Hospital environment as a reservoir for cross transmission. Cleaning and disinfection procedures

Background. Healthcare associated infections (HAIs) represent a serious problem for public health, as they increase the morbidity and mortality rates, present a relevant financial burden, and significantly contribute to the antimicrobial resistance. Methods. The aim of this review was to investigate the literature about HAIs, with particular reference to hospital environments and the role of cleaning and disinfection procedures. Hospital environments are an essential reservoir for HAIs cross transmission, and the application of appropriate procedures related to hand hygiene and disinfection/sterilization of surfaces and instruments remain key strategies for controlling HAIs. Results. Different procedures, based on the risk associated with the healthcare procedure, are recommended for hand hygiene: washing with soap and water, antiseptic rubbing with alcohol-based disinfectants, antiseptic and surgical hand washing. Environmental surfaces can be treated with different products, and the mostly used are chlorine-based and polyphenolic disinfectant. The reprocessing of instruments is related to their use according to the Spaulding's classification. In addition, scientific evidence demonstrated the great relevance of the "bundles" (small set of practices performed together) in controlling HAIs. Conclusions. Research agenda should include the improvement of well-known effective preventive procedures and the development of new bundles devoted to high-risk procedures and specific microorganisms

6th International Conference, HAIS 2011, Wroclaw, Poland, May 23-25, 2011, Proceedings, Part II

The two LNAI volumes 6678 and 6679 constitute the proceedings of the 6th International Conference on Hybrid Artificial Intelligent Systems, HAIS 2011, held in Wroclaw, Poland, in May 2011. The 114 papers published in these proceedings were carefully reviewed and selected from 241 submissions. They are organized in topical sessions on hybrid intelligence systems on logistics and intelligent optimization; metaheuristics for combinatorial optimization and modelling complex systems; hybrid systems for context-based information fusion; methods of classifier fusion; intelligent systems for data mining and applications; systems, man, and cybernetics; hybrid artificial intelligence systems in management of production systems; habrid artificial intelligent systems for medical applications; and hybrid intelligent approaches in cooperative multi-robot systems

6th International Conference, HAIS 2011, Wroclaw, Poland, May 23-25, 2011, Proceedings, Part I

The two LNAI volumes 6678 and 6679 constitute the proceedings of the 6th International Conference on Hybrid Artificial Intelligent Systems, HAIS 2011, held in Wroclaw, Poland, in May 2011. The 114 papers published in these proceedings were carefully reviewed and selected from 241 submissions. They are organized in topical sessions on hybrid intelligence systems on logistics and intelligent optimization; metaheuristics for combinatorial optimization and modelling complex systems; hybrid systems for context-based information fusion; methods of classifier fusion; intelligent systems for data mining and applications; systems, man, and cybernetics; hybrid artificial intelligence systems in management of production systems; habrid artificial intelligent systems for medical applications; and hybrid intelligent approaches in cooperative multi-robot systems

The incidence of healthcare-associated infections, their clinical forms, and microbiological agents in intensive care units in southern Poland in a multicentre study from 2016 to 2019

Introduction. Healthcare-associated infections (HAIs) are a serious problem of modern medicine. Patients hospitalized in intensive care units (ICUs) develop HAI significantly more often than patients in other hospital units. Materials and Methods. Analysis involved HAIs from three ICUs in southern Poland. The study was conducted in 2016–2019 on the basis of methodology recommended by the Healthcare-Associated Infections Surveillance Network (HAI-Net) and European Centre for Disease Prevention and Control (ECDC). The objective was to analyse HAIs, their clinical forms, and microbiological agents. Results. The study included 3028 patients hospitalized for 26,558 person-days (pds) in ICU. A total of 540 HAIs were detected; incidence per 100 hospitalizations was 17.8%, incidence density per 1000 pds was 20.3. The mortality of patients with HAI was 16%, and in Clostridioidesdifficile infection (CDI), the mortality was 28%. The most common clinical form of HAI was bloodstream infection (BSI): 209 cases (incidence rate 6.9%), followed by pneumonia (PN): 131 (incidence rate 4.3%), and urinary tract infection (UTI): 110 cases (incidence rate 3.6%). The most frequently isolated bacteria were Klebsiella pneumoniae 16.4%, Acinetobacter baumannii 14.4%, Staphylococcus aureus 11.8%, and Escherichia coli 11.4%. Conclusions. A two-fold higher incidence rate of BSI was detected compared to the average incidence in European countries. BSI of unknown source (BSI-UNK) was predominant. K. pneumoniae and A. baumannii bacteria were the most often isolated microorganisms causing HAI. Infection control based on incidence rate for each type of infection is necessary in ICU to assess the epidemiological situation

Incidence, microbiological profile and risk factors of healthcare-associated infections in intensive care units : a 10 year observation in a provincial hospital in Southern Poland

Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016. The study was conducted in compliance with the methodology recommended by the Healthcare-associated Infections Surveillance Network (HAI-Net) of the European Centre for Disease Prevention and Control (ECDC). During the 10 years of the study, 1849 patients hospitalized in an ICU for a total of 17,599 days acquired 510 with overall HAIs rates of 27.6% and 29.0% infections per 1000 ICU days. Intubation-associated pneumonia (IAP) posed the greatest risk (15.2 per 1000 ventilator days), followed by CLA-BSI (8.0 per 1000 catheter days) and CA-UTI (3.0 per 1000 catheter days). The most common isolated microorganism was Acinetobacter baumannii (25%) followed by Coagulaase-negativ staphylococci (15%), Escherichia coli (9%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (7%), Candida albicans (6%). Acinetobacter baumannii in 87% and were classified as extensive-drug resistant (XDR). In summary, in ICU patients pneumonia and bloodstream infections were the most frequently found. Acinetobacter baumannii strains were most often isolated from clinical materials taken from HAI patients and showed resistance to many groups of antibiotics. A trend of increasing resistance of Acinetobacter baumannii to carbapenems was observed

Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Africa, Eastern Europe, Latin America, and the Middle East: Findings of the International Nosocomial Infection Control Consortium (INICC)

Objective: Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs. Design: Prospective cohort study. Setting: This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries. Participants: The study included patients admitted to ICUs across 24 years. Results: In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16-1.28; P <.0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07-1.08; P <.0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23-1.31; P <.0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57-15.48; P <.0001)Revisión por pare

Improving the Accuracy of Action Classification Using View-Dependent Context Information

Proceedings of: 6th International Conference, HAIS 2011, Wroclaw, Poland, May 23-25, 2011This paper presents a human action recognition system that decomposes the task in two subtasks. First, a view-independent classifier, shared between the multiple views to analyze, is applied to obtain an initial guess of the posterior distribution of the performed action. Then, this posterior distribution is combined with view based knowledge to improve the action classification. This allows to reuse the view-independent component when a new view has to be analyzed, needing to only specify the view dependent knowledge. An example of the application of the system into an smart home domain is discussed.This work was supported in part by Projects CICYT TIN2008-06742-C02-02/ TSI, CICYT TEC2008-06732-C02-02/TEC, CAM CONTEXTS (S2009/ TIC-1485) and DPS2008-07029-C02-02.Publicad

A General Purpose Context Reasoning Environment to Deal with Tracking Problems: An Ontology-based Prototype

Proceedings of: 6th International Conference on Hybrid Artificial Intelligence Systems (HAIS 2011). Wroclaw, Poland, May 23-25, 2011The high complexity of semantics extraction with automatic video analysis has forced the researchers to the generalization of mixed approaches based on perceptual and context data. These mixed approaches do not usually take in account the advantages and benefits of the data fusion discipline. This paper presents a context reasoning environment to deal with general and specific tracking problems. The cornerstone of the environment is a symbolic architecture based on the Joint Directors of Laboratories fusion model. This architecture may build a symbolic data representation from any source, check the data consistency, create new knowledge and refine it through inference obtaining a higher understanding level of the scene and providing feedback to autocorrect the tracking errors. An ontology-based prototype has been developed to carry out experimental tests. The prototype has been proved against tracking analysis occlusion problems.This work was supported in part by Projects CICYT TIN2008-06742-C02-02/TSI, CICYT TEC2008-06732-C02-02/TEC, CAM CONTEXTS (S2009/ TIC-1485) and DPS2008-07029-C02-02.Publicad

A Practical Approach to the Development of Ontology-Based Information Fusion Systems

Proceedings of: NATO Advanced Study Institute (ASI) on Prediction and Recognition of Piracy Efforts Using Collaborative Human-Centric Information Systems, Salamanca, 19-30 September, 2011Ontology-based representations are gaining momentum among other alternatives to implement the knowledge model of high-level fusion applications. In this paper, we provide an introduction to the theoretical foundations of ontology-based knowledge representation and reasoning, with a particular focus on the issues that appear in maritime security –where heterogeneous regulations, information sources, users, and systems are involved. We also present some current approaches and existing technologies for high-level fusion based on ontological representations. Unfortunately, current tools for the practical implementation of ontology-based systems are not fully standardized, or even prepared to work together in medium-scale systems. Accordingly, we discuss different alternatives to face problems such as spatial and temporal knowledge representation or uncertainty management. To illustrate the conclusions drawn from this research, an ontology-based semantic tracking system is briefly presented. Results and latent capabilities of this framework are shown at the end of the paper, where we also envision future opportunities for this kind of applications.This research activity is supported in part by Projects CICYT TIN2008-06742-C02-02/TSI, CICYT TEC2008-06732-C02-02/TEC, CAM CONTEXTS (S2009/TIC-1485) and DPS 2008-07029-C02-02.Publicad