A ten-year review of healthcare-associated bloodstream infections from forty hospitals in Québec, Canada

Fakih, Iman; Fortin, Élise; Smith, Myron L.; Carignan, Alex; Tremblay, Claude; Villeneuve, Jasmin; Moisan, Danielle; Frenette, Charles; Quach, Caroline; Spin-Bactot, for

doi:10.1017/ice.2018.185

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…The HABSI rate of 0.26 per 1000 patient days is comparable to that shown in previous studies, but lower than acute hospital data . These differences in prevalence rates, together with different organisms and sources probably reflect different populations.…”

Section: Discussionsupporting

confidence: 78%

“…HABSI in this subacute older population are predominantly caused by Gram‐negative organisms with nearly two‐thirds arising from a urinary source. The range of organisms and sources seen was different to an acute general hospital population, where there is usually a predominance of Gram‐positive organisms such as Staphylococcus aureus and more intravascular device (IVD) infections . In this series, S. aureus HABSI were much less frequent (11%) and only four patients had IVD.…”

Section: Discussionmentioning

confidence: 69%

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Inpatient healthcare‐associated bloodstream infections in older people

Hanger

Michelle

2019

Internal Medicine Journal

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chronic haemophilic arthropathy with normal synovial appearance. Due to patient mental health comorbidities, appointments with orthopaedic surgeons were not attended and conservative management with the addition of tranexamic acid continues. DiscussionPseudotumours are rarely seen among patients with haemophilia in Australia. These two cases represent the first cases of pseudotumours in two haemophilia treatment centres (one paediatric and one adult), which in total service over 200 patients with severe haemophilia. The cause in the first case was suspected to be secondary to repeated bleeds to the area, in combination with nonadherence to prophylaxis. The second case did not demonstrate a clear bleeding history, and given the development of a second pseudotumour while adherent to the prescribed regular prophylaxis, this points to an alternative biological process. The diagnosis should be considered in patient who present with symptoms refractory to typical therapy, non-adherence to therapy or with pathological fractures. MRI is the modality of choice to examine for pseudotumours, and clinicians should be mindful that a normal CT or X-ray does not exclude the disease. The ideal management of this condition is not known, and given the rarity of the condition the development of an international registry would be of benefit. References1 Lim MY, Nielsen B, Ma A, Key NS. Clinical features and management of haemophilic pseudotumours: a single US centre experience over a 30-year period. Haemophilia 2014; 20: e58-62. 2 Senol K, Tutuncu T, Yuksek YN, Ozdemir N, Guney Y, Kama NA. Management of a recurrent massive abdominal haemophilic pseudotumour with adjuvant radiotherapy. Haemophilia 2015; 21: 333-5. 3 Magailon M, Monteagudo J, Altisent C, Ibanez A, Rodriguez-Perez A, Riba J et al. Hemophilic pseudotumour: multicentre experience over a 25 year period. AbstractThis retrospective study describes inpatient healthcare-associated bloodstream infections (HABSI) in older adults and explores whether urinary catheters (presence/insertion/removal) were related to HABSI events. One hundred and sixty-seven HABSI events were identified, predominantly (124, 74%) with Gram-negative bacteria. HABSI was attributed to a urinary source in 110 patients (66%), with over half (63, 57%) of these associated with urinary catheters. Catheter-associated HABSI may be avoidable and potential preventative strategies are discussed. AbstractHealthcare encompasses multiple discourses to which health professionals, researchers, patients, carers and lay individuals contribute. Networks of patients and nonprofessionals often act collectively to build capacity, enhance access to resources, develop understanding and improve provision of care. This article explores the concept of health collectives and three notable examples that have had an enduring and profound impact in the Australian context.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 69%

Inpatient healthcare‐associated bloodstream infections in older people

Hanger

Michelle

2019

Internal Medicine Journal

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“…Healthcare-associated infections (HAI) continue to threaten patient safety in healthcare facilities. Approximately 80,000 to 90,000 patients suffer from a HAI in Quebec, Canada annually [1][2][3]. Clostridium difficile infections (CDI) and antibiotic-resistant infections such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci are among the most common.…”

Section: Introductionmentioning

confidence: 99%

Healthcare workers’ attitudes toward hand hygiene practices: Results of a multicentre qualitative study in Quebec

Atif

Lorcy

Dubé

2019

CJIC

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Background: Hand hygiene (HH) is one of the most effective practices to reduce healthcare-associated infection (HAI) transmission, though compliance remains inadequate among hospital personnel. The aim of this study was to explore perceived barriers and enablers of HH compliance in hospital care and healthcare workers’ (HCW) HAI risk and severity perceptions. Methods: Qualitative study using semi-structured interviews and observations. Interview recordings were transcribed verbatim and supplemented with transcribed observations and field notes. Data was aggregated and coded thematically using a qualitative data analysis software. Results: 65 interviews and 18 observations with HCWs were conducted in nine hospital centres in Quebec, Canada. Data analysis revealed several factors that may influence HCWs’ compliance with HH recommendations. These included clinical environment factors (e.g., lack of sinks), organizational factors (e.g., inadequate staffing, demanding workloads), and communication factors (e.g., dissemination of infection prevention and control [IPAC] information, feedback, and interpersonal professional relationships). At the individual level, knowledge of IPAC and HAI risk perceptions were associated with the adoption of HH. Conclusion: Understanding the determinants of HH adoption is crucial for improving current practices and reducing HAI rates in hospital care. Our findings suggest that environmental strategies (e.g., additional sinks and HH stations) and organizational and communication strategies (e.g., continuing education and training sessions, support from hospital management, positive feedback) could help raise HCWs’ awareness of HAI prevention and adoption of HH guidelines.

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“…BACTOT data collection has been described elsewhere. 24 In brief, beginning on April 1, 2007, Surveillance provinciale des infections nosocomiales (SPIN; the provincial nosocomial infection surveillance program) required participating hospitals to perform active HABSI surveillance in their facility, excluding psychiatric wards, long-term care, and nurseries. On April 1, 2013, participation in BACTOT became mandatory for all hospitals with >1,000 admissions per surveillance year.…”

Section: Data Collectionmentioning

confidence: 99%

“…To our knowledge, the handful of hospital-wide HABSI surveillance programs in progress have been established in Belgium, 17,18 Finland, 19,20 Australia, 21,22 and Quebec, Canada. 23,24 In 2007, the Surveillance des bactériémies nosocomiales panhospitalières (BACTOT) program was initiated in Quebec to monitor all HABSI in the province's acute-care hospitals. BACTOT has grown from 40 participating hospitals in 2007-2008 to 89 in 2016-2017.…”

mentioning

confidence: 99%

Healthcare-associated bloodstream infection trends under a provincial surveillance program

Fakih

Fortin

Smith

et al. 2019

Infect. Control Hosp. Epidemiol.

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Objective:BACTOT, Quebec’s healthcare-associated bloodstream infection (HABSI) surveillance program has been operating since 2007. In this study, we evaluated the changes in HABSI rates across 10 years of BACTOT surveillance under a Bayesian framework.Design:A retrospective, cohort study of eligible hospitals having participated in BACTOT for at least 3 years, regardless of their entry date. Multilevel Poisson regressions were fitted independently for cases of HABSI, catheter-associated bloodstream infections (CA-BSIs), non–catheter-associated primary BSIs (NCA-BSIs), and BSIs secondary to urinary tract infections (BSI-UTIs) as the outcome and log of patient days as the offset. The log of the mean Poisson rate was decomposed as the sum of a surveillance year effect, period effect, and hospital effect. The main estimate of interest was the cohort-level rate in years 2–10 of surveillance relative to year 1.Results:Overall, 17,479 cases and 33,029,870 patient days were recorded for the cohort of 77 hospitals. The pooled 10-year HABSI rate was 5.20 per 10,000 patient days (95% CI, 5.12–5.28). For HABSI, CA-BSI, and BSI-UTI, there was no difference between the estimated posterior rates of years 2–10 compared to year 1. The posterior means of the NCA-BSI rate ratios increased from the seventh year until the tenth year, when the rate was 29% (95% confidence interval, 1%–89%) higher than the first year rate.Conclusions:HABSI rates and those of the most frequent subtypes remained stable over the surveillance period. To achieve reductions in incidence, we recommend that more effort be expended in active interventions against HABSI alongside surveillance.

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A ten-year review of healthcare-associated bloodstream infections from forty hospitals in Québec, Canada

Cited by 4 publications

References 23 publications

Inpatient healthcare‐associated bloodstream infections in older people

Inpatient healthcare‐associated bloodstream infections in older people

Healthcare workers’ attitudes toward hand hygiene practices: Results of a multicentre qualitative study in Quebec

Healthcare-associated bloodstream infection trends under a provincial surveillance program

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