Daily antibiotic cost of nosocomial infections in a Turkish university hospital

BACKGROUND: Many studies associated nosocomial infections with increased hospital costs due to extra days in hospital, staff time, extra investigations and drug treatment. The cost of antibiotic treatment for these infections represents a significant part of hospital expenditure. This prospective observational study was designed to determine the daily antibiotic cost of nosocomial infections per infected adult patient in Akdeniz University Hospital. METHODS: All adult patients admitted to the ICUs between January 1, 2000, and June 30, 2003 who had only one nosocomial infection during their stay were included in the study. Infection sites and pathogens, antimicrobial treatment of patient and it's cost were recorded. Daily antibiotic costs were calculated per infected patient. RESULTS: Among the 8460 study patients, 817 (16.6%) developed 1407 episodes of nosocomial infection. Two hundred thirty three (2.7%) presented with only one nosocomial infection. Mean daily antibiotic cost was $89.64. Daily antibiotic cost was$99.02 for pneumonia, $94.32 for bloodstream infection,$94.31 for surgical site infection, $52.37 for urinary tract infection, and$162.35 for the other infections per patient. The treatment of Pseudomonas aeruginosa infections was the most expensive infection treated. Piperacillin-tazobactam and amikacin were the most prescribed antibiotics, and meropenem was the most expensive drug for treatment of the nosocomial infections in the ICU. CONCLUSIONS: Daily antibiotic cost of nosocomial infections is an important part of extra costs that should be reduced providing rational antibiotic usage in hospitals

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

The effect of allergic rhinitis on nasal septal body size Alerjik rinitin nazal septal cisim büyüklü¤ü üzerindeki etkisi ve Bilimsel Araflt›rmalar Derne¤i (SEBAD)

The nasal septal body (NSB) is a widened region of anterior nasal septum which is located superior to the inferior, and anterior to the middle turbinate. It consists of mucosa and a marked soft tissue overlying the cartilage and bone. Both cartilage and mucosa is thicker here compared to the other parts of the nasal septum. NSB plays an important role in the regulation of nasal airflow. Because it contains venous sinusoids, it is also called the septal turbinate. Because it contains venous sinusoids, it is also called as septal turbinate. Despite of its important role in the regulation of nasal airflow, it is often ignored and may be confused with a high nasal septal deviation. In published studies, NSB has been mainly investigated histologically. Although there are a limited number of histological and anatomical studies related to NSB, to our best knowledge there are no study on radiological examination of NSB size in patients with allergic rhinitis. Here, our aim was to determine whether there is any radiologically detected effect of allergic rhinitis on NSB size. Yöntem: Daha önce alerjik rinit tan›s› konmufl 40 hasta ve alerjik riniti olmayan randomize yöntemle seçilmifl otuz kontrol dene¤i bu çal›fl-maya dahil edildi. Koronal düzlem paranazal sinüs BT'sinde nazal septal cisim (NSC) boyutlar› ölçüldü. Nazal cerrahi geçirmifl hastalar, nazal polipleri olanlar, halen topikal nazal sprey, oral antihistaminik, oral steroid ve oral lökotriyen kullananlar çal›flmaya al›nmad›. Bulgular: NSC'nin ortalama kal›nl›¤›n›n alerjik rinitli hastalarda 11.2 mm, alerjik riniti olmayanlarda 10.74 mm oldu¤u saptand›. Koronal düzlemde paranazal sinüs BT incelemesinde NSC'nin büyüklü¤ü aç›-s›ndan alerjik riniti olan ve olmayanlar aras›nda anlaml› farkl›l›k yoktu. Sonuç: Sonuçlar›m›z önceki çal›flmalar›n bulgular›n› desteklememifltir. Ancak daha kesin yorumlar için daha fazla randomize, prospektif, kontrollü ve daha genifl serilere gerek vard›r. Anahtar sözcükler: Alerjik rinit, nazal septum, nazal septal cisim, nazal obstrüksiyon, bilgisayarl› tomografi. Abstract Objective: To determine whether there is any radiologically detected effect of allergic rhinitis on nasal septal body (NSB) size. Methods: Forty patients previously diagnosed with allergic rhinitis, and randomly selected thirty controls without allergic rhinitis were included in this study. Measurements of NSB size were performed in coronal plane paranasal sinus CT. Patients who had undergone nasal surgery, those with nasal polyposis, patients still using topical nasal spray, oral antihistamines, oral steroids and oral leukotrienes were excluded from the study. Results: The average width of NSB was found 11.2 mm in patients with allergic rhinitis and 10.74 mm in patients without allergic. There was no significant difference between patients with and without allergic rhinitis in terms of NSB size on coronal plane paranasal sinus CT examination. Conclusion: Our results did not support the findings of previous studies. However, further randomized, prospective, controlled trials on larger series are necessary for making more precise interpretations