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Infection control in ICU

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https://www.readbyqxmd.com/read/29151417/-effect-of-early-use-of-different-doses-of-enteral-nutrition-on-prognosis-of-patients-with-acute-respiratory-failure
#1
Jianting Gao, Qiuyan Wang
OBJECTIVE: To observe the impact of initial low-dose (trophic type) enteral nutrition (EN) support on mechanical ventilation (MV) time, the incidence of complications and survival rate in patients with acute respiratory failure (ARF). METHODS: A prospective study was conducted. Forty-four patients with ARF undergoing MV admitted to Department of Critical Care Medicine of Hangzhou Traditional Chinese Medical Hospital from September 2015 to February 2017 were enrolled, and they were divided into a trophic feeding group (n = 23, study group) and a standard-dose feeding group (n = 21, control group)...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29143704/identification-of-clostridium-difficile-reservoirs-in-the-patient-environment-and-efficacy-of-aerial-hydrogen-peroxide-decontamination
#2
Samuel Yui, Shanom Ali, Monika Muzslay, Annette Jeanes, A Peter R Wilson
OBJECTIVE To identify, using a novel enhanced method of recovery, environmental sites where spores of Clostridium difficile persist despite cleaning and hydrogen peroxide aerial decontamination. DESIGN Cohort study. SETTING Tertiary referral center teaching hospital. METHODS In total, 16 sites representing high-frequency contact or difficult-to-clean surfaces in a single-isolation room or bed area in patient bed bays were sampled before and after terminal or hydrogen peroxide disinfection using a sponge swab...
November 16, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#3
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29130231/-effect-of-postoperative-hyperglycemia-on-clinical-outcome-of-gastrointestinal-fistula-patients-undergoing-gastrointestinal-reconstruction
#4
Qiongyuan Hu, Jian'an Ren, Wenhao Tang, Jieshou Li
OBJECTIVE: To investigate the effect of hyperglycemia within postoperative 48 hours on gastrointestinal (GI) fistula patients without preoperative diagnosis of diabetes undergoing selective GI reconstruction. METHODS: Clinical data of GI fistula patients with age of 18 to 70 years and without diffuse peritonitis and systemic infection undergoing definitive GI reconstruction at Intestinal Fistula Center of Jinling Hospital from September 2012 to December 2015 were retrospectively analyzed...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29128300/enteral-versus-parenteral-early-nutrition-in-ventilated-adults-with-shock-a-randomised-controlled-multicentre-open-label-parallel-group-study-nutrirea-2
#5
Jean Reignier, Julie Boisramé-Helms, Laurent Brisard, Jean-Baptiste Lascarrou, Ali Ait Hssain, Nadia Anguel, Laurent Argaud, Karim Asehnoune, Pierre Asfar, Frédéric Bellec, Vlad Botoc, Anne Bretagnol, Hoang-Nam Bui, Emmanuel Canet, Daniel Da Silva, Michael Darmon, Vincent Das, Jérôme Devaquet, Michel Djibre, Frédérique Ganster, Maité Garrouste-Orgeas, Stéphane Gaudry, Olivier Gontier, Claude Guérin, Bertrand Guidet, Christophe Guitton, Jean-Etienne Herbrecht, Jean-Claude Lacherade, Philippe Letocart, Frédéric Martino, Virginie Maxime, Emmanuelle Mercier, Jean-Paul Mira, Saad Nseir, Gael Piton, Jean-Pierre Quenot, Jack Richecoeur, Jean-Philippe Rigaud, René Robert, Nathalie Rolin, Carole Schwebel, Michel Sirodot, François Tinturier, Didier Thévenin, Bruno Giraudeau, Amélie Le Gouge
BACKGROUND: Whether the route of early feeding affects outcomes of patients with severe critical illnesses is controversial. We hypothesised that outcomes were better with early first-line enteral nutrition than with early first-line parenteral nutrition. METHODS: In this randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2 trial) done at 44 French intensive-care units (ICUs), adults (18 years or older) receiving invasive mechanical ventilation and vasopressor support for shock were randomly assigned (1:1) to either parenteral nutrition or enteral nutrition, both targeting normocaloric goals (20-25 kcal/kg per day), within 24 h after intubation...
November 8, 2017: Lancet
https://www.readbyqxmd.com/read/29127842/budesonide-facilitates-weaning-from-mechanical-ventilation-in-difficult-to-wean-very-severe-copd-patients-association-with-inflammatory-mediators-and-cells
#6
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29126595/burn-patients-with-infection-related-ventilator-associated-complications-have-worse-outcomes-compared-to-those-without-ventilator-associated-events
#7
Duraid Younan, Russell Griffin, Ahmed Zaky, Jean-Francois Pittet, Bernard Camins
BACKGROUND: The Centers for Disease Control and Prevention (CDC) replaced its definition for ventilator-associated pneumonia (VAP) in 2013. The aim of the current study is to compare the outcome of burn patients with ventilator associated events (VAEs). METHODS: Burn patients with at least two days of ventilator support were identified from the registry between 2013 and 2016. Kruskal-Wallis and Fisher's exact tests were utilized for continuous and categorical variables, respectively...
October 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29123370/assessing-hand-hygiene-compliance-among-healthcare-workers-in-six-intensive-care-units
#8
REVIEW
M Musu, A Lai, N M Mereu, M Galletta, M Campagna, M Tidore, M F Piazza, L Spada, M V Massidda, S Colombo, P Mura, R C Coppola
Introduction: Healthcare associated infections (HAIs) are a cause of high morbidity, disability and reduced quality of life, as well as mortality and rising costs for health systems. Preventing the HAI risk by planning and implementing effective preventive strategies is important to safeguard patient health. Methods: The study aimed to evaluate the presence of procedures and protocols for infection control, to assess the adhesion to the different aspects of hand hygiene (HH) and hand washing technique by healthcare workers in six ICUs...
September 2017: Journal of Preventive Medicine and Hygiene
https://www.readbyqxmd.com/read/29122787/effect-of-daily-antiseptic-body-wash-with-octenidine-on-nosocomial-primary-bacteraemia-and-nosocomial-multidrug-resistant-organisms-in-intensive-care-units-design-of-a-multicentre-cluster-randomised-double-blind-cross-over-study
#9
Anne Meißner, Dirk Hasenclever, Oana Brosteanu, Iris Freya Chaberny
INTRODUCTION: Nosocomial infections are serious complications that increase morbidity, mortality and costs and could potentially be avoidable. Antiseptic body wash is an approach to reduce dermal micro-organisms as potential pathogens on the skin. Large-scale trials with chlorhexidine as the antiseptic agent suggest a reduction of nosocomial infection rates. Octenidine is a promising alternative agent which could be more effective against Gram-negative organisms. We hypothesise that daily antiseptic body wash with octenidine reduces the risk of intensive care unit (ICU)-acquired primary bacteraemia and ICU-acquired multidrug-resistant organisms (MDRO) in a standard care setting...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29113779/hospital-acquired-lower-respiratory-tract-infections-among-high-risk-hospitalized-patients-in-a-tertiary-care-teaching-hospital-in-china-an-economic-burden-analysis
#10
Tianyuan Yan, Yingxia Li, Yu Sun, Haiyan Wang, Jingna Wang, Weili Wang, Yunhong Liu, Xiaohui Wu, Shuhui Wang
BACKGROUND: Data on the economic burden of hospital-acquired lower respiratory tract infection (LRTI) among high risk hospitalized patients are lacking in China. This study aims to fill this knowledge gap. METHODS: We used a prospective matched cohort design, comparing patients with LRTIs and 1:1 matched patients without LRTIs. Study period was from January 2013 to December 2015 analyzing inpatients from high risk wards - intensive care unit (ICU), dialysis, hematology, etc...
November 4, 2017: Journal of Infection and Public Health
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/29104124/control-of-endemic-multidrug-resistant-gram-negative-bacteria-after-removal-of-sinks-and-implementing-a-new-water-safe-policy-in-an-intensive-care-unit
#12
Evelyn Shaw, Laura Gavaldà, Jordi Càmara, Rosa Gasull, Santiago Gallego, Fe Tubau, Rosa Maria Granada, Pilar Ciercoles, M Angeles Dominguez, Rafael Mañez, Jordi Carratalà, Miquel Pujol
BACKGROUND: Contaminated handwashing sinks have been identified as reservoirs that can facilitate colonisation/infection of patients with multidrug-resistant (MDR) gram-negative bacteria (GNB) in intensive care units (ICUs). To eliminate endemic MDR-GNB in our ICU, we implemented a water-safe policy that involved the removal of all sinks from patients' rooms. AIM: We aimed to assess the impact of removing patients' sinks and implementing other water-safe strategies on the annual rates of ICU-acquired MDR-GNB...
November 2, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29103639/surveillance-guided-selective-digestive-decontamination-of-carbapenem-resistant-enterobacteriaceae-in-the-intensive-care-unit-a-cost-effectiveness-analysis
#13
Joyce H S You, Hong-Kiu Li, Margaret Ip
BACKGROUND: Clinical findings have shown effectiveness and safety of selective digestive decontamination (SDD) for eradication of carbapenem-resistant Enterobacteriaceae (CRE) in high-risk carriers. We aimed to evaluate the cost-effectiveness of SDD guided by CRE surveillance in the intensive care unit (ICU). METHODS: Outcomes of surveillance-guided SDD (test-guided SDD) and no screening (control) in the ICU were compared by Markov model simulations. Model outcomes were CRE infection and mortality rates, direct costs, and quality-adjusted life year (QALY) loss...
November 2, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29102989/universal-or-targeted-approach-to-prevent-the-transmission-of-extended-spectrum-beta-lactamase-producing-enterobacteriaceae-in-intensive-care-units-a-cost-effectiveness-analysis
#14
Lidia Kardaś-Słoma, Jean-Christophe Lucet, Anne Perozziello, Camille Pelat, Gabriel Birgand, Etienne Ruppé, Pierre-Yves Boëlle, Antoine Andremont, Yazdan Yazdanpanah
OBJECTIVE: Several control strategies have been used to limit the transmission of multidrug-resistant organisms in hospitals. However, their implementation is expensive and effectiveness of interventions for the control of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) spread is controversial. Here, we aim to assess the cost-effectiveness of hospital-based strategies to prevent ESBL-PE transmission and infections. DESIGN: Cost-effectiveness analysis based on dynamic, stochastic transmission model over a 1-year time horizon...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29097331/infection-incidence-associated-with-external-ventriculostomy-placement-a-comparison-of-outcomes-in-the-ed-icu-and-or
#15
Gurkirat Kohli, Roshansa Singh, Yehuda Herschman, Antonios Mammis
OBJECTIVE: External ventricular drain (EVD) placement is a common neurosurgical procedure used to control acute hydrocephalus and other neurosurgical complications. The infection and complication rates reported in the literature are highly variable and iatrogenic factors determine the outcome of drain placement. We examined the impact of the setting of the EVD placement (ED vs. ICU vs. OR) and the experience of the operating surgeon on the infection rate, complication rate, EVD replacement, eventual placement of VP shunt and need for further surgical intervention...
October 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29097104/characterization-of-microbial-community-composition-antimicrobial-resistance-and-biofilm-on-intensive-care-surfaces
#16
K Johani, D Abualsaud, D M Costa, H Hu, G Whiteley, A Deva, K Vickery
BACKGROUND: Organisms causing healthcare associated infections can be sourced from the inanimate environment around patients. Residing in a biofilm increases the chances of these organisms persisting in the environment. We aimed to characterise bacterial environmental contamination, genetically and physiologically, and relate this to general intensive care unit (ICU) cleanliness. METHODS: Cleanliness was determined by adenosine triphosphate (ATP) measurements of 95 high-touch objects...
October 30, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/29081854/toxic-shock-in-children-with-bone-and-joint-infections-a-review-of-seven-years-of-patients-admitted-to-one-intensive-care-unit
#17
D L Kerr, E K Loraas, A C Links, T V Brogan, G A Schmale
PURPOSE: The objective of this study was to compare the frequency of severe systemic, multi-organ involvement and toxic shock syndrome (TSS) in patients with Staphylococcus aureus (SA) and Group A β-haemolytic Streptococcus pyogenes (GABS) bone and joint infections. METHODS: We retrospectively reviewed patients treated for septic arthritis or osteomyelitis at one children's hospital between 2002 and 2009. The rates of intensive care unit (ICU) admission for methicillin-sensitive SA (MSSA), methicillin-resistant SA (MRSA) and GABS infections were compared, as were the lengths of stay, number of surgeries, operative procedures and cases of TSS...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29067985/point-prevalence-risk-factor-assessment-for-hospital-acquired-infections-in-a-tertiary-care-hospital-in-pune-india
#18
Velu Nair, A K Sahni, Dinesh Sharma, Naveen Grover, S Shankar, A Chakravarty, Seema Patrikar, Kailas Methe, S S Jaiswal, S S Dalal, Anupam Kapur, Rajesh Verma, Jyoti Prakash, Ashutosh Gupta, Anvita Bhansali, Deepak Batura, G Gopal Rao, D P Joshi, B K Chopra
BACKGROUND & OBJECTIVES: Hospital-acquired infections (HAIs) are a major challenge to patient safety and have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The true burden of HAI remains unknown, particularly in developing countries. The objective of this study was to estimate point prevalence of HAI and study the associated risk factors in a tertiary care hospital in Pune, India. METHODS: A series of four cross-sectional point prevalence surveys were carried out between March and August 2014...
June 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29067906/the-age-of-blood-evaluation-able-randomised-controlled-trial-description-of-the-uk-funded-arm-of-the-international-trial-the-uk-cost-utility-analysis-and-secondary-analyses-exploring-factors-associated-with-health-related-quality-of-life-and-health-care-costs
#19
Timothy S Walsh, Simon Stanworth, Julia Boyd, David Hope, Sue Hemmatapour, Helen Burrows, Helen Campbell, Elena Pizzo, Nicholas Swart, Stephen Morris
BACKGROUND: At present, red blood cells (RBCs) are stored for up to 42 days prior to transfusion. The relative effectiveness and safety of different RBC storage times prior to transfusion is uncertain. OBJECTIVE: To assess the clinical effectiveness and cost-effectiveness of transfusing fresher RBCs (stored for ≤ 7 days) compared with current standard-aged RBCs in critically ill patients requiring blood transfusions. DESIGN: The international Age of BLood Evaluation (ABLE) trial was a multicentre, randomised, blinded trial undertaken in Canada, the UK, the Netherlands and France...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29063386/assessment-of-immune-organ-dysfunction-in-critical-illness-utility-of-innate-immune-response-markers
#20
REVIEW
Carmen Andrea Pfortmueller, Christian Meisel, Michaela Fux, Joerg C Schefold
In critically ill patients, organ dysfunctions are routinely assessed, monitored, and treated. Mounting data show that substantial critical illness-induced changes in the immune system can be observed in most ICU patients and that not only "hyper-inflammation" but also persistence of an anti-inflammatory phenotype (as in sepsis-associated immunosuppression) is associated with increased morbidity and mortality. Despite common perception, changes in functional immunity cannot be adequately assessed by routine inflammatory biomarkers such as C-reactive protein, procalcitonin, or numerical analysis of leukocyte (sub)-counts...
October 23, 2017: Intensive Care Medicine Experimental
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