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Guidelines for Hospital-acquired infection

Martin Mielke
Clinically relevant infections are the primary indication for the use of antimicrobial agents in human medicine. Consequently, the prevention of infections is the fundament of all measures to rationally reduce the use of antibiotics. A prevented infection must not be treated. For the prevention of several community-acquired infections, vaccines are available. In addition, several infections may be prevented on the basis of knowledge and responsible behavior. However, the prevention of nosocomial infections depends mainly on the responsibility of third parties in the context of medical procedures...
March 19, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
Suzanne S Dunne, Merja Ahonen, Martina Modic, Francy Rl Crijns, Minna M Keinänen-Toivola, Ruth Meinke, C William Keevil, Jim Gray, Nuala H O'Connell, Colum P Dunne
Recognized issues with poor hand hygiene compliance among healthcare workers, and reports of re-contamination of previously chemically disinfected surfaces through hand contact, emphasize need for novel hygiene methods in addition to those currently available. One such approach involves antimicrobial (nano)-coatings (AMC), whereby integrated active ingredients are responsible for elimination of microorganisms that come into contact with treated surfaces. While widely studied under laboratory conditions with promising results, studies under real life healthcare conditions are scarce...
March 14, 2018: Journal of Hospital Infection
Sien Ombelet, Jean-Baptiste Ronat, Timothy Walsh, Cedric P Yansouni, Janneke Cox, Erika Vlieghe, Delphine Martiny, Makeda Semret, Olivier Vandenberg, Jan Jacobs
Low-resource settings are disproportionately burdened by infectious diseases and antimicrobial resistance. Good quality clinical bacteriology through a well functioning reference laboratory network is necessary for effective resistance control, but low-resource settings face infrastructural, technical, and behavioural challenges in the implementation of clinical bacteriology. In this Personal View, we explore what constitutes successful implementation of clinical bacteriology in low-resource settings and describe a framework for implementation that is suitable for general referral hospitals in low-income and middle-income countries with a moderate infrastructure...
March 5, 2018: Lancet Infectious Diseases
Farnaz Foolad, Angela M Huang, Cynthia T Nguyen, Lindsay Colyer, Megan Lim, Jessica Grieger, Julius Li, Sara Revolinski, Megan Mack, Tejal Gandhi, J Njeri Wainaina, Gregory Eschenauer, Twisha S Patel, Vincent D Marshall, Jerod Nagel
Background: The increased emphasis on pneumonia-related performance measures and patient outcomes has led hospitals to implement multifaceted approaches to quickly identify patients with community-acquired pneumonia (CAP), start timely therapy and reduce readmission. However, there has been minimal focus on duration of therapy (DOT) and patients often receive prolonged antibiotic courses. The IDSA and American Thoracic Society (IDSA/ATS) CAP guidelines recommend 5 days of therapy for clinically stable patients that quickly defervesce and stewardship teams are well positioned to influence prescribing practices...
February 16, 2018: Journal of Antimicrobial Chemotherapy
Hussain Shallwani, Hakeem J Shakir, Ashley M Aldridge, Maureen T Donovan, Elad I Levy, Kevin J Gibbons
BACKGROUND: Surgical site infections (SSIs) are noteworthy and costly complications. New recommendations from a national organization have urged the elimination of traditional surgeon's caps (surgical skull caps) and mandated the use of bouffant caps to prevent SSIs. OBJECTIVE: To report SSI rates for >15 000 class I (clean) surgical procedures 13 mo before and 13 mo after surgical skull caps were banned at a single site with 25 operating rooms. METHODS: SSI data were acquired from hospital infection control monthly summary reports from January 2014 to March 2016...
May 10, 2017: Neurosurgery
Sorin Claudiu Man, Valentina Sas, Cristina Schnell, Camelia Florea, Adelina Ţuţu, Ariana Szilágyi, Sergiu Belenes, Amalia Hebriştean, Anca Bonaţ, Claudia Cladovan, Cornel Aldea
Background and aims: Community-acquired pneumonia (CAP) is a both common and serious childhood infection. Antibiotic treatment guidelines help to reduce inadequate antibiotics prescriptions. Methods: We conducted a retrospective study at the Clinical Emergency Hospital for Children, 3rd Pediatric Clinic, Cluj-Napoca and Dr. Gavril Curteanu Clinical City Hospital, in Oradea. All patients discharged with a diagnosis of CAP between December 1, 2014 and February 28, 2015, were included in the study...
2018: Clujul Medical (1957)
Fernando Chaves, José Garnacho-Montero, José Luis Del Pozo, Emilio Bouza, José Antonio Capdevila, Marina de Cueto, M Ángeles Domínguez, Jaime Esteban, Nuria Fernández-Hidalgo, Marta Fernández Sampedro, Jesús Fortún, María Guembe, Leonardo Lorente, Jose Ramón Paño, Paula Ramírez, Miguel Salavert, Miguel Sánchez, Jordi Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica and the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias)...
February 2018: Enfermedades Infecciosas y Microbiología Clínica
Emmanuel Ofori, Daryl Ramai, Monica Dhawan, Fareeza Mustafa, James Gasperino, Madhavi Reddy
BACKGROUND: The epidemiological landscape of Clostridium difficile infection (CDI) has changed over the past 30 years. AIM: To review studies of CDI in the community setting. METHODS: Electronic databases including PubMed, MEDLINE, Embase, Google Scholar, Scopus,, and Cochrane Databases were searched for human studies performed between 2000 and 2017 that assessed the epidemiology, risk factors, ribotypes, hospital and intensive care unit outcomes, and management of community-acquired CDI...
January 30, 2018: Journal of Hospital Infection
F Chaves, J Garnacho-Montero, J L Del Pozo, E Bouza, J A Capdevila, M de Cueto, M Á Domínguez, J Esteban, N Fernández-Hidalgo, M Fernández Sampedro, J Fortún, M Guembe, L Lorente, J R Paño, P Ramírez, M Salavert, M Sánchez, J Vallés
Catheter-related bloodstream infections (CRBSI) constitute an important cause of hospital-acquired infection associated with morbidity, mortality, and cost. The aim of these guidelines is to provide updated recommendations for the diagnosis and management of CRBSI in adults. Prevention of CRBSI is excluded. Experts in the field were designated by the two participating Societies (the Spanish Society of Infectious Diseases and Clinical Microbiology and [SEIMC] and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units [SEMICYUC])...
January 2018: Medicina Intensiva
Balvinder Mohan, Amber Prasad, Harsimran Kaur, Vinaykumar Hallur, Neha Gautam, Neelam Taneja
PURPOSE: Carbapenem-resistant Enterobacteriaceae (CRE) have emerged and disseminated widely causing a variety of infections. In India, the carriage of CRE in hospitalised patients has not been well-studied. Therefore, we conducted the present study to observe gut carriage rate of CRE in patients admitted to our tertiary care hospital. METHODS: A total of 232 faecal swabs collected from consecutive stool samples from admitted patients were inoculated on ChromID extended spectrum β-lactamase plates and members of Enterobacteriaceae family were subjected to antibiotic susceptibility as per the Clinical Laboratory Standards Institute guidelines...
October 2017: Indian Journal of Medical Microbiology
Bhagyashri D Navalkele, Teena Chopra
Clostridium difficile infection (CDI) is the most common health care-acquired infection associated with high hospital expenditures. The incidence of subsequent recurrent CDI increases with prior episodes of CDI, 15%-35% risk after primary CDI to 35%-65% risk after the first recurrent episode. Recurrent CDI is one of the most challenging and a very difficult to treat infections. Standard guidelines provide recommendations on treatment of primary CDI. However, treatment choices for recurrent CDI are limited. Recent research studies have focused on the discovery of newer alternatives for prevention of recurrent CDI targeting prime virulence factors involved in C...
2018: Biologics: Targets & Therapy
Jeffrey Pernica, Stuart Harman, April Kam, Jacob Bailey, Redjana Carciumaru, Sarah Khan, Martha Fulford, Lehana Thabane, Robert Slinger, Cheryl Main, Marek Smieja, Mark Loeb
BACKGROUND: Community-acquired pneumonia (CAP) is commonly diagnosed in children. The Infectious Disease Society of America guidelines recommend 10 days of high-dose amoxicillin for the treatment of non-severe CAP but 5-day "short course" therapy may be just as effective. Randomized trials in adults have already demonstrated non-inferiority of 5-day short-course treatment for adults hospitalized with severe CAP and for adults with mild CAP treated as outpatients. Minimizing exposure to antimicrobials is desirable to avoid harms including diarrhoea, rashes, severe allergic reactions, increased circulating antimicrobial resistance, and microbiome disruption...
February 1, 2018: Trials
Patricia Finch Guthrie, Shelley Rayborn, Howard K Butcher
Delirium is a common cause of morbidity and mortality in hospitalized older adults often superimposed on dementia. Older patients with delirium are more likely than other populations to develop hospital-acquired infections, pressure ulcers, and immobility and nutritional issues, as well as to have increased health care costs, longer hospital stays, and long-term care following discharge. Interventions that prevent or mitigate the effects of delirium while promoting recovery are essential for caring for hospitalized older patients...
February 1, 2018: Journal of Gerontological Nursing
Jaffar Al-Sheikhli, Hussein Taqi, John Drake, Ayaaz Habib
A 75-year-old man of Asian descent presented to the acute medical unit with signs and symptoms suggestive of a community-acquired pneumonia. He had multiple comorbidities and was relatively immunocompromised as a result. Initial investigations supported the diagnosis of community-acquired pneumonia complicated by a cavitating lung lesion, and the patient was treated as per hospital guidelines. He continued to deteriorate despite appropriate therapy and developed a hydropneumothorax, requiring the insertion of a chest drain...
January 10, 2018: BMJ Case Reports
Rujipas Sirijatuphat, Kantarida Sripanidkulchai, Adhiratha Boonyasiri, Pinyo Rattanaumpawan, Orawan Supapueng, Pattarachai Kiratisin, Visanu Thamlikitkul
The global antimicrobial resistance surveillance system (GLASS) was launched by the World Health Organization (WHO) in 2015. GLASS is a surveillance system for clinical specimens that are sent to microbiology laboratory for clinical purposes. The unique feature of GLASS is that clinical data is combined with microbiological data, and deduplication of the microbiological results is performed. The objective of the study was to determine feasibility and benefit of GLASS for surveillance of blood culture specimens...
2018: PloS One
Daniel S Burns, M R Riley, A Mason, M S Bailey
INTRODUCTION: Infectious diseases are a frequent cause of morbidity among British troops. The aim of this paper is to describe the spectrum of infectious diseases seen when UK service personnel are evacuated for definitive care to the Role 4 Medical Treatment Facility based at Birmingham Heartlands Hospital. METHOD: A retrospective analysis of all military patients presenting with infectious diseases and treated at Birmingham Heartlands Hospital between 14 April 2005 and 31 December 2013 was undertaken...
December 25, 2017: Journal of the Royal Army Medical Corps
Elizabeth B Nimmich, P Brandon Bookstaver, Joseph Kohn, Julie Ann Justo, Katie L Hammer, Helmut Albrecht, Majdi N Al-Hasan
Background: Appropriate empirical antimicrobial therapy is associated with improved outcomes of patients with Gram-negative bloodstream infections (BSI). Objective: Development of evidence-based institutional management guidelines for empirical antimicrobial therapy of Gram-negative BSI. Methods: Hospitalized adults with Gram-negative BSI in 2011-2012 at Palmetto Health hospitals in Columbia, SC, USA, were identified. Logistic regression was used to examine the association between site of infection acquisition and BSI due to Pseudomonas aeruginosa or chromosomally mediated AmpC-producing Enterobacteriaceae (CAE)...
November 2017: Hospital Pharmacy
Angus McLure, Archie C A Clements, Martyn Kirk, Kathryn Glass
BACKGROUND: Clostridium difficile infections are common among hospitalised patients, with some infections acquired in hospital and others in the community. International guidelines classify cases as hospital-acquired if symptom onset occurs >2 days after admission. This classification informs surveillance and infection control, but has not been verified by empirical or modelling studies. AIMS: To assess current classification of C. difficile acquisition using a simulation model as a gold standard...
December 16, 2017: Journal of Hospital Infection
Samir T Kumar, Arsheena Yassin, Tanaya Bhowmick, Deepali Dixit
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) continue to represent the most common nosocomial-associated infections, resulting in significant attributable mortality, increased length of hospital stay, and financial burden.1 The updated Infectious Diseases Society of America (IDSA) guidelines provide guidance on the diagnosis and management of nonimmunocompromised hosts with HAP and VAP.
December 2017: P & T: a Peer-reviewed Journal for Formulary Management
Shelanah A Fernando, Timothy J Gray, Thomas Gottlieb
Healthcare-acquired infections (HAI) impact on patient care and have cost implications for the Australian healthcare system. The management of HAI is exacerbated by rising rates of antimicrobial resistance (AMR). Health-care workers and a contaminated hospital environment are increasingly implicated in the transmission and persistence of multi-resistant organisms (MRO), as well as other pathogens, such as Clostridium difficile. This has resulted in a timely focus on a range of HAI prevention actions. Core components include antimicrobial stewardship, to reduce overuse and ensure evidence-based antimicrobial use; infection prevention strategies, to control MRO - particularly methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp...
December 2017: Internal Medicine Journal
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