Healthcare-acquired infection rates in a long-term acute care hospital: A 3-year study

Stamilio, C.; Shuey, J.; Waters, Mary Jo; Hnatuck, P.; Tkatch, Lisa S.

doi:10.1016/j.ajic.2005.04.234

Cited by 2 publications

(3 citation statements)

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“…Since these bacteria also have minimal nutritional requirements, they are able to grow in aqueous products, including disinfectants (Oie and Kamiya, 1996; Ghazal et al, 2006). Contamination of albuterol and sulbutamol nebulization solutions (Balkhy et al, 2005; Ghazal et al, 2006), nebulizers (Hutchinson et al, 1996), mouthwash (Matrician et al, 2000), nasal sprays (Dolan et al, 2005), and ultrasound gel (Jacobson et al, 2006) have resulted in outbreaks of nosocomial infections by Bcc bacteria. Therefore, the surveillance of unexplained outbreaks of less common pathogens is essential; in particular, those involving poorly represented species, like B. cepacia , especially in patients with underlying lung disease and increased risk such as CF patients.…”

Section: A 16-year Systematic Study Of Burkholderia Cepacia Complex Rmentioning

confidence: 99%

Long-term colonization of the cystic fibrosis lung by Burkholderia cepacia complex bacteria: epidemiology, clonal variation, and genome-wide expression alterations

Coutinho¹

2011

Front. Cell. Inf. Microbio.

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Long-term respiratory infections with Burkholderia cepacia complex (Bcc) bacteria in cystic fibrosis (CF) patients generally lead to a more rapid decline in lung function and, in some cases, to a fatal necrotizing pneumonia known as the “cepacia syndrome.” Bcc bacteria are ubiquitous in the environment and are recognized as serious opportunistic pathogens that are virtually impossible to eradicate from the CF lung, posing a serious clinical threat. The epidemiological survey of Bcc bacteria involved in respiratory infections at the major Portuguese CF Treatment Center at Santa Maria Hospital, in Lisbon, has been carried out by our research group for the past 16 years, covering over 500 clinical isolates where B. cepacia and B. cenocepacia are the predominant species, with B. stabilis, B. contaminans, B. dolosa, and B. multivorans also represented. The systematic and longitudinal study of this CF population during such an extended period of time represents a unique case–study, comprehending 41 Bcc-infected patients (29 pediatric and 12 adult) of whom around 70% have been persistently colonized between 7 months and 9 years. During chronic infection, the CF airways represent an evolving ecosystem, with multiple phenotypic variants emerging from the clonal population and becoming established in the patients’ airways as the result of genetic adaptation. Understanding the evolutionary mechanisms involved is crucial for an improved therapeutic outcome of chronic infections in CF. This review focuses on our contribution to the understanding of these adaptive mechanisms based on extensive phenotypic, genotypic, and genome-wide expression approaches of selected Bcc clonal variants obtained during long-term colonization of the CF airways.

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Section: A 16-year Systematic Study Of Burkholderia Cepacia Complex Rmentioning

confidence: 99%

Long-term colonization of the cystic fibrosis lung by Burkholderia cepacia complex bacteria: epidemiology, clonal variation, and genome-wide expression alterations

Coutinho¹

2011

Front. Cell. Inf. Microbio.

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“…Patients treated in LTAC facilities are at an increased risk for BSI because the majority have an indwelling vascular device. 53,54 In the past, the BSI rates have been reported as high as 4 -9 cases per 1,000 line days; there is one report from 2 LTAC hospitals with a rate of 16.4 cases per 1,000 line days. [55][56][57] Increased BSI rates have been reported with the use of needleless mechanical valve devices.…”

Section: Blood Stream Infection Ratesmentioning

confidence: 99%

“…A 3-year Penn-sylvania study showed CAUTI rates of 4. 54 The CAUTI pooled mean rate published by the NHSN for LTAC hospitals is 2.6 cases per 1,000 catheter days, and for adult step-down units (post-critical care) is 1.9 cases per 1,000 catheter days. 48 During 2010 our institution had a CAUTI rate of 4.88 cases per 1,000 catheter days, and a urinary catheter utilization ratio of 0.76 catheter days per number of patient days.…”

Section: Catheter-associated Urinary Tract Infection Ratesmentioning

confidence: 99%

Infections and the Compromised Immune Status in the Chronically Critically Ill Patient: Prevention Strategies

Cabrera-Cancio

2012

Respir Care

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An estimated 2-3% of all hospitalized patients become critically ill. These patients are in a state of relative immune exhaustion, which cripples their response to infections. Patients are sicker, have many comorbidities, and undergo complex procedures. This clinical picture, combined with increasing technologies and improved survival, presents unique challenges and demands a high level of services and expertise over a prolonged period of time. Long-term acute care hospitals provide these services, and the migration of chronically critically ill patients to these institutions facilitates defining (and quantifying) the spectrum of disease and how to best manage them. The prevalence of multidrug-resistant organism colonization and infection upon arrival to long-term acute care hospitals is high. Admission screening, and appropriate isolation and infection control practices can prevent transmission of these organisms. The implementation of ventilator-associated pneumonia prevention protocols, blood stream infection prevention protocols, and minimizing Foley urinary catheter use can decrease hospital-acquired infection rates and keep them low. In addition, specific attention is required to environmental services and surface and equipment cleaning. A well organized infection control program and an antimicrobial stewardship program have become indispensable to achieve these goals. All of these key principles and recommendations are also relevant to the chronically ill patient in acute care hospital ICUs and step-down units.

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Healthcare-acquired infection rates in a long-term acute care hospital: A 3-year study

Cited by 2 publications

References 0 publications

Long-term colonization of the cystic fibrosis lung by Burkholderia cepacia complex bacteria: epidemiology, clonal variation, and genome-wide expression alterations

Long-term colonization of the cystic fibrosis lung by Burkholderia cepacia complex bacteria: epidemiology, clonal variation, and genome-wide expression alterations

Infections and the Compromised Immune Status in the Chronically Critically Ill Patient: Prevention Strategies

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