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Infection control in ICU

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https://www.readbyqxmd.com/read/28321578/silver-embedded-screens-in-the-intensive-care-unit-a-new-tool-to-control-multi-drug-resistant-bacterial-cross-transmission
#1
J Ruiz, P Ramirez, E Villarreal, M Gordon, S Cuesta, M Piñol, J Frasquet, Á Castellanos
The purpose of this study was to assess the effectiveness of silver-embedded surfaces (BactiBlock®) to prevent surface colonization by multi-resistant bacteria (MRB) and to reduce the incidence of MRB colonization and infection in patients admitted to an intensive care unit (ICU). A 6-month prospective observational study in a 24-bed mixed ICU divided into two identical subunits (12 beds each) was designed. Seven solid mobile screens were placed in one of the subunits while in the other cloth screens remained...
March 20, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28303847/trends-in-drug-resistance-of-acinetobacter-baumannii-over-a-10-year-period-nationwide-data-from-the-china-surveillance-of-antimicrobial-resistance-program
#2
Lei Gao, Yuan Lyu, Yun Li
BACKGROUND: Acinetobacter baumannii has emerged as an important pathogen causing a variety of infections. Using data from the China Surveillance of Antimicrobial Resistance Program conducted biennially, we investigated the secular changes in the resistance of 2917 isolates of A. baumannii from 2004 to 2014 to differ antimicrobial agents. METHODS: Pathogen samples were collected from 17 to 20 hospitals located in the eastern, central, and western regions of China...
March 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28302496/community-acquired-pneumococcal-pneumonia-in-virologically-suppressed-hiv-infected-adult-patients-a-matched-case-control-study
#3
Catia Cillóniz, Antoni Torres, Christian Manzardo, Albert Gabarrús, Juan Ambrosioni, Adriana Salazar, Felipe García, Adrián Ceccato, Josep Mensa, Jorge Puig de la Bella Casa, Asunción Moreno, Jose M Miró
BACKGROUND: The study aimed to investigate whether the clinical presentations and outcomes (length-of-stay (LOS), intensive care unit (ICU) admission and 30-day mortality) of pneumococcal pneumonia in virologically suppressed HIV-infected patients on ART with a CD4+ T cell count >350 cells/mm(3) are comparable to those seen in non-HIV-infected patients, using a case-control design. METHODS: A case-control study was carried out in Hospital Clinic, Barcelona, Spain (2001-2016)...
March 13, 2017: Chest
https://www.readbyqxmd.com/read/28300495/hospital-acquired-infections-in-paediatric-medical-wards-at-a-tertiary-hospital-in-kwazulu-natal-south-africa
#4
Kevin B Spicer, Jennifer Green, Barnesh Dhada
BACKGROUND: Hospital-acquired infections (HAIs) impact care and costs in hospitals across the globe. There are minimal data on HAIs in sub-Saharan Africa and data specific to paediatrics are especially limited. OBJECTIVE: To describe the incidence of HAIs in the paediatric medical units at Grey's Hospital, a tertiary government hospital in KwaZulu-Natal, South Africa. METHODS: The Infection Prevention and Control (IPC) team collects data on all laboratory-confirmed infections, including from paediatric patients in two medical units (52 beds), the paediatric intensive/high-care unit (PICU, 8 beds) and the neonatal intensive care unit (NICU, 23 beds)...
March 16, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28291668/under-utilization-of-taps-in-intensive-care-unit-as-a-cause-of-reservoirs-of-nonfermenting-gram-negative-bacilli
#5
Gonzalo de-Las-Casas-Cámara, María Dolores Martín-Ríos, Maria Isabel Adillo-Montero, María Carmen Muñoz-Egea, Javier Zapardiel-Ferrero, Concepción Pérez-Jorge Peremarch
INTRODUCTION: The under-utilisation of taps is associated with the generation of reservoirs of non-fermenting gram-negative bacilli with the ability to disseminate. We describe the detection and approach of the problem in an ICU. METHODS: Observational descriptive study in an ICU with individual cubicles with their own sink. We collected clinical samples from patients and environmental samples from tap aerators and reviewed the unit's hygiene measures. RESULTS: We detected four cases due to Chryseobacterium indologenes, one to Elizabethkingia meningoseptica and another to Pseudomonas aeruginosa; they were identified both in clinical and the environmental samples...
March 10, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28289522/device-associated-infection-rates-mortality-length-of-stay-and-bacterial-resistance-in-intensive-care-units-in-ecuador-international-nosocomial-infection-control-consortium-s-findings
#6
Estuardo Salgado Yepez, Maria M Bovera, Victor D Rosenthal, Hugo A González Flores, Leonardo Pazmiño, Francisco Valencia, Nelly Alquinga, Vanessa Ramirez, Edgar Jara, Miguel Lascano, Veronica Delgado, Cristian Cevallos, Gasdali Santacruz, Cristian Pelaéz, Celso Zaruma, Diego Barahona Pinto
AIM: To report the results of the International Nosocomial Infection Control Consortium (INICC) study conducted in Quito, Ecuador. METHODS: A device-associated healthcare-acquired infection (DA-HAI) prospective surveillance study conducted from October 2013 to January 2015 in 2 adult intensive care units (ICUs) from 2 hospitals using the United States Centers for Disease Control/National Healthcare Safety Network (CDC/NHSN) definitions and INICC methods. RESULTS: We followed 776 ICU patients for 4818 bed-days...
February 26, 2017: World Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28273965/emergence-of-carbapenem-resistant-non-fermenting-gram-negative-bacilli-isolated-in-an-icu-of-a-tertiary-care-hospital
#7
Sonika Agarwal, Barnali Kakati, Sushant Khanduri, Shalini Gupta
INTRODUCTION: The emergence and spread of Multi-Drug Resistant (MDR) Non-Fermenting Gram-Negative Bacilli (NFGNB) in Intensive Care Units (ICU) and their genetic potential to transmit diverse antibiotic resistance regardless of their ability to ferment glucose poses a major threat in hospitals. The complex interplay of clonal spread, persistence, transmission of resistance elements and cell-cell interaction leads to the difficulty in controlling infections caused by these multi drug-resistant strains...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28242072/active-surveillance-for-carbapenem-resistant-acinetobacter-baumannii-in-a-medical-intensive-care-unit-can-it-predict-and-reduce-subsequent-infections-and-the-use-of-colistin
#8
Joon Hwan An, Yu-Hyoung Kim, Jung-Eun Moon, Jong Hae Jeong, Su-Hyun Kim, Seung-Ji Kang, Kyung-Hwa Park, Sook-In Jung, Hee-Chang Jang
BACKGROUND: Infection caused by carbapenem-resistant Acinetobacter baumannii (CRAB) has become a major problem in intensive care units (ICUs), with high incidence and mortality. This prospective study investigated the diagnostic value and influence of active surveillance, followed by isolation and enhanced contact precaution (IECP), on the subsequent CRAB infection and colistin use. METHODS: The study prospectively enrolled 1,115 patients who were admitted to the medical ICU of Chonnam National University Hwasun Hospital between April 2011 and November 2014...
February 24, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28239453/the-sink-as-a-potential-source-of-transmission-of-carbapenemase-producing-enterobacteriaceae-in-the-intensive-care-unit
#9
Deborah De Geyter, Lieve Blommaert, Nicole Verbraeken, Mark Sevenois, Luc Huyghens, Helena Martini, Lieve Covens, Denis Piérard, Ingrid Wybo
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) are emerging pathogens that represent a major public health threat. In the University Hospital of Brussels, the incidence of new patients with CPE rose from 1 case in 2010 to 35 cases in 2015. Between January and August 2015, five patients became infected/colonized with CPE during their stay in the same room in the intensive care unit (ICU). Since the time period between those patients was relatively short and the strains belonged to different species with different antibiograms and mechanisms of resistance, the hypothesis was that the environment could be a possible source of transmission...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28228491/maldi-tof-alone-versus-maldi-tof-combined-with-real-time-antimicrobial-stewardship-interventions-on-time-to-optimal-antimicrobial-therapy-in-patients-with-positive-blood-cultures
#10
Maya Beganovic, Michael Costello, Sarah M Wieczorkiewicz
Introduction: Matrix-assisted laser desorption ionization time of flight (MALDI-TOF) decreases time to organism identification and improves clinical and financial outcomes. The purpose of this study was to evaluate the impact of MALDI-TOF alone vs MALDI-TOF combined with real-time, pharmacist-driven, antimicrobial stewardship (AMS) intervention on patient outcomes.Methods: This single-center, pre-post quasi-experimental study evaluated hospitalized patients with positive blood cultures identified via MALDI-TOF combined with prospective AMS intervention, compared to a control cohort with MALDI-TOF identification without AMS intervention...
February 22, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28224111/attributable-cost-of-a-nosocomial-infection-in-the-intensive-care-unit-a-prospective-cohort-study
#11
Binila Chacko, Kurien Thomas, Thambu David, Hema Paul, Lakshmanan Jeyaseelan, John Victor Peter
AIM: To study the impact of hospital-acquired infections (HAIs) on cost and outcome from intensive care units (ICU) in India. METHODS: Adult patients (> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224108/implementation-of-enteral-feeding-protocol-in-an-intensive-care-unit-before-and-after-study
#12
Martin Padar, Gerli Uusvel, Liis Starkopf, Joel Starkopf, Annika Reintam Blaser
AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection Control Service...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28219190/-efficacy-and-safety-of-procalcitonin-guidance-in-reducing-the-duration-of-antibiotic-treatment-of-sepsis-patients
#13
X L Xu, F D Yan, J Q Yu, Q H Chen, H Lin, R Q Zheng
Objective: To assesse the efficacy and safety of procalcitonin-guided antibiotic treatment of sepsis patients in intensive care units (ICU). Methods: A prospective, randomised, controlled trial was gone in ICU of Northern Jiangsu People's Hospital.Between January 2013 and December 2015.One hundred and fifty-six patients assessed for eligibility were randomly assigned to the procalcitonin-guided group (PCT group, 79) or to regular antibiotic group (RAT group, 77). Patients who received antibiotics for presumed infection according to principle of antimicrobial usage...
February 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28216701/impact-of-modified-quality-control-checklist-on-protocol-adherence-and-outcomes-in-a-post-surgical-intensive-care-unit
#14
Lakshmi Kumar, Meenu Dominic, Sunil Rajan, Sanjeev Singh
BACKGROUND AND AIMS: Quality improvement (QI) is the sum of all activities that create desired changes in the quality. An effective QI system results in a stepwise increase in quality of care. The efficiency of any health-care unit is judged by its quality indicators. We aimed to evaluate the impact of QI initiatives on outcomes in a surgical Intensive Care Unit (ICU). METHODS: This was an observational study carried out using a compliance checklist, developed from the combination of the World Health Organization surgery checklist and Society for Healthcare Epidemiology of America guidelines for the prevention of infections...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215789/a-ten-year-review-of-total-hospital-onset-intensive-care-unit-bloodstream-infections-at-an-academic-medical-center
#15
Anna M Civitarese, Eric Ruggieri, J Matthias Walz, Deborah Ann Mack, Stephen O Heard, Michael Mitchell, Craig M Lilly, Karen E Landry, Richard T Ellison
OBJECTIVE: The rates of central line-associated bloodstream infections (CLABSIs) in United States intensive care units (ICU) have decreased significantly, and a parallel reduction in the rates of total hospital onset bacteremias in these units should also be expected. We report 10-year trends for total hospital onset ICU-associated bacteremias at a tertiary care academic medical center. DESIGN: This was a retrospective analysis of all positive blood cultures among patients admitted to seven adult ICUs for the period FY2005 through FY2014 according to Centers for Disease Control and Prevention National Healthcare Safety Network definitions...
February 16, 2017: Chest
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#16
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28178922/risk-factors-for-excessively-prolonged-meropenem-use-in-the-intensive-care-setting-a-case-contol-study
#17
Juri Katchanov, Benno Kreuels, Florian P Maurer, Kai Wöstmann, Johannes Jochum, Christina König, Kariem Seoudy, Holger Rohde, Ansgar W Lohse, Dominic Wichmann, Michael Baehr, Camilla Rothe, Stefan Kluge
BACKGROUND: Inappropriate use of broad-spectrum antimicrobials affects adversely both the individual patient and the general public. The aim of the study was to identify patients at risk for excessively prolonged carbapenem treatment in the ICU as a target for antimicrobial stewardship interventions. METHODS: Case-control study in a network of 11 ICUs of a university hospital. Patients with uninterrupted meropenem therapy (MT) > 4 weeks were compared to controls...
February 8, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28173962/prevalence-of-healthcare-associated-infections-in-polish-adult-intensive-care-units-summary-data-from-the-ecdc-european-point-prevalence-survey-of-hospital-associated-infections-and-antimicrobial-use-in-poland-2012-2014
#18
A Deptuła, E Trejnowska, G Dubiel, M Żukowski, A Misiewska-Kaczur, T Ozorowski, W Hryniewicz
BACKGROUND: Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. Local epidemiological studies need to be conducted to set the priorities for surveillance and prevention programmes. AIM: To investigate the epidemiology of hospital-acquired infections (HAIs) among patients admitted to Polish adult ICUs over a three-year period. METHODS: Data were collected according to the European Centre for Disease Prevention and Control (ECDC) European Union Point Prevalence Survey of Healthcare-associated Infections and Antimicrobial Use in European Acute Care Hospitals (EU-PPS HAI & AU) protocol for 39,318 patients within 160 acute care hospitals...
January 4, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28162098/the-effect-of-universal-decolonization-with-screening-in-critical-care-to-reduce-mrsa-across-an-entire-hospital
#19
Craig W Bradley, Martyn A C Wilkinson, Mark I Garvey
OBJECTIVE To describe the effect of universal methicillin-resistant Staphylococcus aureus (MRSA) decolonization therapy in a large intensive care unit (ICU) on the rates of MRSA cases and acquisitions in a UK hospital. DESIGN Descriptive study. SETTING University Hospitals Birmingham (UHB) NHS Foundation Trust is a tertiary referral teaching hospital in Birmingham, United Kingdom, that provides clinical services to nearly 1 million patients every year. METHODS A break-point time series analysis and kernel regression models were used to detect significant changes in the cumulative monthly numbers of MRSA bacteremia cases and acquisitions from April 2013 to August 2016 across the UHB system...
February 6, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28161384/hospitalization-costs-and-clinical-outcomes-in-cabg-patients-treated-with-intensive-insulin-therapy
#20
Saumeth Cardona, Francisco J Pasquel, Maya Fayfman, Limin Peng, Sol Jacobs, Priyathama Vellanki, Jeff Weaver, Michael Halkos, Robert A Guyton, Vinod H Thourani, Guillermo E Umpierrez
BACKGROUND: The financial impact of intensive (blood glucose [BG] 100-140mg/dl [5.5-7.8mM] vs. conservative (141-180mg/dl (7.9-10.0mM) glucose control in the ICU in patients, with and without diabetes, undergoing coronary artery bypass graft (CABG) surgery is not known. METHODS: This post-hoc cost analysis determined differences in hospitalization costs, resource utilization and perioperative complications in 288 CABG patients with diabetes (n=143) and without diabetes (n=145), randomized to intensive (n=143) and conservative (n=145) glucose control...
April 2017: Journal of Diabetes and its Complications
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