Implementation of an automated cluster alert system into the routine work of infection control and hospital epidemiology: experiences from a tertiary care university hospital

Aghdassi, Seven Johannes Sam; Kohlmorgen, Britta; Schröder, C.; Diaz, Luis Alberto Peña; Thoma, Norbert; Rohde, Anna M.; Piening, Brar; Gastmeier, Petra; Behnke, Michael

doi:10.1186/s12879-021-06771-8

Cited by 14 publications

(22 citation statements)

References 25 publications

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“…14 days after the last day of study period), were considered. To acquire the necessary virology results, the data warehouse (“Hygieneportal”), maintained by the informatics team of Charité’s Institute of Hygiene and Environmental Medicine and routinely utilized for the automated cluster alert system “CLAR” [ 27 ], was employed.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case–control study in a tertiary care university center

Aghdassi

Schwab

Diaz

et al. 2022

Antimicrob Resist Infect Control

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Background Factors contributing to the spread of SARS-CoV-2 outside the acute care hospital setting have been described in detail. However, data concerning risk factors for nosocomial SARS-CoV-2 infections in hospitalized patients remain scarce. To close this research gap and inform targeted measures for the prevention of nosocomial SARS-CoV-2 infections, we analyzed nosocomial SARS-CoV-2 cases in our hospital during a defined time period. Methods Data on nosocomial SARS-CoV-2 infections in hospitalized patients that occurred between May 2020 and January 2021 at Charité university hospital in Berlin, Germany, were retrospectively gathered. A SARS-CoV-2 infection was considered nosocomial if the patient was admitted with a negative SARS-CoV-2 reverse transcription polymerase chain reaction test and subsequently tested positive on day five or later. As the incubation period of SARS-CoV-2 can be longer than five days, we defined a subgroup of “definite” nosocomial SARS-CoV-2 cases, with a negative test on admission and a positive test after day 10, for which we conducted a matched case–control study with a one to one ratio of cases and controls. We employed a multivariable logistic regression model to identify factors significantly increasing the likelihood of nosocomial SARS-CoV-2 infections. Results A total of 170 patients with a nosocomial SARS-CoV-2 infection were identified. The majority of nosocomial SARS-CoV-2 patients (n = 157, 92%) had been treated at wards that reported an outbreak of nosocomial SARS-CoV-2 cases during their stay or up to 14 days later. For 76 patients with definite nosocomial SARS-CoV-2 infections, controls for the case–control study were matched. For this subgroup, the multivariable logistic regression analysis revealed documented contact to SARS-CoV-2 cases (odds ratio: 23.4 (95% confidence interval: 4.6–117.7)) and presence at a ward that experienced a SARS-CoV-2 outbreak (odds ratio: 15.9 (95% confidence interval: 2.5–100.8)) to be the principal risk factors for nosocomial SARS-CoV-2 infection. Conclusions With known contact to SARS-CoV-2 cases and outbreak association revealed as the primary risk factors, our findings confirm known causes of SARS-CoV-2 infections and demonstrate that these also apply to the acute care hospital setting. This underscores the importance of rapidly identifying exposed patients and taking adequate preventive measures.

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Section: Methodsmentioning

confidence: 99%

Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case–control study in a tertiary care university center

Aghdassi

Schwab

Diaz

et al. 2022

Antimicrob Resist Infect Control

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“…The assignment of control patients to cases and the retrospective extraction of parameters was supported by the “Hygieneportal”, an IPC data warehouse developed and maintained by the Institute of Hygiene and Environmental Medicine at the Charité [ 16 , 17 ].…”

Section: Methodsmentioning

confidence: 99%

Risk factors for transmission of carbapenem-resistant Acinetobacter baumannii in outbreak situations: results of a case-control study

Schlosser,

Weikert,

Fucini

et al. 2024

BMC Infect Dis

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Background An increase in patients with multidrug-resistant organisms and associated outbreaks during the COVID-19 pandemic have been reported in various settings, including low-endemic settings. Here, we report three distinct carbapenem-resistant Acinetobacter baumannii (CRAB) outbreaks in five intensive care units of a university hospital in Berlin, Germany during the COVID-19 pandemic. Methods A case-control study was conducted with the objective of identifying risk factors for CRAB acquisition in outbreak situations. Data utilized for the case-control study came from the investigation of three separate CRAB outbreaks during the COVID-19 pandemic (August 2020– March 2021). Cases were defined as outbreak patients with hospital-acquired CRAB. Controls did not have any CRAB positive microbiological findings and were hospitalized at the same ward and for a similar duration as the respective case. Control patients were matched retrospectively in a 2:1 ratio. Parameters routinely collected in the context of outbreak management and data obtained retrospectively specifically for the case-control study were included in the analysis. To analyze risk factors for CRAB acquisition, univariable and multivariable analyses to calculate odds ratios (OR) and 95% confidence intervals (CI) were performed using a conditional logistic regression model. Results The outbreaks contained 26 cases with hospital-acquired CRAB in five different intensive care units. Two exposures were identified to be independent risk factors for nosocomial CRAB acquisition by the multivariable regression analysis: Sharing a patient room with a CRAB patient before availability of the microbiological result was associated with a more than tenfold increase in the risk of nosocomial CRAB acquisition (OR: 10.7, CI: 2.3–50.9), while undergoing bronchoscopy increased the risk more than six times (OR: 6.9, CI: 1.3–38.1). Conclusions The risk factors identified, sharing a patient room with a CRAB patient and undergoing bronchoscopy, could point to an underperformance of basic infection control measure, particularly hand hygiene compliance and handling of medical devices. Both findings reinforce the need for continued promotion of infection control measures. Given that the outbreaks occurred in the first year of the COVID-19 pandemic, our study serves as a reminder that a heightened focus on airborne precautions should not lead to a neglect of other transmission-based precautions.

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“…IPC is a key component of quality control and ensuring patient safety in hospitals. Preventing infections related to healthcare settings and reducing infection transmission are the main goals of IPC [ 2 ]. Direct or indirect contact with people and contact with contaminated materials are the two main ways infectious diseases are passed from one person to another [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Importance of Hospital Infection Control

Kubde,

Badge,

Ugemuge

et al. 2023

Cureus

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The increasing demand for healthcare-acquired infection (HAI) control practices and services has intensified the need to evaluate care quality. The World Health Organization (WHO) introduced an infection prevention and control (IPC) framework to mitigate the impact of HAIs, crucial for ensuring patient safety in hospitals. HAIs acquired after hospitalization pose significant challenges due to factors such as compromised immunity, invasive medical procedures, and antibiotic-resistant pathogens, which have dire consequences, including higher mortality rates and increased healthcare costs. Healthcare workers (HCWs) are critical in implementing IPC measures. Infection control programs that include strategies such as hand hygiene, personal protective equipment (PPE), environmental cleaning, and surveillance have become standard. However, challenges such as resistance to change, resource limitations, patient turnover, and variability in patient conditions persist. Strategies to maintain hospital infection control involve rigorous compliance monitoring, staff education, advanced technologies such as artificial intelligence (AI), machine learning (ML), telemedicine, and innovative sanitation methods. The future of hospital infection control may involve increased integration of environmental monitoring, antimicrobial stewardship, and patient participation while leveraging collaboration among healthcare facilities. The review highlights the criticality of hospital infection control and suggests trends and opportunities to strengthen prevention efforts and patient safety.

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Implementation of an automated cluster alert system into the routine work of infection control and hospital epidemiology: experiences from a tertiary care university hospital

Cited by 14 publications

References 25 publications

Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case–control study in a tertiary care university center

Risk factors for nosocomial SARS-CoV-2 infections in patients: results from a retrospective matched case–control study in a tertiary care university center

Risk factors for transmission of carbapenem-resistant Acinetobacter baumannii in outbreak situations: results of a case-control study

Importance of Hospital Infection Control

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