Healthcare-Associated Bloodstream Infections Secondary to a Urinary Focus The Québec Provincial Surveillance Results

Fortin, Élise; Rocher, Isabelle; Frenette, Charles; Tremblay, Claude; Quach, Caroline

doi:10.1086/665323

Cited by 40 publications

(33 citation statements)

References 12 publications

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“…Most MSRA bloodstream infections were healthcare related, secondary to central line infections and caused by CMRSA2 genotype strains. This is in agreement with previously published reports [14]. We have also found, as have others, that CA-MRSA bacteraemias were most frequently secondary to skin and soft tissue infections [9,26,27], and commonly associated with intravenous drug use, a well-recognized risk factor for CA-MRSA infections [28,29].…”

Section: Discussionsupporting

confidence: 93%

Molecular epidemiology and antimicrobial susceptibility profiles of methicillin-resistantStaphylococcus aureusblood culture isolates: results of the Quebec Provincial Surveillance Programme

et al. 2014

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The objectives of this study were to characterize methicillin-resistant Staphylococcus aureus (MRSA) blood culture isolates and to determine their relative importance in both nosocomial and community-acquired infections. A total of 535 MRSA blood culture isolates were analysed. In vitro susceptibility to 14 agents was determined. The genes nuc, mecA and coding for PVL toxin were identified by PCR. All isolates were characterized by PFGE or spa typing to assess their genomic relationships. Most MRSA isolates were retrieved from nosocomial bloodstream infections (474, 89%) and were of the CMRSA2 genotype. Healthcare-associated (HA)-MRSA bloodstream infections were associated with older age (70-89 years, P = 0·002) and most often secondary to central line infections (P = 0·005). Among MRSA strains associated with community-acquired (CA)-MRSA, 28·8% were isolated in intravenous drug users. CA-MRSA genotypes were more frequently found in young adults (20-39 years, P < 0·0001) with skin/soft tissue as the primary sources of infection (P = 0·006). CMRSA10 genotype was the predominant CA-MRSA strain. All MRSA isolates were susceptible to doxycycline, tigecycline, trimethoprim/sulfamethoxazole and vancomycin. Both the presence of the genes coding for PVL toxin (89·8%) and susceptibility to clindamycin (86·5%) were predictive of CA-MRSA genotypes. Whereas in the USA, HA-MRSA have been replaced by USA300 (CMRSA10) clone as the predominant MRSA strain type in positive blood cultures from hospitalized patients, this phenomenon has not been observed in the province of Quebec.

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Section: Discussionsupporting

confidence: 93%

Molecular epidemiology and antimicrobial susceptibility profiles of methicillin-resistantStaphylococcus aureusblood culture isolates: results of the Quebec Provincial Surveillance Programme

et al. 2014

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“…The incidence was 1.4 urinary bloodstream infections/10,000 patient days. All cause 30 day mortality in patients with CA-UTI bacteremia was 15% [26]. …”

Section: Reviewmentioning

confidence: 99%

Catheter associated urinary tract infections

Nicolle

2014

Antimicrob Resist Infect Control

409

382

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Urinary tract infection attributed to the use of an indwelling urinary catheter is one of the most common infections acquired by patients in health care facilities. As biofilm ultimately develops on all of these devices, the major determinant for development of bacteriuria is duration of catheterization. While the proportion of bacteriuric subjects who develop symptomatic infection is low, the high frequency of use of indwelling urinary catheters means there is a substantial burden attributable to these infections. Catheter-acquired urinary infection is the source for about 20% of episodes of health-care acquired bacteremia in acute care facilities, and over 50% in long term care facilities. The most important interventions to prevent bacteriuria and infection are to limit indwelling catheter use and, when catheter use is necessary, to discontinue the catheter as soon as clinically feasible. Infection control programs in health care facilities must implement and monitor strategies to limit catheter-acquired urinary infection, including surveillance of catheter use, appropriateness of catheter indications, and complications. Ultimately, prevention of these infections will require technical advances in catheter materials which prevent biofilm formation.

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“…[9][10][11] This study is a secondary analysis of a database that includes data for adult, pediatric, and NICU patients. We selectively extracted data pertaining to NICU patients.…”

Section: Study Setting and Designmentioning

confidence: 99%

Central Line–Associated Bloodstream Infection in Neonatal Intensive Care Units

Blanchard

Fortin

Rocher³

et al. 2013

Infect. Control Hosp. Epidemiol.

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Healthcare-Associated Bloodstream Infections Secondary to a Urinary Focus The Québec Provincial Surveillance Results

Abstract: U-BSI characteristics suggest that urinary catheters may remain in patients for ease of care or because practitioners forget to remove them. Ongoing surveillance will enable hospitals to monitor trends in U-BSIs and impacts of process surveillance that will be implemented shortly.

Cited by 40 publications

References 12 publications

Molecular epidemiology and antimicrobial susceptibility profiles of methicillin-resistantStaphylococcus aureusblood culture isolates: results of the Quebec Provincial Surveillance Programme

Molecular epidemiology and antimicrobial susceptibility profiles of methicillin-resistantStaphylococcus aureusblood culture isolates: results of the Quebec Provincial Surveillance Programme

Catheter associated urinary tract infections

Central Line–Associated Bloodstream Infection in Neonatal Intensive Care Units

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