https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)60007-0/pdf

ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients

The preventable proportion of nosocomial infections: an overview of published reports

Distribution of multi-resistant Gram-negative versus Gram-positive bacteria in the hospital inanimate environment.

Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses.

Objective:The proportion of intensive care unit (ICU)-acquired infections that are a consequence of nosocomial cross-transmission between patients in tertiary ICUs is unknown. Such information would be useful for the implementation of appropriate infection control measures.Design:A prospective cohor

How many infections are caused by patient-to-patient transmission in intensive care units?

OBJECTIVE: To determine the percentage of cross-transmissions in an intensive care unit (ICU) with high nosocomial infection (NI) rates according to the data of the German Nosocomial Infection Surveillance System. SETTING: A 14-bed surgical ICU of a 1,300-bed, tertiary-care teaching hospital. METHOD: Prospective surveillance of NIs during a period of 9 months. If an NI was present, the isolates of the following indicator pathogens were stored and typed by species: Staphylococcus aureus, Enterococcus species, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacter species. Pulsed-field gel electrophoresis was performed for typing of S. aureus strains and arbitrarily primed polymerase chain reaction was applied for the other pathogens. The presence of two indistinguishable strains in two patients was considered as one episode of cross-transmission. RESULTS: Two hundred sixty-two patients were observed during a period of 2,444 patient-days; 96 NIs were identified in 59 patients and the overall incidence density of NI was 39.3 per 1,000 patient-days. For 104 isolates, it was possible to consider typing results. Altogether, 36 cross-transmissions have lead to NIs in other patients. That means at least 37.5% of all NIs identified were due to cross-transmissions. CONCLUSION: Because of the method of this study, the percentage of NIs due to cross-transmission identified for this ICU is an at least number. In reality, the number of cross-transmissions, and thus the number of avoidable infections, may have been even higher. However, it is difficult to assess whether the percentage of NIs due to cross-transmission determined for this ICU may be the crucial explanation for the relatively high infection rate in comparison to other surgical ICUs.

Kathrin Pollege

Papers

How many nosocomial infections are associated with cross-transmission? A prospective cohort study in a surgical intensive care unit