American journal of infection control
-
Patient characteristics and system-level factors place children at increased risk for catheter-related bloodstream infection (CR-BSI). National Healthcare Safety Network data from 36 pediatric intensive care units (PICUs) demonstrate a pooled mean of 5.3 CR-BSIs per 1000 catheter-days and a median of 3.5 CR-BSIs per 1000 catheter-days. Almost 60% of CR-BSIs in children are caused by gram-positive bacteria. In the PICU setting, arterial catheterization, increased duration of catheterization, use of extracorporeal life support, and presence of a genetic abnormality are independent risk factors for CR-BSIs. ECONOMICS: In children, cost estimates range from $36,000 to $50,000 per CR-BSI. ⋯ Based on limited data, antimicrobial lock therapy may be appropriate in certain clinical situations, and multifaceted interventions are effective in reducing CR-BSIs in children. In one center, maximum barrier precautions during insertion, antimicrobial-impregnated catheters, annual hospital-wide handwashing campaigns, physical barriers between beds, and use of 2% chlorhexidine skin disinfectant decreased CR-BSIs.
-
Central line-associated bacteremia (CLAB) is associated with increased intensive care unit (ICU) length of stay (LOS) of up to 6 days, increased hospital LOS of approximately 21 days, attributable mortality of approximately 35%, and incremental costs of approximately $56,000 per infection. ⋯ Implementation of a self-study module with pre- and posttests, the use of pictorials and other informational tools, and the implementation of a "scrub the hub" bundle were effective in reducing the rate of CLAB in ICUs and in supporting a culture of zero tolerance for infection.
-
In July 2005, New York State legislation requiring the mandatory reporting of specific hospital-associated infections (HAIs) was passed by the legislature and signed by the governor. In an effort to measure the impact of this legislation on infection control resources, the New York State Department of Health (NYSDOH) conducted a baseline survey in March 2007. This report presents an overview of the methods and results of this survey. ⋯ This survey was designed to monitor and assess infection prevention and control resources and activities in hospitals as New York State embarks on mandatory public reporting of HAI rates. Monitoring infection control resources and activities will be important as HAI reporting moves forward. The information collected will serve as a baseline, and repeat surveys will be conducted to determine which, if any, of the various indicators correlate with the completeness and accuracy of HAI reporting.
-
Am J Infect Control · Dec 2008
Device-associated nosocomial infections in limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC).
The rates of health care-associated infections (HAIs) and bacterial resistance in developing countries are 3 to 5 times higher than international standards. HAIs increase length of stay (10 days), costs (US $5000 to US $12,000), and mortality (by a factor of 2 to 3). ⋯ Implementation of INICC outcome and process surveillance, education, monitoring and performance feedback methodologies increases compliance with hand hygiene and other infection-control interventions and reduces rates of DAIs.
-
Am J Infect Control · Dec 2008
Randomized Controlled TrialInvestigation of a nosocomial outbreak by alginate-producing pan-antibiotic-resistant Pseudomonas aeruginosa.
The nosocomial spread of pan-antibiotic-resistant nonfermentative bacteria is an increasing concern. This study investigated the microbiologic and epidemiologic characteristics of a hospital outbreak due to alginate-producing, pan-antibiotic-resistant Pseudomonas aeruginosa (PAR-Pa). ⋯ This study illustrates the ability of pan-antibiotic-resistant P. aeruginosa to cause an outbreak with significant mortality and stresses the need for precautions to prevent the spread of such highly resistant strains.