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https://www.readbyqxmd.com/read/29158918/challenges-with-surveillance-of-healthcare-associated-infections-in-intensive-care-units-in-south-africa
#1
Saajida Mahomed, Ozayr Mahomed, A Willem Sturm, Stephen Knight, Prashini Moodley
Background: The incidence of healthcare-associated infections (HAIs) in the public health sector in South Africa is not known due to the lack of a surveillance system. We report on the challenges experienced in the implementation of a surveillance system for HAIs in intensive care units (ICUs). Methods: A passive, paper-based surveillance system was piloted in eight ICUs to measure the incidence of ventilator-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bloodstream infection...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29156852/risk-factors-for-recurrent-central-line-associated-bloodstream-infections-in-a-pediatric-intensive-care-unit
#2
Rana İşgüder, İlker Devrim, Gökhan Ceylan, Ahu Kara, Gamze Gülfidan, Hasan Ağın
Background/aim: It is recommended that a central venous catheter (CVC) be removed if central line-associated bloodstream infection (CLABSI) has been diagnosed. The objective of this retrospective study was to evaluate the risk factors for recurrent CLABSI in reinserted catheters in a pediatric intensive care unit. Materials and methods: Patients with recurrent and nonrecurrent CLABSI were compared in terms of the catheter exchange interval, the interval between negative blood culture and reinsertion of the CVC, and the pre-/reinsertion treatment duration...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29154382/review-of-strategies-to-reduce-central-line-associated-bloodstream-infection-clabsi-and-catheter-associated-urinary-tract-infection-cauti-in-adult-icus
#3
Payal K Patel, Ashwin Gupta, Valerie M Vaughn, Jason D Mann, Jessica M Ameling, Jennifer Meddings
Central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) are costly and morbid. Despite evidence-based guidelines, Some intensive care units (ICUs) continue to have elevated infection rates. In October 2015, we performed a systematic search of the peer-reviewed literature within the PubMed and Cochrane databases for interventions to reduce CLABSI and/or CAUTI in adult ICUs and synthesized findings using a narrative review process. The interventions were categorized using a conceptual model, with stages applicable to both CAUTI and CLABSI prevention: (stage 0) avoid catheter if possible, (stage 1) ensure aseptic placement, (stage 2) maintain awareness and proper care of catheters in place, and (stage 3) promptly remove unnecessary catheters...
November 8, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29142743/anti-candida-activity-of-antimicrobial-impregnated-central-venous-catheters
#4
L Cobrado, A Silva-Dias, M M Azevedo, A Rodrigues
Background: Whenever the rate of central line-associated bloodstream infections (CLABSIs) remains high even after the implementation of preventive strategies, the use of chlorhexidine/silver sulfadiazine (CSS) or minocycline/rifampin (MR)-impregnated central venous catheters (CVCs) is currently recommended. Nevertheless, the efficacy of such CVCs against Candida albicans and other emerging non-albicans spp. has been insufficiently studied. This study aims to compare the activity of CSS and MR-impregnated CVCs against the yeasts most frequently isolated from CLABSIs...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29132512/ultrasound-and-other-innovations-for-fluid-management-in-the-icu
#5
REVIEW
Mark Blum, Paula Ferrada
Ultrasound is a user-dependent tool that can help guide therapy. The use of ultrasound to guide central line placement decreases complication rates. Cardiac ultrasound can help with the diagnosis of cases of hypotension. Lung and pleura ultrasound is a useful adjunct for diagnosis causes of desaturation. Abdominal ultrasound can help in rapid visitation of fluid and intra-abdominal structures.
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29122901/spinal-epidural-empyema-extending-from-a-pleural-empyema-case-description-and-anatomical-overview
#6
Gabriel Torrealba Acosta, Sylvia Josephy Hernández, Gabriel Castro Ulloa, Greivin Rodríguez Rojas
We present a case of a patient with diabetes with a pleural empyema originated from a pyomyositis process established after a central line procedure. This empyema later on extended into the spinal canal deriving into an epidural empyema, leading towards a spinal neurogenic shock and death. We discuss the anatomical substrate for this extension as well as the anatomopathological findings observed in the autopsy.
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29119023/improvement-in-quality-metrics-outcomes-and-patient-and-family-satisfaction-in-a-neurosciences-intensive-care-unit-after-creation-of-a-dedicated-neurocritical-care-team
#7
Yaw Sarpong, Premkumar Nattanmai, Ginger Schelp, Robert Bell, Keerthivaas Premkumar, Erin Stapleton, Ashley McCormick, Christopher R Newey
Introduction: Dedicated neurointensivists have been shown to improve outcome measurements in the neurosciences intensive care unit (NSICU). Quality outcome data in relation to patient and family satisfaction is lacking. This study evaluated the impact of newly appointed neurointensivists and creation of a neurocritical care team on quality outcome measures including patient satisfaction in a NSICU. Methods: This is a retrospective study of data over 36 months from a 14-bed NSICU evaluating quality outcome measures and anonymous patient satisfaction questionnaires before and after neurointensivists appointment...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29117964/clinical-characteristics-of-children-evaluated-for-suspected-pulmonary-embolism-with-d-dimer-testing
#8
Jessica Kanis, Jonathan Pike, Cassandra L Hall, Jeffrey A Kline
BACKGROUND: We sought to determine clinical variables in children tested for suspected pulmonary embolism (PE) that predict PE+ outcome for the development of paediatric PE prediction rule. METHODS: Data were collected by query of a laboratory database for D-dimer from January 2004 to December 2014 for a large multicentre hospital system and the radiology database for pulmonary vascular imaging in children aged 5-17. Using explicit, predefined methods, trained abstractors, determined if D-dimer was sent in the evaluation of PE and then recorded predictor data which was tested for association with PE+ outcome using univariate techniques...
November 8, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29114395/gordonia-sternal-wound-infection-treated-with-ceftaroline-case-report-and-literature-review
#9
Kevan Akrami, Joelle Coletta, Sanjay Mehta, Joshua Fierer
Introduction. Case reports have emerged with identification of Gordonia bronchialis infections including sternal wound infections and foreign bodies such as central lines and shunts. Case presentation. We present a case that demonstrates the need to consider Gordonia infection as a cause of sternal wound infection and highlights the utility of novel diagnostics to aid in the identification of unusual pathogens that can cause post-operative infections. We report here the first successful use of ceftaroline for treatment of a G...
September 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29113679/wound-complications-after-chemo-port-placement-in-children-does-closure-technique-matter
#10
Colin Muncie, Richard Herman, Anderson Collier, Barry Berch, Christopher Blewett, David Sawaya
PURPOSE: Wound dehiscence after chemo-port placement is a rare but potentially significant complication. We hypothesize that by using a simple running skin closure technique during chemo-port placement the rate of wound dehiscence and overall wound complications can be significantly decreased. METHODS: IRB approval was obtained and patients <18years that received a tunneled central line with port from June 2012 to April 2016 were analyzed. Data collected on patients included patient demographics, skin closure type, and wound complications within 30days...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29108783/implementation-of-a-national-bundle-care-program-to-reduce-central-line-associated-bloodstream-infections-in-intensive-care-units-in-taiwan
#11
Chih-Cheng Lai, Cong-Tat Cia, Hsiu-Tzy Chiang, Yung-Chung Kung, Zhi-Yuan Shi, Yin-Ching Chuang, Chun-Ming Lee, Wen-Chien Ko, Po-Ren Hsueh
BACKGROUND/PURPOSE: This study assessed the effect of the central line bundle on the rate of central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) in Taiwan. METHODS: This national study was conducted in 27 ICUs with 404 beds total, including 15 medical ICUs, 11 surgical ICUs, and one mixed ICU. The study period was divided into two phases: a pre-intervention (between June 1, 2011 and October 31, 2011) and intervention phase (between December 1, 2011 and October 31, 2012)...
October 25, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/29083464/initiating-exercise-interventions-to-promote-wellness-in-cancer-patients-and-survivors
#12
REVIEW
Anna L Schwartz, Hendrik Dirk de Heer, Jennifer W Bea
Exercise is associated with significant reductions in the recurrence and mortality rates of several common cancers. Cancer survivors who exercise can potentially benefit from reduced levels of fatigue, and improved quality of life, physical function, and body composition (ie, healthier ratios of lean body mass to fat mass). The amount of activity required to achieve protective effects is moderate (eg, walking 30 minutes per day at 2.5 miles per hour). However, many healthcare providers report a lack of awareness of the appropriate exercise recommendations across the phases of cancer survivorship, considerations regarding the timing of exercise interventions, and the ability to refer patients to exercise programs specifically aimed at cancer survivors...
October 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/29074717/2-chlorhexidine-70-isopropyl-alcohol-versus-10-povidone-iodine-for-insertion-site-cleaning-before-central-line-insertion-in-preterm-infants-a-randomised-trial
#13
Emily A Kieran, Anne O'Sullivan, Jan Miletin, Anne R Twomey, Susan J Knowles, Colm Patrick Finbarr O'Donnell
OBJECTIVE: To determine whether 2% chlorhexidine gluconate-70% isopropyl alcohol (CHX-IA) is superior to 10% aqueous povidone-iodine (PI) in preventing catheter-related blood stream infection (CR-BSI) when used to clean insertion sites before placing central venous catheters (CVCs) in preterm infants. DESIGN: Randomised controlled trial. SETTING: Two neonatal intensive care units (NICUs). PATIENTS: Infants <31 weeks' gestation who had a CVC inserted...
October 26, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29066217/impact-of-mucosal-barrier-injury-laboratory-confirmed-bloodstream-infection-mbi-lcbi-on-central-line-associated-bloodstream-infections-clabsis-in-department-of-hematology-at-single-university-hospital-in-japan
#14
Yukiko Kato, Mao Hagihara, Ai Kurumiya, Tomoko Takahashi, Miki Sakata, Yuichi Shibata, Hideo Kato, Arufumi Shiota, Hiroki Watanabe, Nobuhiro Asai, Yusuke Koizumi, Yuka Yamagishi, Hiroshige Mikamo
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are among the most serious complications especially in blood cancer patients. In January 2013, Centers for Disease and Prevention (CDC) introduced a new surveillance definition of mucosal barrier injury-associated laboratory-confirmed bloodstream infection (MBI-LCBI). This study was to determine the impact of MBI-LCBI on CLABSIs and compare the clinical characteristics of MBI versus non-MBI-LCBI cases. PATIENTS AND METHODS: We retrospectively reviewed the records of 250 consecutive patients...
October 21, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29063210/late-onset-sepsis-due-to-urinary-tract-infection-in-very-preterm-neonates-is-not-uncommon
#15
Alexander B Mohseny, Veerle van Velze, Sylke J Steggerda, Vivianne E H J Smits-Wintjens, Vincent Bekker, Enrico Lopriore
Urinary tract infection (UTI) is a common cause of sepsis in infants. Premature infants hospitalized at a neonatal intensive care unit often have risk factors for infection. In this group, the risk of UTI is not clearly known, and guidelines for urine analysis are not unanimous. We aimed to identify the risk of UTI in premature infants with central lines, suspected of late-onset sepsis. We analyzed all 1402 infants admitted to our hospital between 2006 and 2014 with a gestational age less than 32 weeks. Six hundred sixty-two episodes of sepsis evaluations were found with an unknown source of infection based on clinical symptoms...
October 23, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29057135/rare-congenital-aberrant-left-superior-pulmonary-vein-discovered-with-central-line-placement-in-a-patient-with-critical-cardiorespiratory-collapse
#16
Spencer Knox, Mario Madruga, S J Carlan
BACKGROUND: Partial anomalous pulmonary venous connection is a rare congenital vascular disorder that may be asymptomatic. Left-sided connections with the innominate vein are discovered infrequently and those without an atrial septal defect are extremely rare. CASE: A 66-year-old male was found to have an anomalous left pulmonary vein when a central venous catheter was inserted for management of hypoxemia. In addition to the connection with the left innominate vein an echocardiogram revealed no atrial septal defect...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29051092/a-study-on-the-targeted-surveillance-of-nosocomial-infection-in-intensive-care-units-of-177-hospitals-in-jiangsu-province-of-china
#17
Yang Li, Xiao-Li Cao, Hai Ge, Yi-Hong Jiang, Hong Zhou, Wei Zheng
BACKGROUND: Nosocomial infections (NIs) impact care and costs in hospitals across the globe. There are minimal data on targeted surveillance of NI in intensive care units (ICUs), and data specific to the risk factors for NI are especially limited. METHODS: One hundred seventy-seven secondary and tertiary hospitals performed NI targeted surveillance in their ICUs. The data were collected and summarized by Minke software, then fed back once per quarter. RESULTS: The incidence of NI appeared to decrease, and the incidence of NI per 1000 patient-days and adjusted incidence were 25...
October 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29046215/prospective-surveillance-of-device-associated-health-care-associated-infection-in-an-intensive-care-unit-of-a-tertiary-care-hospital-in-new-delhi-india
#18
Shilpee Kumar, Poornima Sen, Rajni Gaind, Pardeep Kumar Verma, Poonam Gupta, Prem Rose Suri, Sunita Nagpal, Anil Kumar Rai
BACKGROUND: Surveillance of health care-associated infections (HAIs) plays a key role in the hospital infection control program and reduction of HAIs. In India, most of the surveillance of HAIs is reported from private sector hospitals that do not depict the situation of government sector hospitals. Other studies do not confirm with the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) surveillance criterion, or deal with ventilator-associated pneumonia (VAP) instead of ventilator-associated event (VAE)...
October 15, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29031864/bloodstream-infections-following-different-types-of-surgery-in-a-finnish-tertiary-care-hospital-2009-2014
#19
Kirsi Skogberg, Keiju S K Kontula, Asko Järvinen, Outi Lyytikäinen
We evaluated the risk and outcome of bloodstream infections (BSIs) following surgery. BSIs were identified in Helsinki University Hospital during 2009-2014 as part of the national surveillance. Of 711 BSIs identified, 51% were secondary and 49% primary. The rate was highest after cardiovascular surgery (8.7/1000 procedures) and lowest after gynaecologic (1.0/1000). Surgical site infection was the most common source of secondary BSIs (34%) and 45% of primary BSIs were central line-associated. The 28-day case fatality ranged from 0% in gynaecology/obstetrics to 21% in cardiovascular surgery...
October 12, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29031430/leadership-line-care-rounds-application-of-the-engage-educate-execute-and-evaluate-improvement-model-for-the-prevention-of-central-line-associated-bloodstream-infections-in-children-with-cancer
#20
Angie Owings, JoBeth Graves, Sherry Johnson, Craig Gilliam, Mike Gipson, Hana Hakim
To prevent central line-associated bloodstream infections (CLABSIs), leadership line care rounds (LLCRs) used the engage, educate, execute, and evaluate improvement model to audit compliance, identify barriers and opportunities, empower patients and families, and engage leadership. Findings of excellence and improvement opportunities were communicated to unit staff and managers. LLCRs contributed to compliance with CLABSI prevention interventions.
October 11, 2017: American Journal of Infection Control
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