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Guidelines for Hospital-acquired infection

Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
Leonor Pássaro, Stephan Harbarth, Caroline Landelle
BACKGROUND: Pneumonia is one of the leading hospital-acquired infections worldwide and has an important impact. Although preventive measures for ventilator-associated pneumonia (VAP) are well known, less is known about appropriate measures for prevention of hospital-acquired pneumonia (HAP). AIM: The purpose of this narrative review is to provide an overview of the current standards for preventing HAP in non-ventilated adult patients. METHODS: A search of the literature up to May 2015 was conducted using Medline for guidelines published by national professional societies or professional medical associations...
2016: Antimicrobial Resistance and Infection Control
S Shrestha, T Tada, B Shrestha, T Kirikae, H Ohara, B P Rijal, B M Pokhrel, J B Sherchand
BACKGROUND: The emergence of multidrug-resistant Acinetobacter baumannii associated with hospital-acquired infections has been increasingly reported worldwide. 16S rRNA methylase producing Gram-negative bacteria are highly resistant to all clinically important aminoglycosides. We analyzed A. baumannii clinical isolates resistant to aminoglycosides from hospitalized patients. The objective of this study was to investigate the emergence of armA in A.baumannii species associated with nosocomial infection in a university hospital in Nepal...
May 2016: Journal of Nepal Health Research Council
H Solís-Téllez, E E Mondragón-Pinzón, M Ramírez-Marino, F R Espinoza-López, F Domínguez-Sosa, J F Rubio-Suarez, R D Romero-Morelos
BACKGROUND: Surgical site infection is defined as an infection related to the surgical procedure in the area of manipulation occurring within the first 30 postoperative days. The diagnostic criteria include: purulent drainage, isolation of microorganisms, and signs of infection. AIMS: To describe the epidemiologic characteristics and differences among the types of prophylactic regimens associated with hospital-acquired infections at the general surgery service of a tertiary care hospital...
November 21, 2016: Revista de Gastroenterología de México
Katherine M Mullin, Christopher S Kovacs, Cynthia Fatica, Colette Einloth, Elizabeth A Neuner, Jorge A Guzman, Eric Kaiser, Venu Menon, Leticia Castillo, Marc J Popovich, Edward M Manno, Steven M Gordon, Thomas G Fraser
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture. METHODS A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs...
November 17, 2016: Infection Control and Hospital Epidemiology
Daniel J Livorsi, Michihiko Goto, Margaret Carrel, Makoto M Jones, Jennifer McDanel, Rajeshwari Nair, Bruce Alexander, Brice Beck, Kelly K Richardson, Eli N Perencevich
OBJECTIVES: We sought to define regional variations in fluoroquinolone non-susceptibility (FQ-NS) among bloodstream isolates of Escherichia coli across the Veterans Health Administration (VHA) in the United States. METHODS: We analyzed a retrospective cohort of patients managed at 136 VHA hospitals who had a blood culture positive for E.coli between 2003 and 2013. Hospitals were classified based on US Census Divisions, and regional variations in FQ-NS were analyzed...
2016: Antimicrobial Resistance and Infection Control
Anthony A Iwuafor, Folasade T Ogunsola, Rita O Oladele, Oyin O Oduyebo, Ibironke Desalu, Chukwudi C Egwuatu, Agwu U Nnachi, Comfort N Akujobi, Ita O Ita, Godwin I Ogban
BACKGROUND: Infections are common complications in critically ill patients with associated significant morbidity and mortality. AIM: This study determined the prevalence, risk factors, clinical outcome and microbiological profile of hospital-acquired infections in the intensive care unit of a Nigerian tertiary hospital. MATERIALS AND METHODS: This was a prospective cohort study, patients were recruited and followed up between September 2011 and July 2012 until they were either discharged from the ICU or died...
2016: PloS One
K Rietberg, J Lloyd, B Melius, P Wyman, R Treadwell, G Olson, M-G Kang, J S Duchin
Two cases of hospital-acquired listeriosis were linked to a commercially produced, pasteurized ice cream mix. Manufacturers should implement safety measures from the Food Safety Modernization Act to minimize the risk of Listeria contamination. Dietary guidelines for persons at high risk of listeriosis may need revision to recognize the potential risk from pasteurized products.
October 2016: Epidemiology and Infection
Frank van Someren Gréve, David S Y Ong, Olaf L Cremer, Marc J M Bonten, Lieuwe D J Bos, Menno D de Jong, Marcus J Schultz, Nicole P Juffermans
BACKGROUND: Clinical guidelines suggest testing for respiratory viruses during the influenza season, but are unclear which categories of patients on the intensive care unit (ICU) should be tested. OBJECTIVE: We described the clinical practice of diagnostic testing for respiratory virus infections in patients presenting to ICU with suspected community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). STUDY DESIGN: Prospective observational study in consecutive CAP and HAP patients with an ICU stay of more than 24h in two tertiary care hospitals in The Netherlands, from 2011 to December 2013...
October 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Karl J Madaras-Kelly, Muriel Burk, Christina Caplinger, Jefferson G Bohan, Melinda M Neuhauser, Matthew Bidwell Goetz, Rongping Zhang, Francesca E Cunningham
OBJECTIVE: Practice guidelines recommend the shortest duration of antimicrobial therapy appropriate to treat uncomplicated pneumonia be prescribed to reduce the emergence of resistant pathogens. A national evaluation was conducted to assess the duration of therapy for pneumonia. DESIGN: Retrospective medication utilization evaluation. SETTING: Thirty Veterans Affairs medical centers. PATIENTS: Inpatients discharged with a diagnosis of pneumonia...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Xiaoying Xie, Yunwen Bao, Nengyong Ouyang, Xinlu Dai, Kunyi Pan, Baiji Chen, Yawen Deng, Xiquan Wu, Fengqin Xu, Hongyu Li, Songyin Huang
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of both hospital and community infections globally. It's important to illuminate the differences between community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA), but there have been confusions on the definition, especially for the MRSA isolates identified within 48 h of admission. This study aimed to determine the molecular characteristics and virulence genes profile of CA and HA-MRSA isolates identified less than 48 h after hospital admission in our region...
2016: BMC Infectious Diseases
Yaakov Dickstein, Ran Nir-Paz, Celine Pulcini, Barry Cookson, Bojana Beović, Evelina Tacconelli, Dilip Nathwani, Rossitza Vatcheva-Dobrevska, Jesus Rodríguez-Baño, Markus Hell, Henri Saenz, Leonard Leibovici, Mical Paul
OBJECTIVES: We aimed to assess the current status of infectious diseases (ID), clinical microbiology (CM) and infection control (IC) staffing in hospitals and to analyze modifiers of staffing levels. METHODS: We conducted an internet-based survey of European Society of Clinical Microbiology and Infectious Diseases members and affiliates, collecting data on hospital characteristics, ID management infrastructure, ID/IC-related activities and the ratio of physicians/100 hospital beds...
June 29, 2016: Clinical Microbiology and Infection
Gunilla Skoog, Johan Struwe, Otto Cars, Håkan Hanberger, Inga Odenholt, Mårten Prag, Katarina Skärlund, Peter Ulleryd, Mats Erntell
This study sought to analyse antimicrobial pressure, indications for treatment, and compliance with treatment recommendations and to identify possible problem areas where inappropriate use could be improved through interventions by the network of the local Swedish Strategic Programme Against Antibiotic Resistance (Strama) groups. Five point-prevalence surveys were performed in between 49 and 72 participating hospitals from 2003 to 2010. Treatments were recorded for 19 predefined diagnosis groups and whether they were for community-acquired infection, hospital-acquired infection, or prophylaxis...
June 23, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Bernhard Jahn, Trudy M Wassenaar, Annemarie Stroh
BACKGROUND: Guidelines for the control of hospital-acquired MRSA include decolonization measures to end MRSA carrier status in colonized and infected patients. Successful decolonization typically requires up to 22 days of treatment, which is longer than the average hospital length of stay (LOS). Incomplete decolonization is therefore common, with long-term MRSA carriage as a consequence. To overcome this, we developed an integrated MRSA Management (IMM) by extending MRSA decolonization to the outpatient and domestic setting...
2016: Antimicrobial Resistance and Infection Control
Lyubov Lytvyn, Dominik Mertz, Behnam Sadeghirad, Faisal Alaklobi, Anna Selva, Pablo Alonso-Coello, Bradley C Johnston
BACKGROUND Clostridium difficile infection (CDI) is the most common cause of hospital-acquired infectious diarrhea. OBJECTIVE To analyze the methodological quality, content, and supporting evidence among clinical practice guidelines (CPGs) on CDI prevention. DESIGN AND SETTING We searched medical databases and gray literature for CPGs on CDI prevention published January 2004-January 2015. Three reviewers independently screened articles and rated CPG quality using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, composed of 23 items, rated 1-7, within 6 domains...
August 2016: Infection Control and Hospital Epidemiology
Fateh Rahimi, Leili Shokoohizadeh
Methicillin resistant Staphylococcus aureus is one of the most common causes of a variety of infections ranging from wound infections to urinary tract infections (UTI) in hospital and community. In this study during 3 years we characterized the antibiotic resistance patterns of 491 hospital acquired MRSA and community associated MRSA strains by the guidelines of clinical and laboratory standard institute. A combination of high resolution PhP typing method and SCCmec typing were used for clonal dissemination of isolates...
August 2016: Microbial Pathogenesis
Xin Fan, Yue Wu, Meng Xiao, Zhi-Peng Xu, Timothy Kudinha, Alda Bazaj, Fanrong Kong, Ying-Chun Xu
For a better understanding of the multidrug resistant Pseudomonas aeruginosa (MDR-PA) epidemiology in mainland China, a nationwide surveillance network of 27 tertiary hospitals was established. Non-duplicate MDR-PA isolates from 254 cases of nosocomial infections, were collected during the period August 2011 to July 2012. Minimum inhibitory concentrations (MICs) of nine antimicrobial agents were determined by broth micro-dilution method according to the CLSI guidelines [M7-A10]. Genotyping analysis was performed by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)...
2016: Scientific Reports
Javier Sánchez-Rubio Ferrández, José Manuel Martínez Sesmero
Pre-exposure prophylaxis" (PrEP) has been recently developed as a prevention strategy which involves the administration of drugs to non-infected individuals who present high exposure or susceptibility to HIV. Although this use is not approved in our country, several guidelines recommend PrEP as a prevention option in adult MSM, heterosexual men and women, and users of parenteral drugs at risk of acquiring the infection. This article presents the characteristics that an ideal agent to be used as PrEP should meet, recent efficacy published data and barriers for the implementation of this new strategy...
May 2016: Farmacia Hospitalaria
Abdel Latif Marini, Raymond Khan, Shihab Mundekkadan
Ventilator associated pneumonia (VAP) remains a worldwide harm associated with hospital acquired infection. Our VAP rate at King Abdulaziz Medical City was 4.0 per 1 000 patient days at baseline. All regulatory bodies continue to emphasize the importance of reducing these infections and include a guideline of practice recommendations to address them, notably the VAP bundle by the Institute for Healthcare Improvement. Our baseline compliance was low and measured to be 83%; this was perceived as an opportunity to work on revising our interventions in the ICUs...
2016: BMJ Quality Improvement Reports
P Borella, A Bargellini, P Marchegiano, E Vecchi, I Marchesi
The waterborne healthcare-associated infections are mainly sustained by Legionella and Pseudomonas spp. Various water factors and plumbing characteristics, and the interaction with other water microorganisms are considered to be predictive of Legionella contamination. It is therefore mandatory to organize plans of surveillance, prevention and control in order to avoid disease appearance in immunosuppressed patients, with higher risk of death. Guidelines for the prevention of Legionnaires' disease have been published, benefiting those who face this problem, but definitive standardized solutions do not exist yet...
March 2016: Annali di Igiene: Medicina Preventiva e di Comunità
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