The Burden of Nosocomial Infection in the Intensive Care Unit: Effects on Organ Failure, Mortality and Costs. A Nested Case-Control Study

Sánchez-Velázquez, Luis David; Rosales, Samuel Ponce de León; Frausto, M. Sigfrido Rangel

doi:10.1016/j.arcmed.2005.07.004

Cited by 28 publications

(21 citation statements)

References 35 publications

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“…Nos résultats sont comparables à d'autres enquêtes [1,8]. Les taux élevés observés dans les services de soins intensifs pourraient être en rapport avec la sévérité des pathologies sous-jacentes, le séjour relativement prolongé des patients et la fréquence des procédures invasives à visée diagnostique et/ou thérapeutique [9][10][11].…”

Section: Discussionunclassified

“…La ventilation artificielle constitue le principal facteur de risque dans la survenue des infections pulmonaires nosocomiales [9,18,19]. La prévention de ces infections repose avant tout sur la maîtrise des risques évitables et vise essentiellement la réanimation et les soins intensifs.…”

Section: Discussionunclassified

“…L'alimentation entérale a encore été identifiée comme facteur de risque significatif dans la littérature. Une étude mexicaine montre qu'elle expose les malades à un risque accru d'infection nosocomiale [9].…”

Section: Discussionunclassified

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Aspects actuels des infections nosocomiales au Centre Hospitalier Libanais de Beyrouth

Al‐Hajje

Ezedine²,

Hammoud³

et al. 2012

East Mediterr Health J

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RÉSUMÉ Les infections nosocomiales constituent un problème majeur et tout hôpital doit connaître sa situation en matière d'infections nosocomiales. Cette étude rétrospective visait à identifier les infections nosocomiales bactériennes chez les patients admis au Centre Hospitalier Libanais de janvier 2006 à janvier 2008, déterminer les germes en cause, étudier la sensibilité de ces germes aux antibiotiques et évaluer le traitement adopté à l'hôpital. Au total, 96 patients développant une infection nosocomiale ont été recensés. Les infections nosocomiales les plus courantes étaient les infections urinaires (42 %), suivies par les infections pulmonaires (28 %). Les bacilles à Gram négatif étaient responsables dans 89 % des cas et les staphylocoques dans 7 %, Escherichia coli et Pseudomonas aeruginosa étant les plus fréquents (46 % et 26 % respectivement), avec une résistance majeure à divers antibiotiques ; 18 % des patients infectés étaient traités par imipénème, 7 % par vancomycine, 42 % par céphalosporines de 3 e génération et 24 % par amikacine. La lutte contre les infections nosocomiales doit passer par des mesures d'hygiène dans l'hôpital et par une politique de prescription d'antibiotiques adaptée à l'évolution des résistances bactériennes. Current status of nosocomial infections in the Lebanese Hospital Center, BeirutABSTRACT Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections (42%) followed by pulmonary infections (28%). Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Esherichia coli and Pseudomonas aeruginosa being the most common (46% and 26% respectively) The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms.

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Section: Discussionunclassified

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Aspects actuels des infections nosocomiales au Centre Hospitalier Libanais de Beyrouth

Al‐Hajje

Ezedine²,

Hammoud³

et al. 2012

East Mediterr Health J

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“…Cardiovascular, respiratory, neurological and hepatic failure were all found to significantly increase in both frequency and duration in patients who experienced a nosocomial infection, with renal and haematological organ failures also increasing, although not significantly (likely due to the study's low patient numbers) [13]. In a prospective study of sepsis patients from 35 French ICUs it was found that most patients experienced two organ dysfunctions with the three most frequent organs affected being the respiratory, circulatory and renal systems [15].…”

Section: Burden Of Infection In the Intensive Care Unitmentioning

confidence: 99%

“…More frequent use of medically invasive procedures is required after a nosocomial infection occurs [13].…”

Section: Burden Of Infection In the Intensive Care Unitmentioning

confidence: 99%

Translating innovative pharmacokinetic sampling techniques into improved antibiotic dosing regimens in critically ill patients

Parker¹

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Antibiotic resistance is a significant and immediate global health concern. An increasing prevalence of multi-drug resistant bacteria is steadily decreasing the number of antibiotics that can be used, and few new antibiotics are available for effective treatment of multi-drug resistant infections. Effective dosing of antibiotics can have a two-fold effect by firstly improving patient outcomes and secondly suppressing the emergence of antibiotic resistance. In critically ill patients there are significant pathophysiological changes that can complicate antibiotic dosing and knowledge of the pharmacokinetic (dose-concentration relationship) and pharmacodynamic (concentration-effect relationship) properties of antibiotics are essential to ensure effective treatment.In an era of increasing antibiotic resistance, there is substantial interest in the optimal use of previously forgotten antibiotics like fosfomycin for the treatment of infections caused by multi-drug resistant bacteria. Given that resistance commonly arises in critically ill patients, a detailed understanding of antibiotic pharmacokinetics in these patients can lead to development of optimised dosing regimens that maximise bacterial killing and suppress the emergence of resistance of these antibiotics. However, pharmacokinetic studies are often expensive to perform and are resourceheavy. Innovative approaches to collecting, storing and transporting clinical samples, including microsampling techniques, could reduce some of these costs. The use of microsampling techniques in pharmacokinetic studies is likely to lead to simpler, less expensive, less invasive sample collection for more informative pharmacokinetic studies in critically ill patients that can then translate to more effective antibiotic dosing.The principal aims of this Thesis are to investigate how innovative microsampling techniques can be translated into pharmacokinetic studies. Additionally, this Thesis aims to describe optimised dosing regimens for fosfomycin through the conduct of a pharmacokinetic study in critically ill patients. 3This Thesis describes a quantitative bioanalytical validation performed using novel volumetric absorptive microsampling (VAMS) devices for sampling fosfomycin in whole blood. The use of the VAMS devices provided acceptable validation results for lower limit of quantification (LLOQ), linearity, and inter-and intra-day precision and accuracy, and matrix effects. However, the results from recovery and stability testing using VAMS devices for the quantitative bioanalysis of fosfomycin suggest challenges remain for the analysis of fosfomycin in whole blood.The microsampling investigations also describe a validated process for quantitatively measuring fosfomycin in blood samples using a dried plasma spot (DPS) sampling technique. The results of the DPS samples from a clinical pharmacokinetic study were found to correlate with the 'goldstandard' of plasma sampling. The translation of this technique into pharmacokinetic studies can reduce the resource burden du...

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Implementing an OR Contact Precautions Decision Algorithm to Promote Interprofessional Teamwork for Infection Prevention

Lacourciere¹,

Kumar²,

Apold³

2019

AORN Journal

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Perioperative nurses use aseptic and sterile technique along with standard cleaning and disinfection practices to prevent surgical site infections. At our hospital, OR team members identified a clinical problem: the lack of a systematic approach to determine the type of postprocedure cleaning required between procedures involving patients with multi‐drug resistant organisms or Clostridium difficile. Facility leaders developed a project to design and implement an evidence‐based decision‐making algorithm to help perioperative nurses rapidly identify the appropriate environmental cleaning procedures for these ORs. After the perioperative nurses were taught how to use the algorithm, it was put into use. Nineteen months later, the nurses completed a postimplementation survey. The results of the survey were generally positive, and the cleaning process was more standardized. We found that a decision‐making algorithm was an effective tool to determine the proper postprocedure environmental cleaning between surgical procedures for patients with multi‐drug resistant organisms or C difficile.

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The Burden of Nosocomial Infection in the Intensive Care Unit: Effects on Organ Failure, Mortality and Costs. A Nested Case-Control Study

Cited by 28 publications

References 35 publications

Aspects actuels des infections nosocomiales au Centre Hospitalier Libanais de Beyrouth

Aspects actuels des infections nosocomiales au Centre Hospitalier Libanais de Beyrouth

Translating innovative pharmacokinetic sampling techniques into improved antibiotic dosing regimens in critically ill patients

Implementing an OR Contact Precautions Decision Algorithm to Promote Interprofessional Teamwork for Infection Prevention

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