A regional informatics platform for coordinated antibiotic resistant infection tracking, alerting and prevention

Background. We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region. Methods. We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010. Results. Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%–23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems. Conclusions. Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission

Epidemiology of Hospital Acquired Methicillin Resistant Staphylococcus Aureus in A Veterans Affairs Medical Center Spinal Cord Injury Unit: Fiscal Years 2008-2011

The purpose of this retrospective case-control study was to assess risk factors contributing to hospital acquired methicillin Staphylococcus aureus (HA-MRSA) and gain a better understanding of the burden of HA-MRSA infection in patients with spinal cord injuries. The study was also conducted to see if new information would be found on HA-MRSA infections and validate or refute current research for patients in a dedicated spinal cord injury unit at a Veterans Affairs Medical Center. During the study period, the infection control department identified 95 cases of HA-MRSA. Additional data retrospectively collected were basic demographics, admitting diagnosis, presence of varying comorbidities, ASIA score, presence of indwelling medical device, BMI, LOS, MRSA colonization, and quarterly hand hygiene compliance. The patient population was described using appropriate univariate descriptive statistics and crude odd ratios (ORs) with 95% confidence intervals (CIs) calculated. The most common sources of infection for cases were ulcer related (31.6%), from skin and soft tissue infections besides pressure ulcers (23.2%), 14.7% were Foley catheter related, 8.4% were blood stream infections and 22.1% were from other sites/sources. Assessment of risk factors for HA-MRSA for spinal cord injury patients in this study found that colonization (OR: 3), device use (Foley OR: 3.3, PICC OR: 39.4, use of both OR: 21.1) , paralysis (1.9), ASIA score A (OR: 4.5), amputee (OR: 3.5), decubitus ulcer (OR: 7.1), length of hospital stay \u3e 30 days (OR: 17.1) and a hand hygiene complianc

Ann Emerg Med

Infection prevention remains a major challenge in emergency care. Acutely ill and injured patients seeking evaluation and treatment in the emergency department (ED) not only have the potential to spread communicable infectious diseases to health care personnel and other patients, but are vulnerable to acquiring new infections associated with the care they receive. This article will evaluate these risks and review the existing literature for infection prevention practices in the ED, ranging from hand hygiene, standard and transmission-based precautions, health care personnel vaccination, and environmental controls to strategies for preventing health care-associated infections. We will conclude by examining what can be done to optimize infection prevention in the ED and identify gaps in knowledge where further research is needed. Successful implementation of evidence-based practices coupled with innovation of novel approaches and technologies tailored specifically to the complex and dynamic environment of the ED are the keys to raising the standard for infection prevention and patient safety in emergency care.20142015-09-01T00:00:00ZR18HS020013/HS/AHRQ HHS/United StatesK08 HS018092/HS/AHRQ HHS/United StatesUL1RR024992/RR/NCRR NIH HHS/United StatesUL1 RR024992/RR/NCRR NIH HHS/United StatesR18 HS020013/HS/AHRQ HHS/United StatesK08 HS18092/HS/AHRQ HHS/United StatesK12 HD001459/HD/NICHD NIH HHS/United StatesKL2RR024994/RR/NCRR NIH HHS/United StatesR13HS021616/HS/AHRQ HHS/United StatesUL1 TR000448/TR/NCATS NIH HHS/United StatesU54 CK000162/CK/NCEZID CDC HHS/United StatesKL2 RR024994/RR/NCRR NIH HHS/United StatesKM1CA156708/CA/NCI NIH HHS/United StatesKM1 CA156708/CA/NCI NIH HHS/United StatesR13 HS021616/HS/AHRQ HHS/United States5K12HD001459-13/HD/NICHD NIH HHS/United StatesKL2 TR000450/TR/NCATS NIH HHS/United States24721718PMC4143473754

Infection Control

Health care associated infection is coupled with significant morbidity and mortality. Prevention and control of infection is indispensable part of health care delivery system. Knowledge of Preventing HAI can help health care providers to make informed and therapeutic decisions thereby prevent or reduce these infections. Infection control is continuously evolving science that is constantly being updated and enhanced. The book will be very useful for all health care professionals to combat with health care associated infections

Effects of an Educational Intervention on Hospital Acquired Urinary Tract Infection Rates

In today\u27s hospital environment, good care has become synonymous with positive patient outcomes. Marring this landscape is the alarming rate of hospital acquired (nosocomial) infections. Urinary tract infection (UTI) is one of the most common hospital acquired infections. The major cause associated with these infections is the use of indwelling urinary catheters. Bacteria invade the lower urinary tract by ascending through or around the catheter. Morbidity associated with urinary catheter-associated UTI can be minimized by prudent decisions concerning catheter usage and good catheter care. The principle route of dispersal of nosocomial infections is likely from patient-to-patient via transiently contaminated hands of hospital personnel. The purpose of this evidence-based project was to determine if hospital-acquired catheter-associated urinary tract infection rates among patients admitted to an acute care facility could be decreased through staff education and consistent application of nursing care using selected perineal infection control interventions. The setting was a 43-bed medical/surgical floor in a 321 bed not for profit Magnet hospital in Northeast Florida. Twenty-four registered nurses and 18 patient care technicians completed targeted in-service education on general nosocomial infections, perineal care, and hand hygiene. A catheter dwell time notification system was also implemented. Chart review data was obtained from 383 admissions (197 pre-intervention, 133 after the educational intervention, and 53 after the dwell time notification). There was a significant difference in catheter-associated urinary tract infection rates after the interventions (11.17 pre-intervention, 10.53 after the educational intervention and 0.392 after the dwell time notification). A longer length of time in practice an on this hospital unit was associated with lower infection rates

Diagnostic stewardship in infectious diseases:a continuum of antimicrobial stewardship in the fight against antimicrobial resistance

Antimicrobial resistance (AMR) has been exacerbated by the inappropriate use of diagnostics, leading to excessive prescription of antimicrobials, and is an imminent threat to global health. Diagnostic stewardship (DS) is an auxiliary to antimicrobial stewardship (AMS) and comprises ordering the right tests, for the right patient, at the right time. It also promotes the judicious use of rapid and novel molecular diagnostic tools to enable the initiation of proper antibiotic therapy, while avoiding excessive use of broad-spectrum antibiotics. Proper interpretation of test results is crucial to avoid overdiagnosis and excessive healthcare costs. Although many rapid diagnostic tools have been developed with a high diagnostic yield, they are often limited by accessibility, cost, and lack of knowledge regarding their use. Careful consideration of clinical signs and symptoms with knowledge of the local epidemiology are essential for DS. This enables appropriate interpretation of microbiological results. Multidisciplinary teams that include well trained professionals should cooperate to promote DS. Challenges and barriers to the implementation of DS are mostly caused by scarcity of resources and lack of trained personnel and, most importantly, lack of knowledge. The lack of resources is often due to absence of awareness of the impact that good medical microbiology diagnostic facilities and expertise can have on the proper use of antibiotics.</p

HICPAC Meeting Minutes June 8-9, 2023

Publication date from document properties.2023-June-HICPAC-Summary-508.pd

Pharmacokinetics of Extended vs Intermittent Intravenous Infusion of Meropenem in Critically Ill Patients Receiving Continuous Veno-Venous Haemofiltration

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