Prevention and control of healthcare-associated infection in Europe: a review of patients' perspectives and existing differences

Marschang, S.; Bernardo, Giuseppe De

doi:10.1016/j.jhin.2015.01.017

Cited by 17 publications

(13 citation statements)

References 11 publications

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“…It is higher than finding from Europe [ 32 ]. Our study also revealed an overall prevalence rate of HAI of 19.41%; a finding which is again much higher than most reports from high income settings [ 16 , 20 , 21 ]. It is also higher than the reported prevalence from some of the studies done in the country [ 25 , 26 ].…”

Section: Discussioncontrasting

confidence: 54%

“…The magnitude of the problem in the low-income settings remains largely unknown and in most cases underestimated due to the complex nature of its diagnosis and lack of proper surveillance [ 18 , 19 ]. Studies conducted in low-income settings showed that hospital-wide prevalence of HAI is about 15.5 per 100 patients [ 18 ] which is much higher than reports from Europe [ 20 ] and North America [ 21 ]. As a matter of fact, most of the global reports of HAIs are focused on prevalence and there are only very few reports about the incidence rate of HAIs.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study

Ali

Birhane

Bekele

et al. 2018

Antimicrob Resist Infect Control

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BackgroundHealthcare associated infection (HAI) is alarmingly increasing in low income settings. In Ethiopia, the burden of HAI is still not well described.MethodsLongitudinal study was conducted from May to September, 2016. All wards of Jimma University Medical Centre were included. The incidence, prevalence and risk factors of healthcare associated infection were determined. A total of 1015 admitted patients were followed throughout their hospital stay. Biological specimens were collected from all patients suspected to have hospital aquired infection. The specimens were processed by standard microbiological methods to isolate and identify bacteria etiology. Clinical and laboratory data were collected using structured case report formats.ResultsThe incidence rate of hospital acquired infection was 28.15 [95% C.I:24.40,32.30] per 1000 patient days while the overall prevalence was 19.41% (95% C.I: (16.97–21.85). The highest incidence of HAI was seen in intensive care unit [207.55 (95% C.I:133.40,309.1) per 1000 patient days] and the lowest incidence was reported from ophthalmology ward [0.98 (95% C.I: 0.05,4.90) per 1000patient days]. Among patients who underwent surgical procedure, the risk of HAI was found to be high in those with history of previous hospitalization (ARR = 1.65, 95% C.I:1.07, 2.54). On the other hand, young adults (18 to 30-year-old) had lower risk of developing HAI (ARR = 0.54 95% C.I: 0.32,0.93) Likewise, among non-surgical care groups, the risk of HAI was found to be high in patients with chest tube (ARR = 4.14, 95% C.I: 2.30,7.46), on mechanical ventilation (ARR = 1.99, 95% C.I: 1.06,3.74) and with underlying disease (ARR = 2.01, 95% C.I: 1.33,3.04). Furthermore, hospital aquired infection at the hosoital was associated with prolonged hospital stay [6.3 more days, 95% C.I: (5.16,7.48), t = 0.000] and increased in hospital mortality (AOR, 2.23, 95% CI:1.15,4.29).ConclusionThis study revealed high burden and poor discharge outcomes of healthcare associated infection at Jimma University Medical Centre. There is a difference in risk factors between patients with and without surgery. Hence, any effort to control the observed high burden of HAI at the hospital should consider these differences for better positive out put.Electronic supplementary materialThe online version of this article (10.1186/s13756-017-0298-5) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study

Ali

Birhane

Bekele

et al. 2018

Antimicrob Resist Infect Control

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“…In Canada, more than 200,000 patients acquire a HAI annually, and as a result, an estimated 8000 die [1]. Figures in the United States and Europe are comparable on a per-capita basis [2,3]. The 2003 severe acute respiratory syndrome (SARS) outbreaks, and more recently of Middle East respiratory syndrome (MERS), highlight the major threat posed by HAIs, both within the hospital and for the wider community.…”

Section: Introductionmentioning

confidence: 99%

Contact among healthcare workers in the hospital setting: developing the evidence base for innovative approaches to infection control

et al. 2018

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BackgroundNosocomial, or healthcare-associated infections (HAI), exact a high medical and financial toll on patients, healthcare workers, caretakers, and the health system. Interpersonal contact patterns play a large role in infectious disease spread, but little is known about the relationship between health care workers’ (HCW) movements and contact patterns within a heath care facility and HAI. Quantitatively capturing these patterns will aid in understanding the dynamics of HAI and may lead to more targeted and effective control strategies in the hospital setting.MethodsStaff at 3 urban university-based tertiary care hospitals in Canada completed a detailed questionnaire on demographics, interpersonal contacts, in-hospital movement, and infection prevention and control practices. Staff were divided into categories of administrative/support, nurses, physicians, and “Other HCWs” - a fourth distinct category, which excludes physicians and nurses. Using quantitative network modeling tools, we constructed the resulting HCW “co-location network” to illustrate contacts among different occupations and with locations in hospital settings.ResultsAmong 3048 respondents (response rate 38%) an average of 3.79, 3.69 and 3.88 floors were visited by each HCW each week in the 3 hospitals, with a standard deviation of 2.63, 1.74 and 2.08, respectively. Physicians reported the highest rate of direct patient contacts (> 20 patients/day) but the lowest rate of contacts with other HCWs; nurses had the most extended (> 20 min) periods of direct patient contact. “Other HCWs” had the most direct daily contact with all other HCWs. Physicians also reported significantly more locations visited per week than nurses, other HCW, or administrators; nurses visited the fewest. Public spaces such as the cafeteria had the most staff visits per week, but the least mean hours spent per visit. Inpatient settings had significantly more HCW interactions per week than outpatient settings.ConclusionsHCW contact patterns and spatial movement demonstrate significant heterogeneity by occupation. Control strategies that address this diversity among health care workers may be more effective than “one-strategy-fits-all” HAI prevention and control programs.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3093-x) contains supplementary material, which is available to authorized users.

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“…Infectious diseases represent one of the greatest concerns about public health worldwide, 1 as they are going to climb soon the rankings of the most common cause of death because of the development of antimicrobial resistance, which has been recently identified as Europe’s biggest health threat. 2 Similarly, sepsis accounting for more than US$20 billion (5.2%) of total US hospital costs in 2011. 3 The management of this phenomenon in the health-care setting deals also with a critical and very current issue about patient safety and medical liability; most of life-threatening infections registered, in fact, are nosocomial (or health-care associated infection (HAI)).…”

Section: Introductionmentioning

confidence: 99%

Septic cardiomyopathy: The value of lactoferrin and CD15 as specific markers to corroborate a definitive diagnosis

Galassi

Turatello

Salvia

et al. 2018

Int J Immunopathol Pharmacol

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Current scientific consensus about the physiopathology in the progression from severe sepsis to septic shock and death focuses on myocardial contractile dysfunction. Nevertheless, objective parameters to establish a pathological correlate of a fatal outcome are lacking; then a cause of death due to sepsis can remain an unsolved problem. We first reviewed all death cases recorded at our institutions during the period from 2007 until 2015. Then, we conducted a retrospective study of a selected autopsy series of people who had received "sepsis" as cause of death. Two pathologists re-examined the heart sections while the most suitable myocardial sample for each case was stained for immunohistochemistry with antibodies targeted for specific inflammatory-related molecules. We used specific antibodies for the following markers: alpha-smooth muscle actin (alpha-SMA); fibronectin; matrix metallopeptidase 9 (MMP-9); intercellular adhesion molecule 1 (ICAM-1); caspase-3; lactoferrin (LF); cluster differentiation 15 (CD15). The statistical significance of differences was assessed using student's t-test for unpaired data or non-parametric Mann-Whitney or Wilcoxon tests for skewed variables or one-way analysis of variance and post hoc Scheffe's test for continuous variables and Pearson's χ-test for discrete variables. Linear regression analysis was used to determine the presence of a correlation between continuous variables. At our institutions, 2220 deaths have been recorded during the period study. Sepsis accounted as a cause of death for the 20% of total. We finally enrolled 56 cases; of these, only 20 were positive for microbiological analysis. At histological examination, clear inflammation was detectable in the 32% of cases; otherwise, immunohistochemical reaction showed a positive reaction for LF and CD15 in more than a half cases (56%). We still ignore all the underlying mechanisms of sepsis and all its pathophysiological connections with cardiac metabolism; in this sense, we aim to corroborate the diagnostic value of anti-LF and anti-CD15 staining for the post-mortem detection of myocardial inflammation.

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Prevention and control of healthcare-associated infection in Europe: a review of patients' perspectives and existing differences

Cited by 17 publications

References 11 publications

Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study

Healthcare associated infection and its risk factors among patients admitted to a tertiary hospital in Ethiopia: longitudinal study

Contact among healthcare workers in the hospital setting: developing the evidence base for innovative approaches to infection control

Septic cardiomyopathy: The value of lactoferrin and CD15 as specific markers to corroborate a definitive diagnosis

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