A Comparison of Nosocomial Infection Density in Intensive Care Units on Relocating to a New Hospital

Türe, Zeynep; Ustuner, Tugba; Santini, Ario; AYDOĞAN, Serhat; Çelik, İ̇lhami

doi:10.2478/jccm-2020-0028

Cited by 8 publications

(25 citation statements)

References 22 publications

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“…Our results differed from the decrease in the incidence of HAIs reported by Ture et al ( 19 ); in particular, these authors pointed out that the type of causative microorganisms and their susceptibility to antimicrobial agents, which we did not study, had not changed. This could be due to the better availability of hand washing facilities, hand sanitizers, and access points at the new site (i.e., posttransfer location), along with the added advantage of the new and clean environment that did not harbor already contaminated areas and fomites that could infect patients, offset by lower nurse-to-bed ratio, larger work area, and higher workload.…”

Section: Discussioncontrasting

confidence: 99%

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A look at the past to draw lessons for the future: how the case of an urgent ICU transfer taught us to always be ready with a plan B

Brunelli,

Miotto,

Del Pin

et al. 2023

Front. Med.

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ObjectiveThe urgent transfer of an intensive care unit (ICU) is particularly challenging because it carries a high clinical and infectious risk and is a critical node in a hospital’s patient flow. In early 2017, exceptional rainfall damaged the roof of the tertiary hospital in Udine, necessitating the relocation of one of the three ICUs for six months. We decided to assess the impact of this transfer on quality of care and patient safety using a set of indicators, primarily considering the incidence of healthcare-associated infections (HAIs) and mortality rates.MethodsWe performed a retrospective, observational analysis of structural, process, and outcome indicators comparing the pre- and posttransfer phases. Specifically, we analyzed data between July 2016 and June 2017 for the transferred ICU and examined mortality and the incidence of HAI.ResultsDespite significant changes in structural and organizational aspects of the unit, no differences in mortality rates or cumulative incidence of HAIs were observed before/after transfer. We collected data for all 393 patients (133 women, 260 men) admitted to the ICU before (49.4%) and after transfer (50.6%). The mortality rate for 100 days in the ICU was 1.90 (34/1791) before and 2.88 (37/1258) after transfer (p = 0.063). The evaluation of the occurrence of at least one HAI included 304 patients (102 women and 202 men), as 89 of them were excluded due to a length of stay in the ICU of less than 48 h; again, there was no statistical difference between the two cumulative incidences (13.1% vs. 6.9%, p = 0.075).ConclusionIn the case studied, no adverse effects on patient outcomes were observed after urgent transfer of the injured ICU. The indicators used in this study may be an initial suggestion for further discussion.

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Section: Discussioncontrasting

confidence: 99%

“…As early as the 2000s, patient safety was also found to be negatively related to staff workload ( 17 , 18 ). To date, few studies have described the impact of ICU transfer on the incidence of HAIs and the consequences for overall patient outcomes ( 19 , 20 ).…”

Section: Introductionmentioning

confidence: 99%

A look at the past to draw lessons for the future: how the case of an urgent ICU transfer taught us to always be ready with a plan B

Brunelli,

Miotto,

Del Pin

et al. 2023

Front. Med.

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“…6,20 Patient follow-up in multibed ICUs increases the risk of nosocomial microorganism colonization and cross contamination as a result of decreased compliance with infection control measures. [21][22][23] Interventions to improve adherence to vascular catheter insertion and care procedures, combined with standard infection control measures, have been shown to reduce hospital BSIs. 20,24,25 In our study, the risk of BSI increased in patients with CVC, which is a risk factor for BSI, and in multibed ICUs where compliance with standard infection control measures decreased.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of prevalance and risk factors for bloodstream infection in severe coronavirus disease 2019 (COVID-19) patients

Erbay

Özger

Tunçcan

et al. 2022

ASHE

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Objectives: In this study, we sought to determine the prevalence of bloodstream infection (BSI) in severe coronavirus disease 2019 (COVID-19) patients and to determine the risk factors of BSI in critical COVID-19 patients. Design: Retrospective, descriptive study between March 2020 and January 2021. Setting: An 1,007-bed university hospital. Participants: Patients who were hospitalized due to severe COVID-19 disease and had an aerobic blood culture taken at least once during hospitalization Methods: Case definitions were made according to National Institutes of Health clinical definitions. According to the blood culture results, the patients were grouped as with and without BSIs, and compared for BSIs risk factors. Results: In total, 195 patients were included in the study. Blood culture positivity was detected in 76 (39.0%) of 196 patients. Excluding blood culture positivity considered as contamination, the prevalence of BSI in all severe COVID-19 cases was 18.5% (n = 36). In intensive care unit patients the prevalence of BSI was 30.6% (n = 26). In multivariate analyses, central venous catheter (odds ratio [OR], 8.17; 95% confidence interval [CI], 2.46–27.1; P < .01) and hospitalization in the multibed intensive care unit (OR, 4.28; 95% CI, 1.28–14.3; P < .01) were risk factors associated with the acquisition of BSI. Conclusion: The prevalence of BSI in COVID-19 patients is particularly high in critically ill patients. The central venous catheter and multibed intensive care follow-up are risk factors for BSI. BSIs can be reduced by increasing compliance to infection control measures and central venous catheter insertion-care procedures. The use of single-bed intensive care units where compliance can be achieved more effectively is important for the prevention of BSIs.

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“…However, prolonged hospitalization and the use of various invasive monitoring devices and vascular catheters have caused the emergence of nosocomial infections in these departments, which can ultimately lead to the failure of other organs (16). These infections appear after 72 hours of patient hospitalization, increasing mortality and treatment costs (17). Pseudomonas, Staphylococcus, Candida, enterococci, and Enterobacter species are among the most important causes of nosocomial infections (18).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Respiratory Microbiota in Patients with and Without Hospital-Acquired Infection

Mohammadi Ebli,

Heshmatipour,

Daneshjou

et al. 2023

Jundishapur J Microbiol

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Background: Nosocomial infections have increased among patients admitted to the intensive care unit (ICU). Objectives: This study investigated the microbiota pattern of the respiratory system in hospitalized patients with treatment-resistant respiratory infections compared to those without treatment-resistant respiratory infections. Methods: This case-control study utilized sputum samples from hospital-acquired infection (HAI) and non-HAI (NHAI) patients over 52 years old hospitalized in the ICU. Identification and determination of the drug sensitivity of the bacteria responsible for treatment-resistant respiratory infections were made by culture method in selective and differential media and VITEK 2 device. Finally, quantitative polymerase chain reaction (qPCR) was used to analyze the microbiota of the respiratory system. Results: Excessive prescription of antibiotics, long hospitalization, and history of surgery were important risk factors for nosocomial infections. The study of antibiotic resistance of pathogens causing hospital infections indicated their high resistance to most common antibiotics. Also, nosocomial infections led to a change in lung microbiota in HAI patients. The frequencies of Streptococcus pyogenes, S. pneumoniae, and Haemophilus influenzae were higher in patients with treatment-resistant respiratory infection (P < 0.05), but the frequency of Neisseria spp. was higher in patients without treatment-resistant respiratory infection (P < 0.05). Conclusions: The pathogens responsible for nosocomial infections had acquired resistance to a wide range of antibiotics, leading to changes in their respiratory microbiota.

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A Comparison of Nosocomial Infection Density in Intensive Care Units on Relocating to a New Hospital

Cited by 8 publications

References 22 publications

A look at the past to draw lessons for the future: how the case of an urgent ICU transfer taught us to always be ready with a plan B

A look at the past to draw lessons for the future: how the case of an urgent ICU transfer taught us to always be ready with a plan B

Evaluation of prevalance and risk factors for bloodstream infection in severe coronavirus disease 2019 (COVID-19) patients

Comparison of Respiratory Microbiota in Patients with and Without Hospital-Acquired Infection

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