Risk factors for nosocomial intensive care infection: a long‐term prospective analysis

Appelgren, Pia; Hellström, Ingrid; Weitzberg, Eddie; Söderlund, V.; Bindslev, L.; Ransjö, Ulrika

doi:10.1034/j.1399-6576.2001.045006710.x

Cited by 86 publications

(77 citation statements)

References 43 publications

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“…Adequate skin disinfection with the appropriate disinfectant and skillful venipuncture may reduce the blood culture-positive rates in our hospital. Catheter-related bloodstream infections are defined as the isolation of the same microorganism from the catheter and from the concurrent blood culture of a patient with clinical sepsis (12). Based on this definition, the number of true bacteremia cases in our study was 6 of 21.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Hospital-acquired Bacteremia

et al. 2005

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Objective Bacteremia is one of the most serious health problems associated with high morbidity and mortality. The aim of this study was to identify risk factors for bacteremia in daily medical care to facilitate rapid and accurate clinical decisions about treatment.Patients and Methods We studied 306 inpatients retrospectively. Age, peripheral neutrophil count, C-reactive protein (CRP), platelets, serum total cholesterol, total protein, albumin and cholinesterase were compared in patients with positive-and negative-blood cultures. The associations between blood culture positivity and glucose tolerance, bedridden state, presence of a central venous catheter (CVC) or urinary catheter were examined. On October 14, 2002, strategies for prevention of catheterrelated infection were altered in our hospital. We studied the impact of these changes on the risk of bacteremia.Results Sixty-seven patients had positive and 239 had negative blood cultures. Age, neutrophil, platelets, total protein, albumin, and cholinesterase were significantly different between the culture-positive patients and the culture-negative patients. Multivariate analysis showed albumin and platelets as independent predictors. The bedridden state and catheter-inserted states (central venous or urinary) conferred significantly higher positive blood culture rates. Multivariate analysis showed using urinary catheters and indwelling femoral CVCs as independent risk factors. There was no significant difference in the blood culture-positive rate before and after the change in prevention strategies; before the change, 6 of 9 catheter-inserted blood culture-positive cases yielded MRSA, while 4 of 12 cultures yielded Staphylococcus epidermidis after the change.Conclusion Our study highlights the risk factors of bacteremia in vulnerable patients. (Internal Medicine 44: 1157-1162, 2005)

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Hospital-acquired Bacteremia

et al. 2005

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“…7 Urinary infections in critically ill patients are associated with increased length of stay and mortality. 8 Strategies to prevent CAUTIs have focused on catheter materials, drainage systems, insertion techniques, and use of anti-infective agents. Among all methods investigated, the most important intervention is limiting catheter use.…”

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Reducing Use of Indwelling Urinary Catheters and Associated Urinary Tract Infections

Elpern

Killeen

Ketchem

et al. 2009

American Journal of Critical Care

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Background Use of indwelling urinary catheters can lead to complications, most commonly catheter-associated urinary tract infections. Duration of catheterization is the major risk factor. These infections can result in sepsis, prolonged hospitalization, additional hospital costs, and mortality. Objectives To implement and evaluate the efficacy of an intervention to reduce catheter-associated urinary tract infections in a medical intensive care unit by decreasing use of urinary catheters. Methods Indications for continuing urinary catheterization with indwelling devices were developed by unit clinicians. For a 6-month intervention period, patients in a medical intensive care unit who had indwelling urinary catheters were evaluated daily by using criteria for appropriate catheter continuance. Recommendations were made to discontinue indwelling urinary catheters in patients who did not meet the criteria. Days of use of a urinary catheter and rates of catheter-associated urinary tract infections during the intervention were compared with those of the preceding 11 months. Results During the study period, 337 patients had a total of 1432 days of urinary catheterization. With use of guidelines, duration of use was significantly reduced to a mean of 238.6 d/mo from the previous rate of 311.7 d/mo. The number of catheter-associated urinary tract infections per 1000 days of use was a mean of 4.7/mo before the intervention and zero during the 6-month intervention period. Conclusions Implementation of an intervention to judge appropriateness of indwelling urinary catheters may result in significant reductions in duration of catheterization and occurrences of catheter-associated urinary tract infections.

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“…Yaşın YBÜ'lerinde enfeksiyon için bir risk faktörü olmadığı-nı belirten çalışmalara rağmen (13,14), 60 üzeri yaşın YBÜ enfeksiyonları için risk faktörü olduğunu bildiren çalışma-larda vardır (15,16). YBÜ'ne primer yatış tanıları ile enfeksiyon türlerinin sıklığı arasında bir ilişki bulunamamıştır (13).…”

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Examination of Changes in Infection Rates in a Restructured Anaesthesia Intensive Care Unit: A Retrospective Study

Deniz¹,

Erhan²,

Bayar³

et al. 2018

Turk J Anaesth Reanim

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GirişH astane enfeksiyonları, uygulanan tüm kontrol önlemlerine karşın tüm dünyada halen önemli bir halk sağlığı sorunu olmaya devam etmektedir (1). Hastane enfeksiyonları hastanede yatış süresinin uzamasına, mortalite, morbidite ve tedavi giderlerinin artışına yol açmaktadır (2). The Centers for Disease Control and Prevention's (CDC's) ve National Nosocomial Infections Surveillance (NNIS) tanımlasına göre, yoğun bakım ünitesi (YBÜ) kökenliObjective: This retrospective study aimed to evaluate the effect of a restructured anaesthesia intensive care unit (ICU) on changes in infection rates and infections. Methods: Organisational restructuring was done in the anaesthesia ICU of Firat University Hospital after it was relocated on 14 March 2012. This study was designed to investigate the effect of restructuring on infection rates through a comparison of periods encompassing one year before relocation and one year after relocation. Nosocomial infections were diagnosed according to modified Centers for Disease Control and Prevention (CDC) criteria. In total, 406 patients who were over 18 years old and admitted to the ICU were included; they were hospitalised for 48 h or longer and had non-infectious diseases according to physical examination, laboratory and culture results on admission. The data of 214 patients (Group A) and 192 patients (Group B) were examined. Results: Parameters such as age, gender, primary diagnosis and mean GCS score at admission and mean duration of hospitalisation showed no effect on the rates of infection, but rates of total infection (41.1% vs. 25%), urinary (18.7% vs. 10.4%) and VIP (32.7% vs. 14.6%) were detected in Groups A and B. Statistically significant differences were found for the causative pathogens Pseudomonas (15.4% vs. 6.8%), Acinetobacter (18.2% vs. 12%) and Escherichia (8.9% vs. 2.1%); the mean duration of mechanical ventilation (15.01±16.681 vs. 12.22±17.595) and discharge with improvement (31.8% vs. 44.3%). Conclusion:We detected that restructuring(such as acclimatization, educated staff, hepa filter) caused a significant decline in infection rates. Because ICU staff may be a major cause of infection, we believe that providing education and conducting effective surveillance programs will be the most important factors for reducing infection rates. Keywords: ICU, acclimatisation, HEPA filter Amaç: Bu çalışmada yeniden yapılandırılan Yoğun Bakım Ünite-si'nin (YBÜ) enfeksiyon oranlarındaki değişimleri ve enfeksiyonlar üzerine olan etkisinin retrospektif olarak incelenmesi amaçlanmıştır. Yöntemler: Fırat Üniversitesi Hastanesi Anestezi YBÜ 14 Mart 2012'de yerinin tamamen değiştirilmesi ile yeniden yapılandırıldı. Bu tarihten önceki (Grup A) ve sonraki (Grup B) bir yıl içinde görülen enfeksiyon oranları karşılaştırılarak yeniden yapılandır-manın enfeksiyon oranları üzerine olan etkisi araştırıldı. Nozokomiyal enfeksiyon tanısı modifiye edilen "Centers for Disease Control and Prevention" (CDC) kriterleri, kültür sonuçları, fizik muayene, laboratuvar ve görüntüleme yöntemleriyle bir...

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Risk factors for nosocomial intensive care infection: a long‐term prospective analysis

Abstract: Trauma cases, with open fractures, were the patients most at risk of infection, despite low disease severity scores. Resources to prevent nosocomial infection should be allocated to these patients.

Cited by 86 publications

References 43 publications

Risk Factors for Hospital-acquired Bacteremia

Risk Factors for Hospital-acquired Bacteremia

Reducing Use of Indwelling Urinary Catheters and Associated Urinary Tract Infections

Examination of Changes in Infection Rates in a Restructured Anaesthesia Intensive Care Unit: A Retrospective Study

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