Preventing nosocomial pneumonia: State of the art and perspectives for the 1990s

Craven, Donald E.; Steger, Kathleen A.; Barber, Thomas W.

doi:10.1016/0002-9343(91)90343-v

Cited by 205 publications

(91 citation statements)

References 60 publications

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“…Hospital acquired infections are also of major concern in persons with burns. These nosocomial infections are attributed with increased length of stay, implying increased costs [20]. Organisms causing nosocomial infections are mostly part of the patients' own normal flora, the environment and healthcare provider [21].…”

Section: Nosocomial Infectionsmentioning

confidence: 99%

The Burns Menace: Antibiotics for the Fight against Burns Bacterial Infection, a Systemic Review

Agbenorku¹,

Amankwa²,

Agbenorku³

et al. 2016

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Burn wound infection delays wound healing, leading to varying degrees of morbidity and mortality. Various antibiotics are administered to burn patients in burn wound management. The emergence of antibiotic resistance is a menace that costs families and the country. This review seeks to expound on infections related to burn wounds, common bacteria of burn wound infections and choice of antibiotics in burns treatment. Words such as burns, wound infection, burns injury and antibiotics were put into the Google search engine. Only articles related to the subject of burns, burn wound infection and antibiotics were used to write the review. Articles obtained included case reports on burns, research articles, review articles, short notes, briefs, literatures and other articles relating to burns. We found that the choice of antibiotics in the management of burns is an issue of major concern due to the evolution of pathogens causing these infections. The challenge of antibiotic resistance still persists in burns wound management. The commonly used topical antimicrobials included silver sulphadiazine, silver nitrate solution, silver impregnated dressings and mafenide acetate. Mafenide acetate has a wide antibacterial activity and also acts against the usual wound pathogens that were identified:Pseudomonas aeruginosa and Staphylococcus aureus. The role of antibiotic resistance is of major concern. Antibiotics must be administered after culture evidence in order to reduce the chance of increasing evolution of resistant strains of bacteria.

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Section: Nosocomial Infectionsmentioning

confidence: 99%

The Burns Menace: Antibiotics for the Fight against Burns Bacterial Infection, a Systemic Review

Agbenorku¹,

Amankwa²,

Agbenorku³

et al. 2016

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“…Although usually transient, hand colonization may persist, particularly in workers with dermatitis. Handwashing before and after contact with patients is an effective method for removing transient bacteria (Craven et al 1991), but this is often a neglected behavior by medical personnel. The use of gloves and gowns can significantly reduce nosocomial infection and pneumonia (Leclair et al 1987).…”

Section: Handwashingmentioning

confidence: 99%

Preventive Strategies for Aspiration Pneumonia in Elderly Disabled Persons

Ohrui

2005

Tohoku J. Exp. Med.

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OHRUI, T. Preventive Strategies for Aspiration Pneumonia in Elderly Disabled Persons. Tohoku J. Exp. Med., 2005, 207 (1), [3][4][5][6][7][8][9][10][11][12] Pneumonia is the fourth leading cause of death despite the availability of potent new antimicrobials in Japan. Aspiration of oropharyngeal bacterial pathogens to the lower respiratory tract is one of the most important risk factors for pneumonia. Impairments in swallowing and cough reflexes among disabled older persons, e.g., related to cerebrovascular disease, increase the risk of pneumonia. Thus, strategies to reduce the volumes and pathogenicity of aspirated material should be pursued. Since both swallowing and cough reflexes are mediated by endogenous substance P contained in the vagal and glossopharyngeal nerves, pharmacologic therapy using angiotensin-converting enzyme inhibitors, which decrease substance P catabolism, can improve both reflexes and result in the lowering of the risk of pneumonia. Similarly, since the production of substance P is regulated by dopaminergic neurons in the cerebral basal ganglia, treatment with dopamine analogs or potentiating drugs such as amantadine can reduce the incidence of pneumonia. Furthermore, since mortality from infections correlates with cutaneous anergy, interventions that reverse these age-associated changes in the immune system are also effective. The main theme of this review is to discuss how pneumonia develops in disabled older people and to suggest preventive strategies that may reduce the incidence of pneumonia among these subjects. pneumonia; disabled older persons; silent aspiration; dopamine; substance P

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“…La mortalidad que se le atribuye a la Neumonía Asociada a Ventilador Mecánico-NAV-presenta un amplio rango que va desde el 30% hasta el 70% según diferentes estudios 4 . A su vez la NAV es señalada en diversos estudios como la principal causa de muerte entre pacientes con infecciones adquiridas 5,6 . La NAV es aún más frecuentes en pacientes con soporte ventilatorio mecánico invasivo en las Unidades de Cuidado Intensivo-UCI-de edades extremas y con larga estancia hospitalaria, alcanzando grandes cifras de morbimortalidad y complicación en la evolución del 8 al 28% de los mismos 7 .…”

Section: Introductionunclassified

Costos de neumonia nosocomial en una unidad de cuidados intensivos en Cartagena, Colombia.

Sanmartin-Ávila¹,

Alvis-Estrada

Valle-Archibold

et al. 2017

Infect

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Cómo citar este artículo: A. Sanmartin-Ávila, et al. Costos de neumonia nosocomial en una unidad de cuidados intensivos en Cartagena, Colombia. Infectio 2018; 22(1): [13][14][15][16][17][18] Resumen Objetivo: Estimar el exceso de costos directos de atención atribuible a la neumonía asociada a ventilador mecánico en una unidad de cuidados intensivos de adultos en la ciudad de Cartagena durante los años 2009 al 2014. Material y Método: Se plantea un estudio de evaluación económica parcial centrado en el análisis de costos directos de atención contrastando los escenarios de neumonía asociada a ventilador mecánico versus los escenarios sin neumonía asociada a ventilador mecánico. La población de estudio la constituye 23 pacientes con neumonía asociada a ventilador mecánico. Del mismo modo, se tomaron 46 controles. La información correspondiente a los costos directos se obtuvo a través del departamento de costos de la institución hospitalaria. Se estimó la razón de costos que permite establecer el exceso de costo atribuible a la enfermedad nosocomial. Resultados: La estancia promedio en los casos fue de 47 días mientras que en los controles fue de 9 días. El costo promedio de un caso de neumonía asociada a ventilador mecánico fue de US$ 44.354 mientras que el de un control fue de US$ 5.037. Discusión: El exceso de costo promedio total así como el incurrido en antibióticos y en estancia resultan ser mucho más altos que los encontrados en otros estudios realizados. Conclusiones: Un caso de neumonía asociada a ventilador mecánico cuesta 10 veces más con respecto a los medicamentos y 8 veces más con relación a exámenes de laboratorios e insumos. La estancia resulta ser 6,6 veces más costosa que cuando no se presenta esta patología. El costo que se asume en antibióticos es 7,8 veces más alto. Los casos de neumonía asociada a ventilador mecánico cuestan en promedio 8,8 veces más que los controles. Costs of pneumonia nosocomial in a unit of intensive care in Cartagena, Colombia. Palabras claves AbstractAims: To estimate the excess direct care costs attributable to ventilator-associated pneumonia in an intensive care unit adult in the city of Cartagena during the years 2009 to 2014. Material and method: A study of partial economic evaluation focused on the analysis of direct care costs contrasting the scenarios of mechanical ventilator associated pneumonia versus scenarios without mechanical ventilator associated pneumonia. The study population is 23 patients with ventilator associated pneumonia. Similarly, 46 control were taken. The information for direct costs was obtained through the cost department of the hospital institution. The ratio of costs for establishing the excess cost attributable to ventilator associated pneumonia was estimated. Results: The average stay in cases was 47 days, while in controls was 9 days. The average cost of a case of ventilator associated pneumonia was US$ 44354 while the control was US$ 5037. Discussion: Excess average total cost incurred as well as antibiotics and stay out to be much higher...

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Preventing nosocomial pneumonia: State of the art and perspectives for the 1990s

Cited by 205 publications

References 60 publications

The Burns Menace: Antibiotics for the Fight against Burns Bacterial Infection, a Systemic Review

The Burns Menace: Antibiotics for the Fight against Burns Bacterial Infection, a Systemic Review

Preventive Strategies for Aspiration Pneumonia in Elderly Disabled Persons

Costos de neumonia nosocomial en una unidad de cuidados intensivos en Cartagena, Colombia.

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