American journal of infection control最新文献

Background: Pseudomonas aeruginosa and Acinetobacter baumannii are common causes of nosocomial infections. Furthermore, antimicrobial resistance is frequently observed in these pathogens, posing significant challenges to treatment.

Objective: This study aimed to determine the prevalence, antimicrobial resistance profiles, and determinants of Acinetobacter baumannii and Pseudomonas aeruginosa isolates among nosocomial infection suspect patients at Debre Markos Comprehensive Specialized Hospital (DMCSH).

Methods: An institutional-based cross-sectional study was conducted from March 01, 2021, to May 30, 2021. A consecutive convenient sampling technique was applied to select 200 nosocomial infection suspected patients. Clinical samples were collected and inoculated on MacConkey agar, blood agar, and Tryptic Soyo broth. Testing for antibiotic susceptibility was done on Mueller Hinton agar.

Results: The overall prevalence of Acinetobacter baumannii and Pseudomonas aeruginosa isolates among nosocomial infection suspected patients was 11.5 %. All isolates of Pseudomonas aeruginoasa and Acinetobacter baumannii were 100% resistant to cefepime and piperacillin. Prolonged hospitalization and antibiotics use were significant determinants of P. aeurgnosa and A. baumannii-induced nosocomial infection (AOR: 5.691, 95% CI: 1.069-7.296, P< 0.050 and AOR: 4.199, 95% CI: 0.997-6.675, P< 0.042, respectively).

Conclusions: The prevalence of Acinetobacter baumannii and Pseudomonas aeruginosa isolates was high in the study area. Therefore, there should be serious attention to control the spread of drug-resistant nosocomial infections in the study area.

Background: Healthcare-associated infections (HAIs) remain a major concern in U.S. hospitals, contributing to significant patient mortality and medical costs. Studies indicate that up to 70% of HAIs are preventable, with proper hand hygiene the most effective method of preventing transmission. Despite this, adherence to hand hygiene in hospitals remains low.

Methods: This article describes the process of developing, testing, and refining a standard to improve hand hygiene adherence in U.S. hospitals. Building on the published literature and guidance from a national expert panel, Leapfrog developed a standard with five key domains.

Results: In 2019, 1,698 hospitals pilot tested an initial set of survey questions intended to measure hospital performance against the hand hygiene standard. Responses were not scored, but reviewed to make refinements. The scoring of hospital responses to the survey questions and the public reporting of hospitals' performance on meeting the hand hygiene standard began in 2020. From 2020 to 2023, the percentage of reporting hospitals that have met each domain of the hand hygiene standard and fully achieved Leapfrog's hand hygiene standard continued to grow.

Conclusion: Leapfrog's hand hygiene standard provides hospitals with a "how-to guide" for best practices to promote hand hygiene and prevent HAIs.

A two-year observational retrospective study of bacteremias was performed in non-ICU patients, focusing on potential differences between community acquired and hospital acquired bacteremias. A total of 120 out of 6383 hospitalized patients (1.87%) were included. The Enterobacterales predominated (73/138; 52.9%), followed by Acinetobacter baumannii (53/138; 38.4%) and Pseudomonas aeruginosa (12/138; 8.7%) whereas, 76% (105/138) of the isolated bacteria exhibited resistant profiles. These results highlight the need for continuing surveillance of MDROs even outside the ICUs.

Objective: We compared the efficacy of chlorhexidine-impregnated central lines (CLs) with plain CLs in preventing central line-associated bloodstream infections (CLABSIs) in critically ill patients.

Methods: The study was conducted from April 2023 to August 2024 in eight hospitals across India, Malaysia, Papua New Guinea, Colombia, Egypt, and Turkey. Data were collected prospectively using the INICC surveillance online system. Cases and controls were recruited simultaneously. Data were analyzed using t-tests, chi-square tests, and Fisher's exact tests when indicated. Relative risks (RR) and their corresponding 95% confidence intervals (CI) were calculated.

Results: A total of 6,672 patients were included. Patients with impregnated CLs had 4,721 CL-days, while those with plain CLs had 18,822 CL-days. The CLABSI rate in patients with impregnated CLs was 1.48 per 1,000 CL-days, compared to 4.78 per 1,000 CL-days in those with plain CLs (RR=0.31, 95%CI=0.14-0.67, p=0.003). A subgroup analysis excluding patients with hemodialysis but using central venous catheters (CVCs) showed 1.72 CLABSIs per 1,000 CL-days in patients with impregnated CVCs compared to 5.84 per 1,000 CL-days in those with plain CVCs (RR=0.29, 95%CI=0.12-0.68, p=0.004).

Conclusion: This study highlights the significant benefits of impregnated CLs over plain CLs in reducing CLABSI rates, achieving a 69% decrease in incidence.

Background: Healthcare-associated infections (HAIs) continue to contribute significantly to Australia's burden of disease. In Queensland, varied surveillance protocols exist contributing to unnecessary complexity. With end-user partners, we defined a minimum dataset to support the public reporting of HAI surveillance data.

Method: A modified, 2-round Delphi study was conducted with field experts. In Round 1, infection control professionals and infectious disease physicians rated HAI measures on importance, feasibility, usefulness, and case definition acceptability using Likert scales. Measures meeting predefined thresholds progressed to Round 2, where a panel of experts achieved ≥70% consensus on the final dataset.

Results: Forty-nine infection control professionals (nurses and physicians) responded in Round 1. From the originally proposed 36 HAI measures, 17 achieved consensus for importance, usefulness and feasibility. In Round 2, 14 experts (11 infection control practitioners; 3 physicians) met to review the 17 measures retained from Round 1. Final measures (n = 13), meeting Round 2 consensus, included bloodstream infections, selected surgical site infections, and significant organisms.

Discussion and conclusion: We developed a 13-item minimum dataset with standardised definitions to support consistent, state-wide HAI surveillance and reporting. The dataset supports efficient data aggregation and will inform targeted prevention activities.

Background: Many bundles have proven effective at preventing surgical site infections (SSIs), but little is known about factors influencing compliance to such bundles.

Methods: This cohort study includes 41,400 surgeries performed in 47 hospitals throughout a decade. The outcome of interest was binary compliance with a 4-element bundle for SSI prevention. A multivariable logistic regression model was computed with 12 predictor variables: patient sex, age, American Society of Anesthesiologists score, surgical specialty, length of preoperative stay, procedure year, procedure duration, surgical technique, presence of a prosthetic implant, elective versus emergent procedure, hospital type, and hospital size.

Results: Bundle compliance has increased significantly since its implementation, reaching 67.1% in the latest year. Lower odds of bundle compliance are correlated with emergent procedures (OR 0.3697), procedure duration above the first tertile (0.8597), age above the first quartile (0.7365), absence of a prosthetic implant, open surgical technique, and preoperative stay above 1 day (0.7920).

Discussion: Older age, longer procedure duration, longer preoperative stay, and an open surgical technique all correlate negatively with bundle compliance and are also known risk factors for SSIs.

Conclusions: Certain patient subgroups are at higher risk for bundle noncompliance, and thus show greater margins for improvement.