001). Interestingly, patients in Cluster 1 had a higher incidence of CAUTIs (3.5 per 100 patients) compared with patients in the other two clusters (2.5 per 100 patients in both clusters; P=0.033). CONCLUSION To the authors' knowledge, this is the first study to use cluster analysis to identify patients at higher risk of CAUTIs who could gain greater benefit from preventive strategies.
Collapse
Affiliation(s)
- M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; Italian Study Group of Hospital Hygiene, Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - A Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; Italian Study Group of Hospital Hygiene, Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
| | - G Favara
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - P M Riela
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - C La Mastra
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - M C La Rosa
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - R Magnano San Lio
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - G Gallo
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - I Mura
- Italian Study Group of Hospital Hygiene, Italian Society of Hygiene, Preventive Medicine and Public Health, Italy; Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy; Italian Study Group of Hospital Hygiene, Italian Society of Hygiene, Preventive Medicine and Public Health, Italy.
| |
Collapse
|
10
|
Sustained reduction of healthcare-associated infections after the introduction of a bundle for prevention of ventilator-associated pneumonia in medical-surgical intensive care units. Braz J Infect Dis 2020; 24:373-379. [PMID: 32949494 PMCID: PMC9392082 DOI: 10.1016/j.bjid.2020.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 08/10/2020] [Accepted: 08/20/2020] [Indexed: 11/21/2022] Open
Abstract
Background Infection control interventions can be erroneously interpreted if outcomes are assessed in short periods. Also, statistical methods usually applied to compare outcomes before and after interventions are not appropriate for analyzing time series. Aims To analyze the impact of a bundle directed at reducing the incidence of ventilator-associated pneumonia (VAP) and other device-associated infections in two medical-surgical intensive care units (ICU) in Brazil. Methods Our study had a quasi-experimental design. Interrupted time series analyses (ITS) was performed assessing monthly rates of overall healthcare-associated infections (HCAI), VAP, laboratory-confirmed central line associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI), from January 2007 through June 2019. Moreover, multivariate ITS was adjusted for seasonality in Poisson regression models. An intervention based on a bundle for VAP prevention was introduced in August 2010. Findings The intervention was followed by sustained reduction in overall HCAI, VAP and CLABSI in both ICU. Continuous post-intervention trends towards reduction were detected for overall HCAI and VAP. Conclusion Interventions aimed at preventing one specific site of infection may have sustained impact on other HCAI, which can be documented using time series analyses.
Collapse
|
11
|
Palmieri PA, Leyva-Moral JM, Camacho-Rodriguez DE, Granel-Gimenez N, Ford EW, Mathieson KM, Leafman JS. Hospital survey on patient safety culture (HSOPSC): a multi-method approach for target-language instrument translation, adaptation, and validation to improve the equivalence of meaning for cross-cultural research. BMC Nurs 2020; 19:23. [PMID: 32308560 PMCID: PMC7153229 DOI: 10.1186/s12912-020-00419-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 03/31/2020] [Indexed: 12/03/2022] Open
Abstract
Background The Hospital Survey on Patient Safety Culture (HSOPSC) is widely utilized in multiple languages across the world. Despite culture and language variations, research studies from Latin America use the Spanish language HSOPSC validated for Spain and the United States. Yet, these studies fail to report the translation method, cultural adaptation process, and the equivalence assessment strategy. As such, the psychometric properties of the HSOPSC are not well demonstrated for cross-cultural research in Latin America, including Peru. The purpose of this study was to develop a target-language HSOPSC for cross-cultural research in Peru that asks the same questions, in the same manner, with the same intended meaning, as the source instrument. Methods This study used a mixed-methods approach adapted from the translation guideline recommended by Agency for Healthcare Research and Quality. The 3-phase, 7-step process incorporated translation techniques, pilot testing, cognitive interviews, clinical participant review, and subject matter expert evaluation. Results The instrument was translated and evaluated in 3 rounds of cognitive interview (CI). There were 37 problem items identified in round 1 (14 clarity, 12 cultural, 11 mixed); and resolved to 4 problems by round 3. The pilot-testing language clarity inter-rater reliability was S-CVI/Avg = 0.97 and S-CVI/UA = 0.86; and S-CVI/Avg = 0.96 and S-CVI/UA = 0.83 for cultural relevance. Subject matter expert agreement in matching items to the correct dimensions was substantially equivalent (Kappa = 0.72). Only 1 of 12 dimensions had a low Kappa (0.39), borderline fair to moderate. The remaining dimensions performed well (7 = almost perfect, 2 = substantial, and 2 = moderate). Conclusions The HSOPSC instrument developed for Peru was markedly different from the other Spanish-language versions. The resulting items were equivalent in meaning to the source, despite the new language and different cultural context. The analysis identified negatively worded items were problematic for target-language translation. With the limited literature about negatively worded items in the context of cross-cultural research, further research is necessary to evaluate this finding and the recommendation to include negatively worded items in instruments. This study demonstrates cross-cultural research with translated instruments should adhere to established guidelines, with cognitive interviews, based on evidence-based strategies.
Collapse
Affiliation(s)
- Patrick A Palmieri
- 1Office of the Vice Chancellor for Research, Universidad Norbert Wiener, Av. Arequipa 444, 15046 Lima, Peru.,2College of Graduate Health Studies, A. T. Still University, 800 West Jefferson Street, Kirksville, MO 63501 USA.,3School of Nursing, Walden University, 100 S Washington Ave, Suite 900, Minneapolis, MN 55401 USA.,4EBHC South America: A Joanna Briggs Institute Affiliated Group, Universidad Norbert Wiener, Av. Arequipa 444, Lima, 15046 Lima, Peru
| | - Juan M Leyva-Moral
- 5Departament d'Infermeria, Facultat de Medicina, Universitat Autonoma de Barcelona, Avda. Can Domenech, Building M. Office M3/211, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.,Center for Health Sciences Research, Universidad María Auxiliadora, Av. Canto Bello 431, 15408 Lima, Peru.,7EBHC South America: A Joanna Briggs Institute Affiliated Group, Universidad Norbert Wiener, Av. Arequipa 444, 15046 Lima, Peru
| | - Doriam E Camacho-Rodriguez
- 7EBHC South America: A Joanna Briggs Institute Affiliated Group, Universidad Norbert Wiener, Av. Arequipa 444, 15046 Lima, Peru.,8School of Nursing, Universidad Cooperativa de Colombia, Calle 30, Santa Marta, Magdalena Colombia
| | - Nina Granel-Gimenez
- 5Departament d'Infermeria, Facultat de Medicina, Universitat Autonoma de Barcelona, Avda. Can Domenech, Building M. Office M3/211, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Eric W Ford
- 9School of Public Health, University of Alabama at Birmingham, Ryals Public Health Building, 1665 University Blvd., Ryals 310E, Birmingham, AL 35233 USA
| | - Kathleen M Mathieson
- 2College of Graduate Health Studies, A. T. Still University, 800 West Jefferson Street, Kirksville, MO 63501 USA
| | - Joan S Leafman
- 2College of Graduate Health Studies, A. T. Still University, 800 West Jefferson Street, Kirksville, MO 63501 USA
| |
Collapse
|
12
|
Drivers of press media response to healthcare-associated infections caused by multidrug-resistant organisms: A report from Brazil. Infect Control Hosp Epidemiol 2020; 41:372-373. [PMID: 32009604 DOI: 10.1017/ice.2020.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
13
|
Ilyas F, Burbridge B, Babyn P. Health Care-Associated Infections and the Radiology Department. J Med Imaging Radiat Sci 2019; 50:596-606.e1. [PMID: 31623975 PMCID: PMC7104925 DOI: 10.1016/j.jmir.2019.07.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 07/01/2019] [Accepted: 07/29/2019] [Indexed: 12/12/2022]
Abstract
Health care-associated infections (HCAIs) are a significant concern for both health care workers (HCWs) and patients. They are a major contributing factor of disease in industrialized countries, and are responsible for significant morbidity, mortality, and a direct annual financial loss of $6-7 billion in North America alone. They are an increasingly challenging health issue due to multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci among others, along with an increasing number of susceptible patients. Over the last three decades, the risk of HCAIs has increased in the radiology department (RD) in part because of an increased number of patients visiting the department and an increase in the utilization of imaging modalities. In this review, we will discuss how patients and staff can be exposed to HCAIs in the RD, including contaminated inanimate surfaces, radiology equipment, and associated medical devices. As the role of medical imaging has extended from primarily diagnosis to include more interventions, the implementation and development of standardized infection minimization protocols and infection control procedures are vital in the RD, particularly in interventional radiology. With globalisation and the rapid movement of people regionally, nationally, and globally, there is greater risk of exposure to contagious diseases such as Ebola, especially if infected patients are undiagnosed when they travel. For effective infection control, advanced training and education of HCWs in the RD is essential. The purpose of this article is to provide an overview of HCAIs as related to activities of the RD. We will discuss the following major topics including the variety of HCAIs commonly encountered, the role of the RD in HCAIs, transmission of infections to patients and HCWs in the RD, standard infection prevention measures, and the management of susceptible/infected patients in the RD. We shall also examine the role of, and the preparedness of, HCWs, including RD technologists and interventional radiologists, who may be exposed to undiagnosed, yet infected patients. We shall conclude with a brief discussion of the role of further research related to HCAIs. Learning Objectives After the completion of this review article, the readers will • Understand the exposure and role of radiology department in health care-associated infections, • Know the causes/modes/transmission of infections in radiology department, • Be conscious of standard disinfection protocols, • Be aware of current and future strategies required for the effective control of health care-associated infection in the radiology department. This is a CME article and provides the equivalent of 2 hours of continuing education that may be applied to your professional development credit system. A 10-question multiple-choice quiz follows this reading. Please note that no formalized credit (category A) is available from CAMRT.
Collapse
Affiliation(s)
- Fatima Ilyas
- Department of Medical Imaging, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan, Canada.
| | | | | |
Collapse
|
14
|
Gatadi S, Gour J, Shukla M, Kaul G, Dasgupta A, Madhavi YV, Chopra S, Nanduri S. Synthesis and evaluation of new quinazolin-4(3H)-one derivatives as potent antibacterial agents against multidrug resistant Staphylococcus aureus and Mycobacterium tuberculosis. Eur J Med Chem 2019; 175:287-308. [PMID: 31096152 DOI: 10.1016/j.ejmech.2019.04.067] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/25/2019] [Accepted: 04/25/2019] [Indexed: 01/05/2023]
Abstract
Staphylococcus aureus and Mycobacterium tuberculosis are major causative agents responsible for serious nosocomial and community-acquired infections impacting healthcare systems globally. Over several decades, these pathogens have developed resistance to multiple antibiotics significantly affecting morbidity and mortality. Thus, these recalcitrant pathogens are amongst the most formidable microbial pathogens for which international healthcare agencies have mandated active identification and development of new antibacterial agents for chemotherapeutic intervention. In our present work, a series of new quinazolin-4(3H)-one derivatives were designed, synthesized and evaluated for their antibacterial activity against ESKAP pathogens and pathogenic mycobacteria. The experiments revealed that 4'c, 4'e, 4'f and 4'h displayed selective and potent inhibitory activity against Staphylococcus aureus with MIC values ranging from 0.03-0.25 μg/mL. Furthermore, compounds 4'c and 4'e were found to be benign to Vero cells (CC50 = >5 μg/mL) and displayed promising selectivity index (SI) > 167 and > 83.4 respectively. Additionally, 4'c and 4'e demonstrated equipotent MIC against multiple drug-resistant strains of S. aureus including VRSA, concentration dependent bactericidal activity against S. aureus and synergized with FDA approved drugs. Moreover, compound 4'c exhibited more potent activity in reducing the biofilm and exhibited a PAE of ∼2 h at 10X MIC which is comparable to levofloxacin and vancomycin. In vivo efficacy of 4'c in murine neutropenic thigh infection model revealed that 4'c caused a similar reduction in cfu as vancomycin. Gratifyingly, compounds 4d, 4e, 9a, 9b, 14a, 4'e and 4'f also exhibited anti-mycobacterial activity with MIC values in the range of 2-16 μg/mL. In addition, the compounds were found to be less toxic to Vero cells (CC50 = 12.5->100 μg/mL), thus displaying a favourable selectivity index. The interesting results obtained here suggest the potential utilization of these new quinazolin-4(3H)-one derivatives as promising antibacterial agents for treating MDR-Staphylococcal and mycobacterial infections.
Collapse
Affiliation(s)
- Srikanth Gatadi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India
| | - Jitendra Gour
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India
| | - Manjulika Shukla
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India
| | - Grace Kaul
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India
| | - Arunava Dasgupta
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India
| | - Y V Madhavi
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India
| | - Sidharth Chopra
- Division of Microbiology, CSIR-Central Drug Research Institute, Sitapur Road, Sector 10, Janakipuram Extension, Lucknow, 226031, Uttar Pradesh, India.
| | - Srinivas Nanduri
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, 500037, India.
| |
Collapse
|
15
|
Synthesis and evaluation of new 4-oxoquinazolin-3(4H)-yl)benzoic acid and benzamide derivatives as potent antibacterial agents effective against multidrug resistant Staphylococcus aureus. Bioorg Chem 2019; 83:569-579. [DOI: 10.1016/j.bioorg.2018.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/27/2018] [Accepted: 11/06/2018] [Indexed: 01/22/2023]
|
16
|
Westerway SC, Basseal JM, Abramowicz JS. Medical Ultrasound Disinfection and Hygiene Practices: WFUMB Global Survey Results. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:344-352. [PMID: 30409470 DOI: 10.1016/j.ultrasmedbio.2018.09.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/19/2018] [Accepted: 09/19/2018] [Indexed: 06/08/2023]
Abstract
As ultrasound technology rapidly evolves and is used more frequently in every area of medical diagnosis and treatment, it may be overlooked as a potential vector in the transmission of a health care-associated infection. A survey on disinfection and hygiene practice in medical ultrasound was disseminated via the World Federation for Ultrasound in Medicine and Biology (WFUMB) to its six member federations and associated ultrasound societies globally. One thousand twenty-nine responses were obtained across a broad range of ultrasound practitioners. A total of 76% of respondents used transducer covers every time to scan open wounds and 71% when blood and bodily fluids were present or for an interventional procedure. Approved high-level disinfectants are not always used, even when blood comes into contact with the transducer or after endocavity scans. Alcohol-based wipes were used by many respondents to clean both external transducers and endocavity transducers. Open-ended responses indicated that a large caseload hindered the time required for cleaning and that access to clear guidelines would be beneficial. Global survey results indicate that some users do not comply with disinfection practice, and there is a gap in knowledge on basic infection prevention and control education within the ultrasound unit. As the infectious status of a patient is not often disclosed prior to an ultrasound examination, training in suitable protocols for the cleaning and disinfection of ultrasound equipment is imperative to mitigate the risk of potential infection.
Collapse
Affiliation(s)
- Susan Campbell Westerway
- Department of Dentistry and Health Sciences, Charles Sturt University, New South Wales, Australia; World Federation for Ultrasound in Medicine and Biology (WFUMB), Chicago, Illinois, USA
| | - Jocelyne M Basseal
- Australasian Society for Ultrasound in Medicine, Chatswood, New South Wales, Australia.
| | - Jacques S Abramowicz
- World Federation for Ultrasound in Medicine and Biology (WFUMB), Chicago, Illinois, USA; Department of Obstetrics & Gynecology, University of Chicago, Chicago, Illinois, USA
| |
Collapse
|
17
|
Benammar S, Pantel A, Aujoulat F, Benmehidi M, Courcol R, Lavigne JP, Romano-Bertrand S, Marchandin H. First molecular characterization of related cases of healthcare-associated infections involving multidrug-resistant Enterococcus faecium vanA in Algeria. Infect Drug Resist 2018; 11:1483-1490. [PMID: 30271181 PMCID: PMC6149901 DOI: 10.2147/idr.s164487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose Vancomycin-resistant Enterococcus (VRE) faecium (VREfm) are highly resistant bacteria emerging worldwide and rarely studied using molecular tools in Algeria since their first report in 2006. The aim of the study was to investigate healthcare-associated infections (HAIs) involving the first VRE in Batna University Hospital, Algeria, and characterize isolates using molecular tools. Patients and methods Medical charts were reviewed for patients with VREfm. van genes were detected by multiplex polymerase chain reaction (PCR), and strains were characterized by automated repetitive sequence-based PCR (rep-PCR), multiplex rep-PCR, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). Results During a 6-month period, VREfm infections occurred in four patients hospitalized in three wards. The four isolates were E. faecium vanA belonging to the hospital-adapted clonal complex 17. PCR-based methods did not discriminate the isolates but MLST and PFGE delineated a subgroup of three VREfm of identical pulsotype and sequence type (ST) 80 (yet identified for five isolates in the international PubMLST database) while the fourth isolate was of ST789 (not previously identified for a VREfm) and displayed an unrelated pulsotype. The three genotypically related isolates were recovered in patients who underwent surgery in the same department, suggesting an outbreak for which the source and route of transmission remained unidentified. Conclusion This first molecular epidemiology study of VRE in Algeria was useful in delimiting an outbreak involving three of the four HAI cases and revealed rarely encountered genotypes. Considering the threat and burden of VRE infections worldwide, particularly in the USA, and the late emergence in Algeria, our study supports the urgent need for improved and early adequate infection control measures to avoid VRE spread in North African hospitals.
Collapse
Affiliation(s)
- Sonia Benammar
- Department of Microbiology, University Hospital Center Touhami Benflis, Batna, Algeria.,Department of Medicine, University Batna 2, Batna, Algeria
| | - Alix Pantel
- Department of Microbiology, Nîmes University Hospital, Nîmes, France, .,Faculty of Medicine, National Institute of Health and Medical Research, INSERM U1047, University of Montpellier, Nîmes, France
| | - Fabien Aujoulat
- HydroSciences Montpellier, CNRS, IRD, University of Montpellier, University Hospital of Montpellier-Nîmes, Montpellier, France,
| | - Messaoud Benmehidi
- Department of Microbiology, University Hospital Center Touhami Benflis, Batna, Algeria.,Department of Medicine, University Batna 2, Batna, Algeria
| | - René Courcol
- Faculty of Medicine, University of Lille, Lille, France.,Department of Bacteriology, Institute of Microbiology, Lille University Hospital, Lille, France
| | - Jean-Philippe Lavigne
- Department of Microbiology, Nîmes University Hospital, Nîmes, France, .,Faculty of Medicine, National Institute of Health and Medical Research, INSERM U1047, University of Montpellier, Nîmes, France
| | - Sara Romano-Bertrand
- HydroSciences Montpellier, CNRS, IRD, University of Montpellier, University Hospital of Montpellier-Nîmes, Montpellier, France, .,Department of Infection Control, Montpellier University Hospital, Montpellier, France
| | - Hélène Marchandin
- Department of Microbiology, Nîmes University Hospital, Nîmes, France, .,HydroSciences Montpellier, CNRS, IRD, University of Montpellier, University Hospital of Montpellier-Nîmes, Montpellier, France,
| |
Collapse
|
18
|
Chen Y, Shan X, Zhao J, Han X, Tian S, Chen F, Su X, Sun Y, Huang L, Grundmann H, Wang H, Han L. Predicting nosocomial lower respiratory tract infections by a risk index based system. Sci Rep 2017; 7:15933. [PMID: 29162852 PMCID: PMC5698311 DOI: 10.1038/s41598-017-15765-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/01/2017] [Indexed: 01/12/2023] Open
Abstract
Although belonging to one of the most common type of nosocomial infection, there was currently no simple prediction model for lower respiratory tract infections (LRTIs). This study aims to develop a risk index based system for predicting nosocomial LRTIs based on data from a large point-prevalence survey. Among the 49328 patients included, the prevalence of nosocomial LRTIs was 1.70% (95% confidence interval [CI], 1.64% to 1.76%). The areas under the receiver operating characteristic (ROC) curve for logistic regression and fisher discriminant analysis were 0.907 (95% CI, 0.897 to 0.917) and 0.902 (95% CI, 0.892 to 0.912), respectively. The constructed risk index based system also displayed excellent discrimination (area under the ROC curve: 0.905 [95% CI, 0.895 to 0.915]) to identify LRTI in internal validation. Six risk levels were generated according to the risk score distribution of study population, ranging from 0 to 5, the corresponding prevalence of nosocomial LRTIs were 0.00%, 0.39%, 3.86%, 12.38%, 28.79% and 44.83%, respectively. The sensitivity and specificity of prediction were 0.87 and 0.79, respectively, when the best cut-off point of risk score was set to 14. Our study suggested that this newly constructed risk index based system might be applied to boost more rational infection control programs in clinical settings.
Collapse
Affiliation(s)
- Yong Chen
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Xue Shan
- School of Public Health, Peking University, Beijing, China
| | - Jingya Zhao
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Xuelin Han
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Shuguang Tian
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Fangyan Chen
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Xueting Su
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Yansong Sun
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Liuyu Huang
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China
| | - Hajo Grundmann
- Department of Infection Prevention and Hospital Hygiene, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Medical Microbiology, University Medical Center Groningen, Rijksuniversteit Groningen, Groningen, The Netherlands
| | - Hongyuan Wang
- School of Public Health, Peking University, Beijing, China.
| | - Li Han
- Chinese PLA Institute for Disease Control and Prevention, Beijing, China.
| |
Collapse
|
19
|
Ouedraogo AS, Sanou M, Kissou A, Sanou S, Solaré H, Kaboré F, Poda A, Aberkane S, Bouzinbi N, Sano I, Nacro B, Sangaré L, Carrière C, Decré D, Ouégraogo R, Jean-Pierre H, Godreuil S. High prevalence of extended-spectrum ß-lactamase producing enterobacteriaceae among clinical isolates in Burkina Faso. BMC Infect Dis 2016; 16:326. [PMID: 27400864 PMCID: PMC4939587 DOI: 10.1186/s12879-016-1655-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 06/08/2016] [Indexed: 11/10/2022] Open
Abstract
Background Nothing is known about the epidemiology and resistance mechanisms of extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) in Burkina Faso. The objective of this study was to determine ESBL-PE prevalence and to characterize ESBL genes in Burkina Faso. Methods During 2 months (June-July 2014), 1602 clinical samples were sent for bacteriologic investigations to the microbiology laboratories of the tree main hospitals of Burkina Faso. Isolates were identified by mass spectrometry using a matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) BioTyper. Antibiotic susceptibility was tested using the disk diffusion method on Müller-Hinton agar. The different ESBL genes in potential ESBL-producing isolates were detected by PCR and double stranded DNA sequencing. Escherichia coli phylogenetic groups were determined using a PCR-based method. Results ESBL-PE frequency was 58 % (179 strains among the 308 Enterobacteriaceae isolates identified in the collected samples; 45 % in outpatients and 70 % in hospitalized patients). The CTX-M-1 group was dominant (94 %, CTX-M-15 enzyme), followed by the CTX-M-9 group (4 %). ESBL producers were more often found in E. coli (67.5 %) and Klebsiella pneumoniae (26 %) isolates. E. coli isolates (n = 202; 60 % of all Enterobacteriaceae samples) were distributed in eight phylogenetic groups (A = 49, B1 = 15, B2 = 43, C = 22, Clade I = 7, D = 37, F = 13 and 16 unknown); 22 strains belonged to the sequence type ST131. No association between a specific strain and ESBL production was detected. Conclusions This report shows the alarming spread of ESBL genes in Burkina Faso. Public health efforts should focus on education (population and healthcare professionals), surveillance and promotion of correct and restricted antibiotic use to limit their dissemination.
Collapse
Affiliation(s)
- Abdoul-Salam Ouedraogo
- Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso. .,Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France. .,Université Montpellier 1, Montpellier, France. .,INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
| | - Mahamadou Sanou
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - Aimée Kissou
- Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso
| | - Soufiane Sanou
- Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso
| | - Hermann Solaré
- Centre Hospiatlier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Firmin Kaboré
- Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso
| | - Armel Poda
- Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso
| | - Salim Aberkane
- Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.,Université Montpellier 1, Montpellier, France.,INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France
| | - Nicolas Bouzinbi
- Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.,Université Montpellier 1, Montpellier, France.,INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France
| | - Idrissa Sano
- Centre Hospiatlier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Boubacar Nacro
- Centre Hospitalier Universitaire Souro Sanou, BP 676, Bobo Dioulasso, Burkina Faso
| | - Lassana Sangaré
- Centre Hospiatlier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Christian Carrière
- Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.,Université Montpellier 1, Montpellier, France.,INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France
| | - Dominique Decré
- CIMI, team E13 (bacteriology), Sorbonne University, UPMC Université Paris 06 CR7, F-75013, Paris, France.,INSERM U1135, CIMI, team E13, Paris, France.,AP-HP, Microbiology, St-Antoine Hospital, Paris, France
| | - Rasmata Ouégraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - Hélène Jean-Pierre
- Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France
| | - Sylvain Godreuil
- Centre Hospitalier Régional Universitaire (CHRU) de Montpellier, Département de Bactériologie-Virologie, Montpellier, France.,Université Montpellier 1, Montpellier, France.,INSERM U1058 "Infection by HIV and by agents with mucocutaneous tropism: from pathogenesis to prevention" and Department of Bacteriology-Virology, CHU Arnaud de Villeneuve, 371 avenue du doyen Gaston Giraud, 34295, Montpellier Cedex 5, France
| |
Collapse
|
20
|
Schulte DM, Duster M, Warrack S, Valentine S, Jorenby D, Shirley D, Sosman J, Catz S, Safdar N. Feasibility and patient satisfaction with smoking cessation interventions for prevention of healthcare-associated infections in inpatients. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2016; 11:15. [PMID: 27113448 PMCID: PMC4845502 DOI: 10.1186/s13011-016-0059-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 04/17/2016] [Indexed: 01/25/2023]
Abstract
Background Smoking increases hospitalization and healthcare-associated infection. Our primary aim of this pilot, randomized-controlled trial was to examine the feasibility and acceptability of a tobacco cessation intervention compared with usual care in inpatients. S. aureus carriage, healthcare-associated infections and infections post discharge were exploratory outcomes. Methods Current inpatient smokers from a university hospital facility were randomized to usual care or a face to face tobacco cessation counseling session where patients’ tobacco use and strategies for quitting were discussed. Patient engagement, satisfaction and withdrawal symptoms were measured at 1 week and 12 weeks post discharge. Nasal swabs were collected at enrollment and discharge and assessed for S. aureus colonization. P-values were calculated using Fisher’s exact and t-tests were used to compare groups. Results For the study’s primary outcome, participants reported the intervention as being generally acceptable and reported high overall levels of satisfaction, with a Likert scale score of at least 4/5 for all measures of satisfaction. No subjects utilized free tobacco cessation services after discharge. 83 % of the intervention group and 93 % of the control group smoked at least one cigarette after discharge. Secondary outcomes with regard to infections showed that, at discharge, 12 % of the intervention group (n = 17) and 18 % of the control group (n = 22) tested positive for S. aureus. After 3 months, 9 % of the intervention group developed infection, 41 % visited an emergency room, and 24 % were readmitted within 3 months post-discharge, compared to 27, 32 and 36 % of the control group respectively. Conclusions With regards to the primary aim of this study, there were overall high levels of satisfaction with the intervention, indicating good feasibility and acceptance among patients. However, more intensive interventions in hospitalized patients and impact on healthcare-associated infections and post-discharge infections should be explored.
Collapse
Affiliation(s)
- Danielle M Schulte
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.,Department of Population Health Sciences, University of Wisconsin - Madison School of Medicine and Public Health, Madison, WI, USA
| | - Megan Duster
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Simone Warrack
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Susan Valentine
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Douglas Jorenby
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.,Center for Tobacco Research and Intervention, University of Wisconsin-Madison, Madison, WI, USA
| | - Daniel Shirley
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - James Sosman
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sheryl Catz
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Nasia Safdar
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA. .,University of Wisconsin Hospitals and Clinics, Madison, WI, USA. .,William S. Middleton Memorial Veterans Affairs Medical Center, 5221 MFCB, 1685 Highland Avenue, Madison, WI, 53705, USA.
| |
Collapse
|
21
|
Forstner C, Diab-Elschahawi M, Kivaranovic D, Graninger W, Mitteregger D, Macher M, Wrba T, Presterl E. Non-linear significant relationship between use of glycopeptides and isolation of vancomycin-resistant Enterococcus species in a university hospital setting. Antimicrob Resist Infect Control 2015; 4:25. [PMID: 26078865 PMCID: PMC4466807 DOI: 10.1186/s13756-015-0064-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 05/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emergence of colonization and infection with vancomycin-resistant enterococci (VRE) has become a worldwide challenge. To investigate whether the increasing incidence of VRE isolation can be correlated with use of glycopeptides in the hospital setting, we conducted a hospital-wide two-year study in the university hospital of Vienna. METHODS Within the period from January 2011 through December 2012 all patients with isolation of invasive or non-invasive VRE were retrospectively included. Specialty-specific data concerning the consumption of vancomycin and teicoplanin, fluoroquinolones and third generation cephalosporins in defined daily doses (DDDs) from June 2010 through May 2012 were extracted from the hospital pharmacy computer system. To assess the relationship between the usage of those antibiotics and the incidence of VRE (VRE-rate per 10 000 patients) a Poisson regression was performed. FINDINGS In the study period 266 patients were colonized or infected with VRE. Specialty-specific VRE isolation was as follows: general surgical units (44 patients), bone marrow transplant unit (35 patients), general medical units (33 patients), cardiothoracic surgery (27 patients), nephrology (26 patients), haematooncology (22 patients), gastroenterology (17 patients), urology (17 patients), and the infectious diseases unit (11 patients). Hospital-wide consumption of glycopeptides was higher for teicoplanin than for vancomycin (26 242 versus 8677 DDDs). Specialty-specific VRE incidence significantly increased with the use of glycopeptides, fluoroquinolones or third generation cephalosporins (p < 0.001). The results of the Poisson regression for vancomycin (p = 0.0018) and teicoplanin (p < 0.0001) separately were both highly significant. Spearman's correlation coefficient indicated a strong correlation between the two variables (rho = 0.8). CONCLUSION Overall usage of glycopeptides, fluoroquinolones or third generation cephalosporins contributed to the emergence of VRE in the hospital setting.
Collapse
Affiliation(s)
- Christina Forstner
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria ; Center for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
| | - Magda Diab-Elschahawi
- Department of Hospital Epidemiology and Infection Control, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria
| | - Danijel Kivaranovic
- Section for Medical Statistics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria
| | - Wolfgang Graninger
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria
| | - Dieter Mitteregger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria
| | - Maria Macher
- Hospital Pharmacy, General Hospital of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria
| | - Thomas Wrba
- Center of Medical Statistics, Informatics and Systems Intelligence, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria
| | - Elisabeth Presterl
- Department of Hospital Epidemiology and Infection Control, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna Austria
| |
Collapse
|
22
|
Kanamori H, Kunishima H, Tokuda K, Kaku M. Infection Control Campaign at Evacuation Centers in Miyagi Prefecture after the Great East Japan Earthquake. Infect Control Hosp Epidemiol 2015; 32:824-6. [DOI: 10.1086/661224] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
23
|
Predicting severe enterovirus 71 infection: Age, comorbidity, and parental behavior matter. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2014; 50:10-16. [PMID: 25678038 DOI: 10.1016/j.jmii.2014.11.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/07/2014] [Accepted: 11/17/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Enterovirus 71 (EV71) is one of the major pathogens that cause severe enteroviral infections. Our aim was to study the behavioral and household risk factors for its serious complications. METHODS Between May 2011 and November 2012, we enrolled children who had symptoms of EV71 infection from six hospitals in Taiwan. The caregivers of each patient were interviewed to determine their hand hygiene habits in relation to EV71 infection. The severity of EV71 infection was classified as follows: Stage 1, hand-foot-mouth disease or herpangina; Stage 2, meningitis or myoclonic jerk; Stage 3A, encephalitis; Stage 3B, cardiopulmonary failure. Stages 2 to 3B were defined as severe EV71 infection. Children with Stages 3A and 3B infection were designated as the critical group. RESULTS A total of 399 patients had laboratory-confirmed EV71 infection. Three risks factors were associated with the different degrees of severity in EV71 infection. Children <2 years old had much greater risks for severe EV71 infection [odds ratio (OR) 1.8; 95% confidence interval (CI), 1.2-2.8], delayed medical evaluation for critical infection (OR 9.4; 95% CI, 3.6-24.1), and developmental retardation for cardiopulmonary failure (OR 8.3; 95% CI, 2.0-33.7). Among all the habits and household factors, caregivers in the critical group had a significantly lower rate in terms of cleaning the faucet after washing their hands (OR 2.63; 95% CI, 1.14-6.08). CONCLUSIONS Children <2 years old, developmental retardation, and delayed medical intervention were associated with severe EV71 infection. Cleaning water faucets after hand washing was a protective habit that reduced the risk of complications.
Collapse
|
24
|
Cinotti E, Perrot JL, Labeille B, Maguet H, Couzan C, Flori P, Cambazard F. Inefficacy of alcohol-based hand rub on mites in a patient with hyperkeratotic scabies. Clin Exp Dermatol 2014; 40:177-81. [PMID: 25251891 DOI: 10.1111/ced.12467] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The World Health Organization is strongly promoting alcohol-based hand rubs to interrupt transmission of pathogens within the healthcare environment, and in some hospitals they are being recommended in cases of scabies. However, there are no studies that demonstrate the efficacy of such hand rubs against scabies. AIM To evaluate the viability of Sarcoptes scabiei after the application of various topical antiseptics used for hand hygiene, and the effect of hand washing on the number of parasites present on the skin surface of a patient with scabies. METHODS We applied three different topical antiseptics (two alcohol-based and one povidone-iodine-based) to the skin of one hand that was affected by scabies, and took a skin scraping of each area to evaluate the viability of the mites over time. A skin scraping of a control area without antiseptic application was also taken. We also tested the antiseptics directly on the mites. Statistical comparison between the percentages of vital mites in the different samples was assessed using the χ(2) test. We also captured a dermoscopic image of the other hand before and after hand washing to count the number of parasites on the skin surface. RESULTS Topical antiseptics did not reduce the number of living mites compared with control skin, and hand washing did not reduce the number of parasites on the skin surface. CONCLUSIONS Application of topical antiseptics does not reduce the viability of S. scabiei, and is therefore unable to prevent the transmission of scabies. The usefulness of hand washing in preventing transmission of scabies to new subjects remains to be investigated.
Collapse
Affiliation(s)
- E Cinotti
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | | | | | | | | | | | | |
Collapse
|
25
|
|
26
|
Storberg V. ESBL-producing Enterobacteriaceae in Africa - a non-systematic literature review of research published 2008-2012. Infect Ecol Epidemiol 2014; 4:20342. [PMID: 24765249 PMCID: PMC3955770 DOI: 10.3402/iee.v4.20342] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 01/21/2014] [Accepted: 02/12/2014] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBL) has been found all over the world, and risk factors for acquiring these bacteria involve hospital care and antibiotic treatment. Surveillance studies are present in Europe, North America, and Asia, but there is no summarizing research published on the situation in Africa. AIM This review aims to describe the prevalence of ESBL-producing Enterobacteriaceae in hospital and community settings in Africa and the ESBL genes involved. METHOD A non-systematic literature search was performed in PubMed. All articles published between 2008 and 2012 were screened and read in full text. Relevant articles were assessed for quality of evidence and included in the review. Articles were divided into regional areas in Africa and tabulated. RESULTS ESBL-producing Enterobacteriaceae in hospitalized patients and in communities varies largely between countries and specimens but is common in Africa. ESBLs (class A and D) and plasmid-encoded AmpC (pAmpC) were regularly found, but carbapenemases were also present. CONCLUSION ESBL-producing Enterobacteriaceae in hospital and community settings in Africa is common. Surveillance of antimicrobial resistance needs to be implemented in Africa to tailor interventions targeted at stopping the dissemination of ESBL-producing Enterobacteriaceae.
Collapse
Affiliation(s)
- Viktor Storberg
- Department of Women's and Children's Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| |
Collapse
|
27
|
What can we learn from each other in infection control? Experience in Europe compared with the USA. J Hosp Infect 2013; 83:173-84. [DOI: 10.1016/j.jhin.2012.12.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 12/06/2012] [Indexed: 11/22/2022]
|
28
|
Jarlier V, Carlet J, McGowan J, Goossens H, Voss A, Harbarth S, Pittet D. Priority actions to fight antibiotic resistance: results of an international meeting. Antimicrob Resist Infect Control 2012; 1:17. [PMID: 22958318 PMCID: PMC3436666 DOI: 10.1186/2047-2994-1-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 05/03/2012] [Indexed: 11/10/2022] Open
Affiliation(s)
- Vincent Jarlier
- UPMC Univ Paris 6 EA1541 Bactériologie-Hygiène 75005 and Hôpital Pitié-Salpêtrière, Assistance Publique, Hôpitaux de Paris, 75013, France.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
García Leoni ME, Macías Bou B, Martín González L, Martínez Larrull E. Infecciones respiratorias. Medicine (Baltimore) 2011; 10:5947-5954. [PMID: 32287892 PMCID: PMC7143692 DOI: 10.1016/s0304-5412(11)70203-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Affiliation(s)
- M E García Leoni
- Servicio de Urgencias. Hospital General Universitario Gregorio Marañón. Madrid. España
- Facultad de Medicina. Departamento de Medicina. Universidad Complutense de Madrid. Madrid. España
| | - B Macías Bou
- Servicio de Urgencias. Hospital General Universitario Gregorio Marañón. Madrid. España
- Facultad de Medicina. Departamento de Medicina. Universidad Complutense de Madrid. Madrid. España
| | - L Martín González
- Servicio de Urgencias. Hospital General Universitario Gregorio Marañón. Madrid. España
- Facultad de Medicina. Departamento de Medicina. Universidad Complutense de Madrid. Madrid. España
| | - E Martínez Larrull
- Servicio de Urgencias. Hospital General Universitario Gregorio Marañón. Madrid. España
- Facultad de Medicina. Departamento de Medicina. Universidad Complutense de Madrid. Madrid. España
| |
Collapse
|
30
|
Dolinger DL, Jacobs AA. Molecular Diagnostics and Active Screening for Health Care-Associated Infections: Stepping-Up the Game: Table 1. Lab Med 2011. [DOI: 10.1309/lmh144zoetkvqcju] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
31
|
Pittet D, Panesar SS, Wilson K, Longtin Y, Morris T, Allan V, Storr J, Cleary K, Donaldson L. Involving the patient to ask about hospital hand hygiene: a National Patient Safety Agency feasibility study. J Hosp Infect 2011; 77:299-303. [PMID: 21236515 DOI: 10.1016/j.jhin.2010.10.013] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Accepted: 10/03/2010] [Indexed: 11/29/2022]
Abstract
Healthcare-associated infections (HAIs) affect at least 300,000 patients annually in the UK and represent a significant, yet largely preventable, burden to healthcare systems. Hand hygiene by healthcare workers (HCWs) is the leading prevention measure, but compliance with good practice is generally low. The UK National Patient Safety Agency surveyed the public, inpatients, and HCWs, particularly frontline clinical staff and infection control nurses, in five acute care hospitals to determine whether they agreed that a greater level of involvement and engagement with patients would contribute to increased compliance with hand hygiene and reduce HAIs. Fifty-seven percent (302/530) of the public were unlikely to question doctors on the cleanliness of their hands as they assumed that they had already cleaned them. Forty-three percent (90/210) of inpatients considered that HCWs should know to clean their hands and trusted them to do so, and 20% (42/210) would not want HCWs to think that they were questioning their professional ability to do their job correctly. Most HCWs surveyed (178/254, 71%) said that HAI could be reduced to a greater or lesser degree if patients asked HCWs if they had cleaned their hands before touching them. Inviting patients to remind HCWs about hand hygiene through the provision of individual alcohol-based hand-rub containers and actively supporting an 'It's OK to ask' attitude were perceived as the most useful interventions by both patients and HCWs. However, further work is required to refute the myth among HCWs that patient involvement undermines the doctor- or HCW-patient relationship.
Collapse
Affiliation(s)
- D Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Point Prevalence Survey of Nosocomial Infections in University Hospital in Martin. ACTA MEDICA MARTINIANA 2011. [DOI: 10.2478/v10201-011-0005-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
33
|
Baquero F, Cantón R, Cornaglia G. Public health microbiology, a challenge for Europe. Clin Microbiol Infect 2009; 16:123-5. [PMID: 19930270 DOI: 10.1111/j.1469-0691.2009.03126.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F Baquero
- Department of Microbiology, Ramón y Cajal University Hospital, CIBER de Investigación en Salud Pública (CIBERESP), Madrid, Spain
| | | | | |
Collapse
|
34
|
Use of surveillance data for prevention of healthcare-associated infection: risk adjustment and reporting dilemmas. Curr Opin Infect Dis 2009; 22:359-63. [DOI: 10.1097/qco.0b013e32832d04c0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
35
|
Active warming systems to maintain perioperative normothermia in hip replacement surgery: a therapeutic aid or a vector of infection? J Hosp Infect 2009; 73:58-63. [PMID: 19646785 DOI: 10.1016/j.jhin.2009.06.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 06/04/2009] [Indexed: 01/19/2023]
Abstract
Various reliable body heat-regulating systems have been designed and developed with the aim of maintaining an adequate body temperature in the course of major surgery. This is crucial to avoid the onset of potentially severe complications that are especially serious in elderly and debilitated subjects. Among these systems, the Bair Hugger blanket has demonstrated excellent efficacy. However, some reports in the literature have suggested that the use of such devices can increase the risk of nosocomial infections, particularly surgical wound infections. The aim of this study was to assess the risk of contamination of the surgical site correlated to the use of the Bair Hugger blanket during hip replacement surgery. To this end, the level of bacterial contamination of the air in the operating theatre was quantified with and without the use of the Bair Hugger, during the course of 30 total non-cemented hip implants performed in patients with osteoarthritis. Sampling was done both in the empty theatre and during surgical procedures, in different zones around the operating table and on the patient's body surface. Statistical analysis of the results demonstrated that the Bair Hugger system does not pose a real risk for nosocomial infections, whereas it does offer the advantage of preventing the potentially very severe consequences of hypothermia during major orthopaedic surgery. In addition, monitoring patients over the six months following the operation allowed us to exclude a later manifestation of a nosocomial infection.
Collapse
|
36
|
Adrie C, Francais A, Alvarez-Gonzalez A, Mounier R, Azoulay E, Zahar JR, Clec'h C, Goldgran-Toledano D, Hammer L, Descorps-Declere A, Jamali S, Timsit JF. Model for predicting short-term mortality of severe sepsis. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2009; 13:R72. [PMID: 19454002 PMCID: PMC2717433 DOI: 10.1186/cc7881] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 03/09/2009] [Accepted: 05/19/2009] [Indexed: 12/23/2022]
Abstract
Introduction To establish a prognostic model for predicting 14-day mortality in ICU patients with severe sepsis overall and according to place of infection acquisition and to sepsis episode number. Methods In this prospective multicentre observational study on a multicentre database (OUTCOMEREA) including data from 12 ICUs, 2268 patients with 2737 episodes of severe sepsis were randomly divided into a training cohort (n = 1458) and a validation cohort (n = 810). Up to four consecutive severe sepsis episodes per patient occurring within the first 28 ICU days were included. We developed a prognostic model for predicting death within 14 days after each episode, based on patient data available at sepsis onset. Results Independent predictors of death were logistic organ dysfunction (odds ratio (OR), 1.22 per point, P < 10-4), septic shock (OR, 1.40; P = 0.01), rank of severe sepsis episode (1 reference, 2: OR, 1.26; P = 0.10 ≥ 3: OR, 2.64; P < 10-3), multiple sources of infection (OR; 1.45, P = 0.03), simplified acute physiology score II (OR, 1.02 per point; P < 10-4), McCabe score ([greater than or equal to]2) (OR, 1.96; P < 10-4), and number of chronic co-morbidities (1: OR, 1.75; P < 10-3, ≥ 2: OR, 2.24, P < 10-3). Validity of the model was good in whole cohorts (AUC-ROC, 0.76; 95%CI, 0.74 to 0.79; and HL Chi-square: 15.3 (P = 0.06) for all episodes pooled). Conclusions In ICU patients, a prognostic model based on a few easily obtained variables is effective in predicting death within 14 days after the first to fourth episode of severe sepsis complicating community-, hospital-, or ICU-acquired infection.
Collapse
Affiliation(s)
- Christophe Adrie
- Medical-Surgical Intensive Care Unit, Delafontaine Hospital, 93205 Saint Denis, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Wilhelm J, Ebelt H, Buerke M, Schlitt A. Selective decontamination of the digestive tract and oropharynx: new findings for an old approach still under discussion. Expert Rev Anti Infect Ther 2009; 7:399-402. [DOI: 10.1586/eri.09.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|