Hunting Health Care-Associated Infections from the Clinical Microbiology Laboratory: Passive, Active, and Virtual Surveillance

Peterson, Lance R.; Brossette, Stephen E.

doi:10.1128/jcm.40.1.1-4.2002

Cited by 59 publications

(37 citation statements)

References 19 publications

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“…The integration of molecular typing with conventional hospital epidemiologic surveillance has been proven to be costeffective due to an associated reduction in the number of nosocomial infections (28, 71,119,122,[207][208][209]. Cost-effectiveness is maximized by the collaboration of the laboratory, through epidemiologic typing, and the infection control department during outbreak investigations (207-209, 241, 256, 305, 316, 318).…”

Section: Cost-effective Application Of Typing Methodsmentioning

confidence: 99%

Application of Molecular Techniques to the Study of Hospital Infection

et al. 2006

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SUMMARY Nosocomial infections are an important source of morbidity and mortality in hospital settings, afflicting an estimated 2 million patients in United States each year. This number represents up to 5% of hospitalized patients and results in an estimated 88,000 deaths and 4.5 billion dollars in excess health care costs. Increasingly, hospital-acquired infections with multidrug-resistant pathogens represent a major problem in patients. Understanding pathogen relatedness is essential for determining the epidemiology of nosocomial infections and aiding in the design of rational pathogen control methods. The role of pathogen typing is to determine whether epidemiologically related isolates are also genetically related. To determine molecular relatedness of isolates for epidemiologic investigation, new technologies based on DNA, or molecular analysis, are methods of choice. These DNA-based molecular methodologies include pulsed-field gel electrophoresis (PFGE), PCR-based typing methods, and multilocus sequence analysis. Establishing clonality of pathogens can aid in the identification of the source (environmental or personnel) of organisms, distinguish infectious from noninfectious strains, and distinguish relapse from reinfection. The integration of molecular typing with conventional hospital epidemiologic surveillance has been proven to be cost-effective due to the associated reduction in the number of nosocomial infections. Cost-effectiveness is maximized through the collaboration of the laboratory, through epidemiologic typing, and the infection control department during epidemiologic investigations.

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Section: Cost-effective Application Of Typing Methodsmentioning

confidence: 99%

Application of Molecular Techniques to the Study of Hospital Infection

et al. 2006

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“…Laboratories also support and assist health care providers to manage and control infectious disease. 21 Computer analysis of positive culture rates (over a period) could be used to detect clusters of infection and even small outbreaks of infection. 4 This can therefore act as a sensitive and time efficient method for detecting potentially preventable nosocomial infections.…”

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confidence: 99%

Nosocomial and Community Acquired Infections in Korle Bu Teaching Hospital, Accra

Mj¹

2010

West African Journal of Medicine

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BACKGROUND: Nosocomial or hospital acquired infection has been recognized as a serious public health problem in the last twenty years. In most hospitals in Africa-South of the Sahara, although the types of community acquired infections are known, neither the magnitude, nor the common types of nosocomial infections has been documented. OBJECTIVE: This study was carried out to find the prevalence of hospital and community acquired infections in hospitals, and to estimate the overall prevalence of HAI and CAI in Korle Bu Teaching Hospital. METHODS: A one-day prevalence survey of nosocomial and community acquired infection in a tertiary-care hospital in Accra was performed using the 1980 British national protocol and the result was analyzed using computerized gargets. RESULTS: Of the 907 patients on admission (on the day of the study), 61 (6.7%) had hospital-acquired infection and 287 (31.6%) had community acquired infection. The commonest hospital acquired infection was wound infection followed by skin and lower respiratory infections. Of the community infections, the most common cases were lower respiratory and skin infections. Fifty-three percent of all patients were on antimicrobial treatment. Patients on metronidazole were 212 (44%), ampicillin/amoxicillin 199 (41.6%), cloxacillin 163 (34%) and gentamicin 135 (28%). Approximately 20% of patients were on three or more drugs. CONCLUSION: This study has shown that the prevalence of community acquired infections in our hospital is much higher than that from nosocomial infections and that the British national survey protocol can be used in countries with limited resources. WAJM 2009; 28(5): 300-303.Keywords: Nosocomial infection, survey, prevalence, developing country. RÉSUMÉ CONTEXTE: nosocomiales ou infections acquises à l'hôpital a été reconnue comme un grave problème de santé publique dans les vingt dernières années. Dans la plupart des hôpitaux en Afrique au sud du Sahara, bien que les types d'infections acquises dans la collectivité sont connues, ni l'ampleur, ni les types communs d'infections nosocomiales a été documentée. OBJECTIF: Cette étude a été menée pour trouver la prévalence de l'hôpital et la communauté des infections acquises dans les hôpitaux, et d'estimer la prévalence globale de l'HAI et CAI en Korle Bu Teaching Hospital. MÉTHODE: Un questionnaire d'une prévalence du jour de l'infection nosocomiale et communautaire a acquis une infection dans un hôpital de soins tertiaires à Accra a été réalisée en utilisant le protocole de 1980 ressortissant britannique et le résultat a été analysée à l'aide gargets informatisé. RÉSULTATS: Sur les 907 patients à l'admission (le jour de l'étude), 61 (6,7%) avaient des infections nosocomiales et 287 (31,6%) avaient acquises dans la collectivité infection. L'hôpital a acquis l'infection a été plus fréquente infection de la plaie suivie par la peau et les infections pulmonaires. Parmi les infections communautaires, les cas les plus fréquents étaient des voies respiratoires inférieures et les infections

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“…The amount of additional work required for use of these two tools totaled approximately 8 h per month. New computerized tools for increased detection of potential infection control opportunities are rapidly being developed (3) and offer great potential for system-wide surveillance in detecting healthcare-associated infectious diseases (16). After this investigation the 2SD and MI tools were routinely used in our infection control program and continued to supplement outbreak detection at our medical center (18).…”

Section: Discussionmentioning

confidence: 99%

“…After this investigation the 2SD and MI tools were routinely used in our infection control program and continued to supplement outbreak detection at our medical center (18). We have recently adopted a new computer tool with considerably enhanced analysis capacity and over the next 12 months will compare the data mining system to the 2SD and MI analysis methods (16). Use of statistical methods and information technology to analyze microbiology culture result data can supplement traditional infection control outbreak detection in an efficient and cost-effective manner to enhance infection control practice.…”

Section: Discussionmentioning

confidence: 99%

“…The laboratory holds the earliest opportunity to detect specific organism or antimicrobial resistance patterns emerging in the hospital. Efficiently doing so, followed by communication with infection control, can be a key enhancement to detection and the elimination of potential microbial outbreaks (6,16). Each month a typical microbiology laboratory generates many billions of potentially useful pieces of information drawn from all parts of the healthcare organization.…”

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Computer-Assisted Surveillance for Detecting Clonal Outbreaks of Nosocomial Infection

et al. 2004

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Whole-house surveillance for healthcare-associated infection is no longer the recommended practice because of the large personnel time investment required. We developed a computer-based tracking system using microbiologic data as an aid in detecting potential outbreaks of healthcare-associated infections on a hospitalwide basis. Monthly total isolates of 25 clinically significant hospital pathogens were tallied from 1991 to 1998 to form a database for future comparison. Two different algorithm tools (based on increases of organism numbers over baseline) were applied to determine alert thresholds for suspected outbreaks using this information. The first algorithm (2SD) defined an alert as two standard deviations above the mean monthly number of isolates. The second (MI) defined an alert as either a 100% increase from the baseline organism number over 2 months or a >50% increase (compared to baseline) during a three-consecutive-month period. These two methods were compared to standard infection control professional surveillance (ICP) for the detection of clonal outbreaks over 12 months. Overall, a total of seven clonal outbreaks were detected during the 1-year study. Using standard methods, ICP investigated nine suspected outbreaks, four of which were associated with clonal microbes. The 2SD method signaled a suspected outbreak 15 times, of which three were clonal and ICP had detected one. The MI method signaled a suspected outbreak 30 times; four of these were clonal, and ICP had detected one. The sensitivity and specificity values for ICP, 2SD, and MI for detecting clonal outbreaks were 57, 43, and 57% and 17, 83, and 67%, respectively. Statistical methods applied to clinical microbiology laboratory information system data efficiently supplement infection control efforts for outbreak detection.

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Hunting Health Care-Associated Infections from the Clinical Microbiology Laboratory: Passive, Active, and Virtual Surveillance

Cited by 59 publications

References 19 publications

Application of Molecular Techniques to the Study of Hospital Infection

Application of Molecular Techniques to the Study of Hospital Infection

Nosocomial and Community Acquired Infections in Korle Bu Teaching Hospital, Accra

Computer-Assisted Surveillance for Detecting Clonal Outbreaks of Nosocomial Infection

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