Rate and time to develop first central line-associated bloodstream infections when comparing open and closed infusion containers in a Brazilian Hospital

Vilins, Margarete; Blecher, S; Silva, Maria A. Maretti da; Rosenthal, Víctor D.; Salomão, Reinaldo

doi:10.1590/s1413-86702009000500004

Cited by 10 publications

(7 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Until now, data to distinguish between the method of PN preparation and its potential impact on BSI have not been available, although closed-intravenous systems (fully collapsible containers that do not use an external vent to empty the solution, with self-sealing injection ports), have consistently demonstrated significantly lower incidences of central venous catheter-associated bacteraemia than open systems. [35–38] The analysis presented here may provide a greater understanding of the factors that influence infection in PN patients.…”

Section: Discussionmentioning

confidence: 99%

Nutrition Therapy Cost Analysis in the US

Turpin

Canada

Liu

et al. 2011

Applied Health Economics and Health Policy

View full text Add to dashboard Cite

BackgroundBloodstream infections (BSI) occur in up to 350 000 inpatient admissions each year in the US, with BSI rates among patients receiving parenteral nutrition (PN) varying from 1.3% to 39%. BSI-attributable costs were estimated to approximate $US12000 per episode in 2000. While previous studies have compared the cost of different PN preparation methods, this analysis evaluates both the direct costs of PN and the treatment costs for BSI associated with different PN delivery methods to determine whether compounded or manufactured pre-mixed PN has lower overall costs.ObjectiveThe purpose of this study was to compare costs in the US associated with compounded PN versus pre-mixed multi-chamber bag (MCB) PN based on underlying infection risk.MethodsUsing claims information from the Premier Perspective™ database, multivariate logistic regression was used to estimate the risk of infection. A total of 44 358 hospitalized patients aged ≥18 years who received PN between 1 January 2005 and 31 December 2007 were included in the analyses. A total of 3256 patients received MCB PN and 41 102 received compounded PN. The PN-associated costs and length of stay were analysed using multivariate ordinary least squares regression models constructed to measure the impact of infectious events on total hospital costs after controlling for baseline and clinical patient characteristics.ResultsThere were 7.3 additional hospital days attributable to BSI. After adjustment for baseline variables, the probability of developing a BSI was 30% higher in patients receiving compounded PN than in those receiving MCB PN (16.1% vs 11.3%; odds ratio= 1.56; 95% CI 1.37, 1.79; p<0.0001), demonstrating 2172 potentially avoidable infections. The observed daily mean PN acquisition cost for patients receiving MCB PN was $US164 (including all additives and fees) compared with $US239 for patients receiving compounded PN (all differences p < 0.001). With a mean cost attributable to BSI of $US16 141, the total per-patient savings (including avoided BSI and PN costs) was $US1545.ConclusionIn this analysis of real-world PN use, MCB PN is associated with lower costs than compounded PN with regards to both PN acquisition and potential avoidance of BSI. Our base case indicates that $US1545 per PN patient may be saved; even if as few as 50% of PN patients are candidates for standardized pre-mix formulations, a potential savings of $US773 per patient may be realized.

show abstract

Section: Discussionmentioning

confidence: 99%

Nutrition Therapy Cost Analysis in the US

Turpin

Canada

Liu

et al. 2011

Applied Health Economics and Health Policy

View full text Add to dashboard Cite

show abstract

“…It does, however, highlight concerns of publishing (and influencing recommendations in guidelines) lowquality data with the aim to promote a sponsor's product. Four studies, performed in Argentina, Brazil, Italy, and Mexico, concluded that "closed infusion systems" were effective for the prevention of central line-associated bloodstream infections [79][80][81][82]. All but one study [79] were non-controlled before-and-after studies with short baseline and intervention periods.…”

Section: Cathetersmentioning

confidence: 99%

Conflicts of interest in infection prevention and control research: no smoke without fire. A narrative review

et al. 2018

View full text Add to dashboard Cite

Conflicts of interest (COIs) do occur in healthcare research, yet their impact on research in the field of infection prevention and control (IPC) is unknown. We conducted a narrative review aiming to identify examples of COIs in IPC research. In addition to well-known instances, we conducted PubMed and Google searches to identify and report case studies of COIs in IPC and antimicrobial resistance (AMR), which were chosen arbitrarily following consensus meetings, to illustrate different types of COIs. We also searched the Retraction Watch database and blog to systematically identify retracted IPC and/or infectious disease-related papers. Our review highlights COIs in academic research linked to ties between industry and physicians, journal editors, peer-reviewed journals' choice for publication, and guideline committees participants and authors. It explores how COIs can affect research and could be managed. We also present several selected case studies that involve (1) the chlorhexidine industry and how it has used marketing trials and key opinion leaders to promote off-label use of its products; (2) the copper industry and how reporting of its trials in IPC have furthered their agenda; (3) the influence of a company developing "closed infusion systems" for catheters and how this affects networks in low- and middle-income countries and guideline development; (4) potential perverse incentives hospitals may have in reporting healthcare-associated infection or AMR rates and how government intervention may restrict AMR research for fear of bad publicity and subsequent negative economic consequences. Finally, the analysis of reasons for the retraction of previously published papers highlights the fact that misconduct in research may have other motivations than financial gain, the most visible form of COIs. COIs occur in the field of research in general, and IPC and AMR are no exceptions. Their effects pervade all aspects of the research and publication processes. We believe that, in addition to improvements in management strategies of COIs, increased public funding should be available to decrease researchers' dependency on industry ties. Further research is needed on COIs and their management.

show abstract

“…Fifteen ICUs in 7 hospitals, each of which had been an active member of the International Nosocomial Infection Control Consortium (INICC) for at least 1 year, participated in this study. [21][22][23] There were 4 ICUs in 2 hospitals in Argentina, 17 ICUs in 1 hospital in Brazil, 19 4 ICUs in 3 hospitals in Mexico, 18 and 4 ICUs in 1 hospital in Italy. 20 All of these ICUs have had long-standing active nosocomial infection control programs and operate at the highest level of complexity in their respective countries, providing critical care for medical, surgical, and trauma patients.…”

Section: Source Of Patientsmentioning

confidence: 99%

“…); most striking, 17 patients with P p .02 CLABSI (2.8%) died during the period when the open infusion container was in use, compared with only 1 (0.2%) during use of the closed infusion container ( ). P p .003 These findings prompted 3 additional identical interrupted time-series cohort studies in 13 ICUs in Mexico, 18 Brazil, 19 and Italy. 20 We report a meta-analysis of the results of these 4 studies that followed a common protocol.…”

mentioning

confidence: 97%

Impact of Switching from an Open to a Closed Infusion System on Rates of Central Line–Associated Bloodstream Infection: A Meta-analysis of Time-Sequence Cohort Studies in 4 Countries

Maki

Rosenthal²,

Salomão³

et al. 2011

Infect. Control Hosp. Epidemiol.

Self Cite

View full text Add to dashboard Cite

Switching from an open to a closed infusion container resulted in a striking reduction in the overall CLABSI incidence and all-cause ICU mortality. Data suggest that open infusion containers are associated with a greatly increased risk of infusion-related bloodstream infection and increased ICU mortality that have been unrecognized. Furthermore, data suggest CLABSIs are associated with significant attributable mortality.

show abstract

Rate and time to develop first central line-associated bloodstream infections when comparing open and closed infusion containers in a Brazilian Hospital

Cited by 10 publications

References 41 publications

Nutrition Therapy Cost Analysis in the US

Nutrition Therapy Cost Analysis in the US

Conflicts of interest in infection prevention and control research: no smoke without fire. A narrative review

Impact of Switching from an Open to a Closed Infusion System on Rates of Central Line–Associated Bloodstream Infection: A Meta-analysis of Time-Sequence Cohort Studies in 4 Countries

Contact Info

Product

Resources

About