CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting

Horan, Teresa C.; Andrus, Mary; Dudeck, Margaret A.

doi:10.1016/j.ajic.2008.03.002

Cited by 5,434 publications

(4,335 citation statements)

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“…If standard practice guidelines were not available, diagnostic and treatment recommendations from a current textbook of infectious diseases were used [14]. Hospital-acquired infections were defined by Centers for Disease Control and Prevention criteria [15]. If fluoroquinolones were considered necessary, we determined if there was an equally effective alternative agent that could have been prescribed.…”

Section: Methodsmentioning

confidence: 99%

Unnecessary use of fluoroquinolone antibiotics in hospitalized patients

et al. 2011

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BackgroundFluoroquinolones are among the most commonly prescribed antimicrobials and are an important risk factor for colonization and infection with fluoroquinolone-resistant gram-negative bacilli and for Clostridium difficile infection (CDI). In this study, our aim was to determine current patterns of inappropriate fluoroquinolone prescribing among hospitalized patients, and to test the hypothesis that longer than necessary treatment durations account for a significant proportion of unnecessary fluoroquinolone use.MethodsWe conducted a 6-week prospective, observational study to determine the frequency of, reasons for, and adverse effects associated with unnecessary fluoroquinolone use in a tertiary-care academic medical center. For randomly-selected adult inpatients receiving fluoroquinolones, therapy was determined to be necessary or unnecessary based on published guidelines or standard principles of infectious diseases. Adverse effects were determined based on chart review 6 weeks after completion of therapy.ResultsOf 1,773 days of fluoroquinolone therapy, 690 (39%) were deemed unnecessary. The most common reasons for unnecessary therapy included administration of antimicrobials for non-infectious or non-bacterial syndromes (292 days-of-therapy) and administration of antimicrobials for longer than necessary durations (234 days-of-therapy). The most common syndrome associated with unnecessary therapy was urinary tract infection or asymptomatic bacteriuria (30% of all unnecessary days-of-therapy). Twenty-seven percent (60/227) of regimens were associated with adverse effects possibly attributable to therapy, including gastrointestinal adverse effects (14% of regimens), colonization by resistant pathogens (8% of regimens), and CDI (4% of regimens).ConclusionsIn our institution, 39% of all days of fluoroquinolone therapy were unnecessary. Interventions that focus on improving adherence with current guidelines for duration of antimicrobial therapy and for management of urinary syndromes could significantly reduce overuse of fluoroquinolones.

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Section: Methodsmentioning

confidence: 99%

Unnecessary use of fluoroquinolone antibiotics in hospitalized patients

et al. 2011

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“…The Center for Disease Control and Prevention-National Healthcare Safety Network (NHSN) definitions for the catheter-related bloodstream infection was adapted to define IAP-RBSI 4 ; patient had clinical evidence of infection and at least one positive blood culture with organisms not related to an infection at another site. All blood cultures were drawn from peripheral vein, but not from implantable arterial ports.…”

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confidence: 99%

Implantable arterial port-related bloodstream infection in patients with primary or metastatic hepatic malignancies

Honda

Sakurai

Kang

et al. 2013

American Journal of Infection Control

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The incidence of implantable arterial post-related bloodstream infections (IAP-RBSI) among patients with unresectable hepatic malignancies is not well defined. We reviewed the 9-year incidence of IAP-RBSI in patients with hepatic malignancies, at a tertiary care center in Japan. The incidence was 1.9 infections per 10,000 catheter days.Hepatic malignancies including primary (i.e., hepatocellular carcinoma; HCC) and metastatic tumors cause substantial mortality. Although intra-hepatic infusion of chemotherapeutic agents via an implanted arterial port has been used for treating unresectable HCC or hepatic metastases, 1-3 the incidence of implantable arterial port-related bloodstream infections (IAP-RBSI) has not been previously examined. We reviewed the incidence of IAP-RBSI in patients with hepatic malignancies.

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“…A prospective study was carried out with yearly assessment of the incidence of VAP during a 3-month period. Definition of VAP was based on the recommendations of the Centers for Disease Control and Prevention [4]. Overall, out of 550 patients ventilated for >48 hours, only two cases of definite VAP were observed [5].…”

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confidence: 99%

“…*Defined as based on Centers for Disease Control and Prevention criteria [4], with a new and persistent infiltrate on chest X-ray, a positive culture in trachea-aspirate or broncho-alveolar lavage, occurrence of purulent sputum, fever and/or leucocytosis or leucopenia as obligatory features. † Defined as based on Centers for Disease Control and Prevention criteria [4]; all the same circumstances as above except a positive culture as the required parameters.…”

mentioning

confidence: 99%