Showing papers on "Nosocomial infection control published in 2009"
TL;DR: The most significant SSI incidence reduction was observed for hernia repair and caesarean section, and to a lesser extent, cholecystectomy, hip prosthesis arthroplasty, and mastectomy.
133 citations
TL;DR: Length of stay and cost rise proportionally with SENIC score, disease acuity, and patient characteristics such as age, and Surgical site infections are significantly and independently associated with LOS and cost and contribute to inpatient morbidity and expense.
Abstract: Background: Length of stay (LOS) and inpatient costs for open-abdomen colorectal procedures have not been examined recently. The aim of this study was to determine LOS and costs for several colorectal procedures in the context of factors potentially associated with surgical site infection (SSI). Methods: We used a large U.S. hospital database to identify the variables associated with longer LOS and higher costs for colorectal procedures from January 1, 2005, through June 30, 2006. The study population consisted of all patients >18 years, identified via International Classification of Disease, Ninth Revision, procedural codes for elective colorectal surgery. Patient demographics, surgical procedure, and a modified Study of the Efficacy of Nosocomial Infection Control (SENIC) infection risk score were examined using logistic regression as predictors of LOS ≥1 week and cost ≥$15,000. Patients given cefotetan as surgical prophylaxis were compared with patients given cefazolin/metronidazole. Superfici...
125 citations
TL;DR: It is suggested that probiotics or their products (biosurfactants), could be applied to patient care equipment, such as tubes or catheters, with the aim of decreasing colonisation of sites by nosocomial pathogens.
89 citations
TL;DR: The French program for the prevention of healthcare-associated infections and antibiotic resistance appears to have been effective at reducing infection rates, and the second phase of the program involved the implementation of 5 national quality indicators with public reporting.
Abstract: Objective. To describe the French program for the prevention of healthcare-associated infections and antibiotic resistance and provide results for some of the indicators available to evaluate the program. In addition to structures and process indicators, the 2 outcome indicators selected were the rate of surgical site infection and the proportion of methicillin-resistant Staphylococcus aureus (MRSA) isolates among the S. aureus isolates recovered. Design. Descriptive study of the evolution of the national structures for control of healthcare-associated infections since 1992. Through national surveillance networks, process indicators were available from 1993 to 2006, surgical site infection rates were available from 1999 to 2005, and prevalence rates for MRSA infection were available from 2001 to 2007. Results. A comprehensive national program has gradually been set up in France during the period from 1993 to 2004, which included strengthening of organized infection control activities at the local, regional, and national levels and developing large networks for surveillance of specific infections and antibiotic resistance. These achievements were complemented by instituting mandatory notification for unusual nosocomial events, especially outbreaks. The second phase of the program involved the implementation of 5 national quality indicators with public reporting. Surgical site infection rates decreased by 25% over a 6-year period. In France, the median proportion of MRSA among S. aureus isolates recovered from patients with bacteremia decreased from 33.4% to 25.7% during the period from 2001 to 2007, whereas this proportion increased in many other European countries. Conclusions. Very few national programs have been evaluated since the Study on the Efficacy of Nosocomial Infection Control. Although continuing efforts are required, the French program appears to have been effective at reducing infection rates.
83 citations
TL;DR: HAI rates, LOS, mortality, and bacterial resistance were high in Morocco, and programs including surveillance, infection control, and antibiotic policy are a priority in Morocco.
Abstract: Background
Most studies related to healthcare-associated infection (HAI) were conducted in the developed countries. We sought to determine healthcare-associated infection rates, microbiological profile, bacterial resistance, length of stay (LOS), and extra mortality in one ICU of a hospital member of the International Infection Control Consortium (INICC) in Morocco.
83 citations
TL;DR: Bacterial colonization was highest among stethoscopes cleaned with only water and those never cleaned with any agent or never cleaned at all, and integration of stethoscope care in the training curriculum of medical schools will enhance the control nosocomial infections.
Abstract: Our study assessed bacteria on swabs taken from the surface of the diaphragm of stethoscopes used by medical students in Nigeria. We found bacterial contamination on 80.1% of the stethoscopes. Staphylococcus aureus and Pseudomonas aeruginosa were major isolates. Bacterial colonization was highest among stethoscopes cleaned with only water and those never cleaned with any agent or never cleaned at all. The difference was statistically significant (chi2 = 31.9, p < .05). Stethoscopes from students who cleaned them after use on each patient and from those who practised handwashing after contact with each patient had significantly lower bacterial contamination (chi2 = 26.9; p < .05 and chi2=31.9, p < 0.05, respectively). Isolates of Staphylococcus aureus showed the highest susceptibility to antibiotics, while the most effective antibiotics were Ciproflox and Erythromycin. Integration of stethoscope care in the training curriculum of medical schools will enhance the control nosocomial infections.
39 citations
TL;DR: In many hospitals activities are limited by the lack of financial resources, poor infrastructure, overcrowding, inadequate hygiene, poorly functioning laboratory services, poor management, insufficient technology and a shortage of trained staff.
30 citations
TL;DR: Bacterial colonization was highest among stethoscopes cleaned with only water and those never cleaned with any agent or never cleaned at all, and integration of stethoscope care in the training curriculum of medical schools will enhance the control nosocomial infections.
Abstract: Our study assessed bacteria on swabs taken from the surface of the diaphragm of stethoscopes used by medical students in Nigeria. We found bacterial contamination on 80.1% of the stethoscopes. Staphylococcus aureus and Pseudomonas aeruginosa were major isolates. Bacterial colonization was highest among stethoscopes cleaned with only water and those never cleaned with any agent or never cleaned at all. The difference was statistically significant (chi2 = 31.9, p < .05). Stethoscopes from students who cleaned them after use on each patient and from those who practised handwashing after contact with each patient had significantly lower bacterial contamination (chi2 = 26.9; p < .05 and chi2=31.9, p < 0.05, respectively). Isolates of Staphylococcus aureus showed the highest susceptibility to antibiotics, while the most effective antibiotics were Ciproflox and Erythromycin. Integration of stethoscope care in the training curriculum of medical schools will enhance the control nosocomial infections.
23 citations
18 Mar 2009
TL;DR: In this article, the authors used a disk diffusion method with oxacillin (1 μg) and cefoxitin (30 μg) to determine the susceptibility of S aureus to oxacetacillin.
Abstract: Objective: To determine, by phenotypic and genotypic methods, oxacillin susceptibility in Staphylococcus aureus strains isolated from pediatric and neonatal intensive care unit patients seen at the University Hospital of the Botucatu School of Medicine
Methods: A total of 100 S aureus strains isolated from the following materials were studied: 25 blood cultures, 21 secretions, 12 catheters, 3 cannulae and one chest drain from 62 patients in the neonatal unit, and 36 blood cultures, one pleural fluid sample and one peritoneal fluid sample from 38 patients in the pediatric unit Resistance of the S aureus isolates to oxacillin was evaluated by the disk diffusion method with oxacillin (1 μg) and cefoxitin (30 μg), agar screening test using Mueller-Hinton agar supplemented with 6 μg/ml oxacillin and 4% NaCl, and detection of the mecA gene by PCR In addition, the isolates were tested for β-lactamase production using disks impregnated with Nitrocefin and hyperproduction of β-lactamase using amoxicillin (20 μg) and clavulanic acid (10 μg) disks
Results: Among the 100 S aureus strains included in the study, 180% were resistant to oxacillin, with 161% MRSA being detected in the neonatal unit and 210% in the pediatric unit The oxacillin (1 μg) and cefoxitin (30 μg) disk diffusion methods presented 944% and 100% sensitivity, respectively, and 988% specificity The screening test showed 100% sensitivity and 988% specificity All isolates produced β-lactamase and one of these strains was considered to be a hyperproducer
Conclusions: The 30 μg cefoxitin disk diffusion method presented the best result when compared to the 1 μg oxacillin disk The sensitivity of the agar screening test was similar to that of the cefoxitin disk diffusion method and higher than that of the oxacillin disk diffusion method We observed variations in the percentage of oxacillin-resistant isolates during the study period, with a decline over the last years which might be related to improved nosocomial infection control and the rational use of antibiotics
22 citations
TL;DR: There was no relation between the rate of S. aureus carriers and nosocomial involvement during the course and the results also showed a higher incidence of resistance in CNS samples, which is seemingly reported in the scientific literature.
Abstract: INTRODUCTION: The genus Staphylococcus is responsible for a great number of bacterial infections in human, mainly in hospital environment. OBJECTIVES: In view of these considerations and the importance of nursing care and nosocomial infection control, this study verified the rate of S. aureus and coagulase-negative Staphylococci (CNS) carriers resistant to oxacillin in nursing students during their university course. MATERIALS AND METHODS: Nasal samples were collected from Nursing students at Botucatu School of Medicine - UNESP. RESULTS: From 109 isolated samples of Staphylococcus, 30 samples (27.5%) were Staphylococcus aureus and 79 samples (72.5%) were CNS. From 79 identified CNS samples, 63 (79.7%) were S. epidermidis, nine (11.4%) S. warneri, three (3.8%) S. haemolyticus, two (2.5%) S. capitis, one (1.3%) S. simulans and one (1.3%) S. lugdunensis. The antibiotic susceptibility test showed 100% sensibility to the drugs in S. aureus samples and among 79 CNS samples, 10 (12,6%) were resistant to oxacillin. The PCR technique demonstrated negative result for mecA gene in S. aureus samples and 11 positive samples among CNS species. DISCUSSION: There was no relation between the rate of S. aureus carriers and nosocomial involvement during the course. The results also showed a higher incidence of resistance in CNS samples, which is seemingly reported in the scientific literature.
21 citations
TL;DR: A significant association between the prevalence of MRSA infection and ICALIN was found that suggested that a higher ICALin score may be predictive of a lower prevalence ofMRSA infection.
Abstract: OBJECTIVE. To assess whether infection control indicators are associated with the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection in French hospitals. METHODS. We linked the database for the 2006 national prevalence survey of nosocomial infection with the database of infection control indicators (comprised of ICALIN, an indicator of infection control organization, resources, and action, and ICSHA, an indicator of alcohol-based handrub consumption) recorded from hospitals by the Ministry of Health. Data on MRSA infection were obtained from the national prevalence survey database and included the site and origin of infection, the microorganism responsible, and its drug resistance profile. Because the prevalence of MRSA infection was low and often nil, especially in small hospitals, we restricted our analysis to hospitals with at least 300 patients. We used a multilevel logistic regression model to assess the joint effects of patient-level variables (eg, age, sex, or infection) and hospital-level variables (infection control indicators). RESULTS. Two hundred two hospitals had at least 300 patients, for a total of 128,631 patients. The overall prevalence of MRSA infection was 0.34% (95% confidence interval [CI], 0.29%-0.39%). The mean value for ICSHA was 7.8 L per 1,000 patient-days (median, 6.1 L per 1,000 patient-days; range, 0-33 L per 1,000 patient-days). The mean value for ICALIN was 92 of a possible 100 points (median, 94.5; range, 67-100). Multilevel analyses showed that ICALIN scores were associated with the prevalence of MRSA infection (odds ratio for a score change of 1 standard deviation, 0.80; 95% CI, 0.69-0.93). We found no association between prevalence of MRSA infection and ICSHA. Other variables significantly associated with the prevalence of MRSA infection were sex, vascular or urinary catheter, previous surgery, and the McCabe score. CONCLUSIONS. We found a significant association between the prevalence of MRSA infection and ICALIN that suggested that a higher ICALIN score may be predictive of a lower prevalence of MRSA infection.
TL;DR: The ants should be considered an important vector of infections as they carry several pathogenic microorganisms, spreading them on the surface of sterile materials, equipment and uncontaminated food, and special attention must be given by the commissions of Nosocomial Infection Control.
Abstract: Our aim was to study the fauna of ants in the Hospital Universitario of the Universidade Federal do Triângulo Mineiro, municipality of Uberaba, Minas Gerais State, Brazil, as well as to identify the microorganisms the ants carry and their patterns of resistance to antibiotics. Sterile tubes (traps) containing honey were used to attract the ants. Traps were exposed for 3h, and those which attracted ants were considered the test group, while the ones that did not attract the insects constituted the control group. Only the ant species Tapinoma melanocephalum (Fabricius) was sampled. Sixty microorganisms were isolated from the sampled ants, including seven Gram-positive bacilli, 14 Gram-negative bacilli, 22 Gram-positive cocci and 17 filamentous fungi. Pseudomonas, Staphylococcus and Group D Streptococcus were the microorganisms with the highest resistance to the tested antibiotics. The ants should be considered an important vector of infections as they carry several pathogenic microorganisms, spreading them on the surface of sterile materials, equipments and uncontaminated food. It is impossible to define the exact role of ants in nosocomial infections at this moment; however, this issue must be better studied and special attention must be given by the commissions of Nosocomial Infection Control.
TL;DR: O trabalho teve como objetivo determinar os principais microrganismos envolvidos nas infeccoes hospitalares de pacientes soropositivos para a infeCCao pelo HIV-1 e descrever a associacao com seu perfil imunologico.
TL;DR: In this paper, the authors evaluated whether spa typing of MRSA is useful for nosocomial outbreak analysis and epidemiological investigations, and concluded that sequence-based spa typing shows comparable sensitivities to Pulsed-Field Gel Electrophoresis (PFGE), and is a rapid and easy handling method.
Abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is the leading cause of nosocomial infection and MRSA outbreaks have become a major problem. Therefore, the rapid and accurate typing of MRSA isolates is important for epidemiological surveys and nosocomial infection control. Pulsed-field gel electrophoresis (PFGE) is considered as the gold standard technique for MRSA typing, because of its high discriminatory power, but its procedure is rather complicated and time-consuming. The spa gene encodes a cell wall component of Staphylococcus aureus protein A, and exhibits polymorphism. Sequencing the spa gene is expected superior to PFGE in speed and data interpretation. In the present study, we evaluated whether spa typing of MRSA is useful for nosocomial outbreak analysis and epidemiological investigations. We analyzed 19 nosocomial outbreak isolates from 4 separate hospitals and 26 isolates from outpatients of Toyama University Hospital. Either PFGE or spa typing revealed a single nosocomial strain that appears unique to each hospital. Indeed, spa typing confirmed the four different strains, but PFGE demonstrated only 3 strains. With the total 45 isolates, PFGE showed 16 different patterns and spa typing showed 12 patterns. Moreover, we were able to analyze the spa gene in about 2 days, from sampling to obtaining the results, whereas it took about 7 days with PFGE. In conclusion, sequence-based spa typing shows comparable sensitivities to PFGE, and is a rapid and easy handling method. The sequence-based spa typing can be used as the rapid screening test when MRSA outbreak is suspected in areas and hospitals.
01 Jan 2009
TL;DR: A fact-finding survey of nosocomial infection control in hospitals in northern Vietnam and compared the results with those of a survey conducted 4 years previously found remarkable improvement was recognized in this period, although there were considerable differences between the central hospitals in Hanoi and local hospitals.
Journal Article•
TL;DR: There are many kind of multi-drug resistant pathogenic bacteria for nosocomial infection in the authors' burn wards, of which Staphylococcus aureus was the most dominant in recent years.
Abstract: OBJECTIVE To analyse the distribution, drug resistance and epidemiology of pathogenic bacteria in the burn wards of Ruijin Hospital. METHODS Seventeen strains of Methicillin resistant staphylococcus aureus (MRSA), 52 strains of Pseudomonas aeruginosa (PA), and 11 strains of Acinetobacter baumannii (AB) isolated from the wound secretion, venous catheters, blood, urine and stool etc. were collected from burn patients hospitalized in our department from January 2004 to December 2006. The distribution and the drug resistance profile of bacteria were analyzed, and the homology analysis was performed by randomly amplified polymorphic DNA (RAPD). RESULTS MRSA, PA and AB were the major strains in our burn wards in recent years, of which Staphylococcus aureus (SA) was the most dominant. During these 3 years, MRSA accounted for 77% (63/82), 85% (63/74), and 75% (74/99), respectively, for SA isolated in this period. MRSA was resistant to Amikacin, Gentamicin, Erythromycin, Clindamycin and Levofloxacin; PA was resistant to Amikacin, Gentamicin, Piperacillin, Ceftazidime, Cefoperazone, Aztreonam and Imipenem; AB was resistant to Amikacin, Gentamicin, Piperacillin, Ceftazidime, Imipenem and Ciprofloxacin. Three bacteria were found to belong to the same type in the RAPD homology analysis. CONCLUSIONS There are many kind of multi-drug resistant pathogenic bacteria for nosocomial infection in our burn wards. To control the spread of infection due to above-mentioned 3 bacteria is the focus of nosocomial infection control.
Journal Article•
TL;DR: This infection control education was effective in increasing the levels of knowledge and self-confidence for student nurses regarding nosocomial infection control in a nonequivalent control group nonsychronized design.
Abstract: 【Purpose: The purpose of this study was to determine the effects of infection control education, knowledge, attitude and self-confidence of student nurses, regarding nosocomial infection control. Method: This was a nonequivalent control group nonsychronized design. The participants were 83 student nurses who were conveniently assigned to the experimental or a control group. The data were collected from March 5 to June 11, 2008 and analyzed based on Fisher's exact test and t-test. Result: The 1st hypothesis, "Posttest nosocomial infection control knowledge scores for the experimental group will be higher than scores for the control group" was supported (t=2.057, p=.043). The 2nd hypothesis, "Posttest nosocomial infection control attitude scores for the experimental group will be higher than those for the control group" was not statistically significant (t=.466, p=.643), The 3rd hypothesis, "Posttest nosocomial infection control self-confidence scores for the experimental group will be higher than those for the control group" was not statistically significant (t=2.290 p=.025). Conclusion: This infection control education was effective in increasing the levels of knowledge and self-confidence for student nurses regarding nosocomial infection control.】
Journal Article•
TL;DR: It is suggested that the introduction of pre- and post-tests and the clarification of main points in the class as a theme of NIC could be a useful tool for increasing the comprehension of students on the theme.
Abstract: It has been planned to give pre-clinical practice in the clinic, so-called inclusive clinical practice phase I, for fifth-grade students in the School of Dentistry, Faculty of Dentistry, Tokyo Medical and Dental University, to give them the clinical training needed to perform dental practice and clinical practicum for comprehensive patient care, namely inclusive clinical practice phase II. This study analyzed the educative efficiency of the class on nosocomial infection control (NIC) by comparing achievements pre- and post-test, and discussed appropriate education planning on the NIC for dental students. Sixty-two fifth-grade students in the 2007 academic year sat the pre- and post-tests; the mean score and standard deviation of these tests were 5.30 +/- 1.26 (n = 56) and 8.59 +/- 1.18 (n = 59), respectively. There was a statistically significant difference between them (paired t-test, p < 0.01). Another finding was that students with high scores in the post-test did not necessarily achieve high ratings in the pre-test. It is suggested that the introduction of pre- and post-tests and the clarification of main points in the class as a theme of NIC could be a useful tool for increasing the comprehension of students on the theme. Since students at lower grades will attend clinical practice in the university hospital, it is thought that students should be given NIC training early in the clinical course, and the current curriculum should be improved to increase the opportunity for students to study this important issue.
01 Jan 2009
TL;DR: Multiresistant strains were isolated in hospital environment, which can be explained by the improper use of antibiotics, the instrumental approach of the urinary tract, and the existence of risk factors in the patients admitted in the above-mentioned wards.
Abstract: Objectives We propose a comparative study of sensitivity to antibiotics of Gram-positive germs isolated in urocultures from patients in ambulatory and two wards with surgical risk (urology and obstetrics-gynaecology), and also to establish the resistance phenotypes of these strains. Material and method 124 strains of Gram-positive cocci were studied: 28 S. aureus strains, 24 strains of coagulase-negative staphylococcus (CNS), 23 Streptococcus aglactiae strains, 1 Streptococcus anginosus strain and 48 Enterococcus spp. strains. The isolated strains came from 4398 urocultures (1889--ambulatory, 1871--urology, 629--obstetrics-gynaecology). Testing of antibiotic sensitivity was performed through Kirby-Bauer disk-diffusion method, with automatic phenotyping (Osiris Evolution system). Results In ambulatory, the wild phenotype was predominant in all isolated strains (33.33% S. aureus, 50% CNS, 100% Streptococcus aglactiae, 60% Enterococcus spp.). In the urology ward, the following multiresistant strains were isolated: 9 MRSA strains (47.36%), 1 MRSE strain (100%), 1 VRE strain (4.34%). In the obstetrics-gynaecology ward, 7 strains showed multiple antibiotic resistance: 4 MRSA strains (66.66%), 2 MRSE strains (50%), 1 VRE strain (6.66%). Conclusions Multiresistant strains were isolated in hospital environment, which can be explained by the improper use of antibiotics, the instrumental approach of the urinary tract, and the existence of risk factors in the patients admitted in the above-mentioned wards. Enforcement of efficient nosocomial infection control measures is advisable, as well as a policy for rational antibiotic use.
01 Jan 2009
TL;DR: The infection control program for MRSA was effective to decrease the MRSA isolation rate and the incidence of MRSA have decreased in the postintervention as compared with the preintervention group.
Abstract: Purpose: The effectiveness of an infection control program is important to hospital quality improvement and decreases of mortality rate and prevalence Methicillin resistant Staphylococcus aureus (MRSA) is the most common pathogen causing nosocomial infection The aim of the study was to identify the most important risk factors for acquiring an MRSA, to evaluate the MRSA incidence rates after the nursing intervention in Neurosurgery intensive care unit (ICU) Methods: Clinical data were collected prospectively from December 2008 until July 2009 in Neurosurgery ICU The patients were divided into preintervention and postintervention groups An infection was defined as an MRSA if it occurred 48 hr after admission to the Unit Infection control program including hand washing, education of health care workers about MRSA, standard precaution and contact isolation of patients were applied for three month Results: A total of 85 patients were included in the study Forty-five patients of S aurerus were detected Among 45 of S aurerus, MRSA were isolated from 38 patients The incidence MRSA rate of postintervention group was 269% while incidence MRSA rate of preintervention group was 667% In total, The incidence MRSA rate was 447% The incidence of MRSA have decreased in the postintervention as compared with the preintervention group Conclusion: The infection control program for MRSA was effective to decrease the MRSA isolation rate The health care workers regular hand washing, education of nosocomial infection control is important enough to be emphasized
TL;DR: Respiratory infections are responsible for an elevated number of older patient admissions to the ICU, and nosocomial pneumonia (NP) carries a worse prognosis for these patients.
Abstract: Respiratory infections are responsible for an elevated number of older patient admissions to the ICU, and nosocomial pneumonia (NP) carries a worse prognosis for these patients. Preventive measures are even more important for nosocomial infection control in the case of ventilator-associated pneumonia (VAP).