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Introduction Patients with burn wounds are more susceptible to develop healthcare associated (HA) infection. Bacterial isolates from HA burn wound infection vary from one place to the other and also differ in terms of antimicrobial susceptibility pattern. The aim of our study was to assess the incidence of HA burn wound infection, risk factors and to determine the microbiological profile and antimicrobial susceptibility pattern of isolated pathogens. Methods This was a one-year retrospective descriptive study conducted between January 2017 and December 2017, in Al-Babtain Burn and Plastic Surgery center, Kuwait. The identification of bacterial isolates was conducted by conventional biochemical methods according to standard microbiological techniques and commercially available kits using analytical profile index procedure. Results Total body surface area >35% affected and length of stay more than 14 days were statistically significant risk factors for HA burn infection (RR of 10.057 and 5.912, respectively). Analysis of microbiological profile of these positive cultures indicated that the most common isolated organism was Acinetobacter baumannii followed by Klebsiella pneumoniae. Multidrug resistant organisms composed 65.85% of the positive isolates. Vancomycin, tigecycline, teicoplanin and linezolid showed 100% effectiveness for all Gram positive isolates. For Gram negative organisms, imipenem and meropenem showed 38.71% and 41.93% efficacy, respectively. Conclusion Identification of antimicrobial susceptibility patterns helps to tailor the required antibiotic policy to minimize the acquired infections among these vulnerable patients.

Background: To date, central line-associated bloodstream infections (CLABSIs) are the most common healthcare-associated infections in high-risk neonates and children. These infections are associated with significantly longer hospital stays, increased health care cost, and mortality in the health care systems. Application of evidence-based preventive interventions has proven to decrease CLABSI rate. The purpose of this study is to reduce the undesired relative high CLABSI rate through the adoption of standardized quality improvement interventions. Methods: and Methods: The study employed a pre-post-intervention design. Phase one is a retrospective calculation of 12 months of surveillance period as a baseline. Phase 2 establishes a multidisciplinary quality improvement intervention, which includes the formation of a dedicated central line insertion team, provision of central line kit at the bedside, training and educating the team, and selecting bundle checklist. In the third phase, we performed auditing and calculating the checklist compliance and monthly feedback for 12 consecutive postintervention months. During phase 1 and 3, we calculated the following measures; CLABSI per 1000 catheter-days, duration of central line use, and device utilization ratio. Results: During the post-intervention phase the CLABSI rate significantly reduced by 59.5% from 7.5 to 3.0 per 1000 central line day, and the duration of use of the central line decreased from 21.3 AE 9.9 to 11.0 AE 3.2 days (P < 0.05).

Objective: To determine the difference in the rates of dialysis events stratified by vascular access type and to describe the microbiological profile and sensitivity patterns of positive blood cultures over a 3-year period. Subjects and Methods: The dialysis event data of 10,751 chronic hemodialysis patients collected from March 2013 to February 2016 at an outpatient dialysis unit in Kuwait were reviewed. The dialysis events studied were: intravenous (IV) antimicrobial use, a positive blood culture, and signs of inflammation at the vascular access site. Dialysis event rates were stratified by the type of vascular access used for the dialysis, i.e., fistula, graft, and tunneled/nontunneled central line. Rates were expressed per 100 patient-months. Results: The overall dialysis event rate was (10.7/100 patient-months). The rate of IV antimicrobial use was higher (12.53/100 patient-months) in patients with tunneled central lines than in all other vascular access types (10.29/100 patient-months). Positive blood culture and inflammation at the vascular access site were highest in patients with nontunneled central lines (1.65 and 1.54/100 patient-months, respectively) when compared to those with other types of vascular access. Gram-negative rod isolates were predominant in patients with central lines (n = 35; 46.67%); however, common skin commensals and gram-negative rods were also identified in patients with fistula or graft (n = 4; 44.45%). Conclusion: Dialysis event rates were higher among patients with tunneled or nontunneled central lines than in patients with fistula or graft. Gram-negative rods were the most commonly isolated microbial group.