scholarly journals Surveillance of health care associated infections in bavarian intensive care units

2015 ◽  
Vol 4 (S1) ◽  
Author(s):  
C Höller ◽  
N Grundmann ◽  
U Kandler ◽  
S Kolb ◽  
S Nickel ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Associated Infections

scholarly journals Emerging Chryseobacterium indologenes Infection in Indian Neonatal Intensive Care Units: A Case Report

Antibiotics ◽  
2018 ◽  
Vol 7 (4) ◽  
pp. 109 ◽  
Author(s):  
Rishika Mehta ◽  
Ashish Pathak
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Multidrug Resistant ◽  
Neonatal Intensive Care Units ◽  
Indwelling Catheters ◽  
Chryseobacterium Indologenes ◽  
Life Threatening ◽  
Health Care Associated Infections

Antibiotic-resistant pathogens and nosocomial infections constitute common and serious problems for neonates admitted to neonatal intensive care units worldwide. Chryseobacterium indologenes is a non-lactose-fermenting, gram-negative, health care-associated pathogen (HCAP). It is ubiquitous and intrinsically resistant to several antibiotics. Despite its low virulence, C. indologenes has been widely reported to cause life-threatening infections. Patients on chronic immunosuppressant drugs, harboring invasive devices and indwelling catheters become the nidus for C. indologenes. Typically, C. indologenes causes major health care-associated infections such as pneumonia, empyema, pyelonephritis, cystitis, peritonitis, meningitis, and bacteremia in patients harboring central venous catheters. Management of C. indologenes infection in neonates is not adequately documented owing to underreporting, particularly in India. Because of its multidrug resistance and the scant availability of data from the literature, the effective empirical treatment of C. indologenes is challenging. We present an uncommon case of bacteremia caused by C. indologenes in a preterm newborn baby with moderate respiratory distress syndrome who was successfully treated. We also provide a review of infections in the neonatal age group. Henceforth, in neonates receiving treatments involving invasive equipment use and long-term antibiotic therapy, multidrug resistant C. indologenes should be considered an HCAP.

Infection Control in Intensive Care Units

2005 ◽  
Vol 18 (2) ◽  
pp. 84-90
Author(s):  
John Mohr ◽  
Michelle Peninger ◽  
Luis Ostrosky-Zeichner
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Health Risk ◽  
Infection Control ◽  
Intensive Care Units ◽  
Control Programs ◽  
Antimicrobial Utilization ◽  
Health Care Associated Infections

For patients in intensive care units, the development of an infection is associated with an increase in morbidity, mortality, and cost. These infections are largely preventable through the implementation of infection control programs. Infection control programs must focus on 3 general strategies: (1) prevention of health care-associated infections, (2) containment of pathogens that pose a health risk and/or are resistant to routine antibiotics, and (3) development of strategies to limit the emergence of resistant microorganisms through optimal and appropriate antimicrobial utilization. The purpose of this article is to review these 3 general strategies.

Nurse-Physician Collaboration and Hospital-Acquired Infections in Critical Care

2015 ◽  
Vol 35 (2) ◽  
pp. 66-72 ◽  
Author(s):  
Christine Boev ◽  
Yinglin Xia
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Secondary Analysis ◽  
Bloodstream Infections ◽  
Unit Increase ◽  
Health Care Associated Infections ◽  
Critically Ill Adults ◽  
Hospital Acquired ◽  
Ill Adults

BackgroundNurse-physician collaboration may be related to outcomes in health care–associated infections. OBJECTIVE To examine the relationship between nurse-physician collaboration and health care–associated infections in critically ill adults.MethodsA secondary analysis was done of 5 years of nurses’ perception data from 671 surveys from 4 intensive care units. Ventilator-associated pneumonia and central catheter–associated bloodstream infections were examined. Multilevel modeling was used to examine relationships between nurse-physician collaboration and the 2 infections.ResultsNurse-physician collaboration was significantly related to both infections. For every 0.5 unit increase in collaboration, the rate of the bloodstream infections decreased by 2.98 (P= .005) and that of pneumonia by 1.13 (P= .005). Intensive care units with a higher proportion of certified nurses were associated with a 0.43 lower incidence of bloodstream infections (P= .02) and a 0.17 lower rate of the pneumonia (P= .01). With nursing hours per patient day as a covariate, units with more nursing hours per patient day were associated with a 0.42 decrease in the rate of bloodstream infections (P= .05).ConclusionNurse-physician collaboration was significantly related to health care–associated infections.

Parameters of bed occupancy of intensive care units in Hungary

2011 ◽  
Vol 152 (24) ◽  
pp. 946-950 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Insurance ◽  
Intensive Care Units ◽  
Emergency Care ◽  
Present Author ◽  
Bed Occupancy ◽  
National Network ◽  
Bed Capacity

According to the Semmelweis Plan for Saving Health Care, ”the capacity of the national network of intensive care units in Hungary is one but not the only bottleneck of emergency care at present”. Author shows on the basis of data reported to the health insurance that not on a single calendar day more than 75% of beds in intensive care units were occupied. There were about 15 to 20 thousand sick days which could be considered unnecessary because patients occupying these beds were discharged to their homes directly from the intensive care unit. The data indicate that on the whole bed capacity is not low, only in some institutions insufficient. Thus, in order to improve emergency care in Hungary, the rearrangement of existing beds, rather than an increase of bed capacity is needed. Orv. Hetil., 2011, 152, 946–950.

Clinical Predictors for Unsafe Direct Discharge Home Patients From Intensive Care Units

2018 ◽  
Vol 35 (10) ◽  
pp. 1067-1073
Author(s):  
Vincent Issac Lau ◽  
Fran Priestap ◽  
Joyce N. H. Lam ◽  
John Basmaji ◽  
Ian M. Ball
Keyword(s):  
Health Care ◽  
Substance Abuse ◽  
Intensive Care ◽  
Adverse Events ◽  
Intensive Care Units ◽  
Care Facility ◽  
Health Care Facility ◽  
Surgical Trauma ◽  
Home Discharge ◽  
Return Visits

Purpose: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs). Methods: Prospective cohort study of all adult patients who survived their stay in our medical–surgical–trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge. Univariable and multivariable logistic regression analyses were performed to identify factors associated with adverse events or unplanned return visits to a health-care facility following DDH from ICU. Results: A total of 129 DDH patients were enrolled and completed the 8-week follow-up. We identified 39 unplanned return visits (URVs). There was 0% mortality at 8 weeks postdischarge. Eight potential predictors of hospital URVs ( P < .2) were identified in the univariable analysis: prior substance abuse (odds ratio [OR] of URV of 2.50 [95% confidence interval: 1.08-5.80], hepatitis (OR: 6.92 [1.68-28.48]), sepsis (OR: 11.03 [1.19-102.29]), admission nine equivalents of nursing manpower score (NEMS) <24 (OR: 2.28 [1.03-5.04], no fixed address (OR: 22.9 [1.2-437.3]), ICU length of stay (LOS) <2 days (OR: 2.95 [1.28-6.78]), home discharge within London, Ontario (OR: 2.44 [1.00-5.92]), and left against medical advice (AMA; OR: 6.06 [2.04-17.98]). Conclusions: Our study identified 8 covariates that were potential predictors of URV: prior substance abuse, hepatitis, sepsis, admission NEMS <24, no fixed address, ICU LOS <2 days, home discharge within London, Ontario, and left AMA. The practice of direct discharges home from the ICU would benefit from adequately powered multicenter study in order to construct a clinical prediction model (that would require further testing and validation).

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