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Sample records for causing nosocomial infections

  1. RISK FACTORS AND NOSOCOMIAL INFECTIONS CAUSED BY ENTEROCOCCI

    OpenAIRE

    2015-01-01

    Aim: to analyze nosocomial infections and risk factors caused by enterococci. Review of the foreign and domestic literature on biology and virulence factors of enterococci being the leading causative agents of nosocomial infections is done. Information on risk factors and postoperative infectious complications, pathogens of which are enterococci, in surgical hospitals and hospitals for organ transplantations is provided. The growth of antibiotic resistance in enterococci and the relationship ...

  2. Imipenem resistance in nonfermenters causing nosocomial urinary tract infections.

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    Taneja N

    2003-07-01

    Full Text Available Nonfermenting gram-negative bacilli (nonfermenters have emerged as important nosocomial pathogens causing opportunistic infections in immunocompromised hosts. These organisms show high level of resistance to b-lactam agents, fluoroquinolones and aminoglycosides. Imipenem is a carbapenem antibiotic, which can be very useful for treatment of infections caused by nonfermenters. Eighty-five nonfermenters causing nosocomial UTI were tested for MIC to imipenem by agar dilution method. Resistance to other antimicrobial agents was compared between imipenem sensitive (S and resistance (R groups. Overall 36.4% of nonfermenters were resistant to imipenem. Forty two percent of P. aeruginosa and 18.5% of Acinetobacter baumanii were imipenem resistant. Other nonfermenters showed variable resistance, resistance in Alcaligenes spp. being very high. More than 70% of the nonfermenters were resistant to ceftazidime, gentamicin and ciprofloxacin. Piperacillin and amikacin had the best in vitro susceptibility. No significant difference was found in the antibiotic susceptibility profile among imipenem sensitive (S or resistant (R strains.

  3. Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused by Pseudomonas aeruginosa

    OpenAIRE

    Meliha Cagla Sonmezer; Gunay Ertem; Fatma Sebnem Erdinc; Esra Kaya Kilic; Necla Tulek; Ali Adiloglu; Cigdem Hatipoglu

    2016-01-01

    Background. Pseudomonas aeruginosa (P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed with P. aeruginosa-related nosocomial infection. Methods. A retrospective case control study including patients with P. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, pi...

  4. Subcutaneous mucormycosis caused by Rhizopus oryzae: probable nosocomial acquired infection

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    Flávio de Queiroz Telles Filho

    1985-08-01

    Full Text Available The Authors present a case of subcutaneous mucormycosis occurring in a patient with clinical and biochemical evidence of diabetic ketoacidosis. The clinical, mycological and histopathological features are described, emphasizing the relevance of a rapid diagnosis in order to stablish early treatment. The clinical forms of mucormycosis and the main associated conditions are briefly reviewed as well as the most probable conditions which may lead to the enhanced susceptibility to infection in the diabetic patient in ketoacidosis. The recovery of Rhizopus oryzae from the air of the room of the patient suggests a nosocomial infection acquired through contamination of venous puncture site by air borne spores.

  5. The Review Systematic and Meta Analysis of Prevalence and Causes of Nosocomial Infection in Iran

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    Pezhman Bagheri

    2014-12-01

    Full Text Available Background and Aim: The variation of reported nosocomial infection is very high respectively. It seems review systematic and Meta analysis of related documents gives precise estimate of this subject for correct politisize. So tha aim of this study the review systematic and meta analysis of prevalence and causes of nosocomial infection in iran. Materials and Methods: For this study all articles published in Iranian journals and international journals, Final Report of Research Projects, related papers presented at congresses and thesis were reviewed with using standard and sensitive keywords. Then, all articles published between 1997-2010 years that had eligibility Inclusion criteria after quality control, using random model, intered to process of meta-analysis. Results: The finding show that the best estimate of total prevalence of nosocomial infection in Iran is 30.43% and the most common infections of nosocomial infection are respiratory infection 39.4%%, urinary infection 23.88%, bacteremia 21.98% and the most common factors of nosocomial infection are Pseudomonas aeroginosa 26.78%, klebsiella 31.42%, Staphylococcus 23.6% and E.coli 30.93%. The research also found a substantial heterogeneity that using meta regression method the main cause of produce of this heterogeneity, participants people, sample size, average age of the samples, time of study and gender were introduced. Conclusions: The simple review of studied documents in this survey show that prevalence rate of different nosocomial infection in Iran is high relatively. Hence make appropriate and evidence-based educational and control programs to reduce nosocomial infections prevalence rate in Iran should be considered by policy makers.

  6. Nosocomial Infections Caused by Acinetobacter baumannii: Are We Losing the Battle?

    Science.gov (United States)

    Protic, Dragana; Pejovic, Aleksa; Andjelkovic, Dragana; Djukanovic, Nina; Savic, Dragana; Piperac, Pavle; Markovic Denic, Ljiljana; Zdravkovic, Marija; Todorovic, Zoran

    2016-04-01

    The incidence of nosocomial infections caused by multi-drug- and extended-drug resistant strains of Acinetobacter is constantly increasing all over the world, with a high mortality rate. We analyzed the in-hospital data on the sensitivity of Acinetobacter baumannii isolates and correlated them with antibiotic treatment and clinical outcomes of nosocomial infections over a 17-mo period. Retrospective analysis was performed at the Clinical Center "Bezanijska kosa," Belgrade, Serbia. Microbiologic data (number and sensitivity of A. baumannii isolates) and clinical data (medical records of 41 randomly selected patients who developed nosocomial infection caused by A. baumannii) were matched. Acinetobacter baumannii, detected in 279 isolates and obtained from 19 patients (12% of all samples), was resistant to almost all antibiotics tested, including carbapenems, with the exception of colistin and tigecycline. It was obtained most often from the respiratory tract samples. Empiric treatment of the nosocomial infections (pneumonia in 75% of cases) involved cephalosporins, metronidazole, and carbapenems (80%, 66%, and 61% of patients, respectively), whereas tigecyclin and colistin were used primarily in targeted therapy (20% and 12% of patients, respectively). The mortality rate of patients treated empirically was significantly higher (p Nosocomial A. baumannii infections represent a significant clinical problem because of their high incidence, lack of susceptibility to the most commonly used antibiotics, and the often inappropriate treatment, which favors the development of multi-drug-resistant strains.

  7. [Nosocomial infection: clinical aspects].

    Science.gov (United States)

    Frottier, J

    1993-05-01

    Nosocomial infections develop within a hospital or are produced by microorganisms acquired during hospitalization. They may involve not only patients (2 to 10 percent) but also hospital personnel. They arise from complex interactions of multiple causal factors. Patients risk factors are these that reduce the patient's capacity for resisting the injurious effects of the microorganisms and impair natural host defense mechanisms: patients with malignant disorders or immunosuppressive therapy, poor nutritional status, extensive burn wounds ... The young and the elderly are generally more susceptible to infection. Other infections are preventable. Disease causation is often multifactorial. Nosocomial urinary tract infections had the highest rate, followed by lower respiratory tract infections, surgical infections and bacteremias. The emergence of other nosocomial infections, caused by bacteria (tuberculosis), virus (HIV, hepatitis B and C virus, cytomegalovirus...), Aspergillus species or Pneumocystis carinii appears to be recent in origin and is of importance to immunocompromised hosts, other patients and hospital personnel. Nosocomial infections and their social and economic impacts require for their prevention vigorous organized hospital-wide surveillance and control programs.

  8. Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused by Pseudomonas aeruginosa.

    Science.gov (United States)

    Sonmezer, Meliha Cagla; Ertem, Gunay; Erdinc, Fatma Sebnem; Kaya Kilic, Esra; Tulek, Necla; Adiloglu, Ali; Hatipoglu, Cigdem

    2016-01-01

    Background. Pseudomonas aeruginosa (P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed with P. aeruginosa-related nosocomial infection. Methods. A retrospective case control study including patients with P. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and ceftazidime) constituted the study group. Results. One hundred and twenty isolates were isolated. Various risk factors were detected for each antibiotic in the univariate analysis. In the multivariate analysis, previous cefazolin use was found as an independent risk factor for the development of imipenem resistance (OR = 3.33; CI 95% [1.11-10.0]; p = 0.03), whereas previous cerebrovascular attack (OR = 3.57; CI 95% [1.31-9.76]; p = 0.01) and previous meropenem use (OR = 4.13; CI 95% [1.21-14.07]; p = 0.02) were independent factors for the development of meropenem resistance. For the development of resistance to ciprofloxacin, hospitalization in the neurology intensive care unit (OR = 4.24; CI 95% [1.5-11.98]; p = 0.006) and mechanical ventilator application (OR = 11.7; CI 95% [2.24-61.45]; p = 0.004) were independent risk factors. Conclusion. The meticulous application of contact measures can decrease the rate of nosocomial infections.

  9. Epidemiological markers of Serratia marcescens isolates causing nosocomial infections in Spain (1981-1991).

    Science.gov (United States)

    Boquete, T; Vindel, A; Martin-Bourgon, C; Azañedo, L; Sáez-Nieto, J A

    1996-12-01

    The distribution of epidemiological markers (serotyping and phage-typing) of Serratia marcescens isolates from nosocomial episodes (63 nosocomial cutbreaks with 475 isolates, and 1208 sporadic cases) received in our laboratory during the period 1981-1991 was studied. The records for 1683 isolates from Spanish hospitals have been analyzed. In relation with the sporadic cases, the predominant types were serotype O6 (13.4%) and serotype O14 (11.4%); polyagglutinable strains accounted for 15.6%; in outbreaks, type O14 is clearly predominant (27.4%). Phage-typing was a good secondary marker, with a 87.9% of typability; the number of lytic patterns was very high, extended patterns (six or more phages) being the most frequent. We have studied the characteristics of S. marcescens isolates causing infections in the nosocomial environment in Spain.

  10. Risk factors for nosocomial bloodstream infection caused by multidrug resistant gram-negative bacilli in pediatrics

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    Mariana V. Arnoni

    2007-04-01

    Full Text Available The aim of this study was to identify the risk factors for nosocomial bloodstream infections by multidrug resistant Gram-negative bacilli. From November 2001 to December 2003, in the Pediatric Department of the Santa Casa de São Paulo, a retrospective case-control study was developed concerning patients who had nosocomial bloodstream infection caused by Gram-negative bacilli. Patients with multidrug resistant infections were designated as case patients, and control patients were those with an infection that did not meet the criteria for multidrug resistance. Previous use of central venous catheter and previous use of vancomycin plus third generation cephalosporins were associated to a higher chance of infections by multidrug resistant Gram-negative bacilli (Odds ratio - 5.8 and 5.2, respectively. Regarding sensitivity of the isolated agents, 47.8% were multidrug resistant, 54.2% were Klebsiella spp. ESBL producers and 36.4% were imipenem resistant Pseudomonas aeruginosa. The lethality rate was 36.9% in the studied cases and this rate was significantly higher in the group of patients with multidrug resistant infections (p=0.013. Risk factor identification as well as the knowledge of the susceptibility of the nosocomial infectious agents gave us the possibility to perform preventive and control strategies to reduce the costs and mortality related to these infections.

  11. Antimicrobial susceptibility pattern in nosocomial infections caused by Acinetobacter species in Asir Region, Saudi Arabia.

    Science.gov (United States)

    Abdalla, Nazar M; Osman, Amani A; Haimour, Waleed O; Sarhan, Mohammed A A; Mohammed, Mohammed N; Zyad, Eyhab M; Al-Ghtani, Abdalla M

    2013-03-15

    This study aimed at evaluating the sensitivity of antibiotics towards nosocomial infections caused by Acinetobacter species. The study took place during the period Dec. 2011- Dec. 2012 at Assir Central Hospital in collaboration with the department of microbiology, college of medicine, King Khalid University, Abha. A prospective study involving 150 patients presented with nosocomial infections due to Acinetobacter species detected by bacteriological tests; direct microscopy, culture in blood agar media, fermentation test in MacConkey media and MIC (minimum inhibitory concentration) for antibiotics sensitivity using Muller Hinton media and Chemical test using API 20. A 150 nosocomial infections in this study showed gram-negative coccobacilli, non motile, glucose-negative fermentor and oxidase negative. All isolates showed 100% sensitivity to: Imipramine, Meropenem, Colistin. From the rest of tested antibiotics the higher resistant ones were; Nitrofurantoin 87% and Cefoxitin 85%. The least resistant antibiotics; Imipenem 3% and Ticarcillin 7%. While variable resistance in the rest of tested antimicrobials. A 47 patients (31.3%) have used antibiotics prior to this study. The high rate of usage occurred in elder patients. The frequency of Acinetobacter calcoaceticus baumannii complex multi-drugs resistance ABCMDR is rising including almost all commonly used antibiotics. Only few antibiotics exert 100% sensitivity towards these bacteria.

  12. Evaluation of Risk Factors for Antibiotic Resistance in Patients with Nosocomial Infections Caused by Pseudomonas aeruginosa

    Science.gov (United States)

    Ertem, Gunay; Erdinc, Fatma Sebnem; Kaya Kilic, Esra; Adiloglu, Ali; Hatipoglu, Cigdem

    2016-01-01

    Background. Pseudomonas aeruginosa (P. aeruginosa) is resistant to various antibiotics and can cause serious nosocomial infections with high morbidity and mortality. In this clinical study, we investigated the risk factors in patients who were diagnosed with P. aeruginosa-related nosocomial infection. Methods. A retrospective case control study including patients with P. aeruginosa-related nosocomial infection. Patients who were resistant to any of the six antibiotics (imipenem, meropenem, piperacillin-tazobactam, ciprofloxacin, amikacin, and ceftazidime) constituted the study group. Results. One hundred and twenty isolates were isolated. Various risk factors were detected for each antibiotic in the univariate analysis. In the multivariate analysis, previous cefazolin use was found as an independent risk factor for the development of imipenem resistance (OR = 3.33; CI 95% [1.11–10.0]; p = 0.03), whereas previous cerebrovascular attack (OR = 3.57; CI 95% [1.31–9.76]; p = 0.01) and previous meropenem use (OR = 4.13; CI 95% [1.21–14.07]; p = 0.02) were independent factors for the development of meropenem resistance. For the development of resistance to ciprofloxacin, hospitalization in the neurology intensive care unit (OR = 4.24; CI 95% [1.5–11.98]; p = 0.006) and mechanical ventilator application (OR = 11.7; CI 95% [2.24–61.45]; p = 0.004) were independent risk factors. Conclusion. The meticulous application of contact measures can decrease the rate of nosocomial infections. PMID:27656220

  13. [Nosocomial urinary infections].

    Science.gov (United States)

    Butreau-Lemaire, M; Botto, H

    1997-09-01

    The concept of nosocomial urinary tract infection now corresponds to a precise definition. It is generally related to bladder catheterization, constitutes the most frequent form of nosocomial infection (30 to 50% of infections), and represents the third most frequent portal of entry of bacteraemia. The organism most frequently isolated is Escherichia coli; but the flora is changing and the ecological distribution is continually modified. Despite their usually benign nature, these nosocomial infections can nevertheless influence hospital mortality; they increase the hospital stay by an average of 2.5 days and their treatment represents a large share of the antibiotic budget. Prevention of these infections is therefore essential, with particular emphasis on simple and universally accessible measures: very precise indications for vesical catheterization, use of closed circuit drainage, maximal asepsis when handling catheters, after washing the hands.

  14. Risk factors for nosocomial burn wound infection caused by multidrug resistant Acinetobacter baumannii.

    Science.gov (United States)

    Tekin, Recep; Dal, Tuba; Bozkurt, Fatma; Deveci, Ozcan; Palanc, Ylmaz; Arslan, Eyüp; Selçuk, Caferi Tayyar; Hoşoğlu, Salih

    2014-01-01

    Acinetobacter baumannii infections in burn patients may lead to delays in wound healing, graft losses, and development of sepsis. Determining the risk factors for multidrug resistant A. baumannii (MDR-AB) infections is essential for infection control. In the present study, the authors aimed to evaluate risk factors for wound infections caused by A. baumannii in burn patients. The study was conducted at Dicle University Hospital Burn Center, from April 2011 to July 2012, to investigate the risk factors for MDR-AB infections. The data of both the case and control group patients and the result of wound cultures were recorded on a daily basis, on individual forms given for each patient, and analyzed. A total of 30 cases infected with MDR-AB, and 60 uninfected control patients, were included in the study. The mean age (±SD) was 7.7 ± 15.4 years in infected patients and 11.4 ± 16.5 years in uninfected patients. The mean total burn surface area was 13.5 ± 10.9% in uninfected patients and 34.7 ± 16.2% in infected patients. The mean total burn surface area, the abbreviated burn severity index, acute physiological and chronic health evaluation II score, day of admission to hospital, length of hospital stay, first excision day, prior usage of third-generation cephalosporins, and stay in intensive care unit of the infected patients were significantly higher (P infection. Univariate analysis found that high acute physiological and chronic health evaluation II score, first excision time of wound, invasive device usage, admission day to hospital, and prior usage of broad-spectrum antibiotics were risk factors for nosocomial infections. This study showed that multiple factors contribute to multidrug resistance in A. baumannii. A combination of an early diagnosis of wound infections, appropriate antimicrobial treatments, surgical debridement, and early wound closure may be effective in the management.

  15. Antimicrobial resistance in pathogens causing nosocomial bloodstream infections in university hospitals in Egypt.

    Science.gov (United States)

    Saied, Tamer; Elkholy, Amany; Hafez, Soad F; Basim, Hadia; Wasfy, Momtaz O; El-Shoubary, Waleed; Samir, Ahmed; Pimentel, Guillermo; Talaat, Maha

    2011-11-01

    Nosocomial bloodstream infections (BSIs) and antimicrobial resistance (AMR) are worldwide health care problems causing substantial patient morbidity and mortality. This study was conducted to identify bacterial pathogens isolated from nosocomial BSIs and determine their AMR patterns. An active surveillance program for BSIs was conducted in intensive care units in 3 large university hospitals in Egypt between September 1, 2006, and June 30, 2007. Infection prevention and control teams and link nurses in collaboration with intensive care physicians were looking actively to identify patients who acquired BSIs based on Centers for Disease Control and Prevention standard case definitions. Blood cultures were obtained from patients with suspected BSIs and processed to isolate bacteria and test their antimicrobial resistance. During the 10-month active surveillance period, a total of 600 pathogens were isolated from blood cultures of 1,575 patients (38%). Of these 600 isolates, 386 (66%) were gram-negative, 178 (30%) were gram-positive, and 24 (4%) were budding yeasts. The gram-negative organisms included 162 (27%) Klebsiella pneumoniae and 23 (3.8%) Escherichia coli. Extended-spectrum β-lactamase enzymes were detected in 79% of the K pneumoniae isolates and 39% of the E coli isolates. Methicillin-resistant Staphylococcus aureus accounted for 60% of S aureus infections. High rates of β-lactamase resistance and methicillin-resistant S aureus were found in the 3 Egyptian university hospitals studied. This study highlights the need for strengthening infection prevention and control programs, monitoring AMR at each facility, and developing policies for antibiotic use. Published by Mosby, Inc.

  16. Nosocomial infections: Epidemiology, prevention, control and surveillance

    OpenAIRE

    Hassan Ahmed Khan; Fatima Kanwal Baig; Riffat Mehboob

    2017-01-01

    Nosocomial infections or healthcare associated infections occur in patients under medical care. These infections occur worldwide both in developed and developing countries. Nosocomial infections accounts for 7% in developed and 10% in developing countries. As these infections occur during hospital stay, they cause prolonged stay, disability, and economic burden. Frequently prevalent infections include central line-associated bloodstream infections, catheter-associated urinary tract infections...

  17. [Medical responsibility and nosocomial infections].

    Science.gov (United States)

    Scolan, V; Telmon, N; Rouge, J C; Rouge, D

    2000-04-01

    Modifications of the civil and administrative jurisprudence regarding nosocomial infections reflect the will to pay the patient for compensation for injury. The June 29, 1999 decree of the French Court of Cessation shows the transition from presumption of malpractice to obligation of safety. The authors describe those modifications, including the physician's and hospital liabilities, and assess their consequences, as proof of an external cause is now mandatory while proof of absence of malpractice is no longer sufficient.

  18. Nosocomial infections and their control strategies

    Directory of Open Access Journals (Sweden)

    Hassan Ahmed Khan

    2015-07-01

    Full Text Available Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel's skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium difficile shows natural resistance. Excessive and improper use of broad-spectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.

  19. Nosocomial infections and their control strategies

    Institute of Scientific and Technical Information of China (English)

    Hassan Ahmed Khan; Aftab Ahmad; Riffat Mehboob

    2015-01-01

    Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel’s skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium dififcile shows natural resistance. Excessive and improper use of broad-spectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.

  20. Nosocomial infections and their control strategies

    Institute of Scientific and Technical Information of China (English)

    Hassan; Ahmed; Khan; Aftab; Ahmad; Riffat; Mehboob

    2015-01-01

    Nosocomial infections are also known as hospital-acquired/associated infections. National Healthcare Safety Network along with Centers for Disease Control for surveillance has classified nosocomial infection sites into 13 types with 50 infection sites, which are specific on the basis of biological and clinical criteria. The agents that are usually involved in hospitalacquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members, namely, Proteus mirablis, Klebsiella pneumonia, Escherichia coli, Serratia marcescens. Nosocomial pathogens can be transmitted through person to person, environment or contaminated water and food, infected individuals, contaminated healthcare personnel’s skin or contact via shared items and surfaces. Mainly, multi-drug-resistant nosocomial organisms include methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa and Klebsiella pneumonia, whereas Clostridium difficile shows natural resistance. Excessive and improper use of broadspectrum antibiotics, especially in healthcare settings, is elevating nosocomial infections, which not only becomes a big health care problem but also causes great economic and production loss in the community. Nosocomial infections can be controlled by measuring and comparing the infection rates within healthcare settings and sticking to the best healthcare practices. Centers for Disease Control and Prevention provides the methodology for surveillance of nosocomial infections along with investigation of major outbreaks. By means of this surveillance, hospitals can devise a strategy comprising of infection control practices.

  1. Risk factors and prognosis of nosocomial bloodstream infections caused by extended-spectrum-beta-lactamase-producing Escherichia coli.

    Science.gov (United States)

    Rodríguez-Baño, Jesús; Picón, Encarnación; Gijón, Paloma; Hernández, José Ramón; Cisneros, Jose M; Peña, Carmen; Almela, Manuel; Almirante, Benito; Grill, Fabio; Colomina, Javier; Molinos, Sonia; Oliver, Antonio; Fernández-Mazarrasa, Carlos; Navarro, Gemma; Coloma, Ana; López-Cerero, Lorena; Pascual, Alvaro

    2010-05-01

    Extended-spectrum-beta-lactamase (ESBL)-producing Escherichia coli (ESBLEC) is an increasing cause of community and nosocomial infections worldwide. However, there is scarce clinical information about nosocomial bloodstream infections (BSIs) caused by these pathogens. We performed a study to investigate the risk factors for and prognosis of nosocomial BSIs due to ESBLEC in 13 Spanish hospitals. Risk factors were assessed by using a case-control-control study; 96 cases (2 to 16% of all nosocomial BSIs due to E. coli in the participating centers) were included; the most frequent ESBL was CTX-M-14 (48% of the isolates). We found CTX-M-15 in 10% of the isolates, which means that this enzyme is emerging as a cause of invasive infections in Spain. By repetitive extragenic palindromic sequence-PCR, most isolates were found to be clonally unrelated. By multivariate analysis, the risk factors for nosocomial BSIs due to ESBLEC were found to be organ transplant (odds ratio [OR]=4.8; 95% confidence interval [CI]=1.4 to 15.7), the previous use of oxyimino-beta-lactams (OR=6.0; 95% CI=3.0 to 11.8), and unknown BSI source (protective; OR=0.4; 95% CI=0.2 to 0.9), and duration of hospital stay (OR=1.02; 95% CI=1.00 to 1.03). The variables independently associated with mortality were a Pitt score of >1 (OR=3.9; 95% CI=1.2 to 12.9), a high-risk source (OR=5.5; 95% CI=1.4 to 21.9), and resistance to more than three antibiotics, apart from penicillins and cephalosporins (OR=6.5; 95% CI=1.4 to 30.0). Inappropriate empirical therapy was not associated with mortality. We conclude that ESBLEC is an important cause of nosocomial BSIs. The previous use of oxyimino-beta-lactams was the only modifiable risk factor found. Resistance to drugs other than penicillins and cephalosporins was associated with increased mortality.

  2. Nosocomial Infections in Neonatal Intensive Care Units

    OpenAIRE

    2013-01-01

    Neonates, especially prematures, requiring care in Intensive Care Unit are a highly vulnerable population group at increased risk for nosocomial infections. In recent decades become one of the leading causes of morbidity and mortality in the Neonatal Intensive Care Unit. Aim: Highlighting the severity of nosocomial infections for hospitalized infants and the imprinting of risk factors that affects their development. Material-Methods: Searched for studies published in international scientific ...

  3. Nosocomial dermatitis caused by Dermanyssus gallinae.

    Science.gov (United States)

    Bellanger, A P; Bories, C; Foulet, F; Bretagne, S; Botterel, F

    2008-03-01

    The mite Dermanyssus gallinae may cause pruritic dermatitis in humans. We describe a case of nosocomial infestation with D. gallinae from an abandoned pigeon nest suspended on the front wall of the Hôpital Henri Mondor near a window. Close surveillance and regular destruction of pigeon nests could prevent these incidents of infection in humans.

  4. Causes of nosocomial infections in neonates of NICU%NICU新生儿医院感染原因分析

    Institute of Scientific and Technical Information of China (English)

    周葱聪; 陈晓春; 潘璇璇

    2014-01-01

    目的:分析新生儿重症监护病房(N IC U )医院感染的原因,观察对其进行护理干预的效果。方法选取2011年12月-2012年12月N IC U新生儿478例,将其随机均分为两组,各239例;试验组新生儿接受护理干预,对照组仅接受普通护理,回顾性分析两组儿童的各项状况及感染原因。结果 N IC U 478例新生儿中共有38例发生医院感染,感染率7.95%;其中试验组新生儿有12例感染,感染率为5.02%,对照组新生儿有26例感染,感染率10.88%,试验组新生儿感染率明显低于对照组;主要感染病原菌为大肠埃希菌、肺炎克雷伯菌和酿脓链球菌等,分别占25.49%、17.65%、16.67%;发生医院感染原因主要为新生儿自身因素、医护人员操作、环境影响以及药物使用不当。结论 N IC U医院感染原因较多,适当的护理干预措施可以有效降低感染率。%OBJECTIVE To analyze the causes of nosocomial infections in neonates of neonatal intensive care units (NICUs) and observe the effects of nursing interventions .METHODS A total 478 neonates who were treated in the NICUs from Dec 2011 to Dec 2012 were recruited in the study and randomly divided into two groups ,with 239 ca-ses in each ;the neonates in the experimental group received the nursing interventions ,while the neonates in the control group only received the common nursing ;the incidence of nosocomial infections and the causes of infections in the two groups of children were retrospectively analyzed .RESULTS The nosocomial infections occurred in 38 of 478 neonates in the NICUs with the infection rate of 7 .95% ,including 12 (5 .02% ) neonates in the experimental group and 26 (10 .88% ) neonates in the control group ,the incidence of infections in the neonates was significantly lower in the experimental group than in the control group .The Escherichia coli ,Klebsiella pneumoniae ,and Streptococcus pyogenes were the

  5. [Nosocomial infections in intensive care units].

    Science.gov (United States)

    Zaragoza, Rafael; Ramírez, Paula; López-Pueyo, María Jesús

    2014-05-01

    Nosocomial infections (NI) still have a high incidence in intensive care units (ICUs), and are becoming one of the most important problems in these units. It is well known that these infections are a major cause of morbidity and mortality in critically ill patients, and are associated with increases in the length of stay and excessive hospital costs. Based on the data from the ENVIN-UCI study, the rates and aetiology of the main nosocomial infections have been described, and include ventilator-associated pneumonia, urinary tract infection, and both primary and catheter related bloodstream infections, as well as the incidence of multidrug-resistant bacteria. A literature review on the impact of different nosocomial infections in critically ill patients is also presented. Infection control programs such as zero bacteraemia and pneumonia have been also analysed, and show a significant decrease in NI rates in ICUs.

  6. Antibacterial and antioxidant activities of Musa sp. leaf extracts against multidrug resistant clinical pathogens causing nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    Ponmurugan Karuppiah; Muhammed Mustaffa

    2013-01-01

    Objective:To investigate different Musa sp. leave extracts of hexane, ethyl acetate and methanol were evaluated for antibacterial activity against multi-drug resistant pathogens causing nosocomial infection by agar well diffusion method and also antioxidant activities. Methods:The four different Musa species leaves were extracted with hexane, ethyl acetate and methanol. Antibacterial susceptibility test, minimum inhibitory concentration and minimum inhibitory bacterial concentration were determined by agar well diffusion method. Total phenolic content and in vitro antioxidant activity was determined. Results: All the Musa sp. extracts showed moderate antibacterial activities expect Musa paradisiaca with the inhibition zone ranging from 8.0 to 18.6 mm. Among four species ethyl acetate extracts of Musa paradisiaca showed highest activity against tested pathogens particularly E. coli, P. aeruginosa and Citrobacter sp. The minimum inhibitory concentrations were within the value of 15.63-250 µg/mL and minimum bactericidal concentrations were ranging from 31.25-250 µg/mL. Antioxidant activity of Musa acuminate exhibited maximum activity among other three Musa species. Conclusions: The present study concluded that among the different Musa species, Musa paradisiaca displayed efficient antibacterial activity followed by Musa acuminata against multi-drug resistant nosocomial infection causing pathogens. Further, an extensive study is needed to identify the bioactive compounds, mode of action and toxic effect in vivo of Musa sp.

  7. Nosocomial Acinetobacter baumannii Infections and Changing Antibiotic Resistance

    OpenAIRE

    Necati Hakyemez, Ismail; Kucukbayrak, Abdulkadir; Tas, Tekin; Burcu Yikilgan, Aslihan; Akkaya, Akcan; Yasayacak, Aliye; Akdeniz, Hayrettin

    2013-01-01

    Objectives: In the intensive care setting, Acinetobacter baumannii causes ventilator-associated pneumonia and other nosocomial infections that are difficult to treat. Objective of this study was to investigate nosocomial A. baumannii infections and its changing antibiotic resistance. Methods: A total of 56 patients diagnosed with A.baumannii infections between January 2009 and December 2011 were included in the study. Diagnosis for nosocomial infections was established according to the CDC (C...

  8. Association of malnutrition with nosocomial infection.

    Science.gov (United States)

    Gorse, G J; Messner, R L; Stephens, N D

    1989-05-01

    To study the association of malnutrition with nosocomial infection in a general medical and surgical inpatient population, we retrospectively compared 45 patients with nosocomial infection to 45 uninfected control patients, matched using several nonnutritional variables known to predispose to nosocomial infection. Univariate and multivariate analyses were done. Poor nutritional score (derived from serum albumin, total lymphocyte count, and unintentional body weight loss), unintentional body weight loss, low serum albumin level at both time of admission and the first nosocomial infection, and worsening in the nutritional score and serum albumin from admission to the first nosocomial infection were associated with the development of nosocomial infection. Nutritional factors were more abnormal in subgroups of patients with nosocomial pneumonia, urinary tract infection, wound infection, and bacteremia than in controls. The findings suggest that further study of correlations between nutritional factors and nosocomial infections is needed.

  9. Nosocomial bloodstream infections caused by Escherichia coli and Klebsiella pneumoniae resistant to third-generation cephalosporins, Finland, 1999-2013: Trends, patient characteristics and mortality.

    Science.gov (United States)

    Martelius, Timi; Jalava, Jari; Kärki, Tommi; Möttönen, Teemu; Ollgren, Jukka; Lyytikäinen, Outi

    2016-01-01

    Few systematically collected multi-centre surveillance data on nosocomial bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli or Klebsiella pneumoniae have been published. To evaluate trends, patient characteristics and mortality of such infections, nosocomial BSI data reported by the 4-17 hospitals participating in the prospective laboratory-based surveillance during 1999-2013 were analysed. Data were collected by local infection control nurses, patient-days were obtained from the hospital's administrative database, and dates of deaths from the population registry. Resistance to third-generation cephalosporins was further examined in the national reference laboratory. A total of 16 028 nosocomial BSIs were identified; 2217 (14%) were caused by E. coli and 661 (4%) by K. pneumoniae; 207 (7%) were non-susceptible to third-generation cephalosporins, with an increasing trend from 0% in 1999 to 17% in 2013. Patient characteristics did not differ significantly between BSIs caused by third-generation susceptible and resistant E. coli and K. pneumonia, but the case fatality tended to be higher. Most (88%) of the isolates reported as non-susceptible to third-generation cephalosporins had ESBL phenotype, CTX-M (79%) being the most common enzyme. A sharp increase in nosocomial BSIs caused by ESBL producing bacteria was observed. Identification of patients for screening pose a challenge, emphasising the role of infection control guidelines and antibiotic policy in prevention.

  10. Nosocomial fungal infections: candidemia.

    Science.gov (United States)

    Verduyn Lunel, F M; Meis, J F; Voss, A

    1999-07-01

    Candida species are frequently encountered as part of the human commensal flora. Colonization mostly precedes candidemia and is an independent risk factor for the development of candidemia. Genotyping methods showed the similarity between colonizing and infecting strains, thus making endogenous origin likely, though exogenous sources like total parenteral nutrition also have been described. Health care workers (HCWs) play an important role in the transmission of yeasts. Candida species are frequently isolated from the hands of HCWs and can be transmitted from hands to patients. Granulocytopenia and damage of the mucosal lining resulting from intensive chemotherapy due to cancer, the increasing use of broad spectrum antibiotics, and the use of intravenous catheters are other important risk factors for the development of candidemia. Candidemia is associated with a high mortality and prolonged hospitalization. Therefore, and because of the high frequency of dissemination, all candidemias should be treated. Amphotericin B was considered the standard drug for the systemic treatment of candidemia. Fluconazole has been shown to be an effective and safe alternative in non-neutropenic patients. 5-Fluorocytosine has been used in combination with amphotericin B in the treatment of deep-seated infections. Liposomal formulations of amphotericin B and other new antifungal drugs currently are under investigation. C. albicans is the most frequently isolated Candida species, although the proportion of infections caused by non-C. albicans species is increasing. Also, there are reports of development of resistance to amphotericin B. C. lusitaniae is known for primary resistance and the development of resistance to amphotericin B. Development of resistance to fluconazole is mainly seen in AIDS patients with recurrent oropharyngeal candidiasis who receive longer courses of therapy.

  11. Biocidal textiles can help fight nosocomial infections.

    Science.gov (United States)

    Borkow, Gadi; Gabbay, Jeffrey

    2008-01-01

    The rates of nosocomial infections, especially by those caused by antibiotic resistant bacteria, are increasing alarmingly over the globe. Although more rigorous infection control measures are being implemented, it is clear that the current modalities to reduce nosocomial infections are not sufficient. Textiles are an excellent substrate for bacterial growth under appropriate moisture and temperature conditions. Patients shed bacteria and contaminate their pyjamas and sheets. The temperature and humidity between the patients and the bed are appropriate conditions allowing for effective bacterial proliferation. Several studies have found that personnel in contact with contaminated textiles were the source of transmission of the micro-organisms to susceptible patients. Furthermore, it has been reported that bed making in hospitals releases large quantities of micro-organisms into the air, which contaminate the immediate and non-immediate surroundings. Contaminated textiles in hospitals can thus be an important source of microbes contributing to endogenous, indirect-contact, and aerosol transmission of nosocomial related pathogens. We hypothesize that the use of antimicrobial textiles, especially in those textiles that are in close contact with the patients, may significantly reduce bioburden in clinical settings and consequently reduce the risk of nosocomial infections. These textiles should possess broad spectrum biocidal properties. They should be safe for use and highly effective against antibiotic resistant micro-organisms, including those that are commonly involved in hospital-acquired infections, and they should not permit the development of resistant micro-organisms to the active compound.

  12. [Economic impact of nosocomial infections].

    Science.gov (United States)

    Rosales-Aujang, E

    1996-10-01

    A retrospective, analytic and descriptive study of cases of nosocomial infection at Hospital General de Zona 1, IMSS at Aguascalientes, Ags, during the last five years, was carried out. The objectives were incidence; most frequent cases; treatment, and care costs, for both the Hospital General, and Gynecology and Obstetrics Service. A calculation of costs for 1995, according to the obtained results, was done, as well; this showed the great economical, social and laboral impact produced by these complications.

  13. Nosocomial infections due to Pseudomonas aeruginosa: review of recent trends.

    Science.gov (United States)

    Cross, A; Allen, J R; Burke, J; Ducel, G; Harris, A; John, J; Johnson, D; Lew, M; MacMillan, B; Meers, P

    1983-01-01

    The role of Pseudomonas aeruginosa in nosocomial infections occurring since 1975 is reviewed. Data from the National Nosocomial Infections Study conducted by the Centers for Disease Control, from individual medical centers, and from the literature were used to compare the relative frequency of occurrence of nosocomial infection caused by P. aeruginosa with that of infection caused by other gram-negative bacilli. The relative frequency of P. aeruginosa as a nosocomial pathogen has increased, although wide variations are seen among individual medical centers. P. aeruginosa continues to be a major pathogen among patients with immunosuppression, cystic fibrosis, malignancy, and trauma. While Staphylococcus aureus has become the predominant pathogen in some large burn centers, P. aeruginosa is the most important gram-negative pathogen. Periodic review of the epidemiology of P. aeruginosa infection is warranted in view of the changing incidence of infection caused by this organism.

  14. NOSOCOMIAL WOUND INFECTION AMONGST POST OPERATIVE ...

    African Journals Online (AJOL)

    associated with nosocomial infections also becomes a major therapeutic challenge for physicians. Thus ... use of prophylactic and therapeutic antibiotics and determine current antimicrobial .... Laboratory Standards Institute (CLSI) guidelines.

  15. Nosocomial bloodstream infection in patients caused by Staphylococcus aureus: drug susceptibility, outcome, and risk factors for hospital mortality

    Institute of Scientific and Technical Information of China (English)

    CHEN Rong; YAN Zhong-qiang; FENG Dan; LUO Yan-ping; WANG Lei-li; SHEN Ding-xia

    2012-01-01

    Background Previous studies have different viewpoints about the clinical impact of methicillin resistance on mortality of hospital-acquired bloodstream infection (BSI) patients with Staphylococcus aureus (S.aureus).The objective of this study was to investigate the mortality of hospital-acquired BSI with S.aureus in a military hospital and analyze the risk factors for the hospital mortality.Methods A retrospective cohort study was performed in patients admitted to the biggest military tertiary teaching hospital in China between January 2006 and May 2011.All included patients had clinically significant nosocomial BSI with S.aureus.Multivariate Logistic regression analysis was used to identify the risk factors for hospital mortality of patients with S.aureus BSI.Results One hundred and eighteen patients of more than one year old were identified as clinically and microbiologically confirmed nosocomial bacteraemia due to S.aureus,and 75 out of 118 patients were infected with methicillin-resistant S.aureus (MRSA).The overall mortality of nosocomial S.aureus BSI was 28.0%.Methicillin resistance in S.aureus bacteremia was associated with significant increase in the length of hospitalization and high proportion of inappropriate empirical antibiotic treatment.After Logistic regression analysis,the severity of clinical manifestations (APACHE Ⅱ score) (odds ratio (OR) 1.22,95% confidence interval (CI) 1.12-1.34) and inadequacy of empirical antimicrobial therapy (OR 0.25,95% CI 0.09-0.69) remained as risk factors for hospital mortality.Conclusions Nosocomial S.aureus BSI was associated with high in-hospital mortality.Methicillin resistance in S.aureus has no significant impact on the outcome of patients with staphylococcal bacteremia.Proper empirical antimicrobial therapy is very important to the prognosis.

  16. Prevalence and Antibiogram of Microbial Agents Causing Nosocomial Urinary Tract Infection in Surgical Ward of Dhaka Medical College Hospital

    Directory of Open Access Journals (Sweden)

    Tashmin Afroz Binte Islam

    2016-05-01

    Full Text Available Background: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Bangladesh, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints and lack of awareness regarding nosocomial infections. Objective: We carried out this study to determine the prevalence of different microorganisms from urine in surgery ward and antimicrobial susceptibility pattern against various antibiotics. Materials and Methods: This cross sectional study was carried out in Department of Microbiology, Dhaka Medical College, Dhaka over a period of 12 months from July 2011 to June 2012. A total of 52 urine specimens were collected from catheterized patients admitted in general surgery ward of Dhaka Medical College Hospital (DMCH and incubated in blood agar, MacConkey agar media and the isolates were identified by different biochemical tests – oxidase test and reaction in MIU (motility indole urease and Simmon’s citrate and TSI (triple sugar iron media. ESBL producers were detected by double-disk synergy test (DDST. Results: Bacteria were isolated from 35 specimens and Escherichia coli was the commonest isolate (23, 65.71% followed by Pseudomonas aeruginosa 6 (17.14%, Klebsiella pneumoniae 3 (8.57%, Acinetobacter baumannii 2 (5.72% and Proteus vulgaris 1 (2.86% respectively. Among the isolates, 10 (28.57% ESBL producers were detected and the highest ESBL production was observed in Escherichia coli (8, 22.85% followed by Klebsiella pneumoniae 1 (2.86% and Pseudomonas aeruginosa 1 (2.86%. The isolates were resistant to most of the commonly used antimicrobial agents. Conclusion: The emergence of multi-drug resistant (MDR bacteria poses a difficult task for physicians who have limited therapeutic options. However, the high rate of nosocomial infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

  17. 手足口病的医院感染控制%Control of nosocomial infections caused by hand foot and mouth disease

    Institute of Scientific and Technical Information of China (English)

    李星; 蔡水仙; 林慧卿

    2012-01-01

    目的 预防和控制手足口病(HFMD)引起的医院感染或感染的暴发流行.方法 严格执行消毒隔离制度,医护人员实行标准预防,加强手卫生管理,对手足口病患儿和陪护人员进行积极的健康教育.结果 2010年4-10月共收治手足口病患儿217例,均治愈出院,无医院感染病例发生.结论 采取有效的消毒隔离措施,是控制手足口病医院感染的关键.%OBJECTIVE To prevent and control the outbreak and prevalence of nosocomial infections caused by hand foot and mouth disease ( HFMD). METHODS Strict disinfection and isolation system was implemented, the medical staffs were required for standard prevention, the management of hand hygiene was strengthened, health education was actively conducted for HFMD children and the accompanying staffs. RESULTS All the 217 children with HFMD enrolled for treatment from Apr. to Oct. 2010 were cured and discharged, no nosocomial infections occurred. CONCLUSION Adopting effective disinfection and isolation measures is a key to control nosocomial infections due to HFMD.

  18. NOSOCOMIAL INFECTIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

    Directory of Open Access Journals (Sweden)

    F. S. Sadulloev

    2015-01-01

    Full Text Available Abstract:Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period.Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients.Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli (24,0%.

  19. [Viral nosocomial infections: the problem of contemporary hospital management].

    Science.gov (United States)

    Hermanowska-Szpakowicz, Teresa; Zajkowska, Joanna M; Pancewicz, Sławomir A; Kondrusik, Maciej; Grygorczuk, Sambor S

    2003-01-01

    The most frequent viral pathogens which are the cause of nosocomial infections were presented. Influenza and parainfluenza viruses as well as RS virus affect frequently respiratory tract. So called enteric viruses which are rotaviruses, adenoviruses, small round viruses, astroviruses, caliciviruses, corona viruses, Coxackie, ECHO may be the agents of disorders in digestive tract in the form of intoxications. Viruses of viral hepatitis B, C, D and HIV, CMV, EBV may be the source of nosocomial viral infections transmitted by blood (transfusions).

  20. Neonatal listeriosis followed by nosocomial infection

    Directory of Open Access Journals (Sweden)

    M Dinic

    2013-01-01

    Full Text Available Neonatal listeriosis is widely reported, but this is the first case reported in Serbia. A newborn developed respiratory distress syndrome 2 hours after delivery and was admitted to the neonatal intensive care unit. Initial empirical therapy was inappropriate. Consequently, on the second day, the patient developed meningitis. Listeria monocytogenes was isolated from the tracheal aspirate, blood, periumbilical swab, and cerebrospinal fluid. After bacteriology results, the therapy was changed to ampicillin and meropenem. On day 11 of hospitalization, the patient developed nosocomial infection due to multidrug-resistant Stenotrophomonas maltophilia. Since therapeutic options were limited, the patient was treated with ciprofloxacin. After 26 days of hospitalization the patient showed complete recovery and was discharged with no apparent sequelae. This case showed the importance of bacteriological examination in cases of infections caused by uncommon organisms. Pediatricians should be aware of the neonatal infection caused by Stenotrophomonas maltophilia.

  1. Neonatal listeriosis followed by nosocomial infection.

    Science.gov (United States)

    Dinic, M; Stankovic, S

    2013-01-01

    Neonatal listeriosis is widely reported, but this is the first case reported in Serbia. A newborn developed respiratory distress syndrome 2 hours after delivery and was admitted to the neonatal intensive care unit. Initial empirical therapy was inappropriate. Consequently, on the second day, the patient developed meningitis. Listeria monocytogenes was isolated from the tracheal aspirate, blood, periumbilical swab, and cerebrospinal fluid. After bacteriology results, the therapy was changed to ampicillin and meropenem. On day 11 of hospitalization, the patient developed nosocomial infection due to multidrug-resistant Stenotrophomonas maltophilia. Since therapeutic options were limited, the patient was treated with ciprofloxacin. After 26 days of hospitalization the patient showed complete recovery and was discharged with no apparent sequelae. This case showed the importance of bacteriological examination in cases of infections caused by uncommon organisms. Pediatricians should be aware of the neonatal infection caused by Stenotrophomonas maltophilia.

  2. Planning strategies for nosocomial infection control.

    Science.gov (United States)

    Lacanna, Giuseppe

    2014-01-01

    According to the American Centers for Disease Control and Prevention, 99,000 deaths per year in the United States are caused or impacted on by multiple hospital-acquired infections (HAIs), which are roughly estimated to be around 1.7 million cases. In Europe, there are 25,000 deaths per year from the same cause, 17.000 of which are linked to nosocomial infections. Patient safety is a core issue in today's health care settings. There is a growing consensus, supported by scientific investigation, that the role of the built environment is central towards minimizing and controlling the level of such infections. The contribution of architectural solutions and planning choices becomes crucial at this stage. This paper outlines the most common measures to adopt at the architectural and planning level, to combat HAI, focusing on the most critical areas of the hospital: wards, intensive care units and operating theatres.

  3. Nosocomial infection caused by vancomycin-susceptible multidrug-resistant Enterococcus faecalis over a long period in a university hospital in Japan.

    Science.gov (United States)

    Kudo, Michiaki; Nomura, Takahiro; Yomoda, Sachie; Tanimoto, Koichi; Tomita, Haruyoshi

    2014-11-01

    Compared with other developed countries, vancomycin-resistant enterococci (VRE) are not widespread in clinical environments in Japan. There have been no VRE outbreaks and only a few VRE strains have sporadically been isolated in our university hospital in Gunma, Japan. To examine the drug susceptibility of Enterococcus faecalis and nosocomial infection caused by non-VRE strains, a retrospective surveillance was conducted in our university hospital. Molecular epidemiological analyses were performed on 1711 E. faecalis clinical isolates collected in our hospital over a 6-year period [1998-2003]. Of these isolates, 1241 (72.5%) were antibiotic resistant and 881 (51.5%) were resistant to two or more drugs. The incidence of multidrug resistant E. faecalis (MDR-Ef) isolates in the intensive care unit increased after enlargement and restructuring of the hospital. The major group of MDR-Ef strains consisted of 209 isolates (12.2%) resistant to the five drug combination tetracycline/erythromycin/kanamycin/streptomycin/gentamicin. Pulsed-field gel electrophoresis analysis of the major MDR-Ef isolates showed that nosocomial infections have been caused by MDR-Ef over a long period (more than 3 years). Multilocus sequence typing showed that these strains were mainly grouped into ST16 (CC58) or ST64 (CC8). Mating experiments suggested that the drug resistances were encoded on two conjugative transposons (integrative conjugative elements), one encoded tetracycline-resistance and the other erythromycin/kanamycin/streptomycin/gentamicin-resistance. To our knowledge, this is the first report of nosocomial infection caused by vancomycin-susceptible MDR-Ef strains over a long period in Japan.

  4. Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

    Science.gov (United States)

    Bouassida, Khaireddine; Jaidane, Mehdi; Bouallegue, Olfa; Tlili, Ghassen; Naija, Habiba; Mosbah, Ali Tahar

    2016-01-01

    Introduction: Our goal was to investigate the prevalence and antibiogram pattern of extended spectrum beta-lactamase (ESBL) production among uropathogens using isolates from urine samples collected at the Department of Urology in the Sahloul Hospital, Tunisia We also aimed to identify the risk factors for nosocomial urinary tract infections (UTIs) in patients who underwent transurethral resection of the prostate (TURP) and the measures for infection control. Methods: Laboratory records of a five-year period from January 2004 to December 2008 were submitted for retrospective analysis to determine the incidence of ESBL infections. A total of 276 isolates were collected. A case-control study involving comparisons between two groups of patients who underwent TURP was performed to determine the risk factors for ESBL infection. Group 1, designated case subjects, included 51 patients with nosocomial UTI after TURP. Group 2, designated control subjects, consisted of 58 randomly selected patients who underwent TURP without nosocomial UTI in the same period. Factors suspected to be implicated in the emergence of ESBL infection were compared between the two groups in order to identify risk factors for infection. A univariate regression analysis was performed, followed by a multivariate one. Results: The annual prevalence of ESBL infection ranged from 1.3–2.5%. After performing univariate and multivariate regression analysis, the main risk factors for ESBL infections were identified as: use of antibiotics the year preceding the admission, duration of catheter use, and bladder washout (p=0.012, p=0.019, and p<0.001. Conclusions: Urologists have to perform a good hemostasis, especially in endoscopic resections, in order to avoid bladder irrigation and bladder washout and to reduce the time of bladder catheterization, which is a strong risk factor of nosocomial UTIs. PMID:27330585

  5. Managing skin and soft-tissue infection and nosocomial pneumonia caused by MRSA: a 2014 follow-up survey.

    Science.gov (United States)

    Dryden, Matthew; Andrasevic, Arjana Tambic; Bassetti, Matteo; Bouza, Emilio; Chastre, Jean; Baguneid, Mo; Esposito, Silvano; Giamarellou, Helen; Gyssens, Inge; Nathwani, Dilip; Unal, Serhat; Voss, Andreas; Wilcox, Mark

    2015-04-24

    As a follow-up to our 2009 survey, in order to explore opinion and practice on the epidemiology and management of meticillin-resistant Staphylococcus aureus (MRSA) in Europe, we conducted a second survey to elicit current opinions on this topic, particularly around antibiotic choice, dose, duration and route of administration. We also aimed to further understand how the management of MRSA has evolved in Europe during the past 5 years. Members of an expert panel of infectious diseases specialists convened in London (UK) in January 2014 to identify and discuss key issues in the management of MRSA. Following this meeting, a survey was developed comprising 36 questions covering a wide range of topics on MRSA complicated skin and soft-tissue infection and nosocomial pneumonia management. The survey instrument, a web-based questionnaire, was sent to the International Society of Chemotherapy for distribution to registered European infection societies and their members. This article reports the survey results from the European respondents. At the time of the original survey, the epidemiology of MRSA varied significantly across Europe and there were differing views on best practice. The current findings suggest that the epidemiology of healthcare-associated MRSA in Europe is, if anything, even more polarised, whilst community-acquired MRSA has become much more common. However, there now appears to be a much greater knowledge of current treatment/management options, and antimicrobial stewardship has moved forward considerably in the 5 years since the last survey.

  6. Causes of postoperative nosocomial infections in puerpera and control measures%产妇术后医院感染分析及控制研究

    Institute of Scientific and Technical Information of China (English)

    周正; 毛郁蕾; 陈文殊; 冯泽蛟; 廖一丹

    2014-01-01

    目的:探讨剖宫产术后医院感染的主要原因,并采取有效的应对策略,为预防和控制剖宫产术后医院感染提供科学有效的依据。方法回顾性分析2011年6月-2013年6月行剖宫产术的3502例产妇临床资料,数据分析采用SPSS11.0统计软件。结果3502例剖宫产产妇术后共发生医院感染108例,感染率3.08%;医院感染的部位依次为呼吸道、泌尿系统、手术切口、生殖道感染,分别占41.67%、28.70%、16.67%、12.96%;医院感染的原因有高龄、体质量指数高、胎盘异常、胎膜早破、妊娠期糖尿病、妊娠高血压综合征、贫血、手术前阴道指诊次数、术前导尿次数、术中出血量、术后尿管留置时间及手术时间。结论剖宫产术后发生医院感染的原因较多,与产妇高龄、肥胖、术前多次阴道指诊和导尿、合并糖尿病等多种内科合并症等因素有关,针对高危因素积极采取相应的应对策略给予预防,可降低医院感染的发生率。%OBJECTIVE To explore the leading causes of nosocomial infections after cesarean section and take effec‐tive coping strategies so as to provide scientific bases for prevention and control of the nosocomial infections after the cesarean section .METHODS The clinical data of 3 502 puerpera who underwent the cesarean section from Jun 2011 to Jun 2013 were retrospectively analyzed ,and the statistical analysis was performed with the use of SPSS11 . 0 software .RESULTS The nosocomial infections occurred in 108 of 3 502 puerpera who underwent the cesarean section ,with the infection rate of 3 .08% ,of whom 41 .67% were with the respiratory tract infections ,28 .70%with the urinary tract infections ,16 .67% with the surgical incision infections ,12 .96% with the genital tract in‐fections .The causes of the nosocomial infections included the advanced age ,high body mass index ,placental ab‐normalities ,gestational

  7. Inhibitory effect of Lactobacillus plantarum and Lb. fermentum isolated from the faeces of healthy infants against nonfermentative bacteria causing nosocomial infections

    OpenAIRE

    M.M. Soltan Dallal; Davoodabadi, A.; Abdi, M.; M. Hajiabdolbaghi; M.K. Sharifi Yazdi; Douraghi, M.; Tabatabaei Bafghi, S.M.

    2017-01-01

    Nosocomial infection constitutes a major public health problem worldwide. Increasing antibiotic resistance of pathogens associated with nosocomial infections has also become a major therapeutic challenge for physicians. Thus, development of alternative treatment protocols, such as the use of probiotics, matters. The aim of this research was to determine the antagonistic properties of Lactobacillus plantarum and Lb. fermentum isolated from the faeces of healthy infants against nonfermentative ...

  8. [Nosocomial infections: definition, frequence and risk factors].

    Science.gov (United States)

    Diouf, E; Bèye, M D; Diop, Ndoye M; Kane, O; Ka, Sall B

    2007-01-01

    Infection is nosocomial if it missed at the time patient admission in the health establishment. When infectious status of the patient on admission is unknown, infection is generally regarded as nosocomial if it appears after a time of at least 48 hours of hospitalization. For surgical site infection, the commonly allowed time is 30 days, or, in case of prosthesis or an implant, one year after surgical intervention. Nosocomial infections (NI) constitute major health care problem from their frequency, their cost, their gravity. Mortality related to NI can attempt 70% in certain units like intensive care units. Two ways of contamination are possible: the endogenous way is responsible of majority of hospital infections. The normally sterile sites are contaminated then colonized by the flora which is carrying the patient himself, with the favor of a rupture of the barriers of defense. The exogenic way is associated colonization, possibly followed by infection, of the patient by external bacteria, coming from others patients or from environment, transmitted in an indirect way (aerosols, manuportage, materials). Whatever its mode of transmission, apparition of nosocomial infection can be related to several supporting factors: age and pathology, certain treatments (antibiotic which unbalance patients' flora and select resistant bacteria, immunosuppressive treatments), invasive practices necessary to the patient treatment. The prevalence of nosocomial infections is higher in the intensive care units where certain studies bring back rates of 42.8% versus 12.1% in others services. The four sites of nosocomial infection most frequently concerned are: the respiratory site, urinary infections, bloodstream infections (Catheters related bloodstream infections in particular), and surgical sites infections. The relative proportion of these infections varies according to principal activity of the unity.

  9. Nosocomial infection and risk factors in elderly patients in intensive care units

    Directory of Open Access Journals (Sweden)

    Kevser Özdemir

    2015-03-01

    Full Text Available Incidence of nosocomial infections gradually increase in patients over 65 years age population. There is a significant relationship between increased age and predisposition to nosocomial infections. Predisposition to infections in this age group is a result of impaired host defense, underlying chronic diseases, long-term hospitalization, steroids and immunosuppressive therapies and malnutrition. Nevertheless there is not much data about the incidence and risk factors of nosocomial infections in elderly population. In this study we aimed to investigate the incidence and risk factors for nosocomial infections and the factors affecting mortality rates in elderly patients in the medical intensive care units. Nosocomial infection is an important factor causes increased mortality rate and length of hospital stay. Mortality rates and time interval between admission and discharge is significantly higher in nosocomially infected group than others. There are several known independent risk factors for increased mortality rates include increased age and length of hospital stay, impaired conscious levels, co-morbidities, nosocomial infections, immunsupresive conditions such as malnutrition, malignancies, mechanic ventilation and/or central venous catheter usage. As a result nosocomial infection is an important and partially preventable risk factor for mortality among patients treated in intensive care units. Mechanical ventilation, central venous and/or urinary catheterizations are such invasive interventions that may cause higher nosocomial infection rates. In terms of decreasing nosocomial infection rates; less frequently used invasive interventions can help in achieving this purpose of treatment. J Microbiol Infect Dis 2015;5(1: 38-43

  10. Nosocomial urinary tract infections: A review.

    Science.gov (United States)

    Iacovelli, Valerio; Gaziev, Gabriele; Topazio, Luca; Bove, Pierluigi; Vespasiani, Giuseppe; Finazzi Agrò, Enrico

    2014-01-01

    Nosocomial urinary tract infections are a common complication in healthcare systems worldwide. A review of the literature was performed in June 2014 using the Medical Literature Analysis and Retrieval System Online (MEDLINE) database, through either PubMed or Ovid as a search engine, to identify publications regarding nosocomial urinary tract infections (NUTIs) definition, epidemiology, etiology and treatment.According to current definitions, more than 30% of nosocomial infections are urinary tract infections (UTIs). A UTI is defined 'nosocomial' (NUTI) when it is acquired in any healthcare institution or, more generally, when it is related to patient management. The origin of nosocomial bacteria is endogenous (the patient's flora) in two thirds of the cases. Patients with indwelling urinary catheters, those undergoing urological surgery and manipulations, long-stay elderly male patients and patients with debilitating diseases are at high risk of developing NUTIs. All bacterial NUTIs should be treated, whether the patient is harboring a urinary catheter or not. The length of treatment depends on the infection site. There is abundance of important guidance which should be considered to reduce the risk of NUTIs (hand disinfection with instant hand sanitizer, wearing non-sterile gloves permanently, isolation of infected or colonized catheterized patients). Patients with asymptomatic bacteriuria can generally be treated initially with catheter removal or catheter exchange, and do not necessarily need antimicrobial therapy. Symptomatic patients should receive antibiotic therapy. Resistance of urinary pathogens to common antibiotics is currently a topic of concern.

  11. Fluoroquinolone resistance of Pseudomonas aeruginosa isolates causing nosocomial infection is correlated with levofloxacin but not ciprofloxacin use.

    Science.gov (United States)

    Lee, Yuarn-Jang; Liu, Hsin-Yi; Lin, Yi-Chun; Sun, Kuo-Lun; Chun, Chi-Li; Hsueh, Po-Ren

    2010-03-01

    This study investigated the correlation between fluoroquinolone (ciprofloxacin or levofloxacin) use and rates of fluoroquinolone resistance in Pseudomonas aeruginosa isolates from patients with nosocomial infection at a medical centre in Taiwan. Antibiotic utilisation data were extracted on a monthly basis from the inpatient pharmacy computer system records from January 2003 to December 2008. Fluoroquinolone use was expressed as defined daily dose per 1000 patient-days and was correlated with rates of fluoroquinolone-resistant P. aeruginosa every 6 months. Regression analysis was performed to explore the relationship between ciprofloxacin and levofloxacin use (both parenteral and oral forms) and resistance of P. aeruginosa isolates. During the study period, the susceptibility of P. aeruginosa to fluoroquinolones decreased after increasing use of fluoroquinolones, and increased after decreasing use of levofloxacin. Parenteral levofloxacin use was significantly positively correlated with resistance of P. aeruginosa to ciprofloxacin (P=0.015) and fluoroquinolones (either ciprofloxacin or levofloxacin, P=0.014). Use of both parenteral and oral forms of levofloxacin was also significantly positively correlated with resistance of P. aeruginosa isolates to ciprofloxacin (P=0.029), levofloxacin (P=0.031) and fluoroquinolones (P=0.010). The total amount of ciprofloxacin (oral and parenteral) and parenteral ciprofloxacin use were negatively correlated with resistance of P. aeruginosa isolates to fluoroquinolones. However, the amounts of oral ciprofloxacin, parenteral levofloxacin, oral levofloxacin and total levofloxacin use were each positively correlated with resistance of P. aeruginosa to fluoroquinolones. Levofloxacin use was associated with increased resistance of P. aeruginosa to fluoroquinolones, whereas ciprofloxacin use did not have a significant impact on fluoroquinolone resistance rates. Copyright 2009 Elsevier B.V. and the International Society of Chemotherapy

  12. 金黄色葡萄球菌医院感染的临床分析%Clinical Analysis of Nosocomial Infection Caused by Staphylococcus Aureus

    Institute of Scientific and Technical Information of China (English)

    杨榕源; 叶小玲

    2015-01-01

    目的:分析由金黄色葡萄球菌导致的医院感染的临床特点和耐药特征。方法分析导致该院67例患者发生医院感染的危险因素及耐药特点,采用全自动细菌鉴定仪对分离的金黄色葡萄球菌菌株进行鉴定,采用纸片扩散法(K-B法)进行药物敏感性试验。结果67例医院感染患者共分离出75株金黄色葡萄球菌,其中包括61株耐甲氧西林金黄色葡萄球菌和14株甲氧西林敏感金黄色葡萄球菌。耐甲氧西林金黄色葡萄球菌的耐药性明显高于甲氧西林敏感金黄色葡萄球菌(P<0.05)。67例患者均存在严重的基础疾病,其中59例患者临床治疗接受过侵入性操作,发生感染的部位主要为肺部。结论金黄色葡萄球菌医院感染的发病群体主要为病情严重,接受过侵入性操作治疗的患者,感染部位主要为肺部,耐甲氧西林金黄色葡萄球菌对对数抗菌药物具有高耐药性。%Objective To analyze the clinical characteristics of nosocomial infections caused by Staphylococcus aureus and the resistance characteristics of Staphylococcus aureus.Methods The resistance characteristics of Staphylococcus aureus and the risk factors that caused the nosocomial infections in 67 patients of our hospital were analyzed. The automated bacterial identification system was used to identify separated Staphylococcus aureus strains. Drug sensitivity test was conducted by disk diffusion technique (K-B method).Results 75 Staphylococcus aureus were separated from 67 patients with nosocomial infections, including 61 methicillin-resistant Staphylococcus aureus and 14 methicillin-sensitive Staphylococcus aureus. Resistance of methicillin-resistant Staphylococcus aureus was significantly higher than that of methicillin-sensitive Staphylococcus aureus (P <0.05). Underlying diseases were found in 67 patients , among them, 59 patients with Pulmonary infection had received invasive operation during clinical

  13. Analysis of risk factors causing nosocomial infections to hemodialysis patients%血液透析患者医院感染的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈亚萍; 李海霞; 王聪

    2014-01-01

    目的:分析血液透析患者发生医院感染的危险因素,探讨其护理要点,以期为临床防治提供相关依据。方法回顾性分析医院2009年3月-2013年2月241例血液透析患者的临床资料,对其发生医院感染的危险因素进行分析,并结合临床经验提供针对性地护理措施,采用SPSS17.0软件进行统计分析。结果241例血液透析患者发生医院感染57例,感染率为23.65%;感染部位以呼吸系统和消化道为主,分别占42.11%和31.58%;年龄≥60岁、住院时间≥30 d、有留置导管及原发病为糖尿病肾病是血液透析患者发生医院感染的危险因素,其医院感染率分别为34.48%、28.81%、29.56%、35.38%,差异有统计学意义(P<0.05);经非条件 logistic多元回归分析显示,患者年龄大、住院时间长、留置导管、原发病为糖尿病肾病是血液透析患者医院感染的独立危险因素(均 P<0.05)。结论改善血液透析患者营养、采用全身支持疗法、尽量缩短住院天数、做好医院消毒工作、采取有效地护理措施,对减少血液透析患者医院感染具有重要作用。%OBJECTIVE To analyze the risk factors causing nosocomial infections to hemodialysis patients and to discuss nursing points so as to provide relevant evidence for clinical prevention and treatment .METHODS The clinical data of 241 cases of hemodialysis patients from March 2009 to Feb 2013 were retrospectively investigated , the risk factors causing nosocomial infections to them were analyzed ,and they were given corresponding nursing measures combined with clinical experience ;SPSS 17 .0 software was adopted for statistical analysis .RESULTS Totally ,57 of 241 cases of hemodialysis patients suffered nosocomial infections ,with infection rate of 23 .65% . The dominant infection sites were respiratory system and digestive tract ,accounting for 42 .11% and 31 .58

  14. 肝病患者医院感染的危险因素分析%Risk factors causing nosocomial infections to patients with liver diseases

    Institute of Scientific and Technical Information of China (English)

    韩津萍; 轧春妹; 尤炜

    2014-01-01

    OBJECTIVE To study the infection rate of hospitalized patients with liver disease and the relevant risk factors and to establish corresponding nursing strategy according to risk analysis .METHODS The clinical data of 864 cases of liver disease patients who were treated in the hospital from Jan 2009 to Dec 2012 were retrospectively analyzed;96 cases of infected patients were divided into infection group and the 768 cases of uninfected patients were divided into control group ;the two groups of patients were compared and the risk factors causing nosocomial infections was discussed ;SPSS 18 .0 software was adopted for statistical analysis ,and Chi-square test was adopted for testing enumeration data .RESULTS Totally ,96 of the 864 cases of liver disease patients suffered nosocomial infections ,with an infection rate of 11 .11% ;35 cases of patients suffered respiratory tract infections ,28 cases of patients suffered digestive tract infections ,18 cases of patients suffered urogenital system infections ,5 cases cases of skin and soft tissue infections and 10 cases of abdominal infections , accounting for 36 .46% , 29 .17% , 18 .75% ,5 .2% and 10 .42% respectively .The patients'old age ,long hospital stay ,complicated diseases , indwelling catheter ,reception of invasive procedure ,irrational use of antibiotics and use of immunosuppressants were those risk factors causing nosocomial infections to liver disease patients ( P< 0 .05 ) .CONCLUSION The incidence rate of nosocomial infections in liver disease patients is high ,and the patients'old age ,long hospital stay ,complicated diseases ,indwelling catheter ,reception of invasive procedure ,irrational use of antibiotics and use of immunosuppressants are the risk factors causing nosocomial infections ,so it is necessary to perform active intervention and nursing according to the above risk factors .%目的:探讨医院肝病患者感染率及感染发生的危险因素,并根据危险因素制定相应的护理

  15. Nosocomial infections in patients with acute central nervous system infections

    OpenAIRE

    2007-01-01

    Due to current increase in the rate of nosocomial infections, our objective was to examine the frequency, risk factors, clinical presentation and etiology of nosocomial infections in patients with central nervous system infections. 2246 patients with central nervous system infections, treated in the intensive care units of the Institute of Infectious and Tropical Diseases, Clinical Center of Serbia in Belgrade and at the Department of Infectious Diseases of the Clinical Hospital Center Kraguj...

  16. Major Trends in the Microbial Etiiology of Nosocomial Infection

    NARCIS (Netherlands)

    D.R. Schaberg; D.H. Culver; R.P. Gaynes

    1991-01-01

    textabstractTo determine trends in the microbial etiology of nosocomial infections in the 1980s, surveillance data on the microbiology of documented nosocomial infection reported to the National Nosocomial Infections Surveillance System and from the University of Michigan Hospital were analyzed. Ant

  17. Drug resistance of Acinetobacter baumannii causing nosocomial infections in ICU%ICU鲍氏不动杆菌医院感染耐药性分析

    Institute of Scientific and Technical Information of China (English)

    袁咏梅; 许波银; 姜燕南; 张燕萍

    2013-01-01

    OBJECTIVE To investigate the characteristics of distribution of nosocomial infections and drug resistance of Acinetobacter baumannii (ABA) in the intensive care unit so as to provide clinical guidance for reasonable application of antibiotics.METHODS The distributions and drug resistance of 87 strains of ABA isolated from patients in ICU who suffered from nosocomial infections from Jan 2010 to Dec 2010 were statistically analyzed.RESULTS The data showed that the A.baumannii had a higher detection rate in the ICU.Among all the specimens,about 90.80% were isolated from the lower respiratory tract.A.baumannii was highly multidrugresistant; of 87 strains of ABA,the drug resistance rate to the polymyxin was 5.75%,imipenem and meropenem 75.86%,the third generation of cephalosporins 87.36%,the fourth generation cephalosporins 83.91%,and amikacin 80.46%,while the drug resistance rates to piperacillin-tazobactam,gentamicin,ticarcillin-clavulanic acid,and ciprofloxacin were higher than 90.0%.There were 17 (19.54%) strains of pan-drug resistant A.baumannii (PDR-AB) isolated.CONCLUSION The drug resistance of the A.baumannii strains causing nosocomial infections in ICU is serious,the hospital should strengthen the monitoring of drug resistance of the ABA,carry out the effective prevention and control measures,minimize and delay the emergence of the resistant strains so as to prevent the outbreak of nosocomial infections caused by multidrug-resistant ABA.%目的 探讨ICU鲍氏不动杆菌(ABA)医院感染的分布特征及耐药性,为指导临床合理选用抗菌药物提供依据.方法 对2010年1-12月ICU分离出的87株医院感染鲍氏不动杆菌分布及耐药性进行统计分析.结果 鲍氏不动杆菌在ICU的检出率较高,其中90.80%的标本来源于下呼吸道;该菌多药耐药现象严重,87株鲍氏不动杆菌耐药率最低的是多黏菌素为5.75%,对亚胺培南和美罗培南的耐药率达75.86%,对头孢三代、头孢

  18. Sequence-based identification and characterization of nosocomial influenza A(H1N1)pdm09 virus infections

    NARCIS (Netherlands)

    Jonges, M.; Rahamat-Langendoen, J.; Meijer, A.; Niesters, H. G.; Koopmans, M.

    2012-01-01

    Background: Highly transmissible viruses such as influenza are a potential source of nosocomial infections and thereby cause increased patient morbidity and mortality. Aim: To assess whether influenza virus sequence data can be used to link nosocomial influenza transmission between individuals.

  19. Nosocomial Acinetobacter baumannii Infections and Changing Antibiotic Resistance.

    Science.gov (United States)

    Necati Hakyemez, Ismail; Kucukbayrak, Abdulkadir; Tas, Tekin; Burcu Yikilgan, Aslihan; Akkaya, Akcan; Yasayacak, Aliye; Akdeniz, Hayrettin

    2013-09-01

    In the intensive care setting, Acinetobacter baumannii causes ventilator-associated pneumonia and other nosocomial infections that are difficult to treat. Objective of this study was to investigate nosocomial A. baumannii infections and its changing antibiotic resistance. A total of 56 patients diagnosed with A.baumannii infections between January 2009 and December 2011 were included in the study. Diagnosis for nosocomial infections was established according to the CDC (Centers for Disease Control and Prevention) criteria. Identification of the agents isolated was carried out using conventional methods and VITEK 2 automated system, while antibiotic sensitivity testing was performed through VITEK 2 AST-N090 automated system. The most common infection was nosocomial pneumonia by 43%, among which 46% were ventilator-associated pneumonia. Considering all years, the most effective antibiotics on the isolated strains were found as colistin, tigecycline, imipenem and meropenem. However resistance to imipenem and meropenem was observed to increase over years. The issue of increased resistance to antibiotics poses difficulty in treatment of A. baumannii infections which in turn increases the rate of mortality and cost. In order to prevent development of resistance, antibiotics must be used in an appropriate way in accompanied with proper guidance.

  20. Prevention and treatment of neonatal nosocomial infections.

    Science.gov (United States)

    Ramasethu, Jayashree

    2017-01-01

    Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts. Hand hygiene before and after patient contact is the most important measure, and yet, compliance with this simple measure can be unsatisfactory. Alcohol based hand sanitizer is effective against many microorganisms and is efficient, compared to plain or antiseptic containing soaps. The use of maternal breast milk is another inexpensive and simple measure to reduce infection rates. Efforts to replicate the anti-infectious properties of maternal breast milk by the use of probiotics, prebiotics, and synbiotics have met with variable success, and there are ongoing trials of lactoferrin, an iron binding whey protein present in large quantities in colostrum. Attempts to boost the immunoglobulin levels of preterm infants with exogenous immunoglobulins have not been shown to reduce nosocomial infections significantly. Over the last decade, improvements in the incidence of catheter-related infections have been achieved, with meticulous attention to every detail from insertion to maintenance, with some centers reporting zero rates for such infections. Other nosocomial infections like ventilator acquired pneumonia and staphylococcus aureus infection remain problematic, and outbreaks with multidrug resistant organisms continue to have disastrous consequences. Management of infections is based on the profile of microorganisms in the neonatal unit and community and targeted therapy is required to control the disease without leading to the development of more

  1. The risk factors of nosocomial infection in severe craniocerebral trauma

    Institute of Scientific and Technical Information of China (English)

    杨振铭; 李亚松

    2003-01-01

    Objective: To explore the risk factors of nosocomial infection in severe craniocerebral trauma and the way of prevention.Methods: The clinical data of 387 patients with severe craniocerebral trauma were reviewed.Results: The total nosocomial infection rate of this study was 22.99%. Pulmonary nosocomial infection presented most frequently. The G-bacilli were the most common infectious bacteria. The mortality rate of the infection group was 38.20%.Conclusions: Complications of nosocomial infection affect the prognosis of craniocerebral trauma patients. Nosocomial infection is related to the age of the patients, craniocerebral trauma severity, unreasonable utilization of antibiotics and invasive operations, such as tracheal cannula, mechanical ventilation, urethral catheterization and deep venous catheterization. Patients with severe craniocerebral trauma should be carefully treated and nursed to avoid nosocomial infection. In order to reduce the rate of nosocomial infection, intensive measurement should be adopted.

  2. 鲍氏不动杆菌医院感染的耐药性调查%Antimicrobial resistance of Acinetobacter baumannii causing nosocomial infections

    Institute of Scientific and Technical Information of China (English)

    袁启明

    2012-01-01

    OBJECTIVE To investigate the infection status and antimicrobial resistance of Acinetobacter baumannii (ABA) causing nosocomial infections and provide experimental evidence for clinically reasonable application of antibiotics. METHODS According to National Guide to Clinical Laboratory Operation Procedures, bacterial culture and identification were performed for 225 strains of ABA isolated from infective specimens from the inpatients from Jan. 2006 to Dec. 2010. Drug susceptibility testing was performed by K-B methods. The test results were assessed according to CLSI breakpoints. RESULTS The isolation rate of ABA from respiratory tract was 73. 8%, ranking the first. The susceptibility testing results indicated that ABA had been resistant to commonly used antibiotics of various degrees. The resistance rates to imipenem and meropenem were 4. 4% and 5.8%, respectively. Detection rate of pan-resistant ABA strains was 1. 3%. CONCLUSION Hospitals should attach importance to the monitoring of antimicrobial resistance of ABA, prevent and control the outbreaks and prevalence of nosocomial infections caused by multidrug-resistant ABA isolates.%目的 探讨鲍氏不动杆菌(ABA)医院感染现状及对抗菌药物的耐药性,为临床医师合理使用抗菌药物提供试验依据.方法 2006年1月-2010年12月从住院患者感染性标本中分离出225株ABA,细菌培养与鉴定严格按《全国临床检验操作规程》进行;药敏试验采用K-B法进行,依据CLSI最新折点判读结果.结果 ABA在呼吸道标本中检出率居第1位,达73.8%,ABA对常用抗菌药物产生了不同程度的耐药性,对碳青霉烯类抗菌药物亚胺培南、美罗培南耐药率分别为4.4%和5.8%,且发现ABA泛耐药菌株,检出率为1.3%.结论 各级医院务必重视ABA耐药性的监测工作,预防与控制多药耐药ABA医院感染的发生暴发流行.

  3. Antibiotic resistance in nosocomial respiratory infections.

    Science.gov (United States)

    Denys, Gerald A; Relich, Ryan F

    2014-06-01

    Nosocomial respiratory infections are the most common acquired infections in patients with severe underlying conditions and are responsible for high morbidity and mortality in this patient population. Multidrug-resistant (MDR) pathogens are associated with hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). This article describes the etiology, epidemiology, pathogenesis, diagnosis, and treatment of HAP and VAP associated with antibiotic-resistant bacterial pathogens. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Nosocomial infections within the first month of solid organ transplantation.

    Science.gov (United States)

    Dorschner, P; McElroy, L M; Ison, M G

    2014-04-01

    Infections remain a common complication of solid organ transplantation. Early postoperative infections remain a significant cause of morbidity and mortality in solid organ transplant (SOT) recipients. Although significant effort has been made to understand the epidemiology and risk factors for early nosocomial infections in other surgical populations, data in SOT recipients are limited. A literature review was performed to summarize the current understanding of pneumonia, urinary tract infection, surgical-site infection, bloodstream infection, and Clostridium difficult colitis, occurring within the first 30 days after transplantation.

  5. Emerging Trend of Acinetobacter Nosocomial Infection in Northeast of Iran

    Directory of Open Access Journals (Sweden)

    Samaneh Saed

    2015-10-01

    Full Text Available Background: Acinetobacter spp. emerged as an opportunistic pathogen for hospital-acquired infections. Recently, increasing antibiotic resistance among Acinetobacter spp. has worsened the problem. The aim of this study was to investigate  the  emerging  trend  of  infection  due  to Acinetobacter  in Ghaem University Hospital, Mashhad during 2006-2012.Methods: The demographic data and information about redisposing factors was collected. Appropriate bacteriological samples were collected and Acinetobacter spp. was isolated. Antibiotics susceptibility pattern of these isolates againstdifferent antimicrobials agents was determined.Results: Results confirmed that Acinetobacter spp. cause 20.9% of nosocomial infection during this period. The trend of Acinetobacter nosocomial infection was increasing and patients with risk factors such as COPD, bronchectasia, diabetes   mellitus   were   more   prone   to   infection.  There   was   significant association   between   these   infections   and   invasive   procedures   such   as catheterization, mechanical ventilation and broad-spectrum antibiotics usage. Conclusion:  Understanding  trends  in  causative  organisms  of  nosocomial infection can help us to better define our infection control policy.

  6. Norovirus Genotypes in Hospital Settings - Differences between Nosocomial and Community-Acquired Infections

    DEFF Research Database (Denmark)

    Franck, Kristina Træholt; Nielsen, Rikke Thoft; Holzknecht, Barbara Juliane;

    2015-01-01

    BACKGROUND:  Norovirus is a major cause of gastroenteritis and hospital outbreaks, leading to substantial morbidity and direct healthcare expenses as well as indirect societal costs. The aim of the study was to estimate the proportion of nosocomial norovirus infections among inpatients tested...... positive for norovirus in Denmark, 2002-2010, and to study the distribution of norovirus genotypes among inpatients with nosocomial and community-acquired norovirus infections, respectively. METHODS:  Admission and stool sampling dates from 3656 NoV infected patients were used to estimate the proportion...... of nosocomial infections. The associations between nosocomial infection and patient age, gender, and norovirus genotype GII.4 were examined. RESULTS:  Of the 3656 inpatients, 63% were classified as having nosocomial infections. Among these 9 capsid and 8 polymerase norovirus genotypes were detected whereas...

  7. Nosocomial infections and related factors in southern khorasan hospitals

    OpenAIRE

    2014-01-01

    Background and Aim: Nosocomial infections are defined as infections occurring during a patient's stay at hospital (48-72h after admission).Nosocomial infections are one of the important problems of health. This study aimed was determine the prevalence of nosocomial infections, and related factors in hospitals with more than 100 beds in south Khorasan Province. Materials and Methods: In this crass-sectional study, an investigator-administered questionnaire was completed for each patien...

  8. Risk factors for nosocomial infection during extracorporeal membrane oxygenation.

    Science.gov (United States)

    Hsu, M-S; Chiu, K-M; Huang, Y-T; Kao, K-L; Chu, S-H; Liao, C-H

    2009-11-01

    An increasing number of patients receive extracorporeal membrane oxygenation (ECMO) for life support. This study aimed to investigate the incidence and risk factors for nosocomial infection in adult patients receiving ECMO. We reviewed the medical records of adult patients who received ECMO support for more than 72h at Far Eastern Memorial Hospital from 2001 to 2007. ECMO-related nosocomial infections were defined as infections occurring from 24h after ECMO initiation until 48h after ECMO discontinuation. There were 12 episodes of nosocomial infection identified in 10 of the 114 (8.77%) patients on ECMO, including four cases of pneumonia, three cases of bacteraemia, three surgical site infections and two urinary tract infections. The incidence of ECMO-related nosocomial infection was 11.92 per 1000 ECMO-days. The length of ECMO use and intensive care unit (ICU) stay were significantly different between patients with, and without, nosocomial infection (Pnosocomial infection rate (P=0.003). Gram-negative bacilli were responsible for 78% of the nosocomial infections. In the univariate analysis, the duration of ICU stay and duration of ECMO use were associated with nosocomial infection. In the multivariate analysis, only the duration of ECMO was independently associated with nosocomial infection (P=0.007). Overall, the only independent risk factor for ECMO-related nosocomial infection identified in this study was prolonged ECMO use.

  9. Empiric Antibiotic Therapy of Nosocomial Bacterial Infections.

    Science.gov (United States)

    Reddy, Pramod

    2016-01-01

    Broad-spectrum antibiotics are commonly used by physicians to treat various infections. The source of infection and causative organisms are not always apparent during the initial evaluation of the patient, and antibiotics are often given empirically to patients with suspected sepsis. Fear of attempting cephalosporins and carbapenems in penicillin-allergic septic patients may result in significant decrease in the spectrum of antimicrobial coverage. Empiric antibiotic therapy should sufficiently cover all the suspected pathogens, guided by the bacteriologic susceptibilities of the medical center. It is important to understand the major pharmacokinetic properties of antibacterial agents for proper use and to minimize the development of resistance. In several septic patients, negative cultures do not exclude active infection and positive cultures may not represent the actual infection. This article will review the important differences in the spectrum of commonly used antibiotics for nosocomial bacterial infections with a particular emphasis on culture-negative sepsis and colonization.

  10. Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate - A randomized controlled trial

    NARCIS (Netherlands)

    P. Segers; R.G.H. Speekenbrink; D.T. Ubbink; M.L. van Ogtrop; B.A. de Mol

    2006-01-01

    Context Nosocomial infections are an important cause of morbidity and mortality after cardiac surgery. Decolonization of endogenous potential pathogenic microorganisms is important in the prevention of nosocomial infections. Objective To determine the efficacy of perioperative decontamination of the

  11. Nosocomial infections and related factors in southern khorasan hospitals

    Directory of Open Access Journals (Sweden)

    Bita Bijari

    2014-12-01

    Full Text Available Background and Aim: Nosocomial infections are defined as infections occurring during a patient's stay at hospital (48-72h after admission.Nosocomial infections are one of the important problems of health. This study aimed was determine the prevalence of nosocomial infections, and related factors in hospitals with more than 100 beds in south Khorasan Province. Materials and Methods: In this crass-sectional study, an investigator-administered questionnaire was completed for each patient with nosocomial infections diagnosis in hospitals with more than 100 beds in South Khorasan. This questionnaire conation demographic characteristic of patients, department, duration of admission, kind of pathogen and risk factors that was designed according to standard questionnaire of Iranian Nasocomial infections surveillance system (INIS of Center for communicable Disease Control, Ministry of Health. Data were analyzed with SPSS 16 software. Results and discussion: Number of patients with nosocomial infection was 358. The incidence of nosocomial infection was 0.9%. ICU had the highest incidence rate (17.3%. The most common nosocomial infection was pneumonia (43%, and urinary tract infection (UTI (15.1%. In 33.5% culture result were negative. In other cases, culture results showed klebsiella spp. (12.8% and Pseudomonas aeruginosa (9.8% were the most prevalent bacteria. Most factors associated with nosocomial infection in patients were urinary catheters (70.4%, suction (66.8% and tracheal tube (54.2%. 24% of patients expired. The results showed lower ratio of nosocomial infection, that the main reason is failure to detection and reporting of actual cases of nosocomial infection. Promoting detection and reporting system for Prevention and control of nosocomial infection was recommended

  12. Nosocomial Infections in Patients Admitted in Intensive Care Unit of ...

    African Journals Online (AJOL)

    mortality.[4] The risk factors for nosocomial infections include: Diabetes mellitus, intubation, persistent sounding, ... was to study, the current status of nosocomial infection, rate of infection and distribution ... age ranged from 43 to 72 years, mean age being 56 years. .... further systematic and standardized large scale studies.

  13. Hand hygiene for the prevention of nosocomial infections.

    Science.gov (United States)

    Kampf, Günter; Löffler, Harald; Gastmeier, Petra

    2009-10-01

    The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. The relevant scientific literature and national and international evidence-based recommendations (Robert Koch Institute [Germany], WHO) were evaluated. Hygienic hand disinfection has better antimicrobial efficacy than hand-washing and is the procedure of choice to be performed before and after manual contact with patients. The hands should be washed, rather than disinfected, only when they are visibly soiled. Skin irritation is quite common among healthcare workers and is mainly caused by water, soap, and prolonged wearing of gloves. Compliance can be improved by training, by placing hand-rub dispensers at the sites where they are needed, and by physicians setting a good example for others. Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, can reduce the nosocomial infection rate by as much as 40%.

  14. 肿瘤患者医院感染的相关因素分析及预防对策%Analysis of related factors causing nosocomial infections to tumor patients and countermeasures

    Institute of Scientific and Technical Information of China (English)

    杜开齐; 朱有才; 张志豪; 邬冬强; 郭大为; 肖怀清; 陈国军

    2014-01-01

    OBJECTIVE To explore the related factors causing nosocomial infections to tumor patients and the countermeasures so as to provide evidence for reducing the nosocomial infections .METHODS The clinical data of 1837 cases of patients with malignant tumor treated in the hospital from Feb 2010 to Feb 2013 were retrospectively analyzed;the nosocomial infection was diagnosed as per "Nosocomial Infection Diagnosis Criteria" and the data were statistically analyzed with SPSS 13 .0 software .RESULTS Totally ,92 of the 1837 cases patients with malignant tumor suffered nosocomial infections ,with the infection rate of 5 .01% .Respiratory system dominated the infection sites ,accounting for 50 .00% ;of the 92 patients who suffered nosocomial infections ,lung cancer patients accounted for 38 .04% ;patients at Ⅳ stage dominated the infected patients of different stages ,accounting for 59 .78% ;a total of 92 pathogens were detected ,including 49 (53 .26% )strains of gram-negative bacteria ,30 (32 .61% )strains of gram-positive bacteria strains and 13 (14 .43% ) strains of fungi;there was significant difference between the infected patients and uninfected patients′ age ,nutritional status ,antibiotic use ,hospital stays ,reception times of chemotherapy and invasive operations and other factors in patients with and without infections ,the difference was significant (P<0 .01) .CONCLUSIONS Tumor patients are in poor health during treatment with poor immunity , and are susceptible to suffer nosocomial infections for pathogen invasion , therefore ,it is required to take corresponding countermeasures for susceptible factors and effectively reduce the nosocomial infection rate .%目的:探讨肿瘤患者发生医院感染的相关因素及预防对策,为降低医院感染发生提供依据。方法回顾性分析2010年2月-2013年2月收治的1837例恶性肿瘤患者临床资料,医院感染诊断参照《医院感染诊断标准》,调查数据应用SPSS13.0软

  15. Prevention of nosocomial bloodstream infections in preterm infants

    NARCIS (Netherlands)

    K. Helder MScN (Onno)

    2013-01-01

    textabstractProtecting patients from harm is the overarching theme of the studies presented here. More precisely, this thesis places a focus on the prevention of nosocomial or hospitalacquired bloodstream infections in preterm infants, thus saving them from further harm. A nosocomial infection is an

  16. Prevention of nosocomial bloodstream infections in preterm infants

    NARCIS (Netherlands)

    K. Helder MScN (Onno)

    2013-01-01

    textabstractProtecting patients from harm is the overarching theme of the studies presented here. More precisely, this thesis places a focus on the prevention of nosocomial or hospitalacquired bloodstream infections in preterm infants, thus saving them from further harm. A nosocomial infection is an

  17. Prevention of nosocomial infections in the neonatal intensive care unit.

    Science.gov (United States)

    Adams-Chapman, Ira; Stoll, Barbara J

    2002-04-01

    Nosocomial infections are responsible for significant morbidity and late mortality among neonatal intensive care unit patients. The number of neonatal patients at risk for acquiring nosocomial infections is increasing because of the improved survival of very low birthweight infants and their need for invasive monitoring and supportive care. Effective strategies to prevent nosocomial infection must include continuous monitoring and surveillance of infection rates and distribution of pathogens; strategic nursery design and staffing; emphasis on handwashing compliance; minimizing central venous catheter use and contamination, and prudent use of antimicrobial agents. Educational programs and feedback to nursery personnel improve compliance with infection control programs.

  18. [Nosocomial infections and infections with multidrug-resistant pathogens - frequency and mortality].

    Science.gov (United States)

    Gastmeier, Petra; Geffers, Christine; Herrmann, Mathias; Lemmen, Sebastian; Salzberger, Bernd; Seifert, Harald; Kern, Winfried; Fätkenheuer, Gerd

    2016-03-01

    There is no agreement about the frequency of nosocomial infections and infections caused by multidrug resistant organisms (MDRO) in Germany. The aim of this review is to generate updated estimates of the national burden of these infections and to discuss them in an international context. The most important sources of this analysis are the data of the national prevalence studies conducted in various European countries and in the U.S. It can be assumed that there are between 400,000 and 600,000 patients with nosocomial infections each year in Germany. The mortality attributable to them is between 6000 and 15,000 patients. About 30,000 to 35,000 patients develop nosocomial infections caused by MDRO. Currently there are no robust data how many patients die each year because of MDRO infections. According to the best available estimate, the annual number may be between 1000 and 4000 cases. The problems of nosocomial infections and the increase of antimicrobial resistance are highly relevant and should not be belittled. However, an overestimation of this dangerous trend may lead to inappropriate use of limited resources.

  19. Prevalence of Device-associated Nosocomial Infections Caused By Gram-negative Bacteria in a Trauma Intensive Care Unit in Libya.

    Science.gov (United States)

    Zorgani, Abdulaziz; Abofayed, Atef; Glia, Abdulhakim; Albarbar, Ashrf; Hanish, Sami

    2015-07-01

    Device-associated nosocomial infections (DANIs) have a major impact on patient morbidity and mortality. Our study aimed to determine the distribution rate of DANIs and causative agents and patterns of antibiotic resistance in the trauma-surgical intensive care unit (ICU). . Our study was conducted at Abusalim Trauma Hospital in Tripoli, Libya. All devices associated with nosocomial infections, including central venous catheters (CVC), endotracheal tubes (ETT), Foley's urinary catheters, chest tubes, nasogastric tubes (NGT), and tracheostomy tubes, were removed aseptically and examined for Gram-negative bacteria (GNB). . During a one-year study period, 363 patients were hospitalized; the overall mortality rate was 29%. A total of 79 DANIs were identified, the most common site of infection was ETT (39.2%), followed by urinary catheters (19%), NGTs (18%), tracheostomy tubes (11%), CVCs (10%), and chest tubes (3%). The most frequently isolated organisms were Klebsiella pneumonia, Acinetobacter baumannii, and Pseudomonas aeruginosa (30%, 20%, and 14%, respectively). Extremely high resistance rates were observed among GNB to ampicillin (99%), cefuroxime (95%), amoxicillin-clavulante (92%), and nitrofurantoin (91%). Lower levels of resistance were exhibited to amikacin (38%), imipenem (38%), and colistin (29%). About 39% of the isolates were defined as multi-drug resistant (MDR). Overall, extended spectrum β-lactmase producers were expressed in 39% of isolates mainly among K. pneumonia (88%). A. baumannii isolates exhibited extremely high levels of resistance to all antibiotics except colistin (100% sensitive). In addition, 56.3% of A. baumannii isolates were found to be MDR. P. aeruginosa isolates showed 46%-55% effectiveness to anti-pseudomonas antibiotics. . High rates of DANI's and the emergence of MDR organisms poses a serious threat to patients. There is a need to strengthen infection control within the ICU environment, introduce surveillance systems, and

  20. Prevalence of Device-associated Nosocomial Infections Caused By Gram-negative Bacteria in a Trauma Intensive Care Unit in Libya

    Directory of Open Access Journals (Sweden)

    Abdulaziz Zorgani

    2015-07-01

    Full Text Available Objectives: Device-associated nosocomial infections (DANIs have a major impact on patient morbidity and mortality. Our study aimed to determine the distribution rate of DANIs and causative agents and patterns of antibiotic resistance in the trauma-surgical intensive care unit (ICU. Methods: Our study was conducted at Abusalim Trauma Hospital in Tripoli, Libya. All devices associated with nosocomial infections, including central venous catheters (CVC, endotracheal tubes (ETT, Foley’s urinary catheters, chest tubes, nasogastric tubes (NGT, and tracheostomy tubes, were removed aseptically and examined for Gram-negative bacteria (GNB. Results: During a one-year study period, 363 patients were hospitalized; the overall mortality rate was 29%. A total of 79 DANIs were identified, the most common site of infection was ETT (39.2%, followed by urinary catheters (19%, NGTs (18%, tracheostomy tubes (11%, CVCs (10%, and chest tubes (3%. The most frequently isolated organisms were Klebsiella pneumonia, Acinetobacter baumannii, and Pseudomonas aeruginosa (30%, 20%, and 14%, respectively. Extremely high resistance rates were observed among GNB to ampicillin (99%, cefuroxime (95%, amoxicillin-clavulante (92%, and nitrofurantoin (91%. Lower levels of resistance were exhibited to amikacin (38%, imipenem (38%, and colistin (29%. About 39% of the isolates were defined as multi-drug resistant (MDR. Overall, extended spectrum β-lactmase producers were expressed in 39% of isolates mainly among K. pneumonia (88%. A. baumannii isolates exhibited extremely high levels of resistance to all antibiotics except colistin (100% sensitive. In addition, 56.3% of A. baumannii isolates were found to be MDR. P. aeruginosa isolates showed 46%–55% effectiveness to anti-pseudomonas antibiotics. Conclusion: High rates of DANI’s and the emergence of MDR organisms poses a serious threat to patients. There is a need to strengthen infection control within the ICU environment

  1. Nosocomial infection and its molecular mechanisms of antibiotic resistance.

    Science.gov (United States)

    Xia, Jufeng; Gao, Jianjun; Tang, Wei

    2016-02-01

    Nosocomial infection is a kind of infection, which is spread in various hospital environments, and leads to many serious diseases (e.g. pneumonia, urinary tract infection, gastroenteritis, and puerperal fever), and causes higher mortality than community-acquired infection. Bacteria are predominant among all the nosocomial infection-associated pathogens, thus a large number of antibiotics, such as aminoglycosides, penicillins, cephalosporins, and carbapenems, are adopted in clinical treatment. However, in recent years antibiotic resistance quickly spreads worldwide and causes a critical threat to public health. The predominant bacteria include Methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. In these bacteria, resistance emerged from antibiotic resistant genes and many of those can be exchanged between bacteria. With technical advances, molecular mechanisms of resistance have been gradually unveiled. In this review, recent advances in knowledge about mechanisms by which (i) bacteria hydrolyze antibiotics (e.g. extended spectrum β-lactamases, (ii) AmpC β-lactamases, carbapenemases), (iii) avoid antibiotic targeting (e.g. mutated vanA and mecA genes), (iv) prevent antibiotic permeation (e.g. porin deficiency), or (v) excrete intracellular antibiotics (e.g. active efflux pump) are summarized.

  2. Nosocomial Infections in Intensive Care Unit: Pattern of Antibiotic-resistance in Iranian Community.

    Science.gov (United States)

    Esfahani, Bahram Nasr; Basiri, Rozita; Mirhosseini, Seyed Mohammad Mahdy; Moghim, Sharareh; Dolatkhah, Shahaboddin

    2017-01-01

    Bacterial infections are responsible for great number of mortality in Intensive Care Unit (ICU). Knowledge about prevalence of bacterial infections and their antibiotic-resistance pattern would be a great step for their treatment and management. Data about nosocomial infections in ICUs of Alzahra Hospital (referral hospital in Isfahan, center of Iran) were gathered during the years 2007-2010. A questionnaire was fulfilled for any specific patient with nosocomial infection containing demographic data of patient and also characteristics of the infection. Out of all patients, 707 individuals (65.6%) were male and 370 (34.4%) were female. Our data revealed that Pseudomonas aeruginosa (13.9%), Klebsiella (11%), and Escherichia coli (6.4%) were the most prevalent bacterial infections. The most common sites of nosocomial infections in the ICU were respiratory system (399 cases, 37%), urinary system (230 cases, 21.4%), and blood (102 cases, 9.5%). The antibiotic-resistance of each bacteria in ICU ward was assessed and data were categorized in a table. There were less documentary about bacterial cultures in the year 2007 when compared with the next years. We found some differences (such as bacterial prevalence in ICU wards which caused nosocomial infections) in our local prevalence of nosocomial infections and also in their resistance pattern compared to other centers. Knowing about our data will help physicians to administer the most suitable antibiotics for treatment of nosocomial infections in our area.

  3. [Preventive measures and the strife against nosocomial infection].

    Science.gov (United States)

    Kane, O; Bèye, M D; Diop, Ndoye M; Ndiaye, P I; Diouf, E; Sall, Ka B

    2007-01-01

    The nosocomial Infections are associated to an increase of the morbidity, of the mortality and costs. Their frequency stay on raised in our service of cares. Then it is recommended and broadly admitted what each hospital must dispose of a unity of nosocomial infections prevention and to dispose a staff specially vested in those duties. Of the fact the nosocomial infections frequency in reanimation, an imported part of the activity of this specialized staff will have to run out in services of intensive cares. The principal nosocomial infections feature observed is being directly or indirectly associated to engineerings of acting as invasives deputy used to palliate a vital lapse. Of a general manner, all sharp grave affection, as anything severe traumatism (accidental or surgical) drag a capacities reduction of defense against the infection, component so important factors of nosocomial infections installations. Preventive measures pass by the engineerings respect of hands hygiene, the harbour of clean conformable dress, the measures respect of isolation (septic or preventive), the cares grading, the upkeep of the hardware and the bedroom, the respect of the circuit of the linen salts and lastly the sorting and the losses management of activity of cares. For that it must a policy of strife against nosocomial infections with the placing in place of operational unities of hygiene in all hospitals and the redynamisation of the committee of strife against nosocomial infections already existed in different public establishments of health.

  4. Enterobacter cloacae multidrug-resistant: a case report of nosocomial urinary catheter-associated infection

    Directory of Open Access Journals (Sweden)

    Dino De Conno

    2008-12-01

    Full Text Available Enterobacter species, particularly E. cloacae and E. aerogenes, are important nosocomial pathogenes responsible for various infections.We report a 70-y-old patient with catheter-associated urinary tract infection (UTI caused by a nosocomial Enterobacter cloacae with multidrug-resistance.The identification of isolates from clinical culture and the study of pattern antimicrobial susceptibility were performed to the clinical risolution of the patient’s disease.The initial empirical antimicrobial therapy resulted ineffective.

  5. Risk Factors for Nosocomial Infection in the Neonatal Intensive Care Unit by the Japanese Nosocomial Infection Surveillance (JANIS

    Directory of Open Access Journals (Sweden)

    Nakayama,Hideki

    2008-08-01

    Full Text Available We evaluated the infection risks in the neonatal intensive care unit (NICU using data of NICU infection surveillance data. The subjects were 871 NICU babies, consisting of 465 boys and 406 girls, who were cared for between June 2002 and January 2003 in 7 medical institutions that employed NICU infection surveillance. Infections were defined according to the National Nosocomial Infection Surveillance (NNIS System. Of the 58 babies with nosocomial infections, 15 had methicillin-resistant Staphylococcus aureus (MRSA infection. Multiple logistic regression analysis demonstrated that the odds ratio for nosocomial infections was significantly related to gender, birth weight and the insertion of a central venous catheter (CVC. When the birth weight group of more than 1, 500g was regarded as the reference, the odds ratio was 2.35 in the birth weight group of 1,000-1,499g and 8.82 in the birth weight group of less than 1,000g. The odds ratio of the CVC ( for nosocomial infection was 2.27. However, other devices including artificial ventilation, umbilical artery catheter, umbilical venous catheter, and urinary catheter were not significant risk factors. The incidence of MRSA infection rapidly increased from 0.3% in the birth weight group of more than 1,500g to 2.1% in the birth weight group of 1,000-1,499g, and to 11.1% in the birth weight group of less than 1,000g. When the birth weight group of more than 1,500g was regarded as the reference, multiple logistic regression analysis demonstrated that the odds ratio was 7.25 in the birth weight group of 1,000-1,499g and 42.88 in the birth weight group of less than 1,000g. These odds ratios were significantly higher than that in the reference group. However, the application of devices did not cause any significant differences in the odds ratio for MRSA infection.

  6. Risk factors for nosocomial infection in the neonatal intensive care unit by the Japanese Nosocomial Infection Surveillance (JANIS).

    Science.gov (United States)

    Babazono, Akira; Kitajima, Hiroyuki; Nishimaki, Shigeru; Nakamura, Tomohiko; Shiga, Seigo; Hayakawa, Masahiro; Tanaka, Tahei; Sato, Kazuo; Nakayama, Hideki; Ibara, Satoshi; Une, Hiroshi; Doi, Hiroyuki

    2008-08-01

    We evaluated the infection risks in the neonatal intensive care unit (NICU) using data of NICU infection surveillance data. The subjects were 871 NICU babies, consisting of 465 boys and 406 girls, who were cared for between June 2002 and January 2003 in 7 medical institutions that employed NICU infection surveillance. Infections were defined according to the National Nosocomial Infection Surveillance (NNIS) System. Of the 58 babies with nosocomial infections, 15 had methicillin-resistant Staphylococcus aureus (MRSA) infection. Multiple logistic regression analysis demonstrated that the odds ratio for nosocomial infections was significantly related to gender, birth weight and the insertion of a central venous catheter (CVC). When the birth weight group of more than 1, 500 g was regarded as the reference, the odds ratio was 2.35 in the birth weight group of 1,000-1,499 g and 8.82 in the birth weight group of less than 1,000g. The odds ratio of the CVC (+) for nosocomial infection was 2.27. However, other devices including artificial ventilation, umbilical artery catheter, umbilical venous catheter, and urinary catheter were not significant risk factors. The incidence of MRSA infection rapidly increased from 0.3% in the birth weight group of more than 1,500 g to 2.1% in the birth weight group of 1,000-1,499 g, and to 11.1% in the birth weight group of less than 1,000g. When the birth weight group of more than 1,500 g was regarded as the reference, multiple logistic regression analysis demonstrated that the odds ratio was 7.25 in the birth weight group of 1,000-1,499 g and 42.88 in the birth weight group of less than 1,000g. These odds ratios were significantly higher than that in the reference group. However, the application of devices did not cause any significant differences in the odds ratio for MRSA infection.

  7. Secular Trends in Nosocomial Bloodstream Infections : Antibiotic-Resistant Bacteria Increase the Total Burden of Infection

    NARCIS (Netherlands)

    Ammerlaan, H. S. M.; Harbarth, S.; Buiting, A. G. M.; Crook, D. W.; Fitzpatrick, F.; Hanberger, H.; Herwaldt, L. A.; van Keulen, P. H. J.; Kluytmans, J. A. J. W.; Kola, A.; Kuchenbecker, R. S.; Lingaas, E.; Meessen, N.; Morris-Downes, M. M.; Pottinger, J. M.; Rohner, P.; dos Santos, R. P.; Seifert, H.; Wisplinghoff, H.; Ziesing, S.; Walker, A. S.; Bonten, M. J. M.

    2013-01-01

    Background. It is unknown whether rising incidence rates of nosocomial bloodstream infections (BSIs) caused by antibiotic-resistant bacteria (ARB) replace antibiotic-susceptible bacteria (ASB), leaving the total BSI rate unaffected. Methods. We investigated temporal trends in annual incidence densit

  8. Prevention of nosocomial infections in intensive care unit and nursing practices

    Directory of Open Access Journals (Sweden)

    Sevilay Yüceer

    2009-01-01

    Full Text Available Nosocomial infections which are considered as the primary indicator of the quality of care in hospitals, cause to prolong hospitalization at intensive care unit and hospital, increase morbidity, mortality, and the cost of treatment. Although only 5-10% of the patients are treated in the intensive care units, 20-25% of all nosocomial infections are seen in these units. Preventing nosocomial infections in intensive care units is a process started at the patient acceptance to unit that requires an interdisciplinary team approach of intensive care staffs’ and Infection Control Committee members.Intensive care nurses who are in constant contact with patients have important responsibilities in preventing nosocomial infections. Intensive care nurses should be aware that the nosocomial infections can be prevented. They should have current knowledge about universal precautions related to prevention and control of infections, which are accepted by the entire world and they reinforce this knowledge by practice and should provide the most effective care to patients.In this article, nursing practices for prevention of nosocomial infections in intensive care units are discussed based on universal precautions.

  9. Nosocomial infections in neonatal intensive care units: Cost ...

    African Journals Online (AJOL)

    Nosocomial infections in neonatal intensive care units: Cost-effective control strategies in ... Sources: Sources of information were from Google searches and PubMed- ... Conclusion: Hand washing or hand hygiene by health-care personnel

  10. Antibiotic Resistance in Acinetobacter Baumannii Strains Isolated from Nosocomial Infections

    National Research Council Canada - National Science Library

    Pinar Korkmaz

    2016-01-01

    ...%. In this study, it was aimed to assess the frequency of Acinetobacter baumannii species which were considered to be causative agents of nosocomial infection and their resistance to antimicrobial...

  11. NOSOCOMIAL ACINETOBACTER INFECTIONS IN INTENSIVE CARE UNIT

    Directory of Open Access Journals (Sweden)

    Nwadike V. Ugochukwu

    2013-01-01

    Full Text Available Acinetobacter plays an important role in the infection of patients admitted to hospitals. Acinetobacter are free living gram-negative coccobacilli that emerge as significant nosocomial pathogens in the hospital setting and are responsible for intermittent outbreaks in the Intensive Care Unit. The aim of this study was to determine the prevalence of Acinetobacter in patients admitted into the Intensive Care Unit and determine their role in infections in the ICU. A total of one hundred patients were recruited for the study, catheter specimen urine, tracheal aspirate and blood culture were collected aseptically from the patients. The specimens were cultured on blood and MacConkey and the organisms identified using Microbact 12E (0xoid. The Plasmid analysis was done using the TENS miniprep method. Fourteen (14% of the 100 patients recruited into the study, developed Acinetobacter infection. Acinetobacter spp constituted 9% of the total number of isolates. Twelve (86% of the isolates were recovered from tracheal aspirate, 1(7% from urine and 1(7% from blood. All of the isolates harbor plasmids of varying molecular sizes. Ten of the fourteen Acinetobacter were isolated at about the same period of time in the ICU with 6(42.7% having plasmid size in the 23.1kb band and all showed similar pattern revealing that the isolates exhibit some relatedness. The clonal nature of the isolates suggest that strict infection control practices must be adopted in ICU, also an antibiotic policy must be developed for the ICU to prevent abuse of antibiotics that may lead to selection of resistant bacteria.

  12. Causes of nosocomial infections in elderly patients with mental diseases and predictable intervention programs%老年精神病患者医院感染原因分析及预见性干预方案

    Institute of Scientific and Technical Information of China (English)

    袁朝霞; 章秋萍; 盛志娟; 俞红英; 张丽英

    2016-01-01

    OBJECTIVE To explore the causes of nosocomial infections in elderly patients with mental diseases and put forward the prevention countermeasures so as to provide guidance for treatment and prevention of the nosoco-mial infections .METHODS A total of 660 elderly patients with mental diseases who were treated in the hospital from Jan 2012 to Dec 2014 were enrolled in the study ,then the clinical data of the patients were investigated ,the influencing factors for the nosocomial infections were analyzed ,and the effective prevention measures were formu-lated according to the influencing factors .RESULTS Of the 660 patients ,89 (171 case-times ) had the nosocomial infections with the infection rate of 13 .48% ,the case-time infection rate 25 .91% .The infection rate was highest (57 .30% ) in the patients with schizophrenia . The patients with respiratory tract infections accounted for 67 .42% .The infection rate was 35 .96% in the patients aged from 70 to 75 years old .The infection rate was more than 50 .00% in the patients who were hospitalized for no less than 1 year .The prevalence rate was influenced by the temperature and was highest in summer ,and the infection rate was as high as 46 .07% .CONCLUSION There are a variety of influencing factors for the nosocomial infections in the elderly patients with mental diseases ,and the corresponding prevention measures have been formulated based on the related factors .%目的 探讨老年精神病患者医院感染的主要原因及预防对策,为治疗与预防患者医院感染的提供参考依据.方法 调查医院2012年1月-2014年12月收治的660例老年精神病患者临床资料,对其中发生医院感染患者的相关因素进行分析,根据感染因素制定有效的预防措施.结果 660例患者中发生医院感染89例 、171例次,感染率13.48%、例次感染率25.91%;精神分裂患者感染率最高达到57.30%;呼吸道感染是主要的感染部位,占67.42%;70~75岁的患

  13. The Study of Nosocomial Infections in Neonatal Intensive Care Unit, A prospective study in Northwest Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Bagher Hosseini

    2014-08-01

    Full Text Available Background: Nosocomial infections are an important cause of mortality in neonatal intensive care units (NICUs. Therefore, in this study, the incidence and prevalence of nosocomial infections were determined in NICUs of the three largest neonatal centers in northwest Iran, and the causative bacteria were identified in order to provide potential solutions to control the infections in these hospitals. Materials and Methods: This is a descriptive-prospective study in which the cases of nosocomial infections were examined in the three largest hospitals in Tabriz in northwest Iran during 1 year (from June 2012 until May 2013 based on clinical findings, medical and nursing reports of patients, and laboratory results. Results: Of the 3129 patients hospitalized in NICUs of the three hospitals, 208 patients were diagnosed with nosocomial infections. The incidence rate of nosocomial infections was 11.34%.per 100 patient days with 52.4% bacteremia, 32.69% pneumonia, 5.77% urinary tract infections, 5.29% wound infections, and 3.85% necrotizing enterocolitis. There was a statistically significant relationship between invasive procedures (such as umbilical catheters, central venous catheters, surgery, and TPN and sepsis (P = 0.001. The relationships between urinary tract infection and urinary catheter (P = 0.000, and aggressive procedures (such as suctioning and intubation and pneumonia (P = 0.001 were also statistically significant. Conclusion: Incidence of nosocomial infections in premature and low birth weight newborns is considered as a health threat. The findings of this research reiterate the importance of giving further attention to prevention and control of nosocomial infections in the NICU.

  14. The incidence of nosocomial infection in the Intensive Care Unit, Hospital Universiti Kebangsaan Malaysia: ICU-acquired nosocomial infection surveillance program 1998-1999.

    Science.gov (United States)

    Rozaidi, S W; Sukro, J; Dan, A

    2001-06-01

    CU-acquired nosocomial infection (NI) remains one of the major causes of ICU mortality. This study presents the incidence of ICU-acquired nosocomial infection in ICU HUKM for the years 1998 and 1999, as part of the ongoing ICU-acquired nosocomial infection surveillance program. The overall incidence was 23%. The main types of NI was lower respiratory tract infection (15.3%), primary bacteraemia (8.1%), ventilator associated pneumonia (5.4%), urinary tract infection (2.0%), skin infection (1.6%) central venous catheter sepsis (1.2%) and surgical skin infection (0.8%). The overall culture positive nosocomial infection rate was only 12.1%, majority from the lungs (12.6%), blood (7.3%), skin swabs (2.0%), and urine (1.6%). The main gram-negative organism cultured was Acinetobacter sp. (19%) and Staph. aureus (8.5%) was the gram-positive organism. The overall ICU mortality rate was 27.5% of which 60.9% of patients who died were attributed directly to sepsis.

  15. Surveillance and Control of Nosocomial Infection in Neonatal ICU

    Institute of Scientific and Technical Information of China (English)

    ZHONG Xiaozhu

    2002-01-01

    Objective To strengthen the surveillance and control of nosocomial infection in neonatal ICU. Methods To be seriously considered by leaders, to carry out rules and systems, to strengthen education and enhance consciousness of infections, to carry out targeted surveillance on basis of routine surveillance. Results The consciousness of infections has been enhanced. Passive carrying out of sterilization and isolation has turned active carrying out. The air quality in NICU has been improved. Ventilator - related infections have been decreased. Conclusion To strengthen surveillance and control of nosocomial infection in neonatal ICU and to find out and solve the weak link in infection control is the key to control nosocomial infection, to insure medical safety, and to improve medical quality.

  16. The Prevalence Of Nosocomial Infections Caused By Enterobacter Cloacae And Antibiotic Resistant Patterns In Samples Isolated From Patients In Two Hospitals In Tehran

    Directory of Open Access Journals (Sweden)

    S Soleymanzadeh

    2012-06-01

    Full Text Available Background: The increasing use of β-lactam antibiotics in clinics for the treatment of different bacterial infections since early 1980s has led to increased rates of resistant bacteria isolated from patients. One of the problems in the treatment of nosocomial infections is related to resistant bacteria such as Enterobacter cloacae due to cross resistance through extended-spectrum beta-lactamase production. The aim of this study was to determine the prevalence of extended-spectrum beta-lactamase producing E. cloacae from different clinical specimens collected from hospitalized patients. Methods: In the present study, 101 E. cloacae confirmed by standard specific microbiologic tests were collected from different specimens in Milad and Motahri hospitals in Tehran, Iran during February 2010 and September 2011. Antibiotic susceptibility tests were conducted according to the process recommended by the Clinical and Laboratory Standards Institute for 13 antibiotics of choice. Extended-spectrum beta-lactamase producing strains were screened for by combined disk method as a phenotypic diagnostic test. Results: From a total of 101 E. cloacae, 33 (33% were shown to produce extended-spectrum beta-lactamase by phenotypic tests; 5% of the bacteria were resistant to imipenem too. Conclusion: This study clearly showed the high prevalence of resistance to broad-spectrum beta-lactam antibiotics in the isolated E. cloacae among which 5% were multi drug resistant. All the isolated E. cloacae were susceptible to Colistin. These results can be alarming for physicians treating resistant E. cloacae infections, especially extended-spectrum beta-lactamase producing species.

  17. Monitoring and control of nosocomial infection caused by carbapenem-resistant acinetobactor baumannii in ICU%ICU耐碳青霉烯类鲍氏不动杆菌医院感染监测与控制

    Institute of Scientific and Technical Information of China (English)

    周东升; 鲍凤; 林荣; 沈志君

    2011-01-01

    目的 了解医院ICU耐碳青霉烯类鲍氏不动杆菌医院感染状况,查找传染源及传播途径,为及时采取有效的预防控制措施提供依据. 方法 对ICU 2008年7-12月发生的耐碳青霉烯类鲍氏不动杆菌医院感染进行流行病学回顾性调查;对其环境进行大面积卫生学监测,并用肠杆菌属基因间保守重复序列聚合酶链反应(ERIC-PCR)进行耐碳青霉烯类鲍氏不动杆菌同源性分析. 结果 2008 年7-12月,在ICU共23例患者发生了耐碳青霉烯类鲍氏不动杆菌医院感染;环境卫生学监测共采得标本86份,其中在门把手、监护仪、听诊器、医护人员手、呼吸机及患者床头用品等54处检出耐碳青霉烯类鲍氏不动杆菌,污染率达62.8%;DNA图谱显示23株菌均为同一克隆菌株. 结论 医院ICU 有耐碳青霉烯类鲍氏不动杆菌同一克隆株的暴发流行,环境污染严重可能是暴发流行的主要原因;大力加强ICU耐碳青霉烯类鲍氏不动杆菌医院感染管理工作已刻不容缓.%OBJECTIVE To investigate the status of the nosocomial infection caused by carbapenem-cesistant Acinetobactor baumannii in ICU, to search for infection sources and route of transmission, and to provide evidence for the effective control measures. METHODS The retrospective analysis of the nosocomial infection caused by carbapenem-resistant A. baumannii strains in ICU between Jul 2008 and Dec 2008 was conducted, and the environmental health monitoring was executed. ERIC-PCR was carried out for the homology of the isolates.RESULTS Totally 23 patients appeared the nosocomial infection caused by carbapenem-resistant A. baumannii in ICU during Jul 2008 to Dec 2008. In all 86 samples, 54 carbapenem-resistant A. baumannii strains were isolated from door handle, monitor, stethoscopes, the hands of medical personnel, respirator, and household items of patients. The contamination rate was 62. 8% (54/86). DNA homologous analysis indicated that 23

  18. Extensively Drug-Resistant Klebsiella pneumoniae Causing Nosocomial Bloodstream Infections in China: Molecular Investigation of Antibiotic Resistance Determinants, Informing Therapy, and Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Wenzi Bi

    2017-06-01

    Full Text Available The rise in diversity of antimicrobial resistance phenotypes seen in Klebsiella pneumoniae is becoming a serious antibiotic management problem. We sought to investigate the molecular characteristics and clinical implications of extensively drug-resistant (XDR K. pneumoniae isolated from different nosocomial bloodstream infections (BSIs patients from July 2013 to November 2015. Even in combination treatment, meropenem did not protect against mortality of BSIs patients (P = 0.015. In contrast, tigecycline in combination with other antimicrobial agents significantly protected against mortality (P = 0.016. Antimicrobial susceptibility tests, molecular detection of antibiotic resistance determinants, conjugation experiments, multilocus sequence typing (MLST, S1-PFGE, Southern blot, SDS-PAGE, immunoblot analysis, and pulsed-field gel electrophoresis (PFGE were used to characterize these isolates. These XDR K. pneumoniae strains were resistant to conventional antimicrobials except tigecycline and polymyxin B and co-harbored diverse resistance determinants. rmtB, blaKPC−2 as well as blaCTX−M−9 were located on a transferable plasmid of ~54.2 kb and the most predominant replicon type was IncF. 23 of the 35 isolates belonging the predominant clone were found to incorporate the globally-disseminated sequence type ST11, but others including a unique, previously undiscovered lineage ST2281 (allelic profile: 4-1-1-22-7-4-35 were also found and characterized. The porins OmpK35 and OmpK36 were deficient in two carbapenemase-negative carbapenem-resistant strains, suggesting decreased drug uptake as a mechanism for carbapenem resistance. This study highlights the importance of tracking hospital acquired infections, monitoring modes of antibiotic resistance to improve health outcomes of BSIs patients and to highlight the problems of XDR K. pneumoniae dissemination in healthcare settings.

  19. Nosocomial outbreak of hepatitis B virus infection involving two hospitals in the Republic of Ireland.

    LENUS (Irish Health Repository)

    Burns, K

    2012-02-01

    The routes of nosocomial hepatitis B virus (HBV) transmission have changed over the years. Initiatives to prevent transfusion-associated HBV and healthcare worker-to-patient transmission have had a positive impact on these transmission routes. Recent reports of outbreaks of nosocomial HBV have implicated breaches in standard precautions as important causes of HBV transmission. This report describes a nosocomial outbreak of HBV infection in the Republic of Ireland, which occurred between January 2005 and March 2006. The outbreak was detected following identification of a case of acute HBV infection in a patient whose only risk factor was a recent surgical procedure. The extensive multi-agency investigation that followed revealed that the patient was one of five cases of acute HBV infection and that four separate transmission events between infectious cases had occurred in two different hospitals over a 15-month period. A definitive cause for each transmission event was not identified, although lapses in adherence to standard precautions, safe injection and phlebotomy practices could not be ruled out. Two secondary cases of acute HBV infection in community contacts of two of the nosocomial cases were identified. Phylogenetic analysis proved a useful tool in confirming infection with a pre-core HBV mutant and viral transmission between the seven patients. A patient notification exercise involving 1028 potentially exposed patients found no evidence of additional cases of nosocomial HBV infection. These findings highlight the importance of consistent application of standard precautions.

  20. Asymptomatic carriers contribute to nosocomial Clostridium difficile infection

    DEFF Research Database (Denmark)

    Blixt, Thomas; Gradel, Kim Oren; Homann, Christian

    2017-01-01

    BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects of of as......BACKGROUND & AIMS: Nosocomial infection with Clostridium difficile pose a considerable problem despite numerous attempts by health care workers to reduce risk of transmission. Asymptomatic carriers of C difficile might spread their infection to other patients. We investigated the effects...... of of asymptomatic carriers on nosocomial C difficile infections. METHODS: We performed a population-based prospective cohort study at 2 university hospitals in Denmark, screening all patients for toxigenic C difficile in the intestine upon admittance, from October 1, 2012, to January 31, 2013. Screening results...

  1. ICU不同疾病医院感染的经济学损失评价%Evaluation of economic losses caused by nosocomial infection with various diseases in ICU

    Institute of Scientific and Technical Information of China (English)

    王书会; 于子旭; 邓钰; 姚琳; 王海燕; 王一瑶

    2012-01-01

    OBJECTIVE To evaluate the direct economic losses caused by nosocomial infections of inpatients in ICU and inpatients with different diseases. METHODS The retrospective investigation and prospective monitoring were adopted. From Jan. 2004 to Dec. 2010, a total of 2060 inpatients in comprehensive ICU of a tertiary hospital were collected. According to ratio 1 : 1, the patients with infections were set as infection group, and the patients without infections were set as control group. The hospitalization costs of the two groups were compared. RESULTS The direct economic loss caused by nosocomial infections in ICU patients with circulatory system diseases (73 586. 67 yuan) ranked the first, followed by patients with digestive system diseases (73 536. 78 yuan) and complex trauma (52942. 00 yuan). The difference between the infection group and control group was statistically significant (F<0. 05). CONCLUSION Nosocomial infections in ICU inpatients during hospitalization cause significant increase in the medical expense. Do a good job of preventing nosocomial infections in ICU can reduce the infection rate and enable the hospital obtain greater social and economic benefits.%目的 研究ICU住院患者因医院感染所造成的直接经济损失,分析不同疾病种类住院患者医院感染的直接经济损失.方法 采用回顾性调查和前瞻性监测的方法,调查2004年1月-2010年12月某三级甲等医院综合性ICU的住院患者,共收集病例2060例,按条件1:1配比,发生医院感染的患者为病例组,未发生医院感染的患者为对照组,比较两组患者住院费用的差异.结果 ICU医院感染经济损失排在前3位的疾病种类为循环系统疾病、消化系统疾病和复合伤,循环系统疾病患者的医院感染经济学损失为73 586.67元;消化系统疾病患者的医院感染经济学损失为73 536.78元;复合伤患者的医院感染经济学损失为52 942.00元,病例组与对照组

  2. Sequence-based identification and characterization of nosocomial influenza A(H1N1)pdm09 virus infections

    NARCIS (Netherlands)

    Jonges, M.; Rahamat-Langendoen, J.; Meijer, A.; Niesters, H. G.; Koopmans, M.

    2012-01-01

    Background: Highly transmissible viruses such as influenza are a potential source of nosocomial infections and thereby cause increased patient morbidity and mortality. Aim: To assess whether influenza virus sequence data can be used to link nosocomial influenza transmission between individuals. Meth

  3. Antimicrobial resistance of pathogenic bacteria causing nosocomial infection in patients with cerebrovascular diseases%脑血管疾病患者医院感染病原菌耐药性分析

    Institute of Scientific and Technical Information of China (English)

    黄娥; 董虹; 刘天春; 范文

    2014-01-01

    OBJECTIVE To explore the vulnerable sites and antimicrobial resistance of pathogenic bacteria causing nosocomial infection in patients with cerebrovascular diseases and provide the scientific laboratory reference for prevention and control of nosocomial infection following cerebrovascular diseases .METHODS The retrospective review was performed for the clinical data of 3 978 cases of hospitalized patients with cerebrovascular diseases from Jan .2011 to Jun .2013 .The pathogenic bacteria were isolated ,cultured and identified .The WHONET 5 .5 soft‐ware was used to process the data .RESULTS Totally 369 out of 3 978 patients with cerebrovascular diseases had nosocomial infection .The infection rate was 9 .3% .The infection sites were mostly respiratory tract (55 .3% ) , followed by urinary tract (24 .1% ) .Totally 407 pathogenic bacteria were isolated ,including gram negative bacte‐ria (70 .3% ) ,gram positive bacteria (24 .1% ) and fungi (5 .6% ) .Detection rate of methicillin‐resistant Staphy‐lococci (MRS) was 51 .7% .The detection rates of pan‐resistant Pseudomonas aeruginosa and Acinetobacter bau‐mannii were 16 .5% and 21 .8% ,respectively .The detection rate of ESBLs‐producing K lebsiella pneumoniae and Escherichia coli were 55 .0% .CONCLUSION The patients with cerebrovascular diseases were prone to nosocomial infection .The antimicrobial resistance was increasing .Therefore ,the effective measures should be carried out and the management of antibacterial use should be strengthened to prevent and control the outbreak and prevalence of nosocomial infection .%目的:探讨医院脑血管疾病住院患者医院感染的易感部位及病原菌耐药性,为预防脑血管疾病患者继发医院感染及感染控制提供实验室参考依据。方法调查2011年1月-2013年6月收治的3978例脑血管疾病患者的临床资料;病原菌分离培养及菌种鉴定;数据处理采用WHONET 5.5软件。结果3978例脑血管

  4. Prospective analysis of nosocomial infection rates, antibiotic use, and patterns of resistance in a burn population.

    Science.gov (United States)

    Wibbenmeyer, Lucy; Danks, Roy; Faucher, Lee; Amelon, Marge; Latenser, Barbara; Kealey, G Patrick; Herwaldt, Loreen A

    2006-01-01

    Despite significant advances in burn care, infection remains a major cause of morbidity and mortality in burn patients. We sought to determine accurate infection rates, risk factors for infection, and the percentage of infections caused by resistant organisms. In addition, we attempted to identify interventions to decrease the use of antimicrobial drugs. Data were collected prospectively from 157 burn patients admitted to the University of Iowa Carver College of Medicine burn treatment center from October 2001 to October 2002. A research assistant reviewed the medical record for each patient identified by burn surgeons as being infected to determine whether these episodes met the infection control criteria for nosocomial infections. The infection control assessment agreed with the surgeon's assessment for 16.7% of the pneumonias, 70.0% of the burn wound infections, 57.1% of the urinary tract infections, and 70.0% of the bloodstream infections. By multiple logistic regression analysis, body surface area burned, comorbidities, and use of invasive devices were significantly related to acquisition of nosocomial infections as identified by both the burn surgeons and the infection control criteria. Staphylococcus aureus and Pseudomonas were the most common resistant organisms identified. In our population, surgeons could decrease antimicrobial use by using explicit criteria for identifying patients with hospital-acquired infections, limiting perioperative prophylaxis to patients at highest risk of infection, and decreasing the incidence of nosocomial infection with reduced use of devices and strict adherence to aseptic technique.

  5. Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections

    Directory of Open Access Journals (Sweden)

    Gajović Olgica

    2011-01-01

    Full Text Available Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30% patients developed nosocomial pneumonia. The time to develop pneumonia was 10±6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS score <9, mechanical ventilation, duration of mechanical ventilation, tracheostomy, presence of nasogastric tube and enteral feeding. The most commonly isolated pathogens were Klebsiella-Enterobacter spp. (33.3%, Pseudomonas aeruginosa (24.1%, Acinetobacter spp. (16.6% and Staphylococcus aureus (25.9%. Conclusion. Nosocomial pneumonia is the major cause of morbidity and mortality of patients with central nervous system infections. Patients on mechanical ventilation are particularly at a high risk. The mortality rate of patients with nosocomial pneumonia was 54.4% and it was five times higher than in patients without pneumonia.

  6. Impact of nosocomial infections surveillance on nosocomial infection rates: A systematic review.

    Science.gov (United States)

    Li, Ye; Gong, Zhenyu; Lu, Ye; Hu, Guoqing; Cai, Ran; Chen, Zhiping

    2017-06-01

    According to previously studies, nosocomial infections (NIs) surveillance could effectively reduce infection rates. As NIs surveillance systems have been implemented in some hospitals for several years, their impact on NIs need to be explored. Therefore, the purpose of this review is to evaluate the tendency of NI rates during the surveillance period and the impact of surveillance on NI rates. A systematic literature search of the PubMed database to identify papers that evaluated effect of surveillance on NIs, all kinds of NIs occurred during hospitalization or discharged were included. Exclude articles investigated the surveillance combined with other infection control measures. Twenty-five articles were included. NI rates had different levels of reduction during surveillance period, the reduction were not limited by state, department, surveillance system, and NI type. Continuous surveillance had a positive impact on NI, OR/RR were ranged from 0.43 to 0.95. Participation in NI surveillance is associated with reducing infection rates, though RCTs need to further prove the effective role of surveillance. Hospitals may consider to perform NIs surveillance systems according to its own conditions. Copyright © 2017. Published by Elsevier Ltd.

  7. Nursing workload in an intensive care unit and its relation with nosocomial infection incidence

    Directory of Open Access Journals (Sweden)

    Rosana Alameda Varela

    2011-03-01

    Full Text Available Nosocomial infection is one of the most common causes of adverse events and complications related to health care. Development of nosocomial infection is associated with an increase in hospital stay and mortality and an overall increase in health care costs. Knowing the incidence of nosocomial infection is an effective way of controlling and preventing it. Identifying the relationship between nursing workload and nosocomial infections in critical care may be helpful to adjust the staff to the real requirements of the intensive care unit and may help reducing costs. The aim of the present study is to analyze the influence of nursing workload in the development of nosocomial infections in patients admitted to an intensive care unit. A longitudinal correlational research will be performed. The sample will be comprised of the patients admitted in the intensive care unit of the Hospital Universitario Fundación Alcorcón.Data regarding sociodemographical variables, ventilador-associated pneumonia, intravascular catheter location and duration, urinary catheter type and duration, and all pertinent cultures will be obtained from the medical records. Nursing Activities Score scale will be used to assess daily nursing workload in the unit. The number of patients admitted daily, as well as the number of nursing professionals working in each shift will also be taken into account.

  8. 淋巴瘤化疗患者医院感染病原菌分析及护理对策%Pathogenic bacteria causing nosocomial infections in lymphoma patients undergoing chemotherapy and nursing countermeasures

    Institute of Scientific and Technical Information of China (English)

    周小艳

    2013-01-01

    OBJECTIVE To study the distribution of the pathogens causing nosocomial infections in lymphoma patients undergoing chemotherapy so as to guide the clinical nursing. METHODS A total of 120 patients with nosocomial infections were chosen as the study objects during the chemotherapy of lymphoma, The oral cavity, sputum, urine,and blood were sampled for the bacterial cultured and drug susceptibility testing. RESULTS The nosocomial infections frequently occurred in 7 to 14 days after the chemotherapy. Of all the patients investigated, there were 89(74. 17%) patients with pulmonary infections, 19 (15. 83%) patients with urinary tract infections, and 12 (10. 00%) patients with other infections. A total of 196 strains of pathogenic bacteria were isolated,among which Klebsiella pneumonia and Escherichia coli were the predominant species and were highly sensitive to imipenem, the drug resistance rates were 0 and 1. 39%, respectively, while the two species were not sensitive to amikacin, gentamicin, ampicillin, piperacillin, cefuroxime, axtreonam, ciprofloxacin, cefoperazone/sulbactam, cefepime and meropenem. Totally 34 patients were tested with the fungal infections, and Candida albicans, Candida tropicalis, Aspergillus, and Mucoraceae were the most prevalent pathogens. CONCLUSION It is necessary to strengthen the nursing interventions in the patients undergoing lymphoma chemotherapy so as to prevent the nosocomial infections. It is of great significance in guiding the clinical treatment to perform the bacterial culture and drug susceptibility testing.%目的 观察淋巴瘤化疗患者医院感染病原菌的分布特点,为临床护理工作提供指导.方法 选取120例淋巴瘤化疗期间并发医院感染的患者,留取口腔、痰、尿、血液等进行细菌培养及药敏试验.结果 医院感染多发生于化疗的7~14 d;本组患者肺部感染89例,占74.17%,泌尿系感染19例,占15.83%,其他感染12例,占10.00%;培养共检出病原菌196

  9. [Secular trends in the etiology of nosocomial infection at a teaching hospital in Taiwan, 1981-1994].

    Science.gov (United States)

    Chen, M L; Chen, Y C; Pan, H J; Chang, S C; Yang, L S; Ho, S W; Luh, K T; Hsieh, W C; Chuang, C Y

    1995-08-01

    Surveillance system of nosocomial infection was established in 1980 at the National Taiwan University Hospital (NTUH). To identify pathogens and the secular trends in the etiology of nosocomial infection from 1981 to 1994, the prospective, hospital-wide nosocomial surveillance data were analysed. During this period, 22,146 pathogens causing nosocomial infections were isolated. Gram-negative aerobic bacteria remained the major pathogens, but gram-positive cocci and fungi increased rapidly in the past 14 years. When the overall pathogen distribution is examined, Pseudomonas areuginosa was the most frequently isolated pathogen, but Candida albicans and other yeasts have taken the leading position since 1993. Staphylococcus aureus and coagulase-negative staphylococci also increase significantly in recent years. When the pathogens causing infection at the 4 major sites were examined. P. aeruginosa was the pathogen most often associated with respiratory tract and surgical wound infections. In blood stream and urinary tract infections, we observed Escherichia coli was replaced by C. albicans and other yeasts as a most common isolate in these years. In addition, C. albicans and other yeasts and methicillin-resistant S. aureus (MRSA) are emerging as major nosocomial pathogens at NTUH. C. albicans and other yeast increased from 1.8% in 1981 to 14.9% in 1994 in the overall nosocomial infection. The increase was found in the blood stream (2.1% to 16.2%) and urinary tract infections (5.4% to 24.7%). Of 1,742 nosocomial S. aureus isolates, the percentage of MRSA rose from 12.5% in 1981 to 55.2% in 1994. The high percentage of MRSA was observed at 4 major anatomic sites of infection. In summary, significant shifts in the pathogens of nosocomial infection have occurred in the past 14 years at NTUH, and the distribution of nosocomial pathogens was similar to those reported in the United States in recent years.

  10. Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study

    NARCIS (Netherlands)

    M.C. Vos (Margreet); A. Ott (Alewijn); A. Voss (Andreas); J.A.J.W. Kluytmans (Jan); C.M.J.E. Vandenbroucke-Grauls (Christina); M.H.M. Meester (Marlene); P.H.J. van Keulen (Peter); H.A. Verbrugh (Henri); H.F.L. Wertheim (Heiman)

    2004-01-01

    textabstractBACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical patients

  11. Distribution of pathogens causing nosocomial infections in patients undergoing gastrointestinal endoscopy and prevention measures%消化内镜室患者医院感染病原菌分布与预防措施研究

    Institute of Scientific and Technical Information of China (English)

    蔡晓美; 任艳蕊; 左绪艳; 杨柳; 芦芬; 杜芳芳

    2015-01-01

    OBJECTIVE To explore the distribution of pathogens causing nosocomial infections in the patients un‐dergoing gastrointestinal endoscopy and put forward the prevention measures so as to reduce the incidence of the nosocomial infections .METHODS A total of 834 patients who underwent the gastrointestinal endoscopy from Jan 2012 to Jun 2014 were enrolled in the study ,then the clinical data of the patients were retrospectively analyzed , the types of the nosocomial infections and the distribution of the pathogens were observed ,the prevention meas‐ures were put forward ,and the statistical analysis was performed with the use of SPSS17 .0 software .RESULTS The nosocomial infections occurred in 98 of 834 patients with the infection rate of 11 .75% ,of whom 40 .82% had the digestive system infections ,18 .37% had the upper respiratory tract infections ,17 .35% had the lower respira‐tory tract infections ,and 11 .22% had the urinary tract infections .Totally 98 strains of pathogens have been isola‐ted ,including 49 (50 .00% ) strains of gram‐negative bacteria ,43 (43 .88% ) strains of gram‐positive bacteria ,and 6 (6 .12% ) strains of fungi;the Pseudomonas aeruginosa ,Klebsiella pneumoniae ,and Acinetobacter baumannii were dominant among the gram‐negative bacteria;the Staphylococcus aureus and Staphylococcus epidermidis were the predominant species of gram‐positive bacteria;the Candida albicans was the major species of fungi .The qualified rates of the gastroscopes ,enteroscopes ,sinks ,disinfectants ,and hand hygiene of health care workers were significantly higher after the interventions were taken than before they were taken(P<0 .01) .CONCLUSION It is an effective way to carry out the detection of the pathogens causing the nosocomial infections in the patients undergoing the gastrointestinal endoscopy and take the targeted prevention measures so as to reduce the incidence of the nosocomial infections .%目的:探讨消化内镜室患者医院感染的

  12. Nosocomial infections at Clinical Centre in Kragujevac: Prevalence study

    Directory of Open Access Journals (Sweden)

    Ilić Milena

    2010-01-01

    Full Text Available Introduction Nosocomial infections (NIs are a serious health problem in hospitals worldwide and are followed by a series of consequences, medical, judicial, ethical and economic. Objective The main aim of this study was to assess the magnitude of NIs at the Clinical Centre in Kragujevac. Methods A prevalence study of nosocomial infections was conducted from 16th till 20th May, 2005, within Second National Prevalence Study of Niš in the Republic of Serbia. Results The study included 866 patients. 40 patients had a NI, thus the prevalence of patients with NIs and prevalence of NIs was the same, 4.6%. Among NIs, the most frequent were urinary infections (45.0% followed by surgical-site infections (17.5%, skin and soft tissue infections (15% and pneumonia (12.5%. The rate of NIs was highest at departments of orthopaedics and traumatological surgery (12.0%, followed by intensive care units (8.0%. Overall, 67.5% (27/40 NIs were culture-proved; the leading pathogens were Escherichia coli (40.0%, followed by gram-negative bacteria (Pseudomonas species, Proteus mirabilis, Enterobacteriaceae with equal frequency of 8.0%. Nosocomial infections were significantly more frequent in patients aged ≥65 years (p<0.05, with longer hospitalization ≥8 days (p<0.00, in intensive care patients (p<0.05, patients with an intravenous catheter (p<0.00, urinary catheter (p<0.00, and those under antibiotic therapy (p<0.00. Conclusion This study showed that the prevalence of nosocomial infections in our hospital is similar to the prevalence in the developed countries. The study of prevalence provides a prompt insight into basic epidemiological and ethiological characteristics of nosocomial infections, hence identification of hospital priorities and the need to undertake appropriate prevention measures. .

  13. Influence factors causing nosocomial infection to superficial bladder cancer patients after surgery%浅表性膀胱癌患者术后医院感染影响因素分析

    Institute of Scientific and Technical Information of China (English)

    高凤蕊; 金婷婷; 刘伟

    2014-01-01

    目的:探讨浅表性膀胱癌患者术后医院感染危险因素,旨在为采取针对性的预防干预措施提供参考依据。方法选取泌尿外科2011年6月-2013年6月收治的375例浅表性膀胱癌手术患者临床资料,分析浅表性膀胱癌术后医院感染的影响因素,并制定针对性的预防干预措施;采用SPSS18.0软件进行统计分析。结果375例浅表性膀胱癌患者术后发生医院感染54例,感染率为14.40%;在送检的54例标本中50份检出病原菌,检出率为92.59%,共分离出病原菌52株,其中革兰阴性菌38株占73.08%;革兰阳性菌11株占21.15%;真菌3株占5.77%,前3位病原菌依次为大肠埃希菌、变形菌属、粪肠球菌,分别占30.77%、17.31%、11.54%;糖尿病(OR=3.328,P<0.01)和术前因尿潴留行导尿术(OR=7.406,P<0.01)是浅表性膀胱癌术后医院感染发生的危险因素。结论手术治疗浅表性膀胱癌术后医院感染率较高,病原菌以革兰阴性菌为主,其感染发生的影响因素众多,应采取针对性的预防干预措施减少医院感染的发生。%OBJECTIVE To investigate the influence factors causing nosocomial infections to superficial bladder cancer patients after surgery so as to provide reference basis for taking specific intervening measures .METHODS The clinical data of 375 cases of superficial bladder cancer patients who were treated in the urology department from Jun 2011 to Jun 2013 were selected to analyze the influence factors causing nosocomial infections after super-ficial bladder cancer surgery and to establish specific intervening measures ;SPSS 18 .0 software was adopted for statistical analysis .RESULTS Totally 54 of the 375 superficial bladder cancer patients suffered from nosocomial in-fections after surgery ,with an infection rate of 14 .40% .Pathogens were detected from 50 of the 54 specimens submitted for test ,with a

  14. SMART approaches for reducing nosocomial infections in the ICU.

    Science.gov (United States)

    Kollef, Marin

    2008-08-01

    Nosocomial infections are problematic in the ICU because of their frequency, morbidity, and mortality. The most common ICU infections are pneumonia, bloodstream infection, and urinary tract infection, most of which are device related. Surgical site infection is common in surgical ICUs, and Clostridium difficile-associated diarrhea is occurring with increasing frequency. Prospective observational studies confirm that use of evidence-based guidelines can reduce the rate of these ICU infections, especially when simple tactics are bundled. To increase the likelihood of success, follow the specific, measurable, achievable, relevant, and time bound (SMART) approach. Choose specific objectives that precisely define and quantify desired outcomes, such as reducing the nosocomial ICU infection rate of an institution by 25%. To measure the objective, monitor staff adherence to tactics and infection rates, and provide feedback to ICU staff. Make objectives achievable and relevant by engaging stakeholders in the selection of specific tactics and steps for implementation. Nurses and other stakeholders can best identify the tactics that are achievable within their busy ICUs. Unburden the bedside provider by taking advantage of new technologies that reduce nosocomial infection rates. Objectives should also be relevant to the institution so that administrators provide adequate staffing and other resources. Appoint a team to champion the intervention and collaborate with administrators and ICU staff. Provide ongoing communication to reinforce educational tactics and fine-tune practices over time. Make objectives time bound; set dates for collecting baseline and periodic data, and a completion date for evaluating the success of the intervention.

  15. [Nosocomial infections and quality of health care].

    Science.gov (United States)

    Navarrete-Navarro, S; Rangel-Frausto, M S

    1999-01-01

    The main objective of a hospital-acquired infections control program is to decrease the risk of acquisition and the morbidity and costs associated. The organization of a team with technical and humanistic leadership is essential. Every infection control program must also develop strategies that allow: a) identification of the problems, b) to establish the importance of each one, c) to determine their causes, d) to develop solutions and e) the evaluation of the recommended solutions. The development of technical and humanistic abilities by the leader and the members of the team, and the use of the tools mentioned above have produced the only validate and highly effective program of quality improvement in the hospital.

  16. Comparison of two nosocomial infection surveillance in a neonatal ward

    Directory of Open Access Journals (Sweden)

    Masomeh Abedini

    2014-01-01

    Conclusion: It seems that a large part of this considerable differences between the results of this study compared to NNIS based study, is this fact that, for nosocomial infection surveillance in the neonatal field, the presence of a specialist as a performer and leader of the team, is necessary.

  17. [Current status of nosocomial infections in the Lebanese Hospital Center, Beirut].

    Science.gov (United States)

    Al-Hajje, A; Ezedine, M; Hammoud, H; Awada, S; Rachidi, S; Zein, S; Salameh, P

    2012-05-01

    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 Escherichia 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.

  18. [Mortality associated with nosocomial infection, occurring in a general hospital of Sumaré-SP, Brazil].

    Science.gov (United States)

    Guimarães, Aline Caixeta; Donalisio, Maria Rita; Santiago, Thaiana Helena Roma; Freire, June Barreiros

    2011-01-01

    This study investigated the socio-demographic profile, clinical procedures and etiology of nosocomial infection associated with deaths in the Hospital Estadual Sumaré, state of São Paulo, Brazil, from 2007 to 2008. The retrospective study of medical records (n = 133) revealed an average of 35 days of hospitalization. Most patients (97%) underwent some invasive procedure associated with nosocomial infection (p ≤ 0.05), including: 90 (67.7%) pneumonia, 62 (46.6%), urinary infections and 97 (73%) septicemia. Infection was the leading cause of death in 75 (56.4%) cases, with defined etiology in 110 (82.7%); 34 (30.9%) because of microorganisms that were multidrug-resistant. The most common was Staphylococcus aureus (25%), related to pneumonia and blood stream infection. The monitoring of hospital infection contributed to intervention at risk situation and death.

  19. [Antibibiotic resistance by nosocomial infections' causal agents].

    Science.gov (United States)

    Salazar-Holguín, Héctor Daniel; Cisneros-Robledo, María Elena

    2016-01-01

    Introducción: la resistencia a antimicrobianos por agentes causales de infección nosocomial (IN) constituye un grave problemática global que involucra al HGR 1 del IMSS en Chihuahua, México; si bien con particularidades que requirieron especificarla y evaluarla, a fin de concretar una terapéutica eficaz. Métodos: estudio observacional, descriptivo y prospectivo; se llevó a cabo mediante vigilancia activa durante 2014 para la detección de infecciones nosocomiales, su estudio epidemiológico, cultivo y antibiograma para identificar al agente causal y su resistencia a los antibióticos. Resultados: de 13527 egresos hospitalarios, 1079 presentaron IN (8 por 100 egresos) y de ellas destacaron: de líneas vasculares, quirúrgicas, neumonía y de vías urinarias; sumando dos tercios del total. Se realizó cultivo y antibiograma en 300 de ellas (27.8 %); identificando 31 especies bacterianas, siendo siete las principales (77.9 %): Escherichia coli, Staphylococcus aureus y epidermidis, Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae y Enterobacter cloacae; mostrando multirresistencia a 34 antibióticos probados, excepto en siete con baja o nula resistencia: vancomicina, teicoplanina, linezolid, quinupristina-dalfopristina, piperacilina–tazobactam, amikacina y carbapenémicos. Conclusiones: al contrastar tales resultados ante las recomendaciones de las guías de práctica clínica, surgieron contradicciones; por lo que deben tomarse con reserva y ser probadas en cada hospital, mediante cultivos y antibiogramas en prácticamente todos los casos de infección nosocomial.

  20. A multicentre analysis of epidemiology of the nosocomial bloodstream infections in Japanese university hospitals.

    Science.gov (United States)

    Nagao, M

    2013-09-01

    Nosocomial bloodstream infections (BSIs) are an important cause of morbidity and mortality. The current study analysed data from a concurrent surveillance programme to examine the current epidemiological trends for nosocomial BSIs at 22 Japanese university hospitals from 1 April 2008 to 31 March 2012. The number of blood culture sets taken, the rate of multiple blood culture sets and the rates of antibiotic-resistant isolates among six major nosocomial BSI pathogens (Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Candida spp.) not including coagulase-negative staphylococci, were evaluated. The clinical characteristics of nosocomial BSIs caused by these pathogens were also collected for 2941 patients. The number of blood culture sets taken per bed increased during the 4-year study period (from 4.07 in 2008 to 5.37 in 2011), and the rates of multiple blood culture sets also increased (from 29.9% in 2008 to 50.0% in 2011). Methicillin resistance was detected in 50.2% of S. aureus isolates. The prevalence rates of extended-spectrum beta-lactamase-producing E. coli and Klebsiella spp. isolates increased annually during the study period, and the average prevalence rates were 12.3% and 5.8%, respectively. The overall crude mortality of nosocomial BSIs due to the six pathogens evaluated was 24.5% (43.2% in ICU settings and 20.5% in non-ICU settings). Thus, our multicentre study evaluated the current epidemiological trends for nosocomial BSIs, and we found that further efforts are needed to increase the use of multiple blood culture sets and improve the prognosis of nosocomial BSIs in Japanese university hospitals.

  1. Imipenem-resistant Pseudomonas aeruginosa: risk factors for nosocomial infections.

    Science.gov (United States)

    Onguru, Pinar; Erbay, Ayse; Bodur, Hurrem; Baran, Gulseren; Akinci, Esragul; Balaban, Neriman; Cevik, Mustafa Aydin

    2008-12-01

    The aim of this study was to determine the risk factors for nosocomial infections of imipenem-resistant Pseudomonas aeruginosa (IRPA). A prospective case-control study was performed at a tertiary care hospital in Ankara from January to December 2004. The patients with nosocomial P. aeruginosa infection were included in the study. The features of the patients with IRPA infections were compared to those with imipenem-sensitive P. aeruginosa (ISPA) infections. Only the first isolation of P. aeruginosa was considered. Nosocomial infections were defined according to Center for Disease Control (CDC) criteria. IRPA was isolated from 75 (44.1%) patients, and ISPA was isolated from 95 (55.9%) patients during the study period. IRPA were most frequently isolated from endotracheal aspirate (19%) cultures (p=0.048), whereas ISPA were most frequently isolated from urine (28%) cultures (p=0.023). In multivariate analysis, a longer duration of hospital stay until P. aeruginosa isolation (odds ratio [OR], 1.027; 95% confidence interval [CI], 1.002-1.054, p=0.034), arterial catheter administration (OR, 2.508; 95% CI, 1.062-5.920, p=0.036), vancomycin (OR, 2.882; 95% CI, 1.130-7.349, p=0.027), piperacillin-tazobactam (OR, 6.425; 95% CI, 2.187-18.875, p=0.001), and imipenem (OR, 3.580; 95% CI, 1.252-10.245, p=0.017) treatment within the 14 days before isolation of IRPA were independently associated with imipenem resistance. It was concluded that treatment with imipenem, vancomycin and piperacillin-tazobactam were major risk factors for IRPA infections in hospitalized patients. The nosocomial occurrence of IRPA was also strongly related to the duration of hospital stay, arterial catheter administration.

  2. 2013年医院感染病原菌分布及耐药性分析%Analysis on Distribution and Drug Resistance of Pathogens Causing Nosocomial Infection in 2013

    Institute of Scientific and Technical Information of China (English)

    胡振明; 幸勇; 牟必鸿; 刘福

    2015-01-01

    Objective To understand the distribution situation and drug resistance of pathogens causing nosocomial infections during 2013 to provide reference for clinically rational drug use. Methods The sources of pathogens causing nosocomial infections and the drug sus-ceptibility results in a hospital during 2013 were performed the retrospective analysis. Results Totally 64 024 inpatients were monitored during 2013, nosocomial infection occurred in 892 cases ( 1. 39% ) . The common infection sites were the lower respiratory tract, surgical incision and urinary tract;among 423 submitted samples for pathogens detection, 273 strains of pathogens were isolated, in which Gam-negative bacilli accounted for 68. 13%, including Escherichia coli, Klebsiella pneumoniae of Enterobacteriaceae, and Pseudomonas aerugi-nosa and Acinetobacter baumannii of non-fermenting bacteria. The detection rate of ESBLs-producing E. coli was 61. 11% and which of ESBLs-producing K. pneumoniae was 42. 11% ; the drug resistance of A. baumannii was relatively serious, the resistance rate to imipenem was up to 80. 56%;Gram-positive cocci occupied 24. 91%, which mainly was S. aureus, and the detection rate of MRSA was 34. 62%, and no Vancomycin-resistant Staphylococcus aureus was detected. Conclusion The use and management of antibacterial drugs should be strengthened in order to control the drug resistance of bacteria; the monitoring of drug resistance, disinfection, isolation and standardized hand washing of medical staff should be strengthened in order to reduce the dissemination of drug resistant bacteria.%目的:了解2013年医院感染病原菌的分布情况及耐药性,为临床合理选药提供参考。方法回顾性分析2013年某院医院感染病原菌的来源及药物敏感性试验结果。结果共监测住院患者64024例,医院感染率为1.39%(892例),常见感染部位为下呼吸道、手术切口、泌尿道;423例送检病原学标本,分离出病原菌273株

  3. [Prevention of nosocomial infections and antibiotic resistance in nursing homes].

    Science.gov (United States)

    Bleckwenn, Markus; Hammerschmidt, Judith; Rösing, Claudia; Klaschik, Manuela

    2017-06-14

    Nosocomial infections and multidrug-resistant organisms are an increasing problem in nursing homes worldwide; therefore, new approaches for infection control need to be developed. This article gives an overview of infections in nursing homes, their medical treatment and previous measures for infection prevention. The article is based on a selective literature search including the literature database PubMed. In particular, scientific studies on the prevalence of nosocomial infections in German nursing homes, publications for medical care in long-term care facilities in Europe and international studies for infection prevention were evaluated. The basis for an effective reduction of infections is the establishment of a surveillance system. All participating medical professionals provide feedback about local infections and resistance situations and the presence of risk factors, such as urinary catheters or chronic wounds. Only then can targeted antibiotic strategies be adapted and the effectiveness of preventive measures, such as hand disinfection is continuously reviewed. So far, in particular multimodal, multidisciplinary prevention projects were successful. These included frequent staff training, reduction of urinary catheters and a rational use of antibiotics. Most prevention models have been previously tested in hospitals. A possible applicability of the results to the infection prevention in long-term care facilities has so far hardly been studied. Accordingly, further studies on infection control in nursing homes are absolutely necessary.

  4. Antimicrobial resistance of Pseudomonas aeruginosa causing nosocomial infection in department of general surgery%医院普外科感染铜绿假单胞菌的耐药性

    Institute of Scientific and Technical Information of China (English)

    王群兴; 叶湘; 何晓雯; 余良芳; 周宜兰

    2011-01-01

    OBJECTIVE To investigate antimicrobial resistance of Pseudomonas aeruginosa (PAE) causing nosocomial infection in department of general surgery in our hospital and provide the scientific evidence for clinically reasonable use of antibiotics. METHODS Referring to National Guide to Clinical Laboratory Procedures, the bacterial culture and identification were performed. The susceptibility testing was performed by K-B methods recommended by CLSI. RESULTS Among 158 isolates of PAE, resistance rates of imipenem,meropenem, amikacin piperacillin/tazobactam and cefoperazone/sulbactam were the lowest, arriving at 11.4 %-14.6%. The resistance rate of trimethoprim-sulfamethoxazole (60. 1%) was the highest. The detection rate of pan-resistant PAE was 9. 5%. CONCLUSIONS The microbiologists in department of clinical laboratory should monitor dynamically and publish regularly the bacterial drug resistance to control multiresistant strains causing nosocomial infection.%目的 探讨医院普外科感染铜绿假单胞菌(PAE)的耐药特性,为临床医师合理用药提供科学依据.方法 细菌培养和菌株鉴定严格按照进行,采用CLSI推荐的K-B法进行药敏试验和判断结果.结果 普外科158株PAE对亚胺培南、美罗培南、阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦耐药率较低,在11.4%~14.6%;耐药率最高的抗菌药物是磺胺甲嗯唑/甲氧苄啶,为60.1%;PAE泛耐药菌株检出15株,检出率为9.5%.结论 检验科临床微生物室应对细菌耐药性进行动态监测和定期公示,有效控制多药耐药细菌医院感染.

  5. Nosocomial Infections among Pediatric Patients with Neoplastic Diseases

    OpenAIRE

    Peninnah Oberdorfer; Natthida Pongwilairat; Washington, Charles H

    2009-01-01

    Background. Pediatric patients with neoplastic diseases are more likely to develop nosocomial infections (NIs). NIs may prolong their hospital stay, and increase morbidity and mortality. Objectives. The objectives of this study were to determine: (1) the incidence of NIs, (2) sites of NIs, (3) causal organisms, and (4) outcomes of NIs among pediatric patients with neoplastic diseases. Methods. This study was a prospective cohort study of pediatric patients with neoplastic diseases who were ad...

  6. Nosocomial infection and civil liability in Brazilian courts

    Directory of Open Access Journals (Sweden)

    CARVALHO DA SILVA, José Marcio

    2015-07-01

    Full Text Available Nosocomial infection is notoriously one of the primary problems faced by healthcare insti-tutions and by professionals who work for them. This fact is demonstrated by the growing number of legal actions proposed in the legal system by patients and users of the health care system. Because of this scenario, the phenomenon of civil liability has arisen in cases of noso-comial infection. The legal implications of this phenomenon are varied and involve issues of the institutional environment and of professional conduct. Thus, the current study seeks to analyze the literature on the decisions taken by Brazilian courts regarding civil liability in cases of nosocomial infection. Conceptual aspects that define this healthcare problem are listed, as are the types of civil liability, the legal directives that guide conduct regarding this topic, and the decisions of Brazilian courts that consider civil liability in these cases. It was determined that the courts have been supported by the distinction between objective civil liability and subjective civil liability; additionally, it was determined that these courts are guided by the understanding of the existing service relationship between the institution or health care professional and the patient or user of the health care system.

  7. Surveillance of nosocomial infections in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, 1999-2002

    Directory of Open Access Journals (Sweden)

    Djoko Widodo

    2004-06-01

    Full Text Available Nosocomial infection are one of the main problem in hospital which are associated with significant morbidity, mortality and increased economic cost. Surveillance should be attempted regularly to obtain local data of incidence of nosocomial infections, types of infection, pathogen and resistance pattern. We reported the results of nosocomial surveillance in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, in year 1999 to 2002. The data were obtained from surveillance, conducted by Nosocomial Infection Control Committee. Surveillance were performed to patient in risk of nosocomial infections such as underwent surgical procedure, urinary catheter, peripheral or central venous catheter, ventilator and other invasive procedure. Criteria for nosocomial infection which were used, based on technical guidelines of nosocomial infection in Dr. Cipto Mangunkusumo National General Hospital, year 1999; which referred to CDC definition of nosocomial infections. Incidence rate of nosocomial infections in year 1999, 2000, 2001 and 2002 were 1.1, 0.9, 0.6 and 0.4 % respectively. Type of nosocomial infection include catheter related, surgical wound, urinary tract and respiratory tract infections, ranged between 0 to 5.6 %. Gram negative bacteria consist of Pseudomonas sp, Enterobacter aerogenes, Escherichia coli, Proteus mirabilis were the most common nosocomial pathogen. Gram positive bacteria consist of Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus anhemolyticus. Trend of increasing incidence of Gram positive nosocomial infection also showed in our surveillance. Mostly Gram negative bacteria had been resistant to penicillin, co amoxicillin-clavulanic acid and 3rd generation cephalosporin, but still sensitive to 4th generation cephalosporin and aminoglycoside. The Gram positive bacteria were still sensitive to penicillin, co amoxicillin-clavulanic acid, 4th generation cephalosporin and aminoglycoside. (Med J Indones 2004; 13: 107

  8. Prevalence study of nosocomial infections in a north-Bari region hospital in the years 2007-2010

    Directory of Open Access Journals (Sweden)

    Tito Del Gaudio

    2012-09-01

    Full Text Available Nosocomial infections, arising from complications during hospital treatment, represent one of the most important cause of disease. The Andria hospital has initiated a prevalence study, as a part of a general program promoted by the “Agenzia Regionale per la Sanità” (Regional Health Board of Regione Puglia. Samples were collected from patients hospitalized in the period 2007 - 2010. Risk factors, ongoing infections, selected antibiotic therapy, site of infection, microorganism types, as well as patient’s clinic and personal data, were all elements taken into account. The study shows that nosocomial infections, due to different health care related risk factors, are most frequently encountered in Intensive Care Units. A poor adhesion to the Regione Puglia antibiotic prophylaxis guidelines was observed in surgery. An insufficient use of cultural methods to confirm/diagnose the presence of bacterial infections was also observed; this fact could lead to underestimate the incidence of nosocomial infections.

  9. Distribution and antimicrobial resistance of pathogenic bacteria causing nosocomial infections in tumor patients%肿瘤患者医院感染病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    王军; 余清源; 刘华; 瞿秀

    2014-01-01

    OBJECTIVE To understand clinical characteristics ,distribution and antimicrobial resistance of pathogen-ic bacteria causing nosocomial infections in tumor patients in the mountain hospital and offer a reference for clinical anti-infective treatment .METHODS The clinical records were reviewed for 226 tumor patients with nosocomial infections .Infective specimens were collected for bacterial culture and identification by the routine microbiological methods .The susceptibility test was performed by K-B method recommended by CLSI .Measurement of diameter of inhibitor zones and classification of susceptibility ,intermediate and resistance were done according to the newest breakpoints of CLSI .The WHONET 5 .5 software was used to process the data .RESULTS The main sites of nos-ocomial infections were lower respiratory tract and urinary tract .Totally 261 pathogenic bacteria were isolated from 226 infective specimens .Pathogenic bacteria mainly included Pseudomonas aeruginosa (22 .6% ) ,K lebsiella pneumoniae (16 .5% ) , Staphylococcus aureus (13 .4% ) , E . coli (10 .7% ) and Acinetobacter baumannii (9 .6% ) .Susceptibility testing indicated that the above pathogens were multi-resistant to commonly used antibiot-ics .Imipenem-resistant P . aeruginosa and A . baumannii accounted for 16 .9% and 20 .0% , respectively . CONCLUSION It was critical to interfere and control nosocomial infections to treat tumor patients successfully .It was suggested that the clinician should reduce invasive medical procedures and apply the antibiotics reasonably in order to change the adverse tendency of the rapid growth of bacterial resistance and increase the clinical cure rate .%目的:了解山区医院肿瘤患者继发医院感染的临床特点、病原菌分布及耐药性,为有效治疗医院感染提供合理用药的实验室参考依据。方法调查2009年1月-2012年12月发生医院感染的226例肿瘤患者临床资料;标本留取、病原菌培养与鉴定均严格

  10. linical characteristics of nosocomial infections of patients with acute central nervous system infections treated in ICU

    Directory of Open Access Journals (Sweden)

    Olgica Gajović

    2011-08-01

    Full Text Available A retrospective study was performed to evaluate the clinical characteristics of nosocomial infections in patients with acute infection of central nervous system (ACNS infections. The study included 1,686 patients admitted to the ICU. Of 1,686 patients, 936 (55.5% had ACNS infection. Nosocomial infections was confirmedin 221 (23.6% patients with ACNS infection. The most common risk factors for ICU-acquired nosocomial infections were consciousness disorder, mechanical ventilation and nasogastric tube. The coagulase – negative Staphylococcus aureus was the most frequent isolated pathogen (285 isolates, 56.5%. Results suggest that a persistently high level of therapeutic activity and persistently depressed consciousness after the ICU admission are associatedwith the occurrence of hospital-acquired infection in critically ill patients hospitalized at a medical ICU.

  11. Nosocomial infections in the medical ICU: a retrospective study highlighting their prevalence, microbiological profile and impact on ICU stay and mortality.

    Science.gov (United States)

    Pradhan, Neeta P; Bhat, S M; Ghadage, D P

    2014-10-01

    1. To study the prevalence of nosocomial infections in the Medical ICU. 2. To determine common microorganisms causing nosocomial infections in the ICU and their antibiotic- sensitivity profile. 3. To study the impact of nosocomial infections on ICU stay and mortality. A retrospective 1 year analysis of nosocomial infections in the Medical ICU at Smt. Kashibai Navale Medical College and Hospital, Pune, between January and December 2011 was carried out. Prevalence of nosocomial infections was determined; sites of nosocomial infections and common causative microorganisms were identified; their antibiotic-sensitivity profiles were studied. The group of patients with nosocomial infections was matched with a control group drawn from the pool of patients without nosocomial infections; this matching was done with respect to age, gender and clinical diagnosis. Period of ICU stay and patient mortality rates in the two groups were analysed. A total of 366 ICU patient records were analysed. Of these, 32 patients were found-to have developed 35 nosocomial infections (9.6% prevalence), of which respiratory infections were the commonest (65.8%), followed by urinary infections (17.1%) and dual infections (urinary plus respiratory) (17.1%).The most frequently isolated microorganism causing respiratory infections was Acinetobacter (40.4%), 21% isolates of which were multidrug resistant; whereas the most frequently isolated microorganism causing urinary tract infections was Pseudomonas (38.4%). Average ICU stay in patients with and without nosocomial infections was 16.5 and 6.4 days respectively; whereas mortality in the two groups was 28.1% and 31.2% respectively. Overall ICU mortality was 19.9%. The nosocomial infection rate in our ICU was in keeping with the rate in many industrialised countries. The most common site of nosocomial infection was the respiratory tract, followed by the urinary tract. Acinetobacter was the commonest respiratory isolate, whereas Pseudomonas was the

  12. [Nosocomial infection in patients receiving a solid organ transplant or haematopoietic stem cell transplant].

    Science.gov (United States)

    Moreno Camacho, Asunción; Ruiz Camps, Isabel

    2014-01-01

    Bacterial infections are the most common infections in solid organ transplant recipients. These infections occur mainly in the first month after transplantation and are hospital-acquired. Nosocomial infections cause significant morbidity and are the most common cause of mortality in this early period of transplantation. These infections are caused by multi-drug resistant (MDR) microorganisms, mainly Gram-negative enterobacteria, non-fermentative Gram-negative bacilli, enterococci, and staphylococci. The patients at risk of developing nosocomial bacterial infections are those previously colonized with MDR bacteria while on the transplant waiting list. Intravascular catheters, the urinary tract, the lungs, and surgical wounds are the most frequent sources of infection. Preventive measures are the same as those applied in non-immunocompromised, hospitalized patients except in patients at high risk for developing fungal infection. These patients need antifungal therapy during their hospitalization, and for preventing some bacterial infections in the early transplant period, patients need vaccinations on the waiting list according to the current recommendations. Although morbidity and mortality related to infectious diseases have decreased during the last few years in haematopoietic stem cell transplant recipients, they are still one of the most important complications in this population. Furthermore, as occurs in the general population, the incidence of nosocomial infections has increased during the different phases of transplantation. It is difficult to establish general preventive measures in these patients, as there are many risk factors conditioning these infections. Firstly, they undergo multiple antibiotic treatments and interventions; secondly, there is a wide variability in the degree of neutropenia and immunosuppression among patients, and finally they combine hospital and home stay during the transplant process. However, some simple measures could be

  13. Nosocomial infections in neonatal intensive care units

    African Journals Online (AJOL)

    owner

    2012-08-24

    Aug 24, 2012 ... Organization pilot study in sub-. Saharan Africa. ... personnel and the frequent use of antibiotics in their treatment ..... tic use ($0.34 per patient day).57In another study, it was estimated that ..... Impact and cost of infection con-.

  14. Antibacterial Therapy for Nosocomial Pneumonias Caused by Multidrug-Resistant Microorganisms in Critical 1ll Patients

    Directory of Open Access Journals (Sweden)

    V. V. Moroz

    2007-01-01

    Full Text Available The paper presents the results of using the fourth-generation cephalosporin maxicef in the treatment of 20 patients with nosocomial pneumonia and severe concomitant injury. A control group comprised 20 patients receiving a combination of ceftazidime and amikacin. The total efficiency of the antibacterial therapy was 68.5% in the maxicef group and 40.9% in the control group (р<0.05. The therapy had to be modified in 42% of the maxicef group and in 72.7% in the control group (р<0.05. The average treatment cost was US $518 (429—606 and US $482 (368—596 in the maxicef and control groups, respectively. Nephrotoxicity was observed in 9% of the patients receiving a combination of the antibiotics. The activity of maxicef was also analyzed in vitro. Results. Maxicef was demonstrated to be highly active against the majority of gram-negative and gram-positive bacteria in vitro. Its efficacy against the most common bacteria (P.aeruginosa, S.aureus, E.coli, K.pneumonia causing infections in severe injury was in vitro significantly higher than that of ceftazidime. The comparative study indicates that the fourth-generation cephalosporin maxicef may be used as an alternative to the standard combined therapy. Key words: concomitant injury, maxicef, nosocomial pneumonia, a combination of ceftazidime and aminoglycoside, nosocomial infection pathogens.

  15. [Detection of nosocomial infections: a proposal of a protocol for a prospective study].

    Science.gov (United States)

    Gallet, E; Le Coutour, X; Turrou, J; Noyer, V; Lechevalier, B; Charbonneau, P; Bazin, C

    1989-05-01

    If meant to be effective, the detection of nosocomial infections demands considering the means that should be used for a daily gathering of necessary complete information. An experiment led in a medical intensive care unit have suggested the elements of such a gathering work. This must be prospective and aimed to relate the frequency, more that the importance of nosocomial infections. It will be carried by a willing and specialized nurse, and will be limited to the necessary warning signs only. As a rule, the information linked to the infection causes will not be looked for. Finally, a special care will be given to ensure a good feedback to the clinician, which is the main purpose of that work. Yet, such an information gathering protocol has to be flexible, and it is even one of its survival conditions regarding the variety of means and requirements inherent of each department.

  16. Pathogenic bacteria causing nosocomial infections in hospitalized patients and related factors%住院患者医院感染病原学类型与相关因素的关系

    Institute of Scientific and Technical Information of China (English)

    李万兰; 郭晨霞; 邓艳芳; 郑春梅; 祝中年; 余凤姣

    2012-01-01

    OBJECTIVE To analyze the correlation between the species and distribution of the pathogenic bacteria causing nosocomial infections in the hospitalized patients and the ward environment and the medical facilities so as to provide reliable bases for the effective prevention and control of nosocomial infections in grass-roots hospital. METHODS The patients who were enrolled in the hospital from Jan to Sep 2011 were selected as the monitoring subjects, the etiological examination of the patients with infections was performed, the air of the ward, bed unit and objects and the used medical facilities were set as the microbiologic monitoring indexes. RESULTS Of totally 18 037 case-times of hospitalized patients monitored, nosocomial infections occurred in 227 patients with the infection rate of 1. 26%; the etiological examination showed that the gram-negative bacteria accounted for 52. 01% , higher than 31. 51% of gram-positive bacteria and 16. 44% of the fungi; Esckerichia coli (28. 94%) , Pseudomonas aeruginosa (18. 42%), and Acinetobacter baumannii (10. 53%) were the predominant species of gram-negative bacteria; Staphylococcus aureus (34. 78%) and S. haemolyticus (21. 74%), and S. epidermidis (21. 74%) were the predominant gram-positive bacteria; Micrococcus luteus and S. epidermidis were the predominant species of gram-positive cocci in the ward, followed by Bacillus subtilis and other gram-positive bacilli; medical facilities to Bacillus cereus bacteria, Bacillus subtilis and other gram-positive bacilli, followed by the gram-positive bacilli such as black variant spores of Bacillus subtilis ; Cereus and black variant spores of Bacillus subtilis were predominant species of gram-positive bacilli on the medical facilities, followed by the gram-positive cocci such as S. epidermidis; the difference in the constituent ratio of the bacterial species between the air, pillow, quilts and thr bedstands was statistically significant. CONCLUSION It is an effective measure to

  17. 370例重症患者医院感染病原菌调查与分析%Pathogenic microorganism causing nosocomial infections in 370 cases of sever patients: investigation and analysis

    Institute of Scientific and Technical Information of China (English)

    徐丽丽; 侯彩妍; 吴琼; 范静; 翟红岩; 王国权

    2011-01-01

    目的 了解重症患者医院感染病原菌及医院感染情况.方法 对370例住院重症患者采集痰、咽拭子、血液、拔除的大静脉导管、尿、粪便、胸水及穿刺液标本,进行细菌培养,并进行分析.结果 采集的标本细菌培养阳性率为34.43%,最高阳性率的标本为痰液,阳性率为43.53%,其次为穿刺液和尿;痰培养主要的菌群为白色假丝酵母菌、铜绿假单胞菌和鲍氏不动杆菌等;尿培养主要的菌群为白色假丝酵母菌、肺炎克雷伯菌和大肠埃希菌等;血培养主要菌群为铜绿假单胞菌、肺炎克雷伯菌和大肠埃希菌等.结论 重症患者医院感染的首位是呼吸道感染;居高位是尿路感染;高发率是血液感染.%OBJECTIVE To evaluate pathogenic microorganism causing nosocomial infections in severe patients and status of hospital infection in our hospital. METHODS Phlegm, throat swabs, blood, pulling out of filling a catheter, urine, feces, chest water and biopsy specimens were collected from 370 cases of severe patients, then the bacterial culture was analyzed. RESULTS The germiculture positive rate of the specimens was 34. 43%; The highest rate in sputum specimens was 43. 53 %, followed by puncture fluid and urine. The main microbes of sputum culture were Candida albicans, Pseudomonas aeruginosa and Acinetobacter baumannii. The main microbes of urine culture were C. albicans, Klebsiella pneumonia and Escherichia coli, and so on. The main microbes of blood culture were P. aeruginosa, K. pneumonia and E. coli etc. CONCLUSIONS Respiratory tract infection is the first hospital infections in severe patients; the higher isurinary infection; the higher incidences is blood infection.

  18. Nosocomial infection and risk factors in elderly patients in intensive care units

    OpenAIRE

    2015-01-01

    Incidence of nosocomial infections gradually increase in patients over 65 years age population. There is a significant relationship between increased age and predisposition to nosocomial infections. Predisposition to infections in this age group is a result of impaired host defense, underlying chronic diseases, long-term hospitalization, steroids and immunosuppressive therapies and malnutrition. Nevertheless there is not much data about the incidence and risk factors of nosocomial infectio...

  19. Nosocomial infections in the Intesive care unit, University hospital for infectious and tropical diseases, Belgrade, Serbia

    OpenAIRE

    Milošević Ivana; Korać Miloš; Stevanović Goran; Jevtović Đorđe; Milošević Branko; Jovanović Milica; Dulović Olga; Pavlović Milorad

    2014-01-01

    Bacground/Aim. Nosocomial infections (NIs) are an important cause of morbidity, mortality and prolonged hospitalizations. Fifty percent of NIs have been reported in Intensive Care Units. The aim of this study was to determine the frequency and type of NIs among critically ill patients treated in the University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, as well as risk factors for acquiring them. Methods. This prospective cohor...

  20. Retrospective analysis of nosocomial infections in an Italian tertiary care hospital.

    Science.gov (United States)

    Mancini, Alessio; Verdini, Daniele; La Vigna, Giorgio; Recanatini, Claudia; Lombardi, Francesca Elena; Barocci, Simone

    2016-07-01

    Nosocomial infections are one of the leading causes of morbidity and mortality in hospitalized patients. Studies of their prevalence in single institutions can reveal trends over time and help to identify risk factors. The aim of this study was to investigate the nosocomial infections trend and identify the prevalence of predominant bacterial microorganisms and their drug resistance patterns in an Italian tertiary care hospital. Infections were classified according to the Centres for Disease Control and Prevention definitions. A retrospective study was carried out from March 2011 to June 2014, based on the bacterial isolate reports of a hospital located in Central Italy. During the 40-month study period, a total of 1547 isolates were obtained from 1046 hospitalized patients and tested for their antibiotic sensitivity. The most common isolates belonged to the Enterobacteriaceae family (61.7%), followed by Enterococcus species (12.4%), Pseudomonas species (10.7%) and S. aureus (10.0%). The incidence density rate of nosocomial infections was 7.4 per 1000 patient days, with a significant difference among the 3 annual infection rates (Pinfection prevalence rate was found in Internal Medicine Unit (41.3%), followed by Intensive Care Units (12.4%), Surgical Units (9.0%,) and Cardiology (7.1%).

  1. 多药耐药菌医院感染控制措施%Measures to control nosocomial infections caused by multidrug-resistant bacteria

    Institute of Scientific and Technical Information of China (English)

    陈京; 杨怀; 徐艳; 牟霞; 郑金鼎

    2011-01-01

    OBJECTIVE To implement the multi-resistant hospital infection control measures to reduce hospital infection and protect patients and medical staff safety. METHODS Developed control programs and work plans of clinical multi-drug resistant hospital infection,through the medical quality management system, multi-disciplinary efforted to cooperate on the implementation of multi-drug resistant clinical control to all aspects of hospital infection. RESULTS After a multi-sectoral, clinical departments implemented specific communication control program of multi-drug resistant, hospital infection control department for inspectors, and medical quality assessment and feedback. Dissemination of multiple drug-resistant control measures continued to be implemented. Subjects of medical staff and patients under the protection of preventive measures in isolation, diagnosis and treatment of normal activities. CONCLUSION The multi-resistant hospital infection control programs in the medical quality management system in the management level attention. Multiple drug-resistant hospital infection control inspectors at the quality of evaluation in the hospital announce that director of undergraduate responsible the problems to the individual, so that clinicians and nurses, enhance the sense of responsibility, self-awareness increased substantially and facilitate the hospital infection control programs and measures to more comprehensive efforts in the promotion and clinical implementation.%目的 落实多药耐药菌医院感染控制措施,减少医院感染发生,保障患者和医务人员安全.方法 制定临床多药耐药菌医院感染控制方案及工作计划,通过医疗质量管理体系,多学科努力合作,落实到临床控制多药耐药菌医院感染的各个环节.结果 经过多部门合作,临床科室具体落实多药耐药菌传播控制方案,医院感染科进行督察,结合医疗质量考评、反馈,多药耐药菌传播控制措施不断得到落实;各

  2. [Is there a relationship between rectal colonization and nosocomial infection of patients in intensive care unit?].

    Science.gov (United States)

    Yeşilbağ, Zuhal; Çağatay, Arif Atahan; Karadeniz, Aslı; Başaran, Seniha; Orhun, Günseli; Ergin Özcan, Perihan; Özsüt, Halit; Eraksoy, Haluk

    2015-07-01

    Nosocomial infections caused by multidrug-resistant (MDR) microorganisms are a major problem in intensive care units (ICUs) with high mortality and morbidity rates and the prior colonization is an important risk factor for these infections. The aim of this study was to investigate the prevalence of rectal colonization of MDR microorganisms and the association between the microorganisms that caused colonization and infection in the patients with nosocomial infections in ICUs. Rectal swabs were obtained on the day of 0, 3, 7, 14, 21 and weekly thereafter from 80 patients over 18 years of age hospitalized in ICU for more than 48 hours, and cultured for vancomycin-resistant enterococcus (VRE), methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase (ESBL)- producing gram-negative bacilli (GNB) and carbapenem-resistant enteric and nonenteric bacilli. Patients whose rectal swabs were not obtained on admission (on the day of 0), were excluded even they were hospitalized more than 48 hours. Bile esculin agar containing 64 μg/mL ceftazidime and 6 μg/mL vancomycin, chromogenic MRSA agar and blood agar media, MacConkey agar containing 1 mg/L ceftazidime and ceftriaxone, and 5 mL tryptic soy broth media containing 10 µg imipenem and meropenem discs were used for identification. Identification of GNB was determined by conventional methods and ESBL production was determined by double-disc synergy test. Patients have been followed up for nosocomial infections. Bacterial identification and antibiotic susceptibility tests were performed with standard microbiological methods. In 37 (46%) of the 80 patients, at least one MDR microorganism was isolated in rectal swab cultures on the day of 0. The most common microorganisms were ESBL-positive E.coli (19%), followed by ESBL-positive K.pneumoniae (13%), carbapenem-resistant P.aeruginosa (10%), ESBL-positive K.oxytoca (3%), MRSA (1%), VRE (1%), carbapenem-resistant Acinetobacter sp. (1%) and carbapenem

  3. Outbreak of pseudomonas aeruginosa causing nosocomial infection in intensive care unit:investigation and strategy%重症监护病房铜绿假单胞菌医院感染暴发调查与对策

    Institute of Scientific and Technical Information of China (English)

    秦桂英; 杨泽敏; 谢容; 龙盛双; 邱隆敏

    2011-01-01

    OBJECTIVE To investigate an outbreak of Pseudomonas aeruginosa nosocomial infection in an intensive care unit and find out the cause, the risk factor in order to provide the effective strategy to control the same event of nosocomial infection.METHODS The samples were collected according to the regulation specified by Hospital Degermation Technological Specification.After that, the isolation, culture, and identification as well as susceptibility test of bacteria were carried out according National Clinical Laboratory Operating Instruction.RESULTS The detection rate of P.aeruginosa were 100.0% from sputum aspirator dish samples.66.7% from attendance workers’ hands, 50.0% of water tap, 40.0% of corrugated pipe of breathing machine, 40.0% of cure dish, 25.0% of hdoctors' hands and 16.7% of bedside cupboard in the ICU.The P.aeruginosa isolated from both sputum sample of patient and environment have the same antibiotic sensitivity spectrum which was sensitive to ciprofloxacin, amikacin, and tobramycin but resistive to ceftazidime, cefepime, piperacillin/Tzao and tienam.CONCLUSION The outbreak of P.aeruginosa infection is derived from an case of permanent planting patientltingis due to the inadequacy in breathing machine corrugated tube degermation and personnel's hands sanitation.In order to prevent the hospital infection, the case isolation, hands sanitation of medical staff, aseptic technique, pipe management of breathing machine should be emphasized.%目的 对重症监护病房(ICU)发生铜绿假单胞菌感染的暴发进行调查,为控制医院感染提供依据和对策.方法 按要求采样,按细菌分离培养进行细菌鉴定和药敏试验.结果 环境中铜绿假单胞菌检出率从高到低依次为吸痰盘100.0%、护工手66.7%、水龙头50.0%、呼吸机螺纹管道40.0%、治疗盘40.0%、医师手25.0%、床头柜16.7%,患者痰标本及环境中分离到的铜绿假单胞菌具有相同的药敏谱:对环丙沙星、阿米卡

  4. 老年患者医院感染病原菌分布与耐药性分析%Distribution and antimicrobial resistance of pathogenic bacteria causing nosocomial infections in senile patients

    Institute of Scientific and Technical Information of China (English)

    蔡秀娟; 杨家宏; 杨爱明; 孙建军; 彭先贵

    2016-01-01

    目的:了解老年患者医院感染病原菌的种类及耐药性,为医师控制感染选择针对性抗菌药物提供参考依据。方法调查2012年1月-2014年12月3328例老年住院患者的临床资料;细菌培养参照临床细菌学检验技术进行;药敏监测与数据读取遵循K-B法及CLSI当年折点认定敏感或耐药,检验全程坚持室内质控方案,采用WHONET5.5-5.6软件进行统计分析。结果3328例老年患者发生医院感染296例、319例次,感染率8.9%、例次感染率为9.6%;感染部位以呼吸道、泌尿道为主,分别占50.5%、26.6%;共分离病原菌319株,其中革兰阴性菌占65.5%,革兰阳性菌占23.8%,真菌占10.7%;革兰阴性菌对磺胺甲噁唑/甲氧苄啶耐药率最高,均>60.0%,对阿米卡星和亚胺培南的耐药率较低,均<31.0%;检出耐甲氧西林葡萄球菌(MRS)25株,检出率44.6%,检出产ESBLs菌37株,检出率46.3%。结论≥60岁老年人属于感染高发组,医师用药时务必针对老年人生理特点,选择对肝、肾功能低损害的药物抗感染,降低药物不良反应的风险性。%OBJECTIVE To understand the species composition and antimicrobial resistance of pathogenic bacteria causing nosocomial infections in senile patients and provide the reference for controlling the infections .METHODS The clinical data of 3328 senile inpatients from Jan .2012 to Dec .2014 were investigated in this study .Bacterial culture was performed according to the clinical bacteriology inspection specification .Susceptibility testing was car-ried out and results were assessed by K-B methods recommended by CLSI .The indoor quality control was per-formed throughout the experiment .The WHONET 5 .5-5 .6 software was used for statistical analysis .RESULTS Among 3328 cases of elderly patients ,nosocomial infections occurred in 296 cases .The infection rate was 8 .9%and the case

  5. Drug susceptibility of multidrug-resistant bacteria causing nosocomial infections%医院感染多药耐药菌的临床调查与药敏分析

    Institute of Scientific and Technical Information of China (English)

    佟青; 张一兵; 刘阳

    2012-01-01

    OBJECTIVE To investigate the distribution and drug resistance of multiple drug resistant bacteria causing nosocomial infections so as to raise the level of infection prevention and guide clinical rational administration. METHODS The specimens of nosocomial infection were isolated routinely from Jan to Jul 2011} the identification of bacteria and drug susceptibility testing were finished by VITEK2 automatic microbial analyzer. RESULTS A total of 230 strains of pathogenic bacteria were isolated, including 129 (56.1%) multidrug-resistant bacteria. The isolation rate of gram-positive multidrug-resistant bacteria was 4. 8%, Stuphylococcus aureus accounted for 0. 9% and Enlerococci accounted for 3. 9% ; the isolation rate of gram-negative multidrug resistant bacteria was 45. 0% , Escherichia coli accounted for 16. 9%, KUbsiella pneumoniae accounted for 13.0%. CONCLUSION The distribution of multiple resistant bacteria isolated in our hospital is partly different from the target strains reported by the Ministry of Health, which indicates that the antibiotics should be used reasonably on the basis of the species of the pathogens isolated, drug resistance as well as the drug susceptibility testing.%目的 了解医院感染多药耐药菌的分布及耐药性,提高预防感染水平,指导临床合理使用抗菌药物.方法 对2011年1-7月临床标本按常规进行病原菌分离,采用VITEK IMS全自动细菌鉴定与药敏分析仪,对病原菌进行鉴定.结果 共检出病原菌230株,其中多药耐药菌129株,检出率为56.1%;革兰阳性多药耐药菌检出率为4.8%,主要为金黄色葡萄球菌占0,9%,屎肠球菌占3.9%;革兰阴性多药耐药菌检出率为45.0%,主要为大肠埃希菌占16,9%、肺炎克雷伯菌占13.0%.结论 医院分离的多药耐药菌分布与卫生部公布的主要多药耐药目标菌有一定差异,提示临床医师在使用抗菌药物时应根据病原菌的分离株种类、耐药性特点及药敏试验,合理选用抗菌药物.

  6. A prospective study of nosocomial infection in 848 cases of liver diseases

    Institute of Scientific and Technical Information of China (English)

    Zhi Jun Su; Yi Fan Zhang; Mei Yu Shi; Qing Xin Zeng; Ma Lei Chen

    2000-01-01

    AIM To study the nosocomial infection in the patients with liver diseases and its risk factors.METHODS A prospective survey of nosocomial infection in 848 patients with various liver diseases wascarried out in our hospital for a 24-month period.RESULTS Incidence of nosocomial infection in patients with liver diseases was 9.20%, nosocomialinfection rate in severe hepatitis was significantly higherthan in mild and moderate liver diseases. Infectionof respiratory tract accounted for 44.33%. Infection rate in abdominal cavity, intestinal tract, gallbladderand bile ducts, oral region, and other regions was 15.46%, 12.37%, 8.25%, 7.22% and 12.37%,respectively.CONCLUSION The factors related to nosocomial infection were the severity of liver diseases, cellularimmunological condition, Co-infection of hepatitis virus, severe accompanying diseases, improper medicalmanipulations and use of broad-spectrum antibiotics. Nosocomial infection obviously affects the prognosis ofliver diseases.

  7. Distribution and drug resistance of pathogens causing nosocomial infections in hematology department%血液科医院感染病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    方碧兰; 陈蕾; 郑美娣

    2012-01-01

    OBJECTIVE To analyze the distribution and drug resistance of pathogens causing nosocomial infections in hematology department so as to guide the reasonable use of antibiotics. METHODS Totally 364 positive specimens were collected from the hematology department , the identification of the pathogens was performed by using VITEK 32 automatic analyzer, and the antimicrobial susceptibility testing was conducted by disk diffusion technique (K-B method). RESULTS A total of 377 strains of pathogens were mainly isolated from the sputum (53. 32%) , blood (17. 77%) and urine (16. 18%), including 235 (62. 33%) strains of gram-negative bacteria, 105(27. 85%) strains of gram-positive bacteria, and 37 (9. 81%) strains of fungi. The Pseudomonasaeruginosa , Escherichia coli , coagulase-negative Staphylococci, Acinetobacter baumannii, Candida albicans and Staphylococ-cus aureus were top 6 species of pathogens, accounting for 20. 16%, 15. 38%, 12. 73% , 9. 28%, 8. 75% and 8.49%, respectively . The P. aeruginosa, E. coli, and A. baumannii showed multidrug-resistant, the drug resistance rates to imipenem and meropenem were 0. CONCLUSION The pathogens causing nosocomial infections in department of hematology are mainly isolated from the respiratory tract specimens, the gram-negative bacteria are the predominant pathogens and show multidrug-resistant. It is necessary to choose antibiotics based on the antimicrobial susceptibility testing.%目的 分析血液科医院感染病原菌分布及耐药性,为临床合理用药提供指导.方法 选取364份血液科培养阳性的标本,病原菌鉴定采用法国生物梅里埃公司的VITEK-32系统,药敏试验采用K-B纸片法.结果 共分离出病原菌377株,主要来源于痰液、血液和尿液,分别占53.32%、17.77%和16.18%;革兰阴性菌235株占62.33%,革兰阳性菌105株占27.85%,真菌37株占9.81%;分布最多的6种病原菌为铜绿假单胞菌、大肠埃希菌、凝固酶阴性葡萄球菌、鲍氏

  8. Distribution and drug resistance of pathogens causing nosocomial infections in department of neurology%神经内科医院感染病原菌分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    陈燕萍; 田锦勇; 段畅; 李德菊; 喻红

    2015-01-01

    目的:分析医院神经内科医院感染患者病原菌分布特点与耐药性,为临床治疗提供参考依据。方法对医院神经内科2009年8月-2014年8月住院感染患者送检标本检出的1153株病原菌分布特点及耐药性进行分析,全自动微生物鉴定仪进行病原菌的鉴定分型,VIT EK‐2 Compact 药敏测试系统进行病原菌药敏试验。结果神经内科医院感染病原菌以革兰阳性菌为主占57.5%,其次为革兰阴性菌占42.5%,革兰阳性菌中包括肺炎链球菌占20.5%、金黄色葡萄球菌占10.7%、酿脓链球菌占8.5%、屎肠球菌占6.8%、表皮葡萄球菌占4.8%和F型溶血性链球菌占3.5%;革兰阴性菌包括肺炎克雷伯菌占13.4%、鲍氏不动杆菌占8.8%、阴沟肠杆菌占5.0%和铜绿假单胞菌占4.8%;革兰阳性菌对青霉素和头孢唑林不敏感,对万古霉素耐药性低,革兰阴性菌对环丙沙星和头孢呋辛耐药性强,对亚胺培南敏感。结论神经内科医院感染病原菌以革兰阳性菌为主,且具有较强耐药性,需加强临床监测。%OBJECTIVE To investigate the distribution and drug resistance of the pathogens causing nosocomial in‐fections in the patients of department of neurology so as to provide guidance for clinical treatment .METHODS From Aug 2009 to Aug 2014 ,the distribution and drug resistance of 1 153 strains of pathogens causing infections in the patients of department of neurology were observed ,the pathogens were identified by using automatic micro‐organism identification system ,and the drug susceptibility testing was performed with the use of VITEK‐2 Com‐pact drug susceptibility testing system .RESULTS Of the pathogens causing nosocomial infections in the patients of department of neurology ,57 .5% were gram‐positive bacteria ,and 42 .5% were gram‐negative bacteria .Among the gram‐positive bacteria , the Streptococcus pneumoniae

  9. Current status of prevalence of nosocomial infections caused by Serratia marcescens and analysis of drug resistance%褪色沙雷菌医院感染现状及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    方叶青; 胡庆丰; 魏取好; 吕火烊

    2015-01-01

    OBJECTIVE To understand the clinical characteristics of Serratia marcescens infections and observe the current status of drug resistance so as to provide guidance for clinical treatment and control of nosocomial infections .METHODS From 2008 to 2012 ,the distribution of 300 clinical S .marcescens isolates was retrospective‐ly analyzed ,the change of the drug resistance spectrum was observed ,and the drug resistance of the strains was compared between the ICU wards and the non‐ICU wards .RESULTS During the five years ,the clinical isolation rate of S .marcescens causing nosocomial infections was increased year by year ,increasing from 0 .8% in 2008 to 5 .3% in 2012 .Among the isolated S .marcescens strains ,44 .7% were isolated from the ICU1 ,17 .3% from the surgery department ,16 .0% from the internal medicine department ,7 .7% from the respiratory department ;the sputum was the predominant specimen source ,accounting for 85 .6% .The drug resistance of the S .marcescens to cefoperazone‐sulbactam ,ceftazidime , ceftriaxone , imipenem , and gentamycin showed an upward trend ( P<0 .05);by 2012 ,the drug resistance rate to cefoperazone‐sulbactam reached 24 .7% ,ceftriaxone 59 .2% ,imipen‐em 24 .3% ,gentamycin 24 .9% ;the S .marcescens strains were highly susceptible to amikacin ,tobramycin ,and levofloxacin ,with the drug resistance rates of 1 .2% ,3 .6% ,and 5 .9% ,respectively ;the drug resistance rates of the S .marcescens strains isolated from the ICUs to compound preparation ,cephalosporins ,and carbapenems were significantly higher than those of the strains isolated from the non‐ICUs ,while the drug susceptibility rate to ami‐noglycosides and quinolones were higher in the ICUs than in the non‐ICUs .CONCLUSION The incidence of the S . marcescens infections shows an upward trend .It is necessary for the hospital to reasonably use antibiotics on the basis of the results of drug susceptibility testing so as to prevent the emergence of drug

  10. Distribution and antifungal susceptibility of Candida species causing nosocomial candiduria.

    Science.gov (United States)

    Ozhak-Baysan, Betil; Ogunc, Dilara; Colak, Dilek; Ongut, Gozde; Donmez, Levent; Vural, Tumer; Gunseren, Filiz

    2012-07-01

    The aim of the study was to investigate the distribution of Candida species isolated from urine specimens of hospitalized patients in Akdeniz University Hospital, Antalya, Turkey, as well as their susceptibilities to antifungal agents. A total of 100 patients who had nosocomial candiduria between March 2003 and May 2004 at the facility were included in the study. Organisms were identified by conventional methods and the use of API ID 32C strips. Susceptibilities of the isolates to amphotericin B were determined by Etest, whereas the minimum inhibitory concentration (MIC) values of these same strains to fluconazole, voriconazole and caspofungin were assessed using the broth microdilution method. The most common species recovered was C. albicans 44% of all yeasts, followed by C. tropicalis (20%), C. glabrata (18%), C. krusei (6%), C. famata (5%), C. parapsilosis (4%), C. kefyr (2%) and C. guilliermondii (1%). A total of nine (9%) of the isolates, including five C. krusei and four C. glabrata isolates were susceptible dose-dependent (SDD) to fluconazole. In constrast, only two C. glabrata and one C. krusei isolates were resistant to this antifungal. The voriconazole MICs for all Candida isolates were ≤0.5 μg/ml, except for one C. glabrata isolate with a MIC value of 2 μg/ml. Among all isolates, 94% were susceptible to amphotericin B with MIC values of Candida urinary tract infections.

  11. 医院感染褪色沙雷菌的临床分布与耐药性分析%Clinical distribution and drug resistance of Serratia marcescens causing nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    王蓓; 刘红; 邹雪; 蒋晓飞

    2015-01-01

    OBJECTIVE To investigate the clinical distribution of Serratia marcescens causing nosocomial infections and observe the drug resistance to the commonly used antibiotics so as to guide the reasonable clinical use of antibi‐otics .METHODS A total of 434 strains of S .marcescens were isolated from the submitted specimens that were ob‐tained from the patients who were hospitalized Huashan Hospital from Jan 2009 to Dec 2013 .The drug susceptibil‐ity testing and the statistical analysis were performed .The drug resistance rates were analyzed with the use of Whonet5 .4 software .RESULTS Totally 434 strains of S .marcescens were isolated from the submitted specimens , most of which were isolated from the sputum ,wound ,urine ,and secretions specimens .The drug susceptibility rates of the S .marcescens to cefoperazone‐sulbactam ,piperacillin‐tazobactam ,imipenem ,meropenem ,and ertap‐enem were 74 .4% ,82 .5% ,84 .8% ,90 .2% ,and 88 .9% ,respectively ;while the drug resistance rate of the S . marcescens to carbapenems was increased year by year and continued to show an upward trend .CONCLUSION The drug resistance rate of the S .marcescens to carbapenems shows an upward trend ,therefore ,it is necessary for the hospital to monitor the nosocomial infections ,analyze the drug resistance of the pathogens ,reasonably use antibi‐otics based on the results of the drug susceptibility testing ,and curb the spread of drug‐resistant strains .%目的:了解患者医院感染褪色沙雷菌的临床分布特点及对常用抗菌药物的耐药性变化,指导临床合理使用抗菌药物。方法收集2009年1月-2013年12月华山医院住院患者送检标本分离出的褪色沙雷菌434株,进行药敏试验及统计分析;使用世界卫生组织耐药监控网提供的Whonet 5.4软件进行耐药率分析。结果从临床送检标本中共检出434株褪色沙雷菌,主要分离自痰液、伤口、尿液和分泌物等标本;褪色沙雷菌对头

  12. 精神病院医院感染病原菌分布及耐药性分析%Distribution of pathogenic bacteria causing nosocomial infections and drug resistance in a psychiatric hospital

    Institute of Scientific and Technical Information of China (English)

    卢桂华; 郭萍; 王世锴; 宋国华; 顾沈红; 钱敏才

    2013-01-01

    OBJECTIVE To investigate the distribution and drug resistance of the pathogenic bacteria causing nosocomial infections from Jul to Sep 2011 so as to provide basis for reasonable clinical use of antibiotics. METHODS A total of 1684 clinically submitted specimens were cultured for the pathogenic bacteria, the distribution of the pathogens and the drug resistance were analyzed. RESULTS A total of 768 strains of pathogens were detected and the positive rate was 45. 6%. The positive rates of samples from general departments and the geriatric departments were 55. 9% and 48. 4% , respectively , and the positive rate of sputum was 83. 5%. The results suggested that the gram-negative bacteria accounted for 55. 9% , the detection rates of ESBLs-producing strains and the carbopenem-resistant strains were high, and some of the strains remained sensitive to aminoglycosides and β-lactamase inhibitors. The gram-positive bacteria were highly resistant to the commonly used antibiotics, but sensitive to vancomycin. CONCLUSION The measures of prevention and control of the nosocomial infections need to be reinforced, and the predisposing factors should be get rid of. The clinical staff should pay attention to the sample collection and the isolation and culture of the strains and use antibiotics reasonably.%目的 探讨2011年7-9月医院感染病原菌的分布及其耐药性,为临床合理应用抗菌药物提供依据.方法 对临床送检的1684份标本进行分离,对病原菌构成及其耐药性进行分析.结果 1684份送检标本中共检出768份阳性,阳性率为45.6%,综合病区和老年病区的送检阳性率较高,分别为55.9%和48.4%;痰液送检阳性率为83.5%,检出病原菌中革兰阴性菌为55.9%,且产ESBLs及耐碳青霉烯类抗菌药物的菌株检出率较高,但部分仍对氨基糖苷类、碳青霉烯类、β-内酰胺酶抑制剂敏感;革兰阳性菌对常用抗菌药耐药率高,对万古霉素敏感.结论 应加强对医院

  13. Early Diagnosis of Nosocomial Infection Caused by Pulmonary Tuberculosis in Patients with Diabetes Mellitus%唐尿病患者医院感染肺结核的早期诊断指标分析

    Institute of Scientific and Technical Information of China (English)

    张常然; 牛媛媛; 黄知敏; 林建聪; 谭清华; 邢艳利; 李延兵; 刘霞; 李鸣

    2009-01-01

    目的 减少肺结核的医院感染,研究有助于糖尿病合并活动型肺结核的早期诊断指标.方法 回顾分析某三甲医院内分泌科10年糖尿病合并活动型和非活动型肺结核316例患者的临床资料.结果 活动型和非活动型肺结核组的平均年龄分别为(55.01±12.77)岁和(61.92±11.18)岁;非活动型肺结核多有肺结核病史(22.6%),明显多于活动型肺结核组患者(13.4%)(P<0.05);活动型和非活动型肺结核患者咳嗽、咳痰症状、痰涂片找分枝杆菌的阳性率分别为48.4%、80.0%,25.2%、10.0%;活动型和非活动型肺结核组的糖化血红蛋白(GHBA1c)、C肽、空腹血糖分别为(10.74±2.95)%、(0.56±0.38)nmol/L、(13.11±5.63)mmol/L、(8.68±2.08)%、(0.66±0.48)nmol/L、(10.33±9.41)mmol/L,上述指标两组相比,差异均有统计学意义(P<0.05).结论 出现咳嗽、咳痰症状、痰涂片找分枝杆菌、无明显诱因的血糖控制差等指标有助于糖尿病合并活动型肺结核的早期诊断,尽早检查这些指标,及时隔离,可减少肺结核的医院感染.%OBJECTIVE To reduce the nosocomial infection caused by Mycobacterium tuberculosis in patients with diabetes mellitus, and study the some characteristics for early diagnosis of nosocomial infection. METHODS The clinical data of a total of 316 diabetes mellitus patients with pulmonary tuberculosis from Jan 1998 to Dec 2007 were made a retrospectively investigation. RESULTS The age was (55.01±12.77) and (61.92±11.18) years old in the patients with active and inactive pulmonary tuberculosis, respectively. The pulmonary tuberculosis history was more frequent in the patients with inactive pulmonary tuberculosis (22.6%) than those with active one (13.4%). There was significant difference for pulmonary tuberculosis history between two groups(P<0.05). The frequency of cough with profuse sputum and the sputum positive rate with M. tuberculosis were 48.4% and 80.0% vs 25.2% and 10.0% between two groups

  14. Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study.

    NARCIS (Netherlands)

    Wertheim, H.F.; Vos, A.M.C.; Ott, A.; Voss, A.; Kluytmans, J.A.J.W.; Broucke-Grauls, C.M. van den; Meester, M.; Keulen, P.H. van; Verbrugh, H.A.

    2004-01-01

    BACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical patients. OBJECTIVE: To assess the

  15. Mupirocin prophylaxis against nosocomial Staphylococcus aureus infections in nonsurgical patients: a randomized study.

    NARCIS (Netherlands)

    Wertheim, H.F.; Vos, A.M.C.; Ott, A.; Voss, A.; Kluytmans, J.A.J.W.; Broucke-Grauls, C.M. van den; Meester, M.; Keulen, P.H. van; Verbrugh, H.A.

    2004-01-01

    BACKGROUND: Staphylococcus aureus nasal carriage is a major risk factor for nosocomial S. aureus infection. Studies show that intranasal mupirocin can prevent nosocomial surgical site infections. No data are available on the efficacy of mupirocin in nonsurgical patients. OBJECTIVE: To assess the eff

  16. [Distribution and antibiotics resistance related to nosocomial pathogenic bacteria infection in patients after cardiac surgery].

    Science.gov (United States)

    Dang, Hai-ming; Song, Yue; Cao, Jian; Wu, Li-song; Dong, Ran

    2013-05-01

    To investigate the clinical distribution and antibiotics resistance of nosocomial infection caused pathogenic bacteria in patients after cardiac surgery. Clinical data from 612 patients after cardiac surgery under microbiologically documented nosocomial infection was retrospectively analyzed from January 2007 to December 2012. Identification on related bacterial was performed in an automatic ATB Expression system while antimicrobial susceptibility was tested by Kirby-Bauer method. were analyzed by WHONET5.4. There were 697 strains of clinical pathogenic bacilli isolates identified and 421 (60.4%) of them were isolated from sputum while 185 (26.5%) were from blood. Acinetobacter spp. (124 strains, 17.8%), Pseudomonas aeruginosa (85 strains, 12.2%) and Klebsiella pneumoniae (50 strains, 7.2%) were the predominant Gram-negative bacilli while S. epidermidis (75 strains, 10.8%) was the predominant Gram-positive cocci. The predominant eumycete was Candida albicans (43 strains, 6.2%). from the susceptibility test showed that carbapenems, cefoperazone/sulbactam and piperacillin/tazobactam were the most active antibiotics. The detection of meticillin-resistant Staphylococcus (MRS) were 82.9% in S aureus and 95.9% in coagulase negative Staphylococcus. There was no Staphylococcus strains resistant to vancomycin found. Non-fermenting Gram-negative bacilli and Staphylococcus appeared the important pathogens in patients after cardiac surgery. Drug resistance to antibiotics was quite common. Prevention on nosocomial infection and rational use of antibiotics remained very important in reducing the amount of drug resistant strains.

  17. Nosocomial infections and antibiotic resistance pattern in open-heart surgery patients at Imam Ali Hospital in Kermanshah, Iran.

    Science.gov (United States)

    Heydarpour, Fatemeh; Rahmani, Youssef; Heydarpour, Behzad; Asadmobini, Atefeh

    2017-01-01

    Background: Patients undergoing open heart surgery have a relatively high risk of acquiring nosocomial infections. The development of antibiotic-resistant infections is associated with prolonged hospital stays and mortalities. Objectives: The present study was conducted to investigate nosocomial infections and the antibiotic resistance pattern in bacteria causing these infections in open heart surgery patients at Imam Ali Hospital in Kermanshah in the west of Iran over a 4-year period from March 2011 to March 2014. Materials and methods: The present cross-sectional study was conducted on 135 cases of nosocomial infection among open heart surgery patients. The demographic characteristics and the risk factors of each case of infection were recorded. The antibiotic susceptibility test was carried out using the Minimum Inhibitory Concentration (MIC) method based on the Clinical and Laboratory Standards Institute (CLSI) protocol. The data collected were then analyzed in SPSS-16. Results: Out of the 6,000 patients who underwent open heart surgery during this 4-year period at the selected hospital, nosocomial infections developed in 135 patients (2.25%), 59.3% of whom were female and 40.7% male. Surgery site infection (SSI), pneumonia (PNEU), urinary tract infection (UTI) and blood stream infection (BSI) affected 52.6%, 37%, 9.6% and 0.8% of the cases, respectively. E.coli, Klebsiella spp. and S. aureus were the most common bacteria causing the nosocomial infections. E. coli was most frequently resistant to imipenem (23.3%) Klebsiella spp. to gentamicin (38.5%) S. aureus to co-trimoxazole (54.2%). Conclusion: SSI had a high prevalence in this study. Further studies should therefore be conducted to examine the risk factors associated with SSI in open heart surgery. Various studies have shown that antibiotic resistance patterns are different in different regions. Finding a definitive treatment therefore requires an antibiogram.

  18. 集束化管理在静脉用药调配中心预防医院感染的应用%Application of Cluster Management in Nosocomial Infection Prevention for Pharmacy Intravenous Admixture Services

    Institute of Scientific and Technical Information of China (English)

    王雅蘋; 苏素红; 戈霓云; 张琼; 朱光辉

    2016-01-01

    Objective To avoid nosocomial infection in the pharmacy intravenous admixture services (PIVAS), our hospital took cluster management strategy on PIVAS, nosocomial infection control department, logistic engineering department and specialized company.Method The combination of self-examination, random check by nosocomial infection control department with equipment maintenance and purification environment by specialized company were adopted to find out the problems, after which cause analysis and quality improvement were conducted.ResultPIVAS infection control measures were made, which helped the inspection and monitoring indicators meet the standard.Conclusion PIVAS nosocomial infection control was improved by cluster management strategy, which ensured patients' intravenous medication safety.

  19. The impact of interventions to improve adherence to preventive measures on the incidence of nosocomial infections in ICUs

    OpenAIRE

    2014-01-01

    Half of all life-threating nosocomial infections occur in intensive care units (ICUs) and, despite the advances in intensive care, the incidence of nosocomial infections is still high. About one third of nosocomial infections are considered preventable. Awareness of risk factors, adherence to preventive measures and collaboration of all members participating in preventive programmes can lead to reduction of the incidence of nosocomial infections and thus can produce a positive impact...

  20. THE INCIDENCE OF NOSOCOMIAL INFECTIONS IN PATIENTS WITH ISOLATED SEVERE TRAUMATIC BRAIN INJURY

    Directory of Open Access Journals (Sweden)

    Valenčić Lara

    2015-12-01

    Full Text Available Introduction: Traumatic brain injury is the leading cause of death in children and adults in developed countries. Severe traumatic brain injury is classified with Glasgow Coma Scale score 8 and less. About 50% of patients with severe traumatic brain injury developes at least one infection as a complication of primary condition during hospitalization in the Intensive Care Unit, resulting with fatal outcome in 28% of patients. Ventilator associated pneumonia is the leading infection that affects patients with severe traumatic brain injury, with an incidence between 41% and 74%. Following are sepsis and urinary tract infections. The aim: To analyze the number of patients with nosocomial infection and isolated severe traumatic brain injury hospitalized in the Intensive Care Unit of the Clinical Hospital Centre Rijeka, Croatia, from 31st  January 2013 to 31st December 2014. Patients and methods: A two year retrospective study included 46 patients with isolated severe traumatic brain injury and nosocomial infection hospitalized in the Intensive Care Unit of the Clinical Hospital Centre Rijeka,Croatia, in the period from 31st January 2013 to 31st December 2014. All medical data was collected from the Division of Intensive Care Unit, Clinical Hospital Centre Rijeka, Croatia. Results: From 67 patients with isolated severe traumatic brain injury, 46 (68,65% of them developed nosocomial infection. There was statistically significant more male patients than female (p<0.05. The average age of infected patients was 57,8 years. The leading were the infections of the respiratory system. Gram negative bacteria Proteus mirabilis and Pseudomonas aerugnonsa were the leading pathogens. The average duration of the infection was 5,77 days. For 16 (34,78% of 46 patients the treatment outcome was lethal. Conclusion: Nosocomial infections are becoming a major public health problem. The emphasis must be set on the prevention which includes maintaining the hygiene and

  1. [Epidemic of nosocomial infection by rotavirus in a neonatology service].

    Science.gov (United States)

    Bentama, I; Soussi, I; Ghanimi, Z; Riane, S; Tligui, H; Mdaghri Alaoui, A; Thimou Izgua, A

    2012-01-01

    The goal of work is to establish a clinical descriptive analysis of the epidemic of nosocomial rotavirus occurred in the Neonatal Unit of the Hospital's Child Rabat for a winter period. We systematically collected all the patients of the service right from the first case of rotavirus nosocomial infection. Patients with a stay of less than 48 hours of hospitalization were excluded. We have established operating sheets for all positive cases, with the term, birth weight, postnatal age and weight during the sampling, clinical symptoms, treatment, and the evolution. Out of the 36 cases analyzed (where 26 preterm and 10 term neonates), 12 samples were positive for rotavirus, so one third of patients. The patients with positive samples were in 75% symptomatic cases. The clinical signs were represented in term newborns with stool weight with stagnant fluid in 2 cases and weight loss in one case and in premature infants with mucous stools with abdominal distension in 2/3 of cases, and fluid and stool dehydration in 1/3 of cases. A very low rate of breastfeeding (17%) was noted among all newborns service in this epidemic. We performed the isolation of positive patients, with a strengthening of hygiene measures. In addition, infants were started on symptomatic treatment with careful clinical monitoring. Evolution was complicated by necrotizing enterocolitis in 3 cases of preterm infants.

  2. Incidence, pathogens and resistance patterns of nosocomial infections at a rural hospital in Gabon.

    Science.gov (United States)

    Scherbaum, Micha; Kösters, Katrin; Mürbeth, Raymund Egid; Ngoa, Ulysse Ateba; Kremsner, Peter Gottfried; Lell, Bertrand; Alabi, Abraham

    2014-03-04

    Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Africa, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints, deficient surveillance data and lack of awareness regarding nosocomial infections. We carried out this study to determine the incidence and spectrum of nosocomial infections, pathogens and antibiotic resistance patterns in a tertiary regional hospital in Lambaréné, Gabon. This prospective case study was carried out over a period of six months at the Albert Schweitzer Hospital, Lambaréné, Gabon. All patients admitted to the departments of surgery, gynecology/obstetrics and internal medicine were screened daily for signs and symptoms of hospital-acquired infections. A total of 2925 patients were screened out of which 46 nosocomial infections (1.6%) were diagnosed. These comprised 20 (44%) surgical-site infections, 12 (26%) urinary-tract infections, 9 (20%) bacteraemias and 5 (11%) other infections. High rates of nosocomial infections were found after hysterectomies (12%) and Caesarean sections (6%). Most frequent pathogens were Staphylococcus aureus and Escherichia coli. Eight (40%) of 20 identified E. coli and Klebsiella spp. strains were ESBL-producing organisms. The cumulative incidence of nosocomial infections in this study was low; however, the high rates of surgical site infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.

  3. [Hospital management and the role of clinical microbiology laboratory for preventing nosocomial infection].

    Science.gov (United States)

    Ichiyama, S

    1995-10-01

    Nosocomial infection is a serious issue in the hospital management. Countermeasures for this issue have been discussed from various points including clinical and laboratory medicine, nursing as well as hospital administration. This issue is of great importance to those of us medical practitioners, who engage in diagnosis and treatment of infectious diseases. The role of clinical microbiology laboratories for prevention of nosocomial infection includes performing epidemiological survey, giving information and education, and training and instruction to medical staff. In order to instruct and inspect the countermeasures against nosocomial infection, it is necessary to have a dedicated team in the hospital. We have organized an infection control team(ICT) to collect information and offer training and instruction regarding nosocomial infection. The ICT activities include 1) inspecting if the nosocomial infection control manual is followed correctly, 2) reporting the results of epidemiological survey regarding nosocomial infection, 3) offering the information regarding antimicrobial agents and disinfectants, 4) offering the information regarding the isolation of microorganisms in the hospital and their antimicrobial sensitivities, 5) cost calculation for nosocomial infection control.

  4. [Enterovirus nosocomial infections in a neonatal care unit: from diagnosis to evidence, from a clinical observation of a central nervous system infection].

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    Farcy, C; Mirand, A; Marque Juillet, S; Henquell, C; Neulier, C; Foucaud, P; Peigue-Lafeuille, H

    2012-09-01

    Although enteroviruses generally cause asymptomatic or mild disease, neonates are at higher risk for severe illnesses, among which systemic disease characterized by multiorgan involvement is a potentially fatal condition. Enterovirus neonatal infections may be the source of nosocomial infections in neonatology or in pediatric intensive care units. We report central nervous system infections due to Echovirus 11 in two neonates and the molecular evidence of nosocomial transmission of this strain in a neonatal unit by enterovirus genotyping and phylogenetic analysis. This report illustrates the importance of including enterovirus genome detection in the sepsis screening concomitantly with bacteriological investigations performed at admission of a neonate. Rapid diagnosis and subsequent genotyping could have a beneficial impact on clinical practices at the individual level (reducing the length of antibiotic therapy) and public health policy at the collective level by reinforcing hygiene measures to prevent nosocomial infections, with nurseries and neonatal units being at greater risks.

  5. Correlation between levofloxacin consumption and the incidence of nosocomial infections due to fluoroquinolone-resistant Escherichia coli.

    Science.gov (United States)

    Wu, Hui-Hsiu; Liu, Hsin-Yi; Lin, Yi-Chun; Hsueh, Po-Ren; Lee, Yuarn-Jang

    2016-06-01

    The relationship between fluoroquinolone resistance in Escherichia coli isolates causing nosocomial infection and hospital antibiotic consumption were investigated. Restriction of levofloxacin use was implemented to control the incidence of fluoroquinolone-resistant E coli in the hospital. The study was conducted from January 2004 to December 2010. Antimicrobial agent consumption was obtained from the pharmacy computer system and presented as the defined daily doses per 1000 patient-days every 6 months. The incidence of fluoroquinolone-resistant E coli isolates causing nosocomial infections was obtained from the Department of Infection Control every 6 months. An antimicrobial stewardship program, restricting levofloxacain use, was implemented in July 2007. The incidence of fluoroquinolone-resistant E coli causing nosocomial infections was significantly correlated with fluoroquinolone usage (p = 0.005), but not with the use of third- or fourth-generation cephalosporins, piperacillin-tazobactam, or carbapenems. Parenteral (p = 0.002), oral (p = 0.018), and total levofloxacin (p = 0.001) use were significantly correlated with the extent of fluoroquinolone resistance. With a reduction of levofloxacin use, a decrease of the incidence of fluoroquinolone resistance in E coli isolates was observed. There is a significant correlation between levofloxacin use and the incidence of nosocomial fluoroquinolone-resistant E coli isolates. The incidence of fluoroquinolone-resistant E coli could be reduced by limiting levofloxacin consumption. Copyright © 2011. Published by Elsevier B.V.

  6. Surveillance for surgical site infection (SSI) after neurosurgery: influence of the US or Brest (France) National Nosocomial Infection Surveillance risk index on SSI rates.

    Science.gov (United States)

    Lietard, Claire; Thébaud, Véronique; Besson, Gérard; Lejeune, Benoist

    2008-11-01

    A total of 5,628 neurosurgical patients were observed in France to assess the occurrence of surgical site infection (SSI). Their risk of SSI was defined by calculating both the US National Nosocomial Infection Surveillance and the Brest National Nosocomial Infection Surveillance risk indexes. This study compares SSI rates stratified according to either the US or Brest (France) National Nosocomial Infection Surveillance risk index. The SSI rates were correlated with National Nosocomial Infection Surveillance data involving only local operation durations.

  7. Antibiotic resistance pattern of Enterococci isolates from nosocomial infections in a tertiary care hospital in Eastern India.

    Science.gov (United States)

    Chakraborty, Atreyi; Pal, Nishith K; Sarkar, Soma; Gupta, Manideepa Sen

    2015-01-01

    Resistance to commonly used antibiotics by Enterococci causing nosocomial infections is of concern, which necessitates judicious, responsible and evidence-based use of antibiotics. The present study was conducted to review the prevalence and identify therapeutic options for nosocomial Enterococcal infections in our tertiary care hospital. Isolates identified by morphological and biochemical characteristics were tested for antibiotic susceptibility using Kirby-Bauer method. 153 of 2096 culture positive clinical samples comprised of 101 urine, 30 wound swab/pus, 13 blood and 09 high vaginal swab isolates were identified as Enterococcus faecalis (90.85%), Enterococcus faecium (8.50%) and Enterococcus gallinarum (0.65%). Enterococci accounted for 8.45%, 4.53%, 4.23%, 4.43% of urinary, wound swab or pus, blood, high vaginal swab isolates respectively, causing 7.3% of all nosocomial infections. Significant number of Enterococci isolated from nosocomial urinary tract infection (66.01%) and wound infections (19.6%) were multidrug resistant (MDR). Although all isolates were sensitive to vancomycin and linezolid, resistance to erythromycin (71.24%) and ciprofloxacin (49.67%) was frequently observed. High-level gentamicin resistance was observed in 43.88%, and 61.53% of E. faecalis and E. faecium isolates respectively. Minimal inhibitory concentration of vancomycin of all the isolates were ≤1 μg/ml. 7% of the Enterococcal isolates were MDR strains and vancomycin or linezolid were the only effective antibiotics. A combination of vancomycin and/or linezolid were effective against Enterococci causing nosocomial infections in our tertiary care facility, nevertheless continuous and frequent surveillance for resistance patterns are necessary for judicious and evidence based use of antibiotics.

  8. Nurses practices regarding the prevention of nosocomial infections in the neurosurgical intensive care unit

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    Hülya Bulut

    2010-12-01

    Full Text Available Objectives: This study was conducted for determining nurses’ interventions to preventive nosocomial infections seen in a neurosurgery intensive care unit (ICU.Materials and methods: The study population was comprised of with 10 nurses who worked in the neurosurgery ICU of a university hospital in Ankara. The data were collected using a questionnaire and an interventions form. In the analysis of data number of the account was used.Results: Mean knowledge level of the study population was 10.4 on 28 points in the questionnaire. While it is noted that the nurses take measures to prevent some of the nosocomial infections, which are included intervention form, there were no measures against surgical wound infections, meningitis, shunt infections that are seen infrequently in the neurosurgical units.Conclusion: Nurses’ knowledge on nosocomial infections and their interventions to prevent nosocomial infections were found to be inadequate and outdated.

  9. Nosocomial infections in the Intesive care unit, University hospital for infectious and tropical diseases, Belgrade, Serbia

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    Milošević Ivana

    2014-01-01

    Full Text Available Bacground/Aim. Nosocomial infections (NIs are an important cause of morbidity, mortality and prolonged hospitalizations. Fifty percent of NIs have been reported in Intensive Care Units. The aim of this study was to determine the frequency and type of NIs among critically ill patients treated in the University Hospital for Infectious and Tropical Diseases, Clinical Centre of Serbia, as well as risk factors for acquiring them. Methods. This prospective cohort study included 52 patients treated in the Intensive Care Unit from January to June 2004. The diagnosis of NI was established according to the Centers for Disease Control and Prevention (CDC definition, based on clinical presentation, radiological and microbiological findings, etc. Statistical data processing was done by using the electronic data base organized in SPSS for Windows version 10.0. The level of statistical significance was defined as p < 0. 05. Results. NIs were found in 33 (63.4% of 52 inpatients. Urinary tract infections (UTIs, pneumonia, and soft tissue infections, the most common nosocomial infections in our setting, were recorded in 41.0%, 25.6%, and 23.1%, of patients, respectively. Several factors contributed to a high incidence of these infections: chronic comorbidities (p < 0.01, the presence of indwelling devices such as urinary tract catheters (p < 0.01, endotracheal tubes (p < 0.05 along with mechanical ventilation (p < 0.05. Conclusion. The majority of patients with NIs had chronic underlying comorbidities. All the patients with UTIs had urinary catheters. The most important risk factors for the development of nosocomial pneumonias were endotracheal intubation and mechanical ventilation. The patients with pneumonia had the highest mortality.

  10. Antibiogram of nosocomial urinary tract infections in Felege Hiwot referral hospital, Ethiopia.

    Science.gov (United States)

    Melaku, S; Kibret, M; Abera, B; Gebre-Sellassie, S

    2012-06-01

    Nosocomial infections increase the cost of medical care, extend hospital stay and reflect on the morbidity and mortality of the admitted patients. Urinary tract infections (UTIs) are one of the most common nosocomial infections in humans. To determine the prevalence and antibiogram of nosocomial UITs from a referral hospital. A cross-sectional study was conducted on 1 254 patients from April to August 2010. Antimicrobial susceptibility tests were done using disc diffusion technique as per the standard of Kirby-Bauer method. Of the 1 254 patients, 118 (9.4%) developed nosocomial UTIs. Seventy three (61.9%) and 44 (37.1%) of the bacterial isolates were gram negative and gram positive, respectively. One patient had a mixed infection. E. coli, S.aureus and K. pneumonia were the most predominant isolates. Gender, catheterization and pre-operative antimicrobial prophylaxis and underlying diseases were significantly associated with the occurrence of nosocomial UTIs (p=0.001). Most bacterial isolates showed high resistance rates (>80%) to ampicillin, amoxicillin/clavulanic acid, chloramphenicol and cloxacillin. Catheterization and preoperative antibiotic prophylaxis were found to be the risk factors for nosocomial infection. Effective infection prevention measures should be in place to reduce the prevalence of nosocomial UTIs.

  11. Nosocomial infections in a Dutch neonatal intensive care unit: surveillance study with definitions for infection specifically adapted for neonates.

    Science.gov (United States)

    van der Zwet, W C; Kaiser, A M; van Elburg, R M; Berkhof, J; Fetter, W P F; Parlevliet, G A; Vandenbroucke-Grauls, C M J E

    2005-12-01

    The incidence of nosocomial infection in neonatal intensive care units (NICUs) is high compared with other wards. However, no definitions for hospital-acquired infection are available for NICUs. The aim of this study was to measure the incidence of such infections and to identify risk factors in the NICU of the VU University Medical Center, which serves as a level III regional NICU. For this purpose, a prospective surveillance was performed in 1998-2000. We designed definitions by adjusting the current definitions of the Centers for Disease Control and Prevention (CDC) for children risk factors were dichotomized. Analysis of risk factors was performed by Cox regression with time-dependent variables. The relationship between the Clinical Risk Index for Babies (CRIB) and nosocomial infection was investigated. Furthermore, for a random sample of cases, we determined whether bloodstream infection and pneumonia would also have been identified with the CDC definitions. Seven hundred and forty-two neonates were included in the study. One hundred and ninety-one neonates developed 264 infections. Bloodstream infection (N=138, 14.9/1000 patient-days) and pneumonia (N=69, 7.5/1000 patient-days) were the most common infections. Of bloodstream infections, 59% were caused by coagulase-negative staphylococci; in 21% of neonates, blood cultures remained negative. In 25% of pneumonias, Enterobacteriaceae were the causative micro-organisms; 26% of cultures remained negative. Compared with the Nosocomial Infections Surveillance System (NNIS) of the CDC, our device utilization ratios and device-associated nosocomial infection rates were high. The main risk factors for bloodstream infection were birth weight [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.45-2.17] and parenteral feeding with hospital-pharmacy-produced, all-in-one mixture 'Minimix' (HR 3.69, 95%CI 2.03-6.69); administration of intravenous antibiotics (HR 0.39, 95%CI 0.26-0.56) was a protective risk factor. The

  12. Nosocomial bloodstream infections in Brazilian pediatric patients: microbiology, epidemiology, and clinical features.

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    Carlos Alberto Pires Pereira

    Full Text Available BACKGROUND: Nosocomial bloodstream infections (nBSIs are an important cause of morbidity and mortality and are the most frequent type of nosocomial infection in pediatric patients. METHODS: We identified the predominant pathogens and antimicrobial susceptibilities of nosocomial bloodstream isolates in pediatric patients (≤16 years of age in the Brazilian Prospective Surveillance for nBSIs at 16 hospitals from 12 June 2007 to 31 March 2010 (Br SCOPE project. RESULTS: In our study a total of 2,563 cases of nBSI were reported by hospitals participating in the Br SCOPE project. Among these, 342 clinically significant episodes of BSI were identified in pediatric patients (≤16 years of age. Ninety-six percent of BSIs were monomicrobial. Gram-negative organisms caused 49.0% of these BSIs, Gram-positive organisms caused 42.6%, and fungi caused 8.4%. The most common pathogens were Coagulase-negative staphylococci (CoNS (21.3%, Klebsiella spp. (15.7%, Staphylococcus aureus (10.6%, and Acinetobacter spp. (9.2%. The crude mortality was 21.6% (74 of 342. Forty-five percent of nBSIs occurred in a pediatric or neonatal intensive-care unit (ICU. The most frequent underlying conditions were malignancy, in 95 patients (27.8%. Among the potential factors predisposing patients to BSI, central venous catheters were the most frequent (66.4%. Methicillin resistance was detected in 37 S. aureus isolates (27.1%. Of the Klebsiella spp. isolates, 43.2% were resistant to ceftriaxone. Of the Acinetobacter spp. and Pseudomonas aeruginosa isolates, 42.9% and 21.4%, respectively, were resistant to imipenem. CONCLUSIONS: In our multicenter study, we found a high mortality and a large proportion of gram-negative bacilli with elevated levels of resistance in pediatric patients.

  13. [Epidemiology of nosocomial bacterial infection in a neonatal intensive care unit in Morocco].

    Science.gov (United States)

    Maoulainine, F-M-R; Elidrissi, N-S; Chkil, G; Abba, F; Soraa, N; Chabaa, L; Amine, M; Aboussad, A

    2014-09-01

    In neonatal intensive care units, the incidence of nosocomial infection is high. This study aimed to determine the epidemiology of a nosocomial bacterial infection in the neonatal intensive care unit of Mohamed VI university hospital. A total of 702 newborns were included in this study. Of the 702 neonates studied, 91 had developed a nosocomial infection. The incidence rate was 13% and incidence density was 21.2 per 1000 patient-days. The types of infection were: bloodstream infections (89%), pneumonia (6.6%), meningitis (3.3%), and urinary tract infections (1.1%). Nosocomial infection was particularly frequent in cases of low birth weight, prematurity, young age at admission, umbilical venous catheter, and mechanical ventilation. Multiresistant bacteria included enterobacteria producing betalactamase (76.9%), especially enterobacteria that were dominated by Klebsiella pneumoniae (39.7%). The mortality rate was 52.7% in nosocomial infections, 19 (20.87%) of whom had septic shock. The results of this study show that nosocomial infection is an intrahospital health problem that could be remedied by a prevention strategy.

  14. Bacterial profile and antimicrobial susceptibility pattern in catheter related nosocomial infections.

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    Tullu M

    1998-01-01

    Full Text Available This prospective study was carried out over a period of 6 months in the Paediatric Intensive Care Unit (PICU of a tertiary care teaching hospital. The aim of the study was to determine the organisms causing catheter related nosocomial infections in the PICU and to study their antimicrobial susceptibility pattern. Patients with endotracheal intubation, indwelling urinary catheters and central venous catheters (CVC/venous cutdown catheters were included in the study. Colonization of the endotracheal tube, urinary catheter related infections (UCRI and colonization of the CVC/venous cutdown catheters was studied. E. coli was the commonest organism colonizing the endotracheal tube tip with maximum susceptibility to cefotaxime and amikacin. E. coli was also was the commonest organism causing UCRI with maximum susceptibility to nitrofurantoin and amikacin. Acinetobacter was the commonest organism colonizing the CVC/venous cutdown catheters with maximum susceptibility to ciprofloxacin. All these sites of catheter related infections considered together, E. coli and Klebsiella were the commonest nosocomial organisms. Both had maximum susceptibility to amikacin. Methicillin resistant Staphylococcus aureus (MRSA was isolated only from one culture. All the organisms had a poor susceptibility to cefazolin and amoxycillin. A knowledge of the resident microbial flora and their antimicrobial susceptibility pattern is necessary for formulating a rational antibiotic policy in an ICU.

  15. Nosocomial Infections and Epidemiology of Antibiotic Resistance in Teaching Hospitals in South East of Iran.

    Science.gov (United States)

    Rajabi, Mahboobeh; Abdar, Mohammad Esmaeili; Rafiei, Hossein; Aflatoonia, Mohammad Reza; Abdar, Zahra Esmaeili

    2015-06-25

    Antibiotic resistance as one of the most serious health threats worldwide leading to a high rate of morbidity and mortality. The aim of present study was to examine the prevalence of nosocomial infections (NIs) and pattern of antibiotic resistance in teaching hospitals in Iran. This cross-sectional descriptive study was conducted in a period of one year in three teaching hospitals and all patients with suspected NIs symptoms were chooses. Among these patients who showed antibiotic resistance were included in the study. The samples for clinical test in laboratory were obtained with using standard methods and aseptic technique by trained personnel. Antibiotic susceptibility testing was performed by Kirby-Bauer's disk diffusion method on Muller-Hinton agar (Hi Media, Mumbai, India) in accordance with the standards of the Clinical Laboratory Standards Institute. During one year study, 561 patients with nosocomial infections were recognized and among them 340 patients (60.6%) showed some level of antibiotic resistance. The most common cause of NIs in present study was Acinetobacter and the most type of infection was respiratory system infections (52.7%). The highest resistance rate was against Ciprofloxacin (61.8%) followed by Imipenem (50.3%). Rate of NIs and antibiotics resistance is high in Iranian hospital. So Iranian health ministry should provide guideline and suitable programs for prevention of NIs and antibiotic therapy in hospitals.

  16. Clinical importance and cost of bacteremia caused by nosocomial multi drug resistant acinetobacter baumannii

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    Tugba Arslan Gulen

    2015-09-01

    Conclusion: Our results suggest that the occurrence of MDR A.baumannii bacteremia was related with the usage of the wide spectrum antibiotics, and mortality rates were increased in patients that high SAPS II scores, long term hospitalization. Infection control procedures and limited antibiotic usage are very important for prevent nosocomial infections.

  17. Efficacy of an infection control programme in reducing nosocomial bloodstream infections in a Senegalese neonatal unit.

    Science.gov (United States)

    Landre-Peigne, C; Ka, A S; Peigne, V; Bougere, J; Seye, M N; Imbert, P

    2011-10-01

    Neonatal nosocomial infections are public health threats in the developing world, and successful interventions are rarely reported. A before-and-after study was conducted in the neonatal unit of the Hôpital Principal de Dakar, Senegal to assess the efficacy of a multi-faceted hospital infection control programme implemented from March to May 2005. The interventions included clustering of nursing care, a simple algorithm for empirical therapy of suspected early-onset sepsis, minimal invasive care and promotion of early discharge of neonates. Data on nosocomial bloodstream infections, mortality, bacterial resistance and antibiotic use were collected before and after implementation of the infection control programme. One hundred and twenty-five infants were admitted immediately before the programme (Period 1, January-February 2005) and 148 infants were admitted immediately after the programme (Period 2, June-July 2005). The two groups of infants were comparable in terms of reason for admission and birth weight. After implementation of the infection control programme, the overall rate of nosocomial bloodstream infections decreased from 8.8% to 2.0% (P=0.01), and the rate of nosocomial bloodstream infections/patient-day decreased from 10.9 to 2.9/1000 patient-days (P=0.03). Overall mortality rates did not differ significantly. The proportion of neonates who received antimicrobial therapy for suspected early-onset sepsis decreased significantly from 100% to 51% of at-risk infants (Pnosocomial bloodstream infections, and the efficacy of these interventions was long-lasting. Such interventions could be extended to other low-income countries.

  18. Regional distribution of nosocomial infections due to ESBL-positive Enterobacteriaceae in Germany: data from the German National Reference Center for the Surveillance of Nosocomial Infections (KISS).

    Science.gov (United States)

    Leistner, R; Schröder, C; Geffers, C; Breier, A-C; Gastmeier, P; Behnke, M

    2015-03-01

    Surveillance systems for hospital infections are reporting increasing rates of extended-spectrum β-lactamase (ESBL)-positive Enterobacteriaceae in Europe. We aimed to perform a national survey on this trend and on the regional distribution of nosocomial infections due to ESBL-positive Enterobacteriaceae in German hospitals. Data from 2007 to 2012 from two components of the German national nosocomial infection surveillance system were used for this analysis. The data derive from intensive care units and surgical departments. Independent factors determining the proportion of ESBL-positive Enterobacteriaceae among nosocomial infections due to Enterobacteriaceae and changes in its regional distribution (broken down into German federal states) were calculated by regression analysis. From 2007 to 2012, the data showed a significantly increasing proportion of ESBL-positive Enterobacteriaceae in surgical site infections (from 11.46 to 15.38, 134%, p 0.003), urinary tract infections (9.36 to 16.56, 177%, p infections (11.91 to 14.70, 123%, p nosocomial infections has significantly increased in Germany over the last 6 years. Hospitals in Central Germany and surgical departments in all of Germany are especially affected by this development.

  19. Nosocomial Infections among Pediatric Patients with Neoplastic Diseases

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    Peninnah Oberdorfer

    2009-01-01

    Full Text Available Background. Pediatric patients with neoplastic diseases are more likely to develop nosocomial infections (NIs. NIs may prolong their hospital stay, and increase morbidity and mortality. Objectives. The objectives of this study were to determine: (1 the incidence of NIs, (2 sites of NIs, (3 causal organisms, and (4 outcomes of NIs among pediatric patients with neoplastic diseases. Methods. This study was a prospective cohort study of pediatric patients with neoplastic diseases who were admitted to the Chiang Mai University Hospital, Thailand. Results. A total of 707 pediatric patients with neoplastic diseases were admitted. Forty-six episodes of NIs in 30 patients were reported (6.5 NIs/100 admission episodes and 7 NIs/1000 days of hospitalization. Patients with acute lymphoblastic leukemia had the highest number of NIs (41.3%. The most common causal organisms were gram-negative bacteria (47.1%. Patients who had undergone invasive procedures were more likely to develop NIs than those who had not (P<.05. The mortality rate of patients with NIs was 19.6%. Conclusion. Pediatric patients with neoplastic diseases are more likely to develop NIs after having undergone invasive procedures. Pediatricians should be aware of this and strictly follow infection control guidelines in order to reduce morbidity and mortality rates related to NIs.

  20. Nosocomial Infections among Pediatric Patients with Neoplastic Diseases.

    Science.gov (United States)

    Oberdorfer, Peninnah; Pongwilairat, Natthida; Washington, Charles H

    2009-01-01

    Background. Pediatric patients with neoplastic diseases are more likely to develop nosocomial infections (NIs). NIs may prolong their hospital stay, and increase morbidity and mortality. Objectives. The objectives of this study were to determine: (1) the incidence of NIs, (2) sites of NIs, (3) causal organisms, and (4) outcomes of NIs among pediatric patients with neoplastic diseases. Methods. This study was a prospective cohort study of pediatric patients with neoplastic diseases who were admitted to the Chiang Mai University Hospital, Thailand. Results. A total of 707 pediatric patients with neoplastic diseases were admitted. Forty-six episodes of NIs in 30 patients were reported (6.5 NIs/100 admission episodes and 7 NIs/1000 days of hospitalization). Patients with acute lymphoblastic leukemia had the highest number of NIs (41.3%). The most common causal organisms were gram-negative bacteria (47.1%). Patients who had undergone invasive procedures were more likely to develop NIs than those who had not (P < .05). The mortality rate of patients with NIs was 19.6%. Conclusion. Pediatric patients with neoplastic diseases are more likely to develop NIs after having undergone invasive procedures. Pediatricians should be aware of this and strictly follow infection control guidelines in order to reduce morbidity and mortality rates related to NIs.

  1. Phylogenetic Analysis of Stenotrophomonas spp. Isolates Contributes to the Identification of Nosocomial and Community-Acquired Infections

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    Vinicius Godoy Cerezer

    2014-01-01

    Full Text Available Stenotrophomonas ssp. has a wide environmental distribution and is also found as an opportunistic pathogen, causing nosocomial or community-acquired infections. One species, S. maltophilia, presents multidrug resistance and has been associated with serious infections in pediatric and immunocompromised patients. Therefore, it is relevant to conduct resistance profile and phylogenetic studies in clinical isolates for identifying infection origins and isolates with augmented pathogenic potential. Here, multilocus sequence typing was performed for phylogenetic analysis of nosocomial isolates of Stenotrophomonas spp. and, environmental and clinical strains of S. maltophilia. Biochemical and multidrug resistance profiles of nosocomial and clinical strains were determined. The inferred phylogenetic profile showed high clonal variability, what correlates with the adaptability process of Stenotrophomonas to different habitats. Two clinical isolates subgroups of S. maltophilia sharing high phylogenetic homogeneity presented intergroup recombination, thus indicating the high permittivity to horizontal gene transfer, a mechanism involved in the acquisition of antibiotic resistance and expression of virulence factors. For most of the clinical strains, phylogenetic inference was made using only partial ppsA gene sequence. Therefore, the sequencing of just one specific fragment of this gene would allow, in many cases, determining whether the infection with S. maltophilia was nosocomial or community-acquired.

  2. A novel experience in the use of control charts for the detection of nosocomial infection outbreaks

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    Isabel Cristina Gomes

    2011-01-01

    Full Text Available OBJECTIVE: This study aims to compare different control charts to monitor the nosocomial infection rate per 1,000 patient-days. METHODS: The control charts considered in this study were the traditional Shewhart chart and a variation of this, the Cumulative Sum and Exponentially Weighted Moving Average charts. RESULTS: We evaluated 238 nosocomial infections that were registered in the intensive care unit and were detected by the Committee for Nosocomial Infection Control in a university hospital in Belo Horizonte, Brazil, in 2004 and 2005. The results showed that the traditional Shewhart chart was the most appropriate method for monitoring periods with large deviations, while the Exponentially Weighted Moving Average and Cumulative Sum charts were better for monitoring periods with smaller deviations of the mean infection rate. CONCLUSION: The ability to detect nosocomial outbreaks was improved by using the information provided by all three different control charts.

  3. NURSING CARE KNOWLEDGE MANAGEMENT BASED TRAINING DECREASE NOSOCOMIAL INFECTION INCIDEN IN POST SECTIO CESAREA PATIENTS

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    Ahsan Ahsan

    2017-04-01

    Full Text Available Introduction: Model of nursing care based on knowledge management can reduce the incidence of nosocomial infections through the performance of nurses in the prevention of infection. Nursing care based on knowledge management is established from identi fi cation knowledge which is required, prevention performance of nosocomial infections post caesarean section. Nosocomial infections component consists of wound culture result. Method: This study was an observational study with a quasy experimental design. The population were all of nursing staff who working in obstetrics installation and a number of patients who is treated in hospitals A and B post sectio caesarea. Sample is comparised a total population all the nursing staff who worked in obstetrics installation according to criteria of the sample, and most of patients were taken care by nursing staff post caesarean section which is taken by random sampling 15 patients. Data was collected through observation sheets and examination of the wound culture. Data analysis which is used the t test. Result: The result was showed that there was signi fi cant difference in the incidence of nosocomial infection in patients with post sesctio caesarea in hospital before and after nursing care training based on knowledge management (tvalue = 2.316 and p = 0.028 < α = 0.05 level, and the incidence of nosocomial infection was lower after training than before training. Discussion: It can be concluded that training knowledge management based on nursing care effectives to reduce Incidence of Nosocomial Infections in Patients after Sectio Caesarea.

  4. Nosocomial Infections in Pediatric Population and Antibiotic Resistance of the Causative Organisms in North of Iran

    OpenAIRE

    Behzadnia, Salar; Davoudi, Alireza; Rezai, Mohammad Sadegh; Ahangarkani, Fatemeh

    2014-01-01

    Background: Treatment of the nosocomial infections is complicated especially in children due to an increase in the antibiotic-resistant bacteria. Objectives: The aim of this study was to survey the nosocomial infections in children and determine the antibiotic susceptibility of their causative organisms in teaching hospitals in the north of Iran. Patients and Methods: The investigation was designed as a retrospective cross-sectional study. The study population consisted of patients under 12 y...

  5. Distribution of pathogens causing nosocomial infections in patients with spontaneous intracerebral hemorrhage and analysis of risk factors%自发性脑出血患者医院感染病原菌分布与危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈江利; 邵高峰; 陈飞; 杨刚; 袁东海; 刘建芳

    2015-01-01

    OBJECTIVE To explore the distribution of pathogens causing nosocomial infections in patients with spontaneous intracerebral hemorrhage and analyze the risk factors so as to provide guidance fore the clinical diag‐nosis and treatment .METHODS The clinical data of 817 patients with spontaneous intracerebral hemorrhage who were treated from May 2012 to Feb 2014 were retrospectively analyzed ,the incidence of nosocomial infections and the distribution of infection sites were statistically analyzed ,and the relationship between the gender ,age ,stroke scale (NIHSS) score ,Glasgow coma scale (GCS) score ,smoking history ,history of diabetic mellitus and the inci‐dence of nosocomial infections was observed .RESULTS The nosocomial infections occurred in 127 of 817 patients with spontaneous intracerebral hemorrhage ,the incidence of nosocomial infections was 15 .54% .Among the pa‐tients with nosocomial infections ,the patients with respiratory tract infections accounted for 58 .27% ,the patients with gastrointestinal tract infections 16 .54% ,the patients with urinary tract infections 13 .38% .A total of 127 strains of pathogens have been isolated , including 89 (70 .08% ) strains of gram‐negative bacteria and 38 (29 .92% ) strains of gram‐positive bacteria ;the K lebsiella pneumoniae , Pseudomonas aeruginosa , Escherichia coli , Enterobacter cloacae ,and Enterobacter aerogenes were dominant among the gram‐negative bacteria ;the Staphylococcus aureus ,Enterococcus faecalis ,coagulase‐negative Staphylococcus ,and Enterococcus feces were the predominant species of gram‐positive bacteria .The incidence of nosocomial infections in the patients with spon‐taneous intracerebral hemorrhage was associated with the no less than 65 years of age ,NIHSS score no less than 10 points , GCS score less than 8 points , history of diabetic mellitus , and smoking history ( P < 0 .05 ) . CONCLUSION The gram‐negative bacteria are dominant among the pathogens causing

  6. 褪色沙雷菌的医院感染分布与耐药性分析%Distribution and drug resistance of Serratia marcescens causing nosocomial infections

    Institute of Scientific and Technical Information of China (English)

    卫叶林; 来汉江; 佘军; 朱彤

    2012-01-01

    OBJECTIVE To explore the clinical distribution and drug resistance of Serratia marcescens causing nosocomial infections in the ICU and non-ICU so as to provide bases for reasonable use of antibiotics. METHODS The in vitro drug susceptibility testing was performed for 156 clinical isolates of S. marcescens by using KB method, β-lactamase was detected at the same time. RESULTS Of 156 strains of S. marcescens cultured and isolated, there were 57 (36. 5%) strains in ICU, 52 (33. 3%) strains in respiratory department, 28 (17. 9%) strains in neurology department, and 19 (12. 2%) strains in other departments; the average drug resistance rates to imipenem and cefoperazone/sulbactam were 5. 1% and 1.9%, the drug resistance rates to ampicillin, cefazolin, and amoxicillin/clavulanic acid were higher than 90. 0%; there were 21 strains of Ampc enzyme-producing S. marcescens detected with the detection rate of 13. 5%, 18 strains of ESBLs-producing S. marcescens with detection rate of 11. 5% and 7 strains of both Ampc enzyme and ESBLs-producing S. marcescens with detection rate of 4. 5%. CONCLUSION The drug resistance rate of S. marcescens strains isolated from ICU is significantly higher than those isolated from non-ICUs; the detection rates of the three phenotypes of Ampc and ESBLs are higher in ICU than in non-ICUs; the drug resistant mechanism of S. marcescens is complex,and S. marcescens is resistant to multiple antibiotics, it is necessary to reasonably choose antibiotics on the basis of drug susceptibility testing.%目的 了解褪色沙雷菌在医院感染的临床分布和在ICU与非ICU的耐药性,为临床合理选择和应用抗菌药物提供依据.方法 用K-B法对临床分离出的156株褪色沙雷菌进行体外药物敏感试验并统计分析,同时检测其β-内酰胺酶.结果 分离培养的156株褪色沙雷菌在科室分布,ICU 57株占36.5%、呼吸科52株占33.3%、神经内科28株占17.9%、其他科室19株占12.2%;对亚胺培南

  7. Clinical significance of coagulase-negative staphylococci isolates from nosocomial bloodstream infections.

    Science.gov (United States)

    Asaad, Ahmed Morad; Ansar Qureshi, Mohamed; Mujeeb Hasan, Syed

    2016-01-01

    Identification of coagulase-negative staphylococci (CoNS) as nosocomial pathogens or contaminants is significant for microbiologists and clinicians. This study aimed to determine the frequency of isolation and antimicrobial resistance patterns of CoNS isolates from nosocomial bloodstream infections (BSIs) and to identify risk factors associated with true bacteremia caused by these emerging pathogens in a Saudi tertiary care hospital. All CoNS-positive cultures from inpatients were identified using the standard methods during a 10-month period. Antimicrobial susceptibility testing was done using the reference broth microdilution method. A total of 208 isolates were identified; of these 75 (32.2%) were considered infection associated, and 133 (67.8%) were considered contamination. S. epidermidis accounted for 34.7% of bacteremia cases, followed by S. hominis (21.3%), S. haemolyticus (16%), and S. saprophyticus (12%). Central venous catheters (p ≤ 0.0001), prior antibiotic therapy (p ≤ 0.0001), the occurrence of more than one positive blood culture (p ≤ 0.0001), and intensive care unit (ICU) admission (p = 0.007) were all independently associated with CoNS bacteremia. Overall, all isolates were highly resistant to penicillin (94.7%), oxacillin (90.7%), and erythromycin (85.3%). The rates of susceptibility to vancomycin, daptomycin, and teicoplanin were 98.7%, 98.7%, and 93.3%, respectively. Our results further highlight that accurate identification and susceptibility testing of CoNS isolates from nosocomial BSIs are crucial to minimize excessive antibiotic use and unnecessary catheter removal. In addition, daptomycin may be an efficient alternative therapeutic option for CoNS resistant to oxacillin and other commonly used antibiotics.

  8. 神经外科手术患者医院感染特点及病原菌耐药性分析%Characteristics of nosocomial infections caused by pathogens in neurosurgery department patients and analysis of drug resistance

    Institute of Scientific and Technical Information of China (English)

    丁晓萍

    2012-01-01

    目的 分析神经外科手术患者医院感染特点及主要病原菌耐药性,为控制医院感染提供参考信息.方法 对2010年1月-2011年12月神经外科手术患者进行前瞻性监测,定期总结分析反馈临床,提出于预对策.结果 1759例手术患者发生医院感染164例、196例次,感染率9.32%、例次感染率为11.14%;显著高于同期全院手术患者感染率1.43% (P<0.01);感染部位以下呼吸道为主,占52.55%,其次为颅内感染,占17.85%;共检出病原菌164株,以革兰阴性菌为主占76.05%,其次是革兰阳性菌占16.77%;病原菌前4位为鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌和金黄色葡萄球菌,分别占22.75%、15.57%、13.17%和8.98%;所选的抗菌药物中,对革兰阴性菌敏感性较高的有阿莫西林/克拉维酸、美罗培南、亚胺培南;对革兰阳性菌敏感性较高的药物有万古霉素、氯霉素、夫西地酸.结论 加强手术患者及留置管道患者的全程管理,病原菌监测中重点关注感染者与带菌者消毒隔离措施的执行力,是减少医院感染多药耐药菌传播的重要环节.%OBJECTIVE To analyze the characteristics of nosocomial infections in the patients of neurosurgery departments and the drug resistance of the main pathogens so as to provide reference for the control of nosocomial infections. METHODS From Jan 2010 to Dec 2011, the prospective monitoring of the patients of the neurosurgery department was performed, the regular summaries, analysis and feedback to the hospital were carried out, the intervention countermeasures were put forward. RESULTS Of totally 1759 cases of patients investigated, nosocomial infections occurred in 164 patients ( 196 case-times) with the infection rate of 9. 32% (the case-time infection rate of 11. 14% , significantly higher than 1. 43% of the patients of the whole hospital at the same period (F <0. 01); the lower respiratory tract was the main infection site

  9. 肺癌化疗患者院内感染病原菌分布及药敏分析%Pathogens causing nosocomial infections in lung cancer patients treated with chemother-apy and drug susceptibility

    Institute of Scientific and Technical Information of China (English)

    慕玉东; 王永兴; 杨瑞繁

    2016-01-01

    Objective:To investigate the distribution of pathogens nosocomial infections in the lung cancer chemo-therapy patients and analyze drug susceptibility,to provide the basis for clinical treatment. Methods:The clinical data of 240 cases of lung cancer patients,treated with chemotherapy and consolidated nosocomial infection from Jan 2010 to Jun 2015,were retrospectively analyzed,to test infectious pathogen and drug sensitive,analysis of the site of infection, infection of pathogenic bacteria types and constituent ratio,and different kinds of pathogenic bacteria to antibiotics re-sistance. Results:Lung cancer chemotherapy patients with highest proportion of parts of the occurrence of nosocomial infection in respiratory tract of 137 cases(57. 1% ),urinary tract infection,accounting for 22. 5% . Infection of patho-genic bacteria in most gram - negative bacteria 162 strains(67. 5% ),gram - positive bacteria followed 63 strains (26. 3% ),15 fungi strains(6. 2% ). Gram - negative bacteria to ciprofloxacin,piperacillin,clindamycin,gentamicin antibiotic resistant rate was higher,gram - positive bacteria to penicillin G,clindamycin,gentamycin antibiotic resist-ant rate was higher,Fungi to fluconazole,fluorine cytosine had higher resistance. Conclusion:To merge the hospital infection of patients with lung cancer after chemotherapy pathogenic bacteria distribution and drug susceptibility re-sults were analyzed,and to promote the clinical rational use of antibiotics,reducing the generation of drug - resistant bacteria,is of great significance to improve the patientˊs quality of life.%目的:对肺癌化疗患者发生院内感染病原菌的分布及药敏结果进行分析,为临床抗感染治疗提供依据。方法:对2010年1月至2015年6月收治的采取化学治疗合并医院感染的240例肺癌患者的临床资料进行回顾性分析,对于送检的感染性标本进行病原菌检测及药敏试验,分析感染的部位、感染病原菌的种类、构

  10. Nosocomial infection in a Danish Neonatal Intensive Care Unit: a prospective study

    DEFF Research Database (Denmark)

    Olsen, Anne L; Reinholdt, Jes; Jensen, Anders Mørup

    2009-01-01

    AIM: The aim of this study was to estimate the incidence and identify independent risk factors for nosocomial infections in a Danish Neonatal Intensive Care Unit and to compare these findings with international results. METHODS: The study was performed prospectively from January 1, 2005 to December...... 31, 2005 in the Neonatal Intensive Care Unit at Rigshospitalet, Copenhagen. Specific criteria for blood stream infection and respiratory tract infection adapted for neonates in our ward were worked out. RESULTS: Six hundred and eighty-three patients were included. The overall incidence of nosocomial...... and respiratory tract infection, and central venous catheter and parenteral nutrition risk factors for first time blood stream infection. CONCLUSION: This first prospective study of nosocomial infection in a Danish Neonatal Intensive Care Unit found an overall incidence of 8.8/1000 hospital days, which is low...

  11. Clinical Characteristics of Nosocomial Rotavirus Infection in Children in Taiwan

    Directory of Open Access Journals (Sweden)

    Jian-Te Lee

    2008-10-01

    Conclusion: NRI may cause significant morbidity in hospitalized children, especially young infants and those with underlying diseases. Infection control with hospital surveillance, strict isolation and cohort care should be adopted to prevent the spread of rotavirus among special care units.

  12. Nosocomial infections in pediatric population and antibiotic resistance of the causative organisms in north of iran.

    Science.gov (United States)

    Behzadnia, Salar; Davoudi, Alireza; Rezai, Mohammad Sadegh; Ahangarkani, Fatemeh

    2014-02-01

    Treatment of the nosocomial infections is complicated especially in children due to an increase in the antibiotic-resistant bacteria. The aim of this study was to survey the nosocomial infections in children and determine the antibiotic susceptibility of their causative organisms in teaching hospitals in the north of Iran. The investigation was designed as a retrospective cross-sectional study. The study population consisted of patients under 12 years old, which were hospitalized in three teaching hospitals in the north of Iran and had symptoms of nosocomial infections in 2012. The required data of patients were extracted and entered in the information forms. The collected data were analyzed using SPSS (ver. 16). Descriptive statistics and Fisher's exact tests (Monte Carlo) were used. Out of the total number of 34556 hospitalized patients in three teaching hospitals, 61 (0.17%) patients were children under 12 years old age with nosocomial infection from which 50.81% were girls and 49.18% were boys. Most of these patients (55.73%) were admitted to the burn unit. The most common type of nosocomial infection (49.18%) was wound infection. Pseudomonas spp. (36.84%) and Acinetobacter spp. (28.02%) were the most common bacteria isolated from the clinical specimens. All the Acinetobacter spp. were multidrug-resistant. All the gram negative and gram positive bacterial species in our study showed high resistance to antibiotics. The rate of nosocomial infections was low in our study because the detection of nosocomial infection was based on the clinical grounds in most cases and laboratory reports might contain false-negative results. These results provide useful information for future large scale surveillance in the context of prevention programs.

  13. Native Brazilian plants against nosocomial infections: a critical review on their potential and the antimicrobial methodology.

    Science.gov (United States)

    H Moreno, Paulo Roberto; da Costa-Issa, Fabiana Inácio; Rajca-Ferreira, Agnieszka K; Pereira, Marcos A A; Kaneko, Telma M

    2013-01-01

    The growing incidences of drug-resistant pathogens have increased the attention on several medicinal plants and their metabolites for antimicrobial properties. These pathogens are the main cause of nosocomial infections which led to an increasing mortality among hospitalized patients. Taking into consideration those factors, this paper reviews the state-of-the-art of the research on antibacterial agents from native Brazilian plant species related to nosocomial infections as well as the current methods used in the investigations of the antimicrobial activity and points out the differences in techniques employed by the authors. The antimicrobial assays most frequently used were broth microdilution, agar diffusion, agar dilution and bioautography. The broth microdilution method should be the method of choice for testing new antimicrobial agents from plant extracts or isolated compounds due to its advantages. At the moment, only a small part of the rich Brazilian flora has been investigated for antimicrobial activity, mostly with unfractionated extracts presenting a weak or moderate antibacterial activity. The combination of crude extract with conventional antibiotics represents a largely unexploited new form of chemotherapy with novel and multiple mechanisms of action that can overcome microbial resistance that needs to be further investigated. The antibacterial activity of essential oil vapours might also be an interesting alternative treatment of hospital environment due to their ability in preventing biofilm formation. However, in both alternatives more studies should be done on their mode of action and toxicological effects in order to optimize their use.

  14. Etiology and Clinical Investigation of Nosocomial Infections at Ardabil Bou-Ali Hospital during 2010

    Directory of Open Access Journals (Sweden)

    Manoochehr Barak

    2012-11-01

    Full Text Available Background & Objectives: Nosocomial infections occur following admission of patients in the hospitals and usually are accompanied by significant mortalities. This study was conducted to determine the frequency of nosocomial infections and the causatives in Ardabil Bu Ali hospital during 2010.   Methods: This study was a cross-sectional study which has been done on collection of information through practical examinations, laboratory tests and files of nosocomillay infected patients in Ardabil Bu Ali hospital during 2010. Data were analyzed by SPSS.   Results: From a total of 3254 patients, 42 (1.3% had got nosocomial infections. Of these infected patients 47.6% was males and 52.4% was females. Infection was more frequent in patients with ages between 1 month to1 year old (45.2%. Sepsis (33.3%, pneumonia and blood stream infections (23.8% and urinary tract infection (19% were the most frequent infections. The mean length of hospital stay was 26.86 days. Klebsiella pneumoniae was the most common pathogen reported (23.8%. Infection was more common in NICU (38.1%.   Conclusion: In this study, the frequency of nosocomial infection was lower than other studies. Distribution of infection differed with age, ward and length of stay in the hospital.

  15. Nosocomial infections after aneurysmal subarachnoid hemorrhage : time course and causative pathogens

    NARCIS (Netherlands)

    Laban, Kamil G.; Rinkel, Gabriel J. E.; Vergouwen, Mervyn D. I.

    BackgroundNosocomial infections after aneurysmal subarachnoid hemorrhage (aSAH) are associated with prolonged length of stay and poor functional outcome. It remains unclear if infections result in prolonged length of stay or, vice versa, if prolonged length of stay results in more infections. Before

  16. Nosocomial infections after aneurysmal subarachnoid hemorrhage : time course and causative pathogens

    NARCIS (Netherlands)

    Laban, Kamil G.; Rinkel, Gabriel J. E.; Vergouwen, Mervyn D. I.

    2015-01-01

    BackgroundNosocomial infections after aneurysmal subarachnoid hemorrhage (aSAH) are associated with prolonged length of stay and poor functional outcome. It remains unclear if infections result in prolonged length of stay or, vice versa, if prolonged length of stay results in more infections. Before

  17. Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

    OpenAIRE

    2016-01-01

    "> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nos...

  18. Clinical significance of nosocomial acquisition in urinary tract-related bacteremia caused by gram-negative bacilli.

    Science.gov (United States)

    Kang, Cheol-In; Chung, Doo Ryeon; Son, Jun Seong; Ko, Kwan Soo; Peck, Kyong Ran; Song, Jae-Hoon

    2011-03-01

    Although hospital-acquired infections presumably may have a poorer prognosis than community-onset infections because of unanticipated antimicrobial resistance, little data are available on the clinical and microbiological characteristics of hospital-acquired versus community-onset urinary tract-related bacteremia cases. Data were collected from a nationwide database of surveillance for bacteremia. Data from patients with hospital-acquired urinary tract-related bacteremia were compared with those with community-onset bacteremia. Of 398 patients with urinary tract-related bacteremia, 71 (17.8%) had hospital-acquired infection, and the remaining 327 (82.2%) had community-onset infection. Although Escherichia coli was the most common isolate identified, pathogens other than E coli were more frequently isolated in hospital-acquired infections than in community-onset infections (46.5% vs 19.3%). Among E coli isolates causing hospital-acquired infections, 26.3% (10 of 38) were resistant to extended-spectrum cephalosporins (ESCs), whereas among E coli isolates causing community-onset infections, only 6.1% (16 of 264) were ESC-resistant. Hospital-acquired infection had a significantly higher mortality rate than community-onset infection (21.1% [15 of 71] vs 8.3% [27 of 327]; P = .004). Multivariate analysis identified nosocomial acquisition as a significant independent risk factor for mortality, along with severe sepsis, underlying solid tumor, ESC resistance, and high Pitt bacteremia score (all P urinary tract-related bacteremia has a poorer prognosis than community-onset bacteremia. The ESC-resistant nature of gram-negative bacilli, which may be more common in nosocomial isolates than in community isolates, adversely affects the outcome of urinary tract-related bacteremia. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  19. Changes in biochemical parameters on the first day after kidney transplantation: risk factors for nosocomial infection?

    Institute of Scientific and Technical Information of China (English)

    YANG Yi; REN Liang; ZHANG Yong; LIU Hang; CAO Bin; ZHANG Xiao-dong

    2010-01-01

    Background Nosocomial infection in early post-transplantation period is a tough problem for kidney transplantation. Few reports have explored the relations between biochemical parameters and nosocomial infection in kidney transplantation. This retrospective study was carried out to describe the characteristics of nosocomial infection in the very early period of kidney transplantation and to determine the risk factors in biochemical parameters and their alterations. Methods Patients who underwent their first kidney transplantation from January 2001 to March 2009 in Beijing Chao-Yang Hospital were recruited and the nosocomial infectious episodes were collected for this study. Gender, age, donor type, delayed graft function (DGF) and biochemical parameters such as serum uric acid, lipids files and albumin on day 0 (before transplantation) and day 1 (24 hours after transplantation) and their changes were analyzed with Logistic regression models for nosocomial infection. Results A total of 405 patients (315 men and 90 women) were involved in this study. There were 80 patients experiencing 113 infection episodes and 105 strains of microorganism were indentified. In univariate analysis, there were significant differences in DGF, albumin on day 0, lipoprotein (a) (Lp(a)) on day 1, change in low density lipoprotein-cholesterol (LDL-C, day 1-day 0) and change in uric acid (day 1-day 0) between nosocomial infection patients and noninfectious patients (P<0.05). In multivariate analysis, change in uric acid (day 1-day 0) (Off 5.139, 95% Cl 1.176-22.465, P<0.05), change in LDL-C (day 1-day 0) {OR4.179, 95% Cl 1.375-12.703, P<0.05) and DGF (Of? 14.409, 95% Cl 1.603-129.522, P<0.05) were identified as independent risk factors for nosocomial infection in kidney transplantation. Conclusions Most nosocomial infections in early postoperative period of kidney transplantation are bacterial, especially with Gram-negative bacteria. The most common infection sites are respiratory tract

  20. Legionella pneumophila: risk assessment and strategy for the prevention and control of nosocomial infections

    Directory of Open Access Journals (Sweden)

    Salvo Torrisi

    2012-06-01

    Full Text Available The term “Legionellosis” includes all forms of disease caused by microorganisms of the genus Legionella; it may manifest as a flu-like shape (Pontiac fever, or with severe pneumonia with high mortality (Legionnaires Disease. The causative agent was Legionella pneumophila in the literature although other strains of the genus Legionella are classified as pathogens, mode of transmission is through inhalation of aerosol particles produced by hot water or air conditioning systems: for this reason in community settings and nosocomial L. pneumophila represents a serious public health problem. In the light of epidemiological data since the year 2000 the Italian State has issued a series of provisions laws concerning the prevention and control of nosocomial Legionellosis environment and community.The present work aims to evaluate the presence of Legionella species and L. pneumophila comparing the different approaches proposed by the Guidelines of the regions of Lombardy and Piedmont in terms of assessment and prevention of risk “Legionellosis” in the field of nosocomial infection. The analytical methods used are those provided by the Regional Guidelines: the official method in the second CSR April 4 Method 2000 and UNI EN ISO 11731-1: 2008. Checks have been performed on equipment for the comparison of cold water, hot water and air conditioning in nursing homes, retirement homes and hospitals.The results obtained show that the method CSR April 4, 2000 restricts the search to L. pneumophila permitting, than the method EN ISO 11731-1: 2008, to carry out a risk assessment well targeted to the actual pathogen.The culture method for the detection of L. pneumophila allows you to not only prevention, but also to implement a series of targeted interventions following the directions of the legislation.

  1. [Infections as causes of fever of unknown origin].

    Science.gov (United States)

    Schneidewind, A; Ehrenstein, B; Salzberger, B

    2009-06-01

    Infectious diseases are important causes of fever of unknown origin (FUO). The spectrum of infectious agents is broad and diagnosis depends on careful evaluation of individual risk factors. Infectious diseases presenting as FUO are frequently atypical presentations of well known infections, e.g. tuberculosis or infectious endocarditis. In this review we present an overview of infectious causes of FUO classified into community acquired infections, nosocomial infections, and infections in immunocompromised hosts.

  2. [Ecological aspects and prophylaxis of Acinetobacter baumannii nosocomial infection].

    Science.gov (United States)

    Boukadida, J

    2000-01-01

    Acinetobacter Baumannii is an aerobic strit gram negative bacteria cause of epidemic infection in intensive care units this bacteria is isolated from the patient and its environment. The detection of AB infection require the isolation of patients and decontamination of the material despite the virulence of the germ, these measures are necessary due to the rapid extension of epidemic in the absence of adequate means.

  3. Nosocomial transmission and infection control aspects of parasitic and ectoparasitic diseases. Part III. Ectoparasites/summary and conclusions.

    Science.gov (United States)

    Lettau, L A

    1991-03-01

    As a rule, both the standard of hygiene and sanitation prevalent in hospitals in the United States and the rarity of parasitic diseases compared to viral, bacterial, and fungal infections, reduce the hazard of nosocomial acquisition of parasites to relatively trivial levels. However, abetted by the resultant low index of suspicion on the part of clinical staff, certain parasitic microorganisms may at times cause significant morbidity and even mortality in both normal and immunocompromised patients, as summarized in this review. Also, the nosocomial acquisition of parasites may be somewhat underappreciated because the incubation period for clinical illness may be days to weeks and thus a hospital-acquired infection may not be recognized as such, particularly if the parasite is endemic locally. Parasitic diseases have been a much more significant problem in certain special facilities, such as custodial institutions for the mentally ill or retarded, where crowding, poor environmental sanitation, and low levels of personal hygiene have in the past allowed the rapid dissemination and endemic occurrence of a large variety of parasitic infections. It is likely that nosocomial transmission of parasites may be an even greater problem in some hospitals in the tropics, where strict hygienic standards are costly or otherwise more difficult to maintain, and where often an increased proportion of the patient population harbors one or more parasites. However, the exact magnitude of the problem in tropical hospitals is also more difficult to determine because nosocomial acquisition of a parasitic infection may not be distinguished easily versus exogenous infection or reactivation of latent infection.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. 肠球菌医院感染特征及新型抗菌药物耐药性研究%Characteristics of enterococcus causing nosocomial infection and the study with drug resistance to new antibiotic

    Institute of Scientific and Technical Information of China (English)

    王敏; 吴李培; 万晓龙; 韩叶; 宣世海; 茅敏; 赵建春; 周玉贵

    2015-01-01

    目的:探讨肠球菌属细菌分布及耐药性特征,为指导临床合理用药及控制医院感染提供依据。方法对该院2011年1月至2013年12月年临床送检标本进行细菌分离培养、鉴定和药敏试验。结果共检出肠球菌属细菌140株,屎肠球菌71株(50.7%),粪肠球菌60株(42.9%),其他肠球菌9株(6.4%),其中尿液99株(70.7%);粪肠球菌对青霉素、氨苄西林、红霉素的耐药率为15.0%、12.5%和75.0%,屎肠球菌对青霉素、氨苄西林、左氧氟沙星、环丙沙星、红霉素耐药率大于80.0%,粪肠球菌和屎肠球菌对万古霉素(5.0%、4.2%)、利奈唑胺(8.4%、1.4%)极度敏感,喹奴普丁/达福普丁对粪肠球菌耐药率(100.0%)高于屎肠球菌(26.7%),达托霉素无耐药菌株。结论肠球菌属以泌尿系统感染为主,屎肠球菌检出率略大于粪肠球菌,屎肠球菌对大多数抗菌药物耐药率高于粪肠球菌,喹奴普丁/达福普丁仅对屎肠球菌有较高敏感性,万古霉素、利奈唑胺、达托霉素对肠球菌属细菌保持极高敏感性。%Objective To explore the distribution and resistance characteristics of enteroco‐ccus bacteria and offer guidance for rational administration and nosocomial infection .Methods Clinical specimens in our hospital from Jan 2011 to Dec 2013 were cultivated ,then the identification and drug sensitivity test were carried out .Results 140 strains of enterococcus were detected ,in which 99 strains (70 .7% )were from urine;Excrement enterococcus 71 strains (50 .7% ) ,60 in enterococcus strains (42 .9% ) ,9 other enterococcus strains(6 .4% );the drug of resistance rate of E .faecium to penicillin was 15 .0% ,ampicillin 12 .5% ,erythromycin 75 .0% ;while the drug of resistance rates of E .faecalis to penicillin ,ampicillin ,levofloxacin ,ciprofloxacin and erythromycin were more than 80 .0% ;E

  5. NOSOCOMIAL URINARY TRACT INFECTION DUE TO TRICHOSPO RON ASAHII: A RARE CASE REPORT

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    Kumudini

    2012-12-01

    Full Text Available ABSTRACT: Trichosporon asahii is a basidiomycetous yeast which causes white piedra and onychomycosis in immunocompetent hosts. In immunocom promised hosts this species may cause a number of localized and disseminated infect ions. Urinary tract infection by Trichosporon asahii is a rare occurrence .Few cases have been reported from India. We present a microbiologically confirmed urinary tract infecti on with T. asahii in a 52 year old diabetic, female patient who had undergone hysterectomy for dy sfunctional uterine bleeding. Her urine sample was subjected to culture and sensitivity for postoperative rigor. Gram stain examination of the centrifuged urine revealed septate hyphae with arthroconidia and pus cells. Yeast like fungus was isolated in pure culture in three consecu tive samples which was confirmed as Trichosporon asahii by standard tests. The response to antifungal therapy was dramatic. Trichosporon species though occasionally a part of nor mal flora, may be involved in causing nosocomial opportunistic infection more so in immunoc ompromised hosts. Very few cases of microbiologically confirmed urinary tract infection have been reported so far. Its diagnosis is likely to be missed or misinterpreted because of lac k of awareness. Therefore T. asahii deserves recognition as a pathogen

  6. Antimicrobial Resistance Patterns of Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus Isolated From Patients With Nosocomial Infections Admitted to Tehran Hospitals

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    Fallah

    1970-01-01

    Full Text Available Background Nosocomial infections constitute a global health problem, leading to a high rate of morbidity and mortality. The choice of antimicrobial treatment for nosocomial infections is often empirical and based on the knowledge of local antimicrobial activity patterns of the most common bacteria causing such infections. Objectives The aim of this study was to determine the 3 most prevalent bacterial pathogens including Acinetobacter baumannii, Pseudomonas aeruginosa and Staphylococcus aureus causing nosocomial infections and their antimicrobial resistant profiles in patients admitted to three hospitals in Tehran city, Iran. Materials and Methods In this cross-sectional study, the A. baumannii, P. aeruginosa and S. aureus isolates were obtained from different samples of patients with nosocomial infections admitted to different wards of three hospitals including Milad, Motahary and Loghman from November 2014 to April 2015. Nosocomial infections were defined as a culture-proven infection, which occurred more than 48 hours after admission. Antimicrobial susceptibility testing was performed using the disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI guidelines. Results In total, 539 samples were collected during the study period from patients with nosocomial infections. Overall, 198, 75 and 98 A. baumannii, P. aeruginosa and S. aureus isolates were obtained, respectively. Cefepim and meropenem were found to be the most effective antibiotics for nosocomial infections caused by S. aureus with only 1 resistant isolate. Resistance to gentamicin and amikacin and susceptibility to cefepim was the highest compared to other antibiotics amongst P. aeruginosa isolates which is in consistent with the fact that cephalosporins remain useful agents for the management of nosocomial infections caused by P. aeruginosa. Acinetobacter baumannii isolates showed lower susceptibility rates to imipenem and ciprofloxacin than other

  7. Control method exploration of nosocomial bloodstream infection and its effect evaluation

    Institute of Scientific and Technical Information of China (English)

    CHAI Wen-zhao; WANG Xiao-ting; ZHOU Jiong; LI Xin; LUO Hong-bo; LIU Da-wei

    2012-01-01

    Background Currently,slightly more than 50% of bloodstream infections (BSIs) are hospital acquired.When these infections occur in patients in intensive care units,they are associated with a high mortality rate,additional hospital days and excess hospital costs.Because of multifactor of nosocomial BSIs,measurements of control nosocomial BSIs are wide variety and lead to some confusion in practice.The aim of this study was to explore special way in accordance with self-hospital base on common principle.Methods In one ward of the Intensive Care Unit,Peking Union Medical College Hospital,at first,we divided the all operation about bloodstream way into three sections used as keypoints.By surveying keypoints respectively,some operation faults of blood way were discovered.For decreasing the mobidity of nosocomial BSls,some intervention measurements were executed.The rate of nosocomial BSIs was analyzed by chi-square test.Results According to the statistics from January to June,we received and cured 618 patients in total; among them,there were 13 cases of nosocomial BSI and the average occurrence was 2.3 cases/month.After intervention measurements from July to December 2011,we received and cured 639 patients in total with seven cases of nosocomial BSI,and the average occurrence was 1.2 cases/month (P <0.05).From January to April 2012,no nosocomial BSI occurred in the investigated ward.Conclusion Removing the operation faults of bloodstream way might decrease the nosocomial BSI rapidly and efficiently by utilizing a key point survey.

  8. Nosocomial infections in a neonatal intensive care unit : Incidence and risk factors

    NARCIS (Netherlands)

    Nagata, E; Brito, ASJ; Matsuo, T

    2002-01-01

    Background: Nosocomial infections (Nls) have become a matter of major concern in neonatal intensive care units (NICUs). The objectives of this study were to determine the incidence rate and the most frequent sites of infection in a Brazilian NICU from January 1999 to March 2000 and to study the risk

  9. Characterization of Nosocomial Infection in a Pediatric Intensive Care Unit. Cienfuegos 2005-2009

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    Lourdes Elena Duany Badell

    2014-06-01

    Full Text Available Background: children can frequently develop nosocomial infections in pediatric intensive care units. Objective: to characterize nosocomial infections in pediatric patients treated in intensive care units. Methods: a retrospective case series study was conducted in the Intensive Care Unit at Pediatric Hospital of Cienfuegos, between 2005 and 2009. The sample consisted of 70 patients who developed nosocomial sepsis and were admitted directly to the service. The variables studied were age, procedures performed during hospitalization, type of sepsis by site, isolated germs, microbiological support (microbiology tests and condition at discharge (recovered or deceased. Results: nosocomial infections showed a rate of 3.2 per 100 patients discharged. Children under 1 year (41.4 % were the most frequently affected. Pneumonia associated with mechanical ventilation was the most common infection (29.4%. Venous catheterization was used in all cases. Microbiology tests were performed in 84.2 % of cases, 85.3% of them had a positive result. Pseudomonas aeruginosa was the most frequently isolated bacteria and was also associated with highest mortality. Conclusion: nosocomial sepsis in this service was more frequent in children under one year, as a result of mechanical ventilation. Malnutrition and chronic illness were an important predisposing factor in these patients.

  10. A systematic review of nosocomial waterborne infections in neonates and mothers.

    Science.gov (United States)

    Moffa, Michelle; Guo, Wilson; Li, Trudy; Cronk, Ryan; Abebe, Lydia S; Bartram, Jamie

    2017-08-09

    Water is an important, overlooked, and controllable source of nosocomial infection. Hospitalized neonates and their mothers are particularly vulnerable to nosocomial waterborne infections. Our objectives through this systematic review were to: investigate water sources, reservoirs, and transmission routes that lead to nosocomial waterborne infections in neonates and their mothers; establish patient risk factors; compile measures for controlling outbreaks and recommended strategies for prevention; and identify information gaps to improve guidelines for reporting future outbreaks. We searched PubMed, Web of Science, Embase, and clinicaltrials.gov. Peer-reviewed studies reporting contaminated water as a route of transmission to neonates and/or their mothers were included. Twenty-five studies were included. The most common contaminated water sources in healthcare facilities associated with infection transmission were tap water, sinks, and faucets. Low birthweights, preterm or premature birth, and underlying disease increased neonatal risk of infection. Effective control measures commonly included replacing or cleaning faucets and increased or alternative methods for hand disinfection, and recommendations for prevention of future infections highlighted the need for additional surveillance. The implementation of control measures and recommended prevention strategies by healthcare workers and managing authorities of healthcare facilities and improved reporting of future outbreaks may contribute to a reduction in the incidence of nosocomial waterborne infections in neonates and their mothers. Copyright © 2017 Elsevier GmbH. All rights reserved.

  11. Study on risk factors for nosocomial infections caused by high-level aminoglycoside-resistant Enterococcus and aminoglycoside resistance-related genes%耐氨基苷类高水平肠球菌医院感染的危险因素及氨基糖苷类耐药相关基因研究

    Institute of Scientific and Technical Information of China (English)

    范建中; 周田美; 董晓勤; 王贤军

    2012-01-01

    目的 了解耐氨基糖苷类高水平肠球菌(HLAR)的耐药性和医院感染的危险因素,研究HLAR氨基糖苷类耐药相关基因类型分布.方法 采用全自动微生物鉴定仪VITEK-AMS对857株肠球菌属进行鉴定及抗菌药物敏感性检测;PCR法检测HLAR氨基糖苷类耐药相关基因,并对PCR结果进行测序分析.结果 肠球菌属中HLAR占50.4%,利奈唑胺、万古霉素和替考拉宁对HLAR的抗菌作用最好,但有3株屎肠球菌对万古霉素和替考拉宁耐药,粪肠球菌对氯霉素和四环素的耐药率高于屎肠球菌,而屎肠球菌对其他常用抗菌药物的耐药率明显高于粪肠球菌,粪肠球菌和屎肠球菌的耐药谱明显不同,aac(6')-Ie-aph(2〃)-Ia基因为耐庆大霉素高水平肠球菌(HLGR)的主要耐药基因,占HLGR的88.0%,严重的基础疾病、侵入性操作和头孢三代抗菌药物和激素的应用是肠球菌属医院感染的常见危险因素.结论 HLAR已成为医院感染的重要耐药菌,HLGR产生的主要机制是aac(6')-Ie-aph(2〃)-Ia基因介导对庆大霉素高水平耐药,控制常见医院感染危险因素,合理使用抗菌药物,可减少HLAR医院感染的发生.%OBJECTIVE To explore the antibiotic resistance and risk factors for nosocomial infections caused by high-level aminoglycoside-resistant (HLAR) Enterococcus, and investigate the genotypes related to high-level aminoglycoside resistance. METHODS A total of 857 strains of Enterococcus were identified and analyzed for their antimicrobial susceptibility by VITEK-AMS. The aminoglycoside resistance-related genes were detected by PCR. The sequencing analysis of PCR products was performed. RESULTS A total of 50. 4% of Enterococcus isolates were HLAR Enterococcus. Linezolid, vancomycin and teicoplanin were mostly effective against HLAR Enterococcus, but there were three isolates resistant to vancomycin and teicoplanin. The resistance rates to chloramphenicol and tetracycline of E. Faecium were

  12. [Epidemiology of nosocomial infections in a neonatal intensive care unit].

    Science.gov (United States)

    García, Heladia; Martínez-Muñoz, Angeles Nahima; Peregrino-Bejarano, Leoncio

    2014-01-01

    INTRODUCCIÓN: el recién nacido hospitalizado en una unidad de cuidados intensivos tiene alto riesgo de desarrollar una infección nosocomial. El objetivo de este estudio fue registrar la incidencia y el tipo de infecciones nosocomiales, los microorganismos aislados y el perfil de susceptibilidad de estos en recién nacidos atendidos en una unidad de cuidados intensivos neonatales. MÉTODOS: se llevó a cabo un estudio descriptivo prospectivo longitudinal durante un año. De 113 recién nacidos que presentaron infección nosocomial, se registraron variables demográficas, uso de antibióticos antes del ingreso y de catéter venoso central, tipo de infección, microorganismo aislado y perfil de susceptibilidad.

  13. Detection of OXA-Type Carbapenemase Genes in Acinetobacter baumannii Isolates from Nosocomial Infections in Isfahan Hospitals, Iran

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    Vajihe Karbasizade

    2016-02-01

    Full Text Available "> Background: Acinetobacter baumannii as one of the causes of nosocomial infections has becomeresistant to almost all antimicrobial agents. The emergence of resistance to carbapenems, one ofthe last drugs on the shelf, is the major concern about A. baumannii antimicrobial resistance.Resistance to carbapenems is mediated by production of class B and D carbapenemases. The aimof this study was to detect the resistance genes including blaOXA-23, 24, 51, and 58 in A. baumanniiisolates from nosocomial infections in Isfahan hospitals.Methods: A total number of 456 clinical specimens were collected from nosocomial infections andevaluated in order to isolate A. baumannii strains. After identification of the isolates, the antibioticsensitivity to carbapenems was assessed using disk diffusion method. The resistance genes of blaOXA-23, 24, 51, and 58 were detected by multiplex PCR method.Results: Fifty A. baumannii isolates were isolated from clinical specimens. Fifty two percent ofthe isolates showed phenotypic resistance to the carbapenems (imipenem and meropenem.According to PCR results, 88% of resistant isolates had ≥1 blaOXA gene. The frequency of resistantisolates bearing blaOXA-23, blaOXA-24 and blaOXA-58 were 77%, 38% and 15% respectively.Conclusions: This study showed the high frequency of carbapenem resistance genes among A.baumannii isolates. Therefore, adopting an appropriate strategy to confine the spreading of thesestrains and also implementing new treatment regimens are necessary.

  14. First three reported cases of nosocomial fungemia caused by Candida auris.

    Science.gov (United States)

    Lee, Wee Gyo; Shin, Jong Hee; Uh, Young; Kang, Min Gu; Kim, Soo Hyun; Park, Kyung Hwa; Jang, Hee-Chang

    2011-09-01

    Candida auris is a newly described species whose clinical significance is not clear. Here, we describe the first three cases of nosocomial fungemia caused by C. auris, which confirms that it is a causative agent of bloodstream infections. All three patients presented persistent fungemia for 10 to 31 days. The isolates obtained from the three patients were misidentified as Candida haemulonii and Rhodotorula glutinis by the Vitek 2 and the API 20C systems, respectively. C. auris was confirmed by sequence analysis of the internal transcribed spacer region and D1/D2 regions of the 26S ribosomal DNA of the rRNA gene. The MIC ranges of amphotericin B (AMB), fluconazole (FLU), itraconazole, and voriconazole were 0.5 to 1, 2 to 128, 0.125 to 2, and 0.06 to 1 μg/ml, respectively. All isolates were susceptible to caspofungin (MIC = 0.06 μg/ml) and micafungin (MIC = 0.03 μg/ml). One patient developed breakthrough fungemia while receiving FLU therapy, and two patients who received FLU therapy followed by AMB showed therapeutic failure and fatal outcomes. Our cases show that C. auris fungemia can be persistent, despite FLU or AMB therapy, which emphasizes the importance of accurately identifying this species.

  15. Prevalence of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Isolates in Nosocomial and Community-Acquired Urinary Tract Infections

    Science.gov (United States)

    Latifpour, Mohammad; Gholipour, Abolfazl; Damavandi, Mohammad Sadegh

    2016-01-01

    Background Klebsiella pneumoniae is a family member of Enterobacteriaceae. Isolates of K. pneumoniae produce enzymes that cause decomposition of third generation cephalosporins. These enzymes are known as extended-spectrum beta-lactamase (ESBL). Resistance of K. pneumoniae to beta-lactamase antibiotics is commonly mediated by beta-lactamase genes. Objectives The aim of this study was to identify the ESBL produced by K. pneumoniae isolates that cause community-acquired and nosocomial urinary tract infections within a one-year period (2013 to 2014) in Kashani and Hajar university hospitals of Shahrekord, Iran. Patients and Methods From 2013 to 2014, 150 strains of K. pneumoniae isolate from two different populations with nosocomial and community-acquired infections were collected. The strains were then investigated by double disk synergism and multiplex polymerase chain reaction (PCR). Results The study population of 150 patients with nosocomial and community-acquired infections were divided to two groups of 75 each. We found that 48 of the K. pneumoniae isolates in the patients with nosocomial infection and 39 isolates in those with community-acquired infections produced ESBL. The prevalence of TEM1, SHV1 and VEB1 in ESBL-producing isolates in nosocomial patients was 24%, 29.3% and 10.6%, and in community-acquired patients, 17.3%, 22.7% and 8%, respectively. Conclusions The prevalence of ESBL-producing K. pneumoniae isolate is of great concern; therefore, continuous investigation seems essential to monitor ESBL-producing bacteria in patients with nosocomial and community-acquired infections. PMID:27226874

  16. Enterococcus faecium AND Enterococcus faecalis IN BLOOD OF NEWBORNS WITH SUSPECTED NOSOCOMIAL INFECTION

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    Isabela Furtado

    2014-01-01

    Full Text Available Enterococci are Gram-positive cocci saprophyte of the human gastrointestinal tract, diners who act as opportunistic pathogens. They can cause infections in patients hospitalized for a long time or who have received multiple antibiotic therapy. Enterococcus faecalis and Enterococcus faecium are the most common species in human infections. To evaluate the possibility of rapid detection of these species and their occurrence in the blood of newborns with suspected nosocomial infection, blood samples were collected from 50 newborns with late infections, admitted to the Neonatal Care Unit of the University Hospital Federal de Mato Grosso do Sul (UFMS-HU, from September 2010 to January 2011. The samples were subjected to conventional PCR and real time PCR (qPCR to search for Enterococcus faecium and Enterococcus faecalis, respectively. The PCR results were compared with respective blood cultures from 40 patients. No blood cultures were positive for Enterococci, however, eight blood samples were identified as genomic DNA of Enterococcus faecium by qPCR and 22 blood samples were detected as genomic DNA of Enterococcus faecalis by conventional PCR. These findings are important because of the clinical severity of the evaluated patients who were found positive by conventional PCR and not through routine microbiological methods.

  17. Enterococcus faecium and Enterococcus faecalis in blood of newborns with suspected nosocomial infection.

    Science.gov (United States)

    Furtado, Isabela; Xavier, Paula Cristhina Niz; Tavares, Luciana Venhofen Martinelli; Alves, Fabiana; Martins, Sarah Fonseca; Martins, Almir de Sousa; Palhares, Durval Batista

    2014-01-01

    Enterococci are Gram-positive cocci saprophyte of the human gastrointestinal tract, diners who act as opportunistic pathogens. They can cause infections in patients hospitalized for a long time or who have received multiple antibiotic therapy. Enterococcus faecalis and Enterococcus faecium are the most common species in human infections. To evaluate the possibility of rapid detection of these species and their occurrence in the blood of newborns with suspected nosocomial infection, blood samples were collected from 50 newborns with late infections, admitted to the Neonatal Care Unit of the University Hospital Federal de Mato Grosso do Sul (UFMS-HU), from September 2010 to January 2011. The samples were subjected to conventional PCR and real time PCR (qPCR) to search for Enterococcus faecium and Enterococcus faecalis, respectively. The PCR results were compared with respective blood cultures from 40 patients. No blood cultures were positive for Enterococci, however, eight blood samples were identified as genomic DNA of Enterococcus faecium by qPCR and 22 blood samples were detected as genomic DNA of Enterococcus faecalis by conventional PCR. These findings are important because of the clinical severity of the evaluated patients who were found positive by conventional PCR and not through routine microbiological methods.

  18. Daily Bathing with Chlorhexidine and Its Effects on Nosocomial Infection Rates in Pediatric Oncology Patients.

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    Raulji, Chittalsinh M; Clay, Kristin; Velasco, Cruz; Yu, Lolie C

    2015-01-01

    Infections remain a serious complication in pediatric oncology patients. To determine if daily bathing with Chlorhexidine gluconate can decrease the rate of nosocomial infection in pediatric oncology patients, we reviewed rates of infections in pediatric oncology patients over a 14-month span. Intervention group received daily bath with Chlorhexidine, while the control group did not receive daily bath. The results showed that daily bath with antiseptic chlorhexidine as daily prophylactic antiseptic topical wash leads to decreased infection density amongst the pediatric oncology patients, especially in patients older than 12 years of age. Furthermore, daily chlorhexidine bathing significantly reduced the rate of hospital acquired infection in patients older than 12 years of age. The findings of this study suggest that daily bathing with chlorhexidine may be an effective measure of reducing nosocomial infection in pediatric oncology patients.

  19. Evaluation of nosocomial infection risk using APACHE II scores in the neurological intensive care unit.

    Science.gov (United States)

    Li, Hai-Ying; Li, Shu-Juan; Yang, Nan; Hu, Wen-Li

    2014-08-01

    To evaluate the feasibility and accuracy of using the Acute Physiology, Age and Chronic Health Evaluation II (APACHE II) scoring system for predicting the risk of nosocomial infection in the neurological intensive care unit (NICU), 216 patients transferred to NICU within 24hours of admission were retrospectively evaluated. Based on admission APACHE II scores, they were classified into three groups, with higher APACHE II scores representing higher infectious risk. The device utilization ratios and device-associated infection ratios of NICU patients were analyzed and compared with published reports on patient outcome. Statistical analysis of nosocomial infection ratios showed obvious differences between the high-risk, middle-risk and low-risk groups (pAPACHE II model in predicting the risk of nosocomial infection was 0.81, which proved to be reliable and consistent with the expectation. In addition, we found statistical differences in the duration of hospital stay (patient-days) and device utilization (device-days) between different risk groups (pAPACHE II scoring system was validated in predicting the risk of nosocomial infection, duration of patient-days and device-days, and providing accurate assessment of patients' condition, so that appropriate prevention strategies can be implemented based on admission APACHE II scores.

  20. Nosocomial infection in a newborn intensive care unit (NICU, South Korea

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    Jeong Jae

    2006-06-01

    Full Text Available Abstract Background This study aimed to determine the occurrence of nosocomial infections (NIs, including infection rates, main infection sites, and common microorganisms. Patients included in the study were taken from a newborn intensive care unit (NICU, in a hospital in South Korea. Methods A retrospective cohort study was performed by reviewing chart. The subjects were 489 neonates who were admitted to the NICU, survived longer than 72 hours, and not transferred to another unit, between Jan. 1. 1995 to Sep. 30, 1999. NIs were identified according to the NNIS definition. Data were analyzed with descriptive statistics. Results Cumulative incidence rate for NIs was 30.3 neonates out of 100 admissions, with a total of 44.6 infections. The incidence density was average 10.2 neonates and 15.1 infections per 1000 patient days. The most common infections were pneumonia (28%, bloodstream infection (26%, and conjunctivitis (22%. Major pathogens were Gram-positives such as Staphylococcus aureus and coagulase-negative staphylococci. The factors associated with NI was less than 1500 g of birth weight, less than 32 weeks of gestational age, and less than 8 of apgar score. There's no statistical difference in discharge status between two groups, but hospital stay was longer in subjects with nosocomial infection than those without infection. Conclusion Although the distribution of pathogens was similar to previous reports, a high rate of nosocomial infection and in particular conjunctivitis was observed in this study that merits further evaluation.

  1. Targeted investigation of nosocomial infections caused by multidrug-resistant Acinetobacter baumannii and analysis of drug resistance%多药耐药鲍氏不动杆菌医院感染目标性调查及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    杨春玲; 宋平; 杨卉; 周传能

    2013-01-01

    目的 了解多药耐药鲍氏不动杆菌医院感染相关因素及其耐药性,以预防与控制多药耐药鲍氏不动杆菌医院感染的发生与流行.方法 采用前瞻性和回顾性调查方法,对医院2008年1月22日-2010年12月28日多药耐药及全耐药鲍氏不动杆菌感染的63例患者进行综合性分析.结果 多药耐药鲍氏不动杆菌感染患者中,36.5%为肺部感染合并多种基础性疾病,42.9%为多发性创伤骨折,73.0%入住过ICU,60.3%做过手术,38.1%~54.0%进行过各种侵入性操作,69.9%伴随混合菌感染;医院感染率为60.3%,总死亡率为31.7%,肺部感染死亡率高达71.4%;鲍氏不动杆菌耐药率高,其对头孢哌酮/舒巴坦的耐药率为15.9%,其次对亚胺培南的耐药率为31.7%,对其余抗菌药物耐药率达63.5%~100.0%.结论 加强对多药耐药鲍氏不动杆菌医院感染全方位预防和控制,尤其是对ICU的监控已经刻不容缓.%OBJECTIVE To investigate the relevant factors for nosocomial infections caused by multidrug-resistant Acinetobacter baumannii (MDRAB) and analyze its drug resistance so as to prevent and control the incidence and spreacl of MDRAB infections. METHODS By means of the prospective and retrospective survey, a total of 63 patients with multidrug-resistant A. baumannii and full drug-resistant A. baumannii infections, who enrolled the hospital form Jan 22, 2008 to Dec 28, 2010, were comprehensively analyzed. RESULTS Among the patients infected with multidrug-resistant A .baumannii, 36. 5% were with pulmonary infections complicated by multiple underlying diseases, 42. 9% were recurring traumatic fracture, 73. 0% have been hospitalized in ICU, 60. 3% have undergone the surgery, 38. l%-54. 0% undergoing various types of invasive operations, and 69. 9% were complicated by mixed infections. The incidence rate of nosocomial infections was 60. 3%, the overall mortality was 31. 7%, and the fatality rate was 71. 4% due

  2. Nosocomial infections: knowledge and source of information among clinical health care students in Ghana

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    Bello AI

    2011-08-01

    Full Text Available Ajediran I Bello1, Eunice N Asiedu1, Babatunde OA Adegoke2, Jonathan NA Quartey1, Kwadwo O Appiah-Kubi1, Bertha Owusu-Ansah11Department of Physiotherapy, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana; 2Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, NigeriaBackground: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana.Methods: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal–Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05Results: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05 between course of study and knowledge of

  3. Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases

    OpenAIRE

    Fu, Chuanxi; Wang, Shengyong

    2016-01-01

    The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respi...

  4. Nosocomial infections and risk factors in intensive care unit of a university hospital

    OpenAIRE

    2015-01-01

    Objective: The aim of this study is to evaluate nosocomial infections (NIs) in intensive care unit (ICU) in terms of site of infection, distribution of pathogens and risk factors for developing infection.Methods: 80 patients staying for more than 48 hours in the ICU were included in the study. Epidemiologic characteristics of the patients, invasive procedures and other risk factors were noted. Cultures, identification of isolates and antibiotic susceptibility tests were made by standard micro...

  5. Nosocomial Infections in Intensive Care Unit: Pattern of Antibiotic-resistance in Iranian Community

    OpenAIRE

    Bahram Nasr Esfahani; Rozita Basiri; Seyed Mohammad Mahdy Mirhosseini; Sharareh Moghim; Shahaboddin Dolatkhah

    2017-01-01

    Background: Bacterial infections are responsible for great number of mortality in Intensive Care Unit (ICU). Knowledge about prevalence of bacterial infections and their antibiotic-resistance pattern would be a great step for their treatment and management. Materials and Methods: Data about nosocomial infections in ICUs of Alzahra Hospital (referral hospital in Isfahan, center of Iran) were gathered during the years 2007–2010. A questionnaire was fulfilled for any specific patient with nosoco...

  6. Distribution and drug resistance of pathogens causing nosocomial infections in cancer center from 2008 to 2010%2008-2010年肿瘤中心医院感染病原体分布特点及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    张霄旦; 赵擎宇; 梁玉婵; 朱洁梅

    2012-01-01

    OBJECTIVE To investigate the distribution and drug resistance of pathogens causing nosocomial infections in the tumor patients. METHODS A retrospective survey was conducted to analyze the correlated data of the patients with nosocomial infections in Cancer Center of Sun Yat-sen University from Jan 2008 to Dec 2010. RESULTS Among 755 patients with nosocomial infections, there were totally 1183 specimens submitted, from which 1093 strains of pathogens were isolated with the detection rate of 92. 39%, there were 472 (43. 19%) strains of gram-negative bacteria among which Escherichia coli was dominated, there were 336 (30. 74%) strains of fungi among which Candida albicans was dominated, and there were 281 (25. 71%) strains of gram-positive bacteria among which Staphylococci were dominated, in addition, there were 2 strains of herpes zoster viruses and 2 strains of Mycoplasma isolated; the drug resistance rates of both gram-positive bacteria and gram-negative bacteria were relatively high, with 1 strain of vancomycin-resistant Enterococcus faecium being found, and fungi were widely susceptble to the antifungal drugs. CONCLUSION Gram-negative bacteria are the predominant pathogens causing nosocomial infections in the cancer center, and some of the pathogens have produced serious drug resistance to the antibiotics.%目的 分析肿瘤患者医院感染的病原体分布特点及耐药性.方法 回顾性调查分析2008年1月-2010年12月中山大学肿瘤防治中心医院感染相关资料.结果 755例发生医院感染的患者中共送检1183份标本,检出1093株病原体,检出率为92.39%,其中革兰阴性菌472株占43.19%,主要为大肠埃希菌;真菌336株占30.74%,主要为白色假丝酵母菌;革兰阳性菌281株占25.71%,主要为葡萄球菌属;此外检出带状疱疹病毒及支原体属各两株;革兰阳性菌及革兰阴性菌的耐药率均较高,检出1株耐万古霉素屎肠球菌,真菌对抗真

  7. 20 931 medical records of inpatients with nosocomial infection%20931份住院病历医院感染调查分析

    Institute of Scientific and Technical Information of China (English)

    王伶莉; 吴小秋

    2011-01-01

    OBJECTIVE To discuss the clinical characteristics of inpatients nosocomial infection, and provides the theory basis to draw up the nosocomial infection regulatory measures. METHODS A retrospective investigation was performed to all inpatient nosocomial infection during Jul 2008 Jun 2010. RESULTS Of 20 931 cases of inpatients,632 case-times were occurred to nosocomial infection in total with the case-time infection rate of 3.0% and the nosocomial infection cases were 3.0%, the nosocomial infection rate was higher in ICU, cardio-thoracic surgery and neurology, the differences of nosocomial infection rates among the departments had statistical significance (P <0. 01); the lower respiratory tract was the main infected site, accounting for 43. 7%; the most common pathogens causing nosocomial infection were Escherichia coli which accounted for 26.0%, while Pseudomonas aeruginosa accounted for 19.4%; the nosocomial infection rates were increased significantly in > 60 and < 12 patients, and the differences of incidence rates of nosocomial infection among different age groups had statistical significance (P< 0. 01 ). CONCLUSIONS It should strengthen the monitoring to nosocomial infection in key departments, key sites and key crowd, so that the nosocomial infection can be effectively reduced.%目的 探讨某医院住院患者医院感染的临床特点,为制定医院感染控制措施提供依据.方法 对2008年7月-2010年6月所有住院患者医院感染进行回顾性调查分析.结果 在20 931例住院患者中,共发生医院感染632例,医院感染率为3.0%;ICU、心胸外科和神经内科的医院感染率较高,各科室间医院感染率差异有统计学意义(P<0.01);感染部位以下呼吸道为主,占43.7%;医院感染最常见的病原菌是大肠埃希菌(26.0%)、铜绿假单胞菌(19.4%);>60岁和<12岁的患者医院感染率明显提高,各年龄段医院感染发生率之间,差异有统计学意义(P<0.01).结论 应

  8. Effect of executive programs of infection control committees on the prevalence of nosocomial infections in Kermanshah's Hospitals (2010-2011).

    Science.gov (United States)

    Vatankhah, Sodabe; Mokarami, Hamidreza; Karchani, Mohsen; Hosseini, Zahra; Izadi, Babak; Moradi, Farideh

    2014-01-01

    The aim of this study was to investigate the effect of executive programs of infection control committees on the incidence of nosocomial infections in hospitals affiliated with the Kermanshah University of Medical Sciences (Kermanshah, Iran) during 2010 and 2011. The numbers of patients admitted in 2010 and 2011 were 8084 and 7166, respectively, and the average prevalence of nosocomial infections in 2010 and 2011 was 0.8 and 1.9 infections per 100 patients, respectively. In 2010, the mean scores obtained by hospital for regular Infection Control Committee meetings, regular gatherings, registration of program information analysis, and regular follow-up meetings were 19, 31, 30.5, and 41.7 (out of 100), respectively. In 2011, they were 20.2, 36.4, 38.1, and 50, respectively. The results of this study indicated that executive programs of infection control committees had no effect on the incidence of nosocomial infections; therefore, the experts who assess hospitals should pay more attention to the systems that are used to conduct surveillance of nosocomial infection control programs.

  9. Nosocomial Bloodstream Infection Due to Candida spp. in China: Species Distribution, Clinical Features, and Outcomes.

    Science.gov (United States)

    Li, Ying; Du, Mingmei; Chen, Liang-An; Liu, Yunxi; Liang, Zhixin

    2016-08-01

    To investigate the distribution of Candida spp., predictors of mortality, and effects of therapeutic measures on outcomes of nosocomial bloodstream infection (BSI) due to Candida spp. This retrospective, population-based study enrolled adult patients with Candida nosocomial BSI from January 2010 to December 2014 in one tertiary care hospital. The demographics, comorbidities, species distribution, risk factors, and effects of antifungal treatment were assessed. In total, 190 episodes of Candida BSI were identified. The most prevalent species was C. albicans (38.9 %), followed by C. parapsilosis (23.2 %) and C. tropicalis (20.5 %). In vitro susceptibility testing showed that 88.9 % of Candida isolates were susceptible to fluconazole. The 30-day hospital mortality was 27.9 %, while the early mortality (within 7 days) was 16.3 %. In a multivariate regression analysis, the Acute Physiology and Chronic Health Evaluation II score [odds ratio (OR) 1.23; 95 % confidence interval (CI) 1.080-1.390; P = 0.002] and severe sepsis or septic shock (OR 15.35; 95 % CI 2.391-98.502; P = 0.004) were independently correlated with early mortality. Severe sepsis or septic shock (OR 24.75; 95 % CI 5.099-120.162; P < 0.001) was an independent risk factor for 30-day mortality, while proven catheter-related candidemia (OR 0.16; 95 % CI 0.031-0.810; P = 0.027) was a positive factor for 30-day mortality. Early central venous catheter removal and adequate antifungal treatment were closely related to decreased mortality in patients with primary candidemia. The proportion of candidemia caused by C. albicans was lower than that caused by non-albicans species. The severity of illness influenced early mortality, and the origin of the central venous catheter remarkably affected 30-day mortality.

  10. Incidence and clinical implication of nosocomial infections associated with implantable biomaterials - catheters, ventilator-associated pneumonia, urinary tract infections.

    Science.gov (United States)

    Guggenbichler, Josef Peter; Assadian, Ojan; Boeswald, Michael; Kramer, Axel

    2011-01-01

    Health care associated infections, the fourth leading cause of disease in industrialised countries, are a major health issue. One part of this condition is based on the increasing insertion and implantation of prosthetic medical devices, since presence of a foreign body significantly reduces the number of bacteria required to produce infection. The most significant hospital-acquired infections, based on frequency and potential severity, are those related to procedures e.g. surgical site infections and medical devices, including urinary tract infection in catheterized patients, pneumonia in patients intubated on a ventilator and bacteraemia related to intravascular catheter use. At least half of all cases of nosocomial infections are associated with medical devices.Modern medical and surgical practices have increasingly utilized implantable medical devices of various kinds. Such devices may be utilized only short-time or intermittently, for months, years or permanently. They improve the therapeutic outcome, save human lives and greatly enhance the quality of life of these patients. However, plastic devices are easily colonized with bacteria and fungi, able to be colonized by microorganisms at a rate of 0.5 cm per hour. A thick biofilm is formed within 24 hours on the entire surface of these plastic devices once inoculated even with a small initial number of bacteria.The aim of the present work is to review the current literature on causes, frequency and preventive measures against infections associated with intravascular devices, catheter-related urinary tract infection, ventilator-associated infection, and infections of other implantable medical devices. Raising awareness for infection associated with implanted medical devices, teaching and training skills of staff, and establishment of surveillance systems monitoring device-related infection seem to be the principal strategies used to achieve reduction and prevention of such infections. The intelligent use of

  11. Clinical distribution and drug resistance analysis of 2263 strains of pathogens causing nosocomial infection%2263株院内感染常见病原菌分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    翟如波; 张昊; 孙跃岭; 邱广斌

    2012-01-01

    Objective To provide a basis for clinical use of drugs and clinical isolates of the distribution of common pathogens and resistance to commonly used antibiotics were analyzed, retrospectively. Methods Bacteria were isolated from various clinical specimens from January to December 2010, and identified by VITEK-2 Compact automatic analyzer. Antimicrobial susceptibility test was carried out by Kirby-Bauer method, and the results were assessed according to CLSI ( version 2009 ) criteria. Results Total of 2263 nosocomial pathogens were collected, mainly gram-negative bacilli pathogens. The most common pathogens in sequence were Escherichia coli, Klebsiella, Pseudomonas aeruginosa, Staphylococcus aureus and Adnetobacter. Escherichia coli and Klebsiella with ESBL were more resistant to antibiotics than those without ESBL. Pseudomonas aeruginosa and Adnetobacter were multi-drug resistant and were more resistant to carbapenems antibiotics. MRSA appeared multi-drug resistance and heterogeneity, however, no linezolid-resistant and vancomycin-resistant staphylococcus strain was noted. Conclusions By the means of rational usage of antimicrobial drugs, cutting off pathogen transmission routes, strengthening disinfection and isolation and monitoring of critically ill patients, cross-infection prevention, the antibiotics appearance and propagation could be slowed down.%目的 回顾性分析临床分离的引起院内感染的常见病原菌分布及对常用抗菌药物的耐药情况,为临床合理用药提供一定的依据.方法 对本院2010年1月~12月临床送检的各类标本进行分离培养,采用VITEK-2 Compact全自动微生物仪进行菌株鉴定,采用K-B纸片扩散法检测对抗菌药物的敏感性,判定标准依据美国临床和实验室标准化研究所(CLSI)2009年的相关规定.结果 本研究分离出病原菌共2263株,以革兰阴性杆菌为主,常见病原菌依次为大肠埃希菌、克雷伯菌属、铜绿假单胞、金黄色葡萄球

  12. Nosocomial infection of Crimean-Congo haemorrhagic fever in eastern Iran: case report.

    Science.gov (United States)

    Chinikar, Sadegh; Shayesteh, Majid; Khakifirouz, Sahar; Jalali, Tahmineh; Rasi Varaie, Fereshteh Sadat; Rafigh, Mahboubeh; Mostafavi, Ehsan; Shah-Hosseini, Nariman

    2013-01-01

    An outbreak of Crimean-Congo haemorrhagic fever occurred in the county of Birjand in eastern Iran in November 2011. Four cases were involved in this outbreak. Two patients died after admission to hospital, one of whom was a nurse who acquired the infection nosocomially, and the others were treated successfully.

  13. Positive impact of infection prevention on the management of nosocomial outbreaks at an academic hospital

    NARCIS (Netherlands)

    Dik, Jan-Willem H.; Sinha, Bhanu; Lokate, Mariette; Lo-Ten-Foe, Jerome R.; Dinkelacker, Ariane G.; Postma, Maarten J.; Friedrich, Alexander W.

    2016-01-01

    Aim: Infection prevention (IP) measures are vital to prevent (nosocomial) outbreaks. Financial evaluations of these are scarce. An incremental cost analysis for an academic IP unit was performed. Material & methods: On a yearly basis, we evaluated: IP measures; costs thereof; numbers of patients at

  14. Nosocomial pneumonia caused by a glucose-metabolizing strain of Neisseria cinerea.

    OpenAIRE

    Boyce, J M; Taylor, M R; Mitchell, E B; Knapp, J S

    1985-01-01

    We describe what appears to be the first reported case of nosocomial pneumonia caused by Neisseria cinerea. The isolate metabolized glucose when tested in BACTEC Neisseria Differentiation Kits (Johnston Laboratories), but did not produce detectable acid in cystine-Trypticase (BBL Microbiology Systems) agar medium or in modified oxidation-fermentation medium. Clinical laboratories that rely on the BACTEC method for differentiation of pathogenic neisseriae should be aware of the fact that N. ci...

  15. Rotaviruses as a cause of nosocomial, infantile diarrhoea in Northern Brazil: pilot study

    Directory of Open Access Journals (Sweden)

    Rosa Helena P. Gusmão

    1995-12-01

    Full Text Available Faecal samples were obtained from 190 children, aged 0 to 5 years, admitted to a public hospital in Belém, Pará, Brazil. These patients were placed in a pediatric ward with 40 beds distributed in six rooms. Case were classified into three groups: (a nosocomial: children who developed gastroenteritis 72 hr or later after admission; (b community-acquired: patients admitted either with diarrhoea or who had diarrhoea within 72 hr following admission; (c non-diarrhoeic: those children who had no diarrhoea three days before and three days after collection of formed faecal sample. Specimens were routinely processed for the presence of rotaviruses, bacteria and parasites. Rotaviruses were detected through enzyme-linked immunosorbent assay (ELISA and subsequently serotyped/electrophoretyped. Rotaviruses were the most prevalent enteropathogens among nosocomial cases, accounting for 39 % (9/23 of diarrhoeal episodes; on the other hand, rotaviruses ocurred in 8.3 % (11/133 and 9 % (3/34 of community-acquired and non-diarrhoeic categories, respectively. Mixed infections involving rotavirus and Giardia intestinalis and rotavirus plus G. intestinalis and Entamoeba histolytica were detected in frequencies of 8.6 and 4.3 %, respectively, in the nosocomial group. The absence of bacterial pathogens in this category, and the unusual low prevalence of these agents in the other two groups may reflect the early and routine administration of antibiotics following admission to this hospital. Rotavirus serotype 2 prevailed over the other types, accounting for 77.8 % of isolates from nosocomial diarrhoeal episodes. In addition, at least five different genomic profiles could be observed, of which one displayed an unusual five-segment first RNA cluster. Dehydration was recorded in all cases of hospital-acquired, rotavirus-associated diarrhoea, whereas in only 57 % of nosocomial cases of other aetiology. It was also noted that nosocomial, rotavirus-associated diarrhoeal

  16. 综合性医院的医院感染管理%Nosocomial infection managements in general hospital

    Institute of Scientific and Technical Information of China (English)

    杨梅

    2011-01-01

    OBJECTIVE To explore the effective measures of management of nosocomial infection in general hospital, so as to control nosocomial infection. METHODS The training and promotion of the knowledge about nosocomial infection were reinforced, the inspecting management was strengthened. Its emphasis was put on the key departments and links. RESULTS The awareness of the medical staff to nosocomial infection management was improved, and each management system and measure were implemented and the nosocomial infection was well controlled. CONCLUSIONS The management of nosocomial infection in general hospital should be emphasized, the strict supervision and checking can effectively control the nosocomial infection.%目的 探讨综合性医院感染管理的有效方法,以控制医院感染.方法 加强医院感染宣传和培训,加强重点环节和重点科室的督查管理.结果 提高了医护人员对医院感染管理的认识,使各项医院感染管理制度与措施得以落实,有效控制了医院感染.结论 重视综合性医院感染管理工作,加强督查、严格把关,可有效预防控制医院感染.

  17. Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases.

    Science.gov (United States)

    Fu, Chuanxi; Wang, Shengyong

    2016-04-12

    The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented. Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative. Infection control in healthcare settings, in which patients with emerging infectious diseases such as MERS, Ebola virus disease, and the severe acute respiratory syndrome (SARS) are diagnosed and treated, are often imperfect. When it comes to emerging or unknown infectious diseases, before the imported case was finally identified or community transmission was reported, cases have often occurred in clusters in healthcare settings. Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

  18. Nosocomial infection control in healthcare settings: Protection against emerging infectious diseases

    Institute of Scientific and Technical Information of China (English)

    Chuanxi Fu; Shengyong Wang

    2016-01-01

    The Middle East respiratory syndrome (MERS) outbreak in Korea in 2015 may be attributable to poor nosocomial infection control procedures implemented.Strict infection control measures were taken in the hospital where an imported case with MERS was treated in southern China and 53 health care workers were confirmed to be MERS-CoV negative.Infection control in healthcare settings,in which patients with emerging infectious diseases such as MERS,Ebola virus disease,and the severe acute respiratory syndrome (SARS) are diagnosed and treated,are often imperfect.When it comes to emerging or unknown infectious diseases,before the imported case was finally identified or community transmission was reported,cases have often occurred in clusters in healthcare settings.Nosocomial infection control measures should be further strengthened among the workers and inpatients in designated healthcare settings that accommodate suspected cases suffering from emerging or unknown infectious diseases.

  19. Disinfection efficacy of an ultraviolet light on film cassettes for preventive of the nosocomial infection

    Energy Technology Data Exchange (ETDEWEB)

    Kweon, Dae Cheol [Seoul National Univ. Hospital, Seoul (Korea, Republic of); Jeon, Yong Woong; Cho, Am [Dongguk Univ., Seoul (Korea, Republic of)

    2001-06-01

    The bacterial infection on film cassette contact surface was examined at the diagnostic radiology department of the S. hospital. The objective of this study was to assess the contamination level on film cassette contact surface as a predictor of patient prevention from nosocomial infection and for improvement of the hospital environment. The laboratory result was identified non-pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection is proven suitable for bacterial. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In addition education of nosocomial infection for radiographers will be required. In conclusion, ultraviolet is considered effective to irradiate bacterial. Additionally, two minutes are required to sterilize film cassettes.

  20. 儿科医院感染的调查分析及预防控制措施%Investigation and control measures of pediatric nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    何海英

    2011-01-01

    OBJECTIVE To investigate the related factors of pediatric nosocomial infection and prevention methods.METHODS The overall retrospective survey method was adopted to analyze the characteristics and infection-related factors of pediatric nosocomial infection in our hospital from 2008 to 2010.The effective control measures were timely taken.RESULTS The nosocomial infection rates in hospital pediatrics from Mar 2008 to Nov 2010 were 2.7%, 2.5% and 1.7%, including upper respiratory tract infection 50.0%, gastrointestinal tract infection 30.6 % and lower respiratory tract infection 19.4 %.CONCLUSION Analyzing the causes for nosocomial infection,meanwhile, taking effective prevention measures can reduce the incidence of nosocomial infection.%目的 调查分析儿科医院感染的相关因素及防治办法. 方法 采取整体回顾性调查方法分析医院2008-2010年儿科医院感染的特点与感染有关的因素,及时采取有效的控制措施. 结果 2008年3月-2010年11月医院儿科的医院感染率分别为2.7%、2.5%、1.7%;上呼吸道感染占50.0%,胃肠道感染占30.6%,下呼吸道感染占19.4%. 结论 分析医院感染发生的原因,并采取有效的预防控制措施,可降低医院感染的发生率.

  1. Current status of prevalence of nosocomial infections in China and progress of control%我国医院感染现状与控制的进展

    Institute of Scientific and Technical Information of China (English)

    艾源; 张弢; 任晓辉

    2015-01-01

    OBJECTIVE The surveys and researches on the nosocomial infections in China are reviewed to summarize the common epidemiological characteristics of the nosocomial infections and to put forward the prevention measures so as to provide guidance for the control of the nosocomial infections .The gram‐negative bacteria are dominant a‐mong the pathogens causing the nosocomial infections ;the lower respiratory tract is the major infection site ;the infection rate is highest in the ICU ;the infants and elderly people are the populations at high risk of the infections ;the infections mainly transmit through hands .The abuse of antibiotics is the leading risk factor for the nosocomial infections .To control the nosocomial infections ,the sound management system for nosocomial infection should be established ,the training of the health care workers ,especially the new staff and interns ,should be strengthened to improve the level of cognition of infection control ,and the hand hygiene and reasonable use of antibiotics should be paid high attention to .%通过对国内有关医院感染的调查和研究进行综述,总结医院感染中常见的流行性特征和防治措施,为医院感染的控制和管理提供参考依据;医院感染病原菌分布以革兰阴性菌为主,感染部位以下呼吸道感染为主,感染科室中IC U感染率最高,婴幼儿和老年人为易感人群,手是重要传播途径,抗菌药物滥用是医院感染的重要影响因素;为控制医院感染,需建立健全的医院感染的管理制度;加强医务人员,特别是新进人员及实习生培训,提高其医院感染认知水平;重视手卫生和抗菌药物的合理使用。

  2. Nosocomial infection Childhood:he importance of respiratory viruses as agents of these diseases

    OpenAIRE

    Caroline Mary Gurgel Dias FlorÃncio

    2014-01-01

    Nosocomial infections (NI) are a serious public health problem. Knowledge about the etiology of NI is important for the development of control measures, prevention and treatment. Viruses are important etiologic agent of NI has been studied in populations considered at risk as premature, heart disease, lung disease, and immunosuppressed. Respiratory hospital infection (RHI) generate discomfort to patients, postponing medical interventions, postoperative complications, use more drugs and, in so...

  3. Clinical Analysis of Nosocomial Infection in 1496 Cases from Obstetrical Department%1496例产妇医院感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    岳灵英; 王玲玲

    2013-01-01

      Objective To explore the clinical features of nosocomial infection of inpatients in obstetrical department, the causes and prevention of infection. Methods The clinical data of 1496 cases from obstetrical department were reviewed. Results The prevalence rate of nosocomial infection in obstetrical department was 2.21%. the prevalence rate of obstetric infection was the highest, followed by urinary infection. The prevalence rate of nosocomial infection in parturition using vacuum extraction was at a high level;and the prevalence rate of nosocomial infection in parturition by spontaneous delivery was low. Conclusion Choosing the right mode of delivery, using vaginal delivery as far as possible, mastering aseptic technique strictly, and reasonable application of antibiotics is the key of preventing nosocomial infection in dobstetrical department.%  目的探讨产科医院感染的临床特点,感染原因及其防治。方法对产科1496例出院病历进行回顾性分析。结果产科的医院感染发生率为2.21%,产科感染居首位,其次为泌尿道感染。胎头吸引术分娩医院感染发生率高;阴道顺产的医院感染发生率最低。结论选择正确的分娩方式,尽可能阴道顺产,严格掌握无菌操作技术,合理应用抗生素是预防产科医院感染的关键。

  4. Prevalence of Nosocomial Infections Department of infection%医院感染现患率调查结果分析

    Institute of Scientific and Technical Information of China (English)

    叶丹妮; 王露; 王新兰; 陈玉娟

    2014-01-01

    ObjectiveTo investigate theprevalence rate of nosocomial infections in our hospital in order to provide scientific evidence for hospital infection prevention and control. Methods The bedside investigation combined with the review of medical records was adopted. Results Of totally 1160 patients expected to be investigated,1159 patients were actually investigated with the actual investigation rate of 99.91%;and the case-time infection rate was 3.62%.The main infection site was lower respiratory tract,accounting for 34.1%. Gram-negative bacilli were the predominant pathogens causing nosocomial infections.The utilization rate of antibiotics was 33.2%.Single antibiotic was used in 90.65%.Conclusion To clarify the management of nosocomial infections in key departments and links through investigation of the prevalence of nosocomial infections is conducive to the prevention and control of nosocomial infections.%目的:了解我院医院感染现状,为有效预防和控制医院感染提供科学依据。方法采取床旁调查和住院病历调查相结合的方法。结果应查患者1160例,实查1159例,实查率99.91%,医院感染现患率为3.62%,感染部位以下呼吸道居首位占34.1%。革兰氏阴性菌为医院感染的主要病原菌,抗菌药物使用率为33.2%,其中一联用药率为90.65%。结论通过医院感染现患率调查,进一步明确医院感染管理的重点部门和重点环节,有利于更好的预防与控制医院感染的发生。

  5. Antimicrobial susceptibility of Acinetobacter clinical isolates and emerging antibiogram trends for nosocomial infection management

    Directory of Open Access Journals (Sweden)

    Muhammad Sohail

    2016-06-01

    Full Text Available Abstract: Introduction: The drug resistant Acinetobacter strains are important causes of nosocomial infections that are difficult to control and treat. This study aimed to determine the antimicrobial susceptibility patterns of Acinetobacter strains isolated from different clinical specimens obtained from patients belonging to different age groups. METHODS: In total, 716 non-duplicate Acinetobacter isolates were collected from the infected patients admitted to tertiary-care hospitals at Lahore, Pakistan, over a period of 28 months. The Acinetobacter isolates were identified using API 20E, and antimicrobial susceptibility testing was performed and interpreted according to Clinical and Laboratory Standards Institute (CLSI guidelines. RESULTS: The isolation rate of Acinetobacter was high from the respiratory specimens, followed by wound samples. Antibiotic susceptibility analyses of the isolates revealed that the resistance to cefotaxime and ceftazidime was the most common, in 710 (99.2% specimens each, followed by the resistance to gentamicin in 670 (93.6% isolates, and to imipenem in 651 (90.9% isolates. However, almost all isolates were susceptible to tigecycline, colistin, and polymyxin B. CONCLUSIONS: The present study showed the alarming trends of resistance of Acinetobacter strains isolated from clinical specimens to the various classes of antimicrobials. The improvement of microbiological techniques for earlier and more accurate identification of bacteria is necessary for the selection of appropriate treatments.

  6. Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

    Directory of Open Access Journals (Sweden)

    Juliana Pena Porto

    2012-08-01

    Full Text Available INTRODUCTION: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI, namely, sepsis, pneumonia, and urinary tract infection (UTI, in a pediatric intensive care unit (PICU in a developing country and to define the risk factors associated with NI. METHODS: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN was conducted in the unit and children with NI (cases were compared with a group (matched controls in a case-control fashion. RESULTS: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each; Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%, and in UTI the most frequent agents were yeasts (33.3%. The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube, and use of antibiotics. The last two were independent factors for NI. CONCLUSIONS: The incidence of NI acquired in this unit was high and was associated with extrinsic factors.

  7. [Nosocomial infection due to Trichosporon asahii: clinical revision of 22 cases].

    Science.gov (United States)

    Rodrigues, Gustavo da Silva; de Faria, Rodrigo Rosa Ubatuba; Guazzelli, Lucina Silva; Oliveira, Flávio de Mattos; Severo, Luiz Carlos

    2006-06-01

    Twenty two cases of nosocomial infection caused by Trichosporon asahii, detected during a period of six years (1999-2005) is described. The patients were predominantly males with an average age of 47.3 years-old. The predominant diseases in the study group were respiratory insufficiency, cancer, diabetes, chronic renal insufficiency, cirrhosis and AIDS. The main predisposing conditions were antibiotic therapy, mechanical ventilation, urethral catheterization, catheter, corticoids, transplant, immunosuppressive therapy, chemotherapy, granulocytopenia, surgical procedures and continuous ambulatory peritoneal dialysis. The most used antifungal drugs were fluconazole and amphotericin B. In some cases several antifungals were administered. Five patients did not receive antifungal treatment, and one patient received granulocyte colony stimulating factor (G-CSF). Nine patients showed clinical improvement, nine died and the progress of four patients is unknown. T. asahii is an emergent pathogen in patients with immunodeficiency and its presence in these type hosts can not be considered colonization, as there is an important risk of invasive infection. So, in susceptible patients to develop trichosporonosis it is advisable to take into consideration this disease especially in intensive clinical care units.

  8. Anti-infective antibodies: a novel tool to prevent and treat nosocomial diseases.

    Science.gov (United States)

    Nagy, Eszter; Giefing, Carmen; von Gabain, Alexander

    2008-02-01

    The emergence of multidrug-resistant bacteria is a growing challenge for healthcare in the treatment of infectious diseases. In particular, nosocomial infections are getting out of control and reduce the likelihood to recover without, sometimes lethal, complications and long-term damage. Current antibiotics are unable to keep nosocomial infections in check and novel ones move only reluctantly forward and are expected to only delay the problem of multidrug resistance. Progress made in the identification of suitable pathogen targets, a better understanding of host-parasite interactions and the recent inclusion of monoclonal antibodies into the arsenal of novel therapies has provoked the interest to revitalize a historical concept of medicine to treat and prevent bacterial infections with antibodies.

  9. Analysis of Pathogen Distribution and Drug Resistance of Nosocomial Infections Accompanied in Patients with Malignant Tumor

    Institute of Scientific and Technical Information of China (English)

    YAO Dong-mei; CAO Wei; QING Zhi-ju

    2008-01-01

    Objective:To investigate the pathogen distribution and drug resistance of nosocomial infections accompanied in patients with malignant tumor.Methods:The pathogen culture and drug-sensitivity data of 107 specimens isolated from malignant tumor patients accompanied with nosocomial infection were retrospectively analyzed.Results:Among 118 strains of pathogens isolated from 107 specimens,77 were gram-negative bacillus(65.3%),26 were gram-positive coccus(65.3%),and 15 were fungus(12.7%).Eleven specimens were revealed to have combined infection of bacterium and fungus.Gram-negative bacillus showed high sensitivity to amikacin,ciprofloxacin,and tienam.Gram-positive cocci were highly sensitive to tienam and vancomycin.The bacteria were resistant to other antibiotics in different degrees.Vancomycin-resistant staphylococcus was not detected.Candida was sensitive to antifungals.Conclusion:Conditional pathogenic bacteria were mainly responsible for nosocomial infections in malignant tumor patients with considerable drug resistance.This shows that bacterial tests and the rational use of antibiotics should be emphasized in clinical practice to prevent the formation of drug resistant strains and further endogenous infections.

  10. 心内科患者多药耐药铜绿假单胞菌医院感染危险因素的分析%Risk factors analysis of nosocomial infections caused by multidrug resistant Pseudomonas aeruginosa separated from vasculocardiology department

    Institute of Scientific and Technical Information of China (English)

    宣云岗; 陈智理

    2012-01-01

    目的 调查心内科住院患者多药耐药铜绿假单胞菌(MDRPA)的感染现状及医院感染的危险因素,为监测与控制心内科MDRpA感染提供依据.方法 收集心内科2007-2010年分离医院感染的MDRPA,采用Microscan Walk away 96SI全自动微生物鉴定仪鉴定并检测药物敏感性,将检测出的MDRP与同时期敏感铜绿假单胞菌作为对照,采用病例对照研究方法,单因素(t检验、x2检验)及多因素logistic回归进行分析.结果 连续收集到医院感染铜绿假单胞菌(PAE)80株,其中,MDRPA 25株,总分离率31.3%;主要标本来源是呼吸道标本,占77.5%;单因素分析发现,曾入住ICU、基础疾病、住院时间、纤维支气管镜灌洗、机械通气时间、分离出MDRPA前<14 d使用碳青霉烯类抗菌药物与MDRP感染有关;多因素logistic回归分析确定了3项独立危险因素;曾入住ICU、机械通气、分离出MDRP前<14 d用过碳青霉烯类抗菌药物.结论 曾入住ICU、机械通气以及碳青霉烯类抗菌药物的使用,是心内科住院患者MDRPA感染的危险因素;重视无菌技术操作,控制机械性通气的使用,改善住院病室条件是预防心内科MDRPA的重要措施.%OBJECTIVE To provide the evidence for the monitoring and control of multiple drug-resistant Pseudomonas aeruginosa (MDRPA) infections through investigation of the current status of nosocomial infections caused by MDRPA and to analyze the risk factors. METHODS The drug susceptibility of MDRPA separated from vasculocardiology department of our hospital collected from 2007 to 2010 were tested by Microscan Walk away 96SI and compared with the susceptible strains as control. T-test, chi-square test and Logistic regression analysis were used for statistical analysis. RESULTS A total of 80 strains of non-repeated PAE were collected, of which the MDRPA accounted for 25 strains (31. 3%). Samples mainly came from the respiratory system (77.5%). According to univariate

  11. Nosocomial urinary tract infection in the intensive care unit: when should Pseudomonas aeruginosa be suspected? Experience of the French national surveillance of nosocomial infections in the intensive care unit, Rea-Raisin.

    Science.gov (United States)

    Venier, A-G; Lavigne, T; Jarno, P; L'heriteau, F; Coignard, B; Savey, A; Rogues, A-M

    2012-01-01

    Individual and ward risk factors for P. aeruginosa-induced urinary tract infection in the case of nosocomial urinary tract infection in the intensive care unit were determined with hierarchical (multilevel) logistic regression. The 2004-2006 prospective French national intensive care unit nosocomial infection surveillance dataset was used and 3252 patients with urinary tract infection were included; 16% were infected by P. aeruginosa. Individual risk factors were male sex, duration of stay, antibiotics at admission and transfer from another intensive care unit. Ward risk factors were patient turnover and incidence of P. aeruginosa-infected patients.

  12. 内科病房老年病人医院感染调查%Investigation of nosocomial infection of medical elderly inpatients in our hospital

    Institute of Scientific and Technical Information of China (English)

    郭子云

    2001-01-01

    目的 了解我院老年病人医院感染情况,为预防老 年人医院感染提供客观依据。 方法 对1996年1月~1998年12月我院内 科601例住院老年病人采取前瞻性与回顾性调查相结合的方法进行目标性监测。结 果 本组老年病人医院感染率为8.32%,明显高于我院这3年的平均医院感染率(1.4 8%)。感染部位以下呼吸道发生最多,占医院感染的52%。以内分泌、循环、消化、泌尿、呼 吸系统疾病等医院感染发生率较高。检出的医院感染病原菌以条件致病菌——真菌为主,占 85%。结论 老年人免疫功能低下,抗生素的大量应用等是引起医院感染的 主要因素。%Objective To find out nosocomial infection of elde rly patients in our nosocomial and to provide theoretical evidence for preventing nosocomial infection of elderly patients. Methods 601 elderly p ati ents of internal medicine in our hospital were investigated with prospective and retrospective methods from January 1996 to December 1998. Results Nosocomial infectious rate in this age was 8.32%, and it was higher than mean nosocomial infectious rate in our nosocomial during the last three years( 1.48%). Infectious sites was mostly the lower respiratory tract, and it's infe ctious r ate was 52%. Basic diseases such as endocrine system, circulatory system, dige stive system, genitourinary system, respiratory system diseases were higher in nosocomial infection. Opportunitive pathogens were the main cause of the nosocomial infectious pathogens, and fungi took 85% of the opportunitive pa thogens. Conclusions Nosocomial infectious factors are mainly that immune function is lower in the aged and antibiotic is used generally.

  13. Analysis of risk factors for nosocomial infections in lung cancer patients caused by methicillin-resistant Staphylococcus aureus%肺癌患者耐甲氧西林金黄色葡萄球菌医院感染危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈国卿; 苏乘平; 程熙; 付亚斋

    2012-01-01

    目的 分析肺癌患者医院感染耐甲氧西林葡萄球菌(MRSA)的危险因素.方法 收集2004年1月-2010年10月台州市博爱医院肿瘤科90例肺癌患者资料,其中诊断为MRSA感染病例56例为感染组,对照组为同时期同病区未感染MRSA肺癌患者34例;采用纸片扩散(K-B)法进行药敏试验;MRSA的鉴定采用CLSI 2004年指定的头孢西丁法;感染组与对照组之间比较计数资料采用t检验、卡方检验及多因素logistic回归进行分析.结果 t检验、卡方检验结果提示,年龄、混合真菌感染、机械通气、使用糖皮质激素、抗菌药物联合使用为肺癌患者医院感染MRSA的相关因素;多因素logistic回归分析结果表明,混合真菌感染(OR=12.22)、机械通气(OR=8.13)、使用糖皮质激素(OR=6.98)、抗菌药物联合使用(OR=5.18)进入回归方程.结论 混合真菌感染、机械通气、使用糖皮质激素、抗菌药物联合使用为肺癌患者医院感染MRSA的独立危险因素.%OBJECTIVE To investigate the risk factors for nosocomial infections caused by methicillin-resistant Staphylococcus aueus (MRSA) in lung cancer patients. METHODS A total of 90 lung cancer patients admitted in our hospital from Jan. 2004 to Oct. 2010 were analyzed, including 56 cases of MRSA infection (infection group) and 34 cases of non-MRSA infection (control group). Disk diffusion test was adopted for drug susceptibility test. Cefoxitin method recommend by the National Committee for Clinical Laboratory Standards (NCCLS, 2004) was used to identify MRSA. Chi-square test, student t-test and multivariate logistic regression analysis were performed to compare enumeration data between infection group and control group. RESULTS The factors associated with the development of MRSA nosocomial infection were age, co-infection with fungi, mechanical ventilation, use of glucocorticoids and combination of antibiotics. Multivariate logistic regression analysis identified four

  14. Prevalencia de la infección nosocomial en Navarra: Resultados agregados del estudio EPINE 2005 Prevalence of nosocomial infection in Navarre: Aggregated data of the EPINE study for 2005

    Directory of Open Access Journals (Sweden)

    M. García-Cenoz

    2007-04-01

    Full Text Available La infección nosocomial es un problema de importante trascendencia en términos de morbi-mortalidad, que según los datos nacionales de prevalencia del año 2003, afectó al 6,5-7% de los pacientes ingresados en los hospitales españoles. Nuestro objetivo es conocer la prevalencia de la infección nosocomial en Navarra a partir de los datos aportados por cada centro participante en el estudio EPINE del año 2005, analizar las características de las infecciones nosocomiales y compararlas con los datos globales de los hospitales españoles. La prevalencia de pacientes con infección nosocomial fue de 5,6% y la prevalencia de pacientes con infección comunitaria de 13,2%. La prevalencia de infección nosocomial, excluidas las adquiridas en un ingreso anterior, fue del 6,2%. La prevalencia de infección comunitaria fue del 14,2%.Nosocomial infection is a serious problem of morbidity and mortality that, according to the 2003 national prevalence data affected 6,5-7% of all the patients admitted in Spanish hospitals. Our aim is to assess the prevalence of nosocomial infection in Navarre, from the aggregated data of each participant in the EPINE (Study of Prevalence of Nosocomial Infection in Spain in 2005, and to analyse different features of the nosocomial infections to compare them with the global data for Spain. The prevalence of patients with nosocomial infection was 5,6% and the prevalence of patients with community infection was 13,2%. The prevalence of nosocomial infection, excluding those that acquired the nosocomial infection in a previous admission to the hospital, was 6,2%. The prevalence of community infection was 14,2%.

  15. Nosocomial respiratory tract infections in multiple trauma patients. Influence of level of consciousness with implications for therapy

    National Research Council Canada - National Science Library

    J Rello; V Ausina; J Castella; A Net; G Prats

    1992-01-01

    A prospective study of 161 multiple trauma patients was carried out to determine the incidence, the causative agents, and the outcome of nosocomial respiratory tract infections in this highly selected population. Thirty-eight (23.6 percent...

  16. Surgical Site Infection (SSI) Rates in the United States, 1992-1998: The National Nosocomial Infections Surveillance System Basic SSI Risk Index

    National Research Council Canada - National Science Library

    Robert P. Gaynes; David H. Culver; Teresa C. Horan; Jonathan R. Edwards; Chesley Richards; James S. Tolson; The National Nosocomial Infections Surveillance System

    2001-01-01

    By use of the National Nosocomial Infections Surveillance (NNIS) System's surgical patient surveillance component protocol, the NNIS basic risk index was examined to predict the risk of a surgical site infection (SSI...

  17. [Antimicrobial resistance trends in pathogens isolated from nosocomial infections].

    Science.gov (United States)

    Rincón-León, Héctor A; Navarro-Fuentes, Karla R

    2016-01-01

    Introducción: el tratamiento de las infecciones nosocomiales se dificulta por la tendencia al incremento de la resistencia a antimicrobianos de los gérmenes que las causan. El objetivo fue evaluar las tendencias en la resistencia de las bacterias de aislados de infección nosocomial. Métodos: estudio retrospectivo de 2009 a 2012 en un hospital de tercer nivel en Chiapas. Resultados: fueron obtenidos 1300 gérmenes, 62.3 % bacterias Gram negativas, 22.8 % Gram positivas y 14.9 % levaduras; Pseudomonas aeruginosa pasó del 47.1 al 60.5 % de resistencia a imipenem; Escherichia coli mostró un aumento en la resistencia a aztreonam, cefepime y ceftazidima; Acitenobacter baumannii incrementó su resistencia a amikacina, cefepime, ceftazidima y ciprofloxacino; Klebsiella pneumoniae disminuyó su resistencia a amikacina y piperacilina/tazobactam; la resistencia a vancomicina fue del 3.6 al 25.5 %. Conclusiones: predominaron los gérmenes Gram negativos y mostraron tendencias al incremento en la resistencia antimicrobiana. Hubo un aumento proporcional de la incidencia de infección por E. coli, Candida tropicalis y Staphylococcus haemolyticus. Es indispensable contar con planes y programas para el uso racional y basado en evidencia de antimicrobianos, así como la difusión y el apego a las guías de práctica clínica y la implementación de programas novedosos para la vigilancia y el control de las infecciones hospitalarias, las técnicas de aislamiento y los cuidados generales.

  18. Case-mix adjustment approach to benchmarking prevalence rates of nosocomial infection in hospitals in Cyprus and Greece.

    Science.gov (United States)

    Kritsotakis, Evangelos I; Dimitriadis, Ioannis; Roumbelaki, Maria; Vounou, Emelia; Kontou, Maria; Papakyriakou, Panikos; Koliou-Mazeri, Maria; Varthalitis, Ioannis; Vrouchos, George; Troulakis, George; Gikas, Achilleas

    2008-08-01

    To examine the effect of heterogeneous case mix for a benchmarking analysis and interhospital comparison of the prevalence rates of nosocomial infection. Cross-sectional survey. Eleven hospitals located in Cyprus and in the region of Crete in Greece. The survey included all inpatients in the medical, surgical, pediatric, and gynecology-obstetrics wards, as well as those in intensive care units. Centers for Disease Control and Prevention criteria were used to define nosocomial infection. The information collected for all patients included demographic characteristics, primary admission diagnosis, Karnofsky functional status index, Charlson comorbidity index, McCabe-Jackson severity of illness classification, use of antibiotics, and prior exposures to medical and surgical risk factors. Outcome data were also recorded for all patients. Case mix-adjusted rates were calculated by using a multivariate logistic regression model for nosocomial infection risk and an indirect standardization method.Results. The overall prevalence rate of nosocomial infection was 7.0% (95% confidence interval, 5.9%-8.3%) among 1,832 screened patients. Significant variation in nosocomial infection rates was observed across hospitals (range, 2.2%-9.6%). Logistic regression analysis indicated that the mean predicted risk of nosocomial infection across hospitals ranged from 3.7% to 10.3%, suggesting considerable variation in patient risk. Case mix-adjusted rates ranged from 2.6% to 12.4%, and the relative ranking of hospitals was affected by case-mix adjustment in 8 cases (72.8%). Nosocomial infection was significantly and independently associated with mortality (adjusted odds ratio, 3.6 [95% confidence interval, 2.1-6.1]). The first attempt to rank the risk of nosocomial infection in these regions demonstrated the importance of accounting for heterogeneous case mix before attempting interhospital comparisons.

  19. A Survey on The Prevalence and Antibiotic Sensitivity of Nosocomial Infections in the Besat Hospital, Sanandaj, Iran

    OpenAIRE

    Hamid Lavakhamseh; Pegah Shakib; Samaneh Rouhi; Bahman Mohammadi; Rashid Ramazanzadeh

    2014-01-01

    ABSTRACT Background and Objective: Nosocomial infections are the most significant problems in hospitals. The aim of this study was to investigate the prevalence of nosocomial infections and antibiotic resistance of bacteria isolated from patients. Methods: This cross-sectional study was conducted in the Besat Hospital, Sanandaj, Iran from late March 2012 to early April 2013 on 32,400hospitalized patients. Bacteria were isolated from the sepatients and they were detected and identified...

  20. Use of an artificial neural network to predict risk factors of nosocomial infection in lung cancer patients.

    Science.gov (United States)

    Chen, Jie; Pan, Qin-Shi; Hong, Wan-Dong; Pan, Jingye; Zhang, Wen-Hui; Xu, Gang; Wang, Yu-Min

    2014-01-01

    Statistical methods to analyze and predict the related risk factors of nosocomial infection in lung cancer patients are various, but the results are inconsistent. A total of 609 patients with lung cancer were enrolled to allow factor comparison using Student's t-test or the Mann-Whitney test or the Chi-square test. Variables that were significantly related to the presence of nosocomial infection were selected as candidates for input into the final ANN model. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the performance of the artificial neural network (ANN) model and logistic regression (LR) model. The prevalence of nosocomial infection from lung cancer in this entire study population was 20.1% (165/609), nosocomial infections occurring in sputum specimens (85.5%), followed by blood (6.73%), urine (6.0%) and pleural effusions (1.82%). It was shown that long term hospitalization (≥ 22 days, P= 0.000), poor clinical stage (IIIb and IV stage, P=0.002), older age (≥ 61 year old, P=0.023), and use the hormones were linked to nosocomial infection and the ANN model consisted of these four factors .The artificial neural network model with variables consisting of age, clinical stage, time of hospitalization, and use of hormones should be useful for predicting nosocomial infection in lung cancer cases.

  1. ICU ward design and nosocomial infection rates: a cross-sectional study in Germany.

    Science.gov (United States)

    Stiller, A; Schröder, C; Gropmann, A; Schwab, F; Behnke, M; Geffers, C; Sunder, W; Holzhausen, J; Gastmeier, P

    2017-01-01

    There is increasing interest in the effects of hospital and ward design on multi-faceted infection control. Definitive evidence is rare and the state of knowledge about current ward design is lacking. To collect data on the current status of ward design for intensive care units (ICUs) and to analyse associations between particular design factors and nosocomial infection rates. In 2015, operational infrastructure data were collected via an online questionnaire from ICUs participating voluntarily in the German nosocomial infection surveillance system (KISS). A multi-variate analysis was subsequently undertaken with nosocomial infection rates from the KISS database from 2014 to 2015. In total, 534 ICUs submitted data about their operational infrastructure. Of these, 27.1% of beds were hosted in single-bed rooms with a median size of 18m(2) (interquartile range 15-21m(2)), and 73.5% of all ICU beds had a hand rub dispenser nearby. The authors were able to match 266 ICUs in the multi-variate analysis. ICUs with openable windows in patient rooms were associated with lower device-associated lower respiratory tract infections [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.58-0.90]. ICUs with >40% two-bed rooms were associated with lower primary bloodstream infection rates (OR 0.66, 95% CI 0.51-0.86). Only minor associations were found between design factors and ICU infection rates. Most were surrogates for other risk factors. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  2. Nosocomial infection by sequence type 357 multidrug-resistant Acinetobacter baumannii isolates in a neonatal intensive care unit in Daejeon, Korea.

    Science.gov (United States)

    Sung, Ji Youn; Koo, Sun Hoe; Cho, Hye Hyun; Kwon, Kye Chul

    2013-07-01

    Acinetobacter baumannii is an important microorganism responsible for a number of nosocomial outbreaks, in particular, in intensive care units (ICUs). We investigated a nosocomial infection caused by multidrug-resistant (MDR) A. baumannii in a neonatal intensive care unit (NICU) in Korea. A. baumannii isolates were characterized using Etest (AB Biodisk, Sweden), two multiplex PCR assays, and multilocus sequence typing (MLST) scheme. PCR and PCR mapping experiments were performed for detecting and characterizing the determinants of antimicrobial resistance. Eight strains isolated from an NICU belonged to European (EU) clone II and revealed only one sequence type (ST), namely, ST357. All the isolates were susceptible to imipenem but were resistant to amikacin, gentamicin, ceftazidime, cefepime, and ciprofloxacin. To the best of our knowledge, this is the first report of a nosocomial infection in an NICU in Korea caused by ST357 MDR/carbapenem-susceptible A. baumannii strains. This result demonstrates that nosocomial outbreaks of MDR/carbapenem-susceptible strains as well as MDR/carbapenem-resistant isolates may occur in NICUs.

  3. [Impact factors analysis of standardized perioperative antibiotic application on nosocomial infection and drug-resistance bacteria].

    Science.gov (United States)

    Li, Yan; Xu, Yan-shan; Xu, Jing; Liu, Xue-yi; Li, Ya-jun

    2013-11-01

    To investigate the impact factors and clinical significance of standardized perioperative antibiotic application on nosocomial infection and drug-resistant bacteria strains in eye hospital. It was a retrospective series case study. The inpatients underwent ophthalmologic operation of one year before standardized application (from Sep. 2009 to Aug. 2010) and one year after standardized application (from Sep. 2010 to Aug. 2011) in Tianjin Eye Hospital were selected and the incidence rate of nosocomial infection and types of drug-resistant strains in these two years were analyzed. From Sep. 2009 to Aug. 2010, the prophylactic antibiotics application rate for type I incisional surgeries was 80.29% (12937/16 111), the nosocomial infection rate was 0.011% (2/17 563). From Sep. 2010 to Aug. 2011, the same values were 44.50% (7968/17 905) and 0.005% (1/19 441). There was a significant decrease of prophylactic antibiotics application comparing these two years (χ(2) = 4587.78, P nosocomial infection rate (χ(2) = 0.44, P > 0.05). Average antibiotics application rate for inpatient (type I-IV incisional surgeries) was 76.69% (13 469/17 563) from Sep. 2009 to Aug. 2010, and 49.40% (9604/19 441) from Sep. 2010 to Aug. 2011. There was a significant decrease over these two years (χ(2) = 2927.19, P resistance rate of staphylococcus was 42.86% (33/77) from Sep. 2009 to Aug. 2010 and 39.19% (39/74) from Sep. 2010 to Aug. 2011. Drug resistance rate of pseudomonas aeruginosa was 2/11 from Sep. 2009 to Aug. 2010 and 2/13 from Sep. 2010 to Aug. 2011. There were no significant differences in drug resistance rate of staphylococcus and pseudomonas aeruginosa between these two years (χ(2) = 0.09, P > 0.05, χ(2) = 0.03, P > 0.05). By standardizing the perioperative antibiotics application in eye hospital, the rate of systemic administration of antibiotics declined gradually. The Choices and the administrative mode of antibiotics were more rational than before. In the meanwhile, the rate

  4. Microbial Characteristics of Nosocomial Infections and Their Association with the Utilization of Hand Hygiene Products: A Hospital-Wide Analysis of 78,344 Cases.

    Science.gov (United States)

    Liu, Song; Wang, Meng; Wang, Gefei; Wu, Xiuwen; Guan, Wenxian; Ren, Jianan

    Nosocomial infections are the main adverse events during health care delivery. Hand hygiene is the fundamental strategy for the prevention of nosocomial infections. Microbial characteristics of nosocomial infections in the Asia-Pacific region have not been investigated fully. Correlation between the use of hand hygiene products and the incidence of nosocomial infections is still unknown. This study investigates the microbial characteristics of nosocomial infections in the Asia-Pacific region and analyzes the association between the utilization of hand hygiene products and the incidence of nosocomial infections. A total of 78,344 patients were recruited from a major tertiary hospital in China. Microbial characteristics of major types of nosocomial infections were described. The association between the utilization of hand hygiene products and the incidence of nosocomial infections was analyzed using correlation and regression models. The overall incidence of nosocomial infections was 3.04%, in which the incidence of surgical site infection was 1%. Multi-drug resistance was found in 22.8% of all pathogens, in which multi-drug-resistant Acinetobacter baumannii and methicillin-resistant Staphylococcus aureus were 56.6% and 54.9%, respectively. The utilization of hand hygiene products (including hand sanitizer, soap and paper towel) was associated negatively with the incidence of surgical site infection in surgical departments and the incidence of nosocomial infections in non-intensive care unit (ICU) departments (especially in surgical departments). Regression analysis further identified that higher utilization of hand hygiene products correlated with decreased incidence of major types of nosocomial infections. Multi-drug-resistant organisms are emerging in Asia-Pacific health care facilities. Utilization of hand hygiene products is associated with the incidence of nosocomial infections.

  5. Nosocomial infection in the intensive care unit. 1997-2002.

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    Marta Luján Hernández

    2005-04-01

    Full Text Available Fundament: The infections nosocomiales constitute an important problem of health, for what is of supreme importance to identify the epidemic situation of this. Objective: Describe the behaviour of the infections nosocomiales in the Unit of Intensive Cares. Methods: I Study descriptive retrospective carried out in the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ of Cienfuegos during the years 1997-2002. The following variables were included: hospital expenditures, cases infected by months and years, localizations, germs, deaths and procedures of more risk (ventilation mechanics, deep veined catheters and vesical catheters. Results: We check stabilization in the global rates, the cases you find inside the predicted parameters, the main localization was the breathing one with a percentage stocking of 42 in the seven investigated years, while the germ of more circulation was the Acynetobacter with an average of 27,1%. The rates of mortality associated to infection stayed low and the lethality suffered a on decreased in the studied period, however the pneumonias associated to the ventilation mechanics stayed high with an average of 24, 6 for every 1000 patient days and to the closing of the 2002 the service you will find in the area of security of the endemic channel.K

  6. [A survey on nosocomial tuberculosis infection control in hospitals in Osaka City].

    Science.gov (United States)

    Shimouchi, Akira; Konishi, Shozaburo; Tanaka, Takashi

    2005-12-01

    To ascertain nosocomial tuberculosis (TB) infection control practice in hospitals in Osaka City. A questionnaire was distributed in the orientation meeting and collected at the occasion of medical inspection in all 196 hospitals in Osaka City in 2003. TB patients were diagnosed in about half of hospitals in the past 3 years. Basic TB infection control measures were taken in the majority of hospitals; such as chest X-ray screening for all inpatients, health check for employees, tuberculin skin test (TST) for newly employed staff, and nomination of a person in charge of TB infection control. Control measures were practiced more often in hospitals where TB patients were diagnosed, such as "fiberoptic bronchoscopy is to be conducted last in the working hours to avoid contamination of TB bacilli in a room," "TST (including two-step method) for all newly employed staff," "Staff wear N95 mask when they deal with TB patients/suspects," and the differences were statistically significant. It is necessary in hospitals in Osaka City to strengthen nosocomial TB infection control as TB patients were diagnosed in about half of hospitals in the past 3 years. Low cost infection control measures were undertaken more often among hospitals where TB patients were diagnosed. Introduction of high cost equipment or improvement of facilities should be considered in hospitals of high TB risk. Guidelines formulated based on analysis of the survey should facilitate all hospitals to introduce at least low cost effective tuberculosis infection control measures.

  7. The regional commission for medical accidents and nosocomial infections set up by French law.

    Science.gov (United States)

    Bartoli, C; Piercecchi-Marti, M D; Pelissier-Alicot, A L; Cianfarani, F; Leonetti, G

    2005-07-01

    The regional commission for conciliation and compensation for medical accidents, iatrogenic diseases and nosocomial infections (commission régionale de conciliation et d'indemnisation des accidents médicaux, affections iatrogènes et infections nosocomiales, CRCI) offers victims of such events the possibility of obtaining compensation without recourse to legal proceedings. We suggest various points of view about this commission set up by the French law no. 2002-303 of 4 March 2002: the composition, role and competence of the CRCI; the place of the expert's report; the opinion pronounced by the CRCI and its outcome, the compensation of victims and, finally, interaction with other procedures.

  8. Urinary catheter related nosocomial infections in paediatric intensive care unit.

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    Tullu M

    1998-04-01

    Full Text Available The present prospective study was carried out in the Paediatric Intensive Care Unit (PICU of a tertiary care teaching hospital in Mumbai. The objective was to determine the incidence, risk factors, mortality and organisms responsible for urinary catheter related infections (UCRI. Colonization and/or bacteriuria was labelled as urinary catheter related infection (UCRI. Forty-four patients with 51 urinary catheters were studied. Incidence of UCRI was 47.06%. Age, female sex and immunocompromised status did not increase the risk of UCRI. Duration of catheter in-situ and duration of stay in the PICU were associated with higher risk of UCRI. The mortality was not increased by UCRI. Commonest organism isolated in UCRI was E. coli, which had maximum susceptibility to nitrofurantoin and amikacin.

  9. [Nosocomial infections due to human coronaviruses in the newborn].

    Science.gov (United States)

    Gagneur, A; Legrand, M C; Picard, B; Baron, R; Talbot, P J; de Parscau, L; Sizun, J

    2002-01-01

    Human coronaviruses, with two known serogroups named 229-E and OC-43, are enveloped positive-stranded RNA viruses. The large RNA is surrounded by a nucleoprotein (protein N). The envelop contains 2 or 3 glycoproteins: spike protein (or protein S), matrix protein (or protein M) and a hemagglutinin (or protein HE). Their pathogen role remains unclear because their isolation is difficult. Reliable and rapid methods as immunofluorescence with monoclonal antibodies and reverse transcription-polymerase chain reaction allow new researches on epidemiology. Human coronaviruses can survive for as long as 6 days in suspension and 3 hours after drying on surfaces, suggesting that they could be a source of hospital-acquired infections. Two prospective studies conducted in a neonatal and paediatric intensive care unit demonstrated a significant association of coronavirus-positive nasopharyngal samples with respiratory illness in hospitalised preterm neonates. Positive samples from staff suggested either a patient-to-staff or a staff-to-patient transmission. No cross-infection were observed from community-acquired respiratory-syncitial virus or influenza-infected children to neonates. Universal precautions with hand washing and surface desinfection could be proposed to prevent coronavirus transmission.

  10. The Mortality Rate of Nosocomial Infection in Neonatal Intensive Care Unit (NICU of Taleghani Educational and Treatment Center, Tabriz, 2013

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    Parvin Abbasian

    2015-09-01

    Full Text Available Background and Objectives : Information about nosocomial infections (NIs is necessary for both appropriate management and establishment of preventative measures in hospitals. Neonates admitted to the Neonatal Intensive Care Unit (NICU are at high-risk of developing nosocomial infection. The aim of this study was to determine the mortality rate of nosocomial infections and the distribution of pathogens among newborns who were admitted to the neonatal intensive care unit in Taleghani educational and treatment center, Tabriz. Material and Methods : This was a cross-sectional study. The sampling method was census. The inclusion criteria were dead infants who developed signs of infection after 48 hours of hospitalization and those who had symptoms at the admission were excluded. Data were collected through hospital records and were analyzed using Excel software. Results: From 904 infants admitted to NICU, 39 (4.3% acquired hospital infection. Mortality from nosocomial infections in NICU was 20.5% that was 12% of the total deaths. Coagulase-negative staphylococcal Cook (37.5% and Escherichia coli (25% were the most commonly identified agents among dead neonates. Conclusion: For more reduction in nosocomial infection and its mortality rate, mercury hygiene principles and also optimizing bed spaces are recommended. ​

  11. Previous antibiotic exposure and evolution of antibiotic resistance in mechanically ventilated patients with nosocomial infections.

    Science.gov (United States)

    Hui, Chun; Lin, Ming-Chih; Jao, Mei-Shin; Liu, Tu-Chen; Wu, Ren-Guang

    2013-10-01

    This study aimed to evaluate the impact of previous antibiotic exposure and the influence of time interval since exposure on the evolution of antibiotic-resistant infections. We retrospectively analyzed 167 mechanically ventilated patients with nosocomial infections over a 3-year period, with focus on infections in the bloodstream, urinary tract, lower respiratory tract, and surgical sites. Of 167 patients, 62% were confirmed as antibiotic resistant. The most common isolated pathogen was extended-spectrum β-lactamase Enterobacteriaceae (43.9%), followed by methicillin-resistant Staphylococcus aureus (22.8%), and carbapenem-resistant Acinetobacter baumannii (17.5%). Multivariate analysis revealed that the association between resistance and the time interval increased within 10 days (odds ratio [OR], 2.45; P=.133) and peaked at 11 to 20 days (OR, 7.17; P=.012). The data were categorized into 2 groups: when the time interval was more than 20 days, there was a 23.9% reduction in resistance rate compared with when the time interval was 20 days or less (OR, 0.36; P=.002). Although antibiotic exposure increased resistance rate in nosocomial infections, this association decreased as time interval increased. Antibiotic stewardship should consider the significance of time interval while investigating the evolution of subsequent antibiotic-resistant infections. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. [Information on nosocomial infections in hospitals without microbiological laboratories: effective data utilization through outsourcing].

    Science.gov (United States)

    Fujikata, Rie; Hosoi, Susumu; Tsuruoka, Takashi

    2010-06-01

    To implement hospital-acquired infection control, sharing information, including the most recent data, is vital. With the current crisis in community healthcare and a subsequent lack of hospital laboratories, increasing numbers of clinical tests, unprofitable microbiological tests in particular, have been outsourced. At present, most medium- and small-scale hospitals in Japan do not conduct microbiological testing themselves, and so the outsourcing of these tests is essential for the promotion of infection control, including the provision of data on microbial detection. Our hospital, a central and the only general hospital with 160 beds in our area, usually outsources microbiological testing. With the aim of enhancing infection prevention and other clinical support services and promoting hospital infection control, were developing a system, led by the Department of Inspection, to provide appropriate information on nosocomial infections in collaboration with other departments within the hospital and partner organizations.

  13. Are laptop ventilation-blowers a potential source of nosocomial infections for patients?

    Science.gov (United States)

    Siegmund, Katja; Hübner, Nils; Heidecke, Claus-Dieter; Brandenburg, Ronny; Rackow, Kristian; Benkhai, Hicham; Schnaak, Volker; Below, Harald; Dornquast, Tina; Assadian, Ojan; Kramer, Axel

    2010-09-21

    Inadequately performed hand hygiene and non-disinfected surfaces are two reasons why the keys and mouse-buttons of laptops could be sources of microbial contamination resulting consequently in indirect transmission of potential pathogens and nosocomial infections. Until now the question has not been addressed whether the ventilation-blowers in laptops are actually responsible for the spreading of nosocomial pathogens. Therefore, an investigational experimental model was developed which was capable of differentiating between the microorganisms originating from the external surfaces of the laptop, and from those being blown out via the ventilation-blower duct. Culture samples were taken at the site of the external exhaust vent and temperature controls were collected through the use of a thermo-camera at the site of the blower exhaust vent as well as from surfaces which were directly exposed to the cooling ventilation air projected by the laptop. Control of 20 laptops yielded no evidence of microbial emission originating from the internal compartment following switching-on of the ventilation blower. Cultures obtained at the site of the blower exhaust vent also showed no evidence of nosocomial potential. High internal temperatures on the inner surfaces of the laptops (up to 73°C) as well as those documented at the site of the blower exhaust vent (up to 56°C) might be responsible for these findings.

  14. THE CLINICAL RESEARCH OF NOSOCOMIAL INFECTION ON INPATIENTS WITH HEART DISEASE%心内科住院患者医院感染的临床研究

    Institute of Scientific and Technical Information of China (English)

    骆安德

    2011-01-01

    目的 研究心内科医院感染相关因素,为防治措施提供科学依据.方法 采用回顾性调查方法,对本医院心内科住院患者医院感染及其危险因素进行了调查.结果 本次共调查2 764例住院患者,发生54例医院内感染,感染率为1.95%,感染者原发病均为心脏病.感染部位以呼吸道为主,占77.78%,其中下呼吸道感染占50.00%,上呼吸道占27.78%;其次是泌尿道感染,占7.40%.引发心脏内科病人感染的危险因素主要是年龄、合并有基础病、侵人性操作及手卫生等.结论 心脏内科病人医院内感染部位主要是呼吸道,引发感染的危险因素主要有年龄大、基础性疾病和侵入性操作;应加强基础护理和治疗,严格无菌操作.%Objective To study the relative factors of nosocomial infection in cardiology department and provide scientific basis for making protective measures. Methods The retrospective survey was carried out to investigate the nosocomiul infection and related factors of patients with heart disease in our hospital. Results Among 2 764 cases for this investigation,54 cases of nosocomial infections occurred and the infection rate was 1. 95%. The patients suffered from heart disease and the major infection sites were respiratory tract which accounted for 77.78%; the rate of lower respiratory tract infection was 50.00% and that of the upper respiratory tract infection was 27.78%. Secondly the site of nosocomial infection was urinary infection which accounted for 7.40%. The principal risk factors that caused infection of heart disease patients were age,concomitant physical illnesses, virulence operation and hand hygiene. Conclusion The major sites of nosocomial infection for heart disease patients are respiratory tract. The main risk factors of nosocomial infection include age, physical illnesses,and virulence operation. Therefore, basic care and treatments, strict aseptic manipulation should be strengthened.

  15. Nosocomial urinary tract infections and resistance profile to antibiotics

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    Hasan Naz

    2009-06-01

    Full Text Available The aim of this study is to investigate the risk factors, laboratuary results, distrubition of pathogens and sensitivity to antibiotics in patients with hospital acquired urinary tract infections (HAUTI. 161 HAUTI patients were diagnosed. The most common predisposing factors were identified as long term hospitalization, urinary catheterization, hospitalization at intensive care unit and neurologic diseases. The most commom pathogens isolated were Escherichia coli 33 (29.5 %, Pseudomonas spp. 32 (28.6 % and Klebsiella spp. 12 (10.7 %. The lowest rates of resistance in E.coli, Pseudomonas spp. and Klebsiella spp. were observed to amikacin (respectively 3 %, 9 %, 8 %, to imipenem (9 %, 41 %, 8 %, to piperacilin/tazobactam (PIP/TAZ (24 %, 47 %, 17 % and to ciprofloxasin (52 %, 69 %, 25 %. Mortality was detected in 31(19% of 161 patients diagnosed with HAUTI. As a result, high rate resistance was found in bacterial microorganism, especially in Pseudomonas spp.

  16. Comparison of the systemic inflammatory response syndrome between monomicrobial and polymicrobial Pseudomonas aeruginosa nosocomial bloodstream infections

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    Wenzel Richard P

    2005-10-01

    Full Text Available Abstract Background Some studies of nosocomial bloodstream infection (nBSI have demonstrated a higher mortality for polymicrobial bacteremia when compared to monomicrobial nBSI. The purpose of this study was to compare differences in systemic inflammatory response and mortality between monomicrobial and polymicrobial nBSI with Pseudomonas aeruginosa. Methods We performed a historical cohort study on 98 adults with P. aeruginosa (Pa nBSI. SIRS scores were determined 2 days prior to the first positive blood culture through 14 days afterwards. Monomicrobial (n = 77 and polymicrobial BSIs (n = 21 were compared. Results 78.6% of BSIs were caused by monomicrobial P. aeruginosa infection (MPa and 21.4% by polymicrobial P. aeruginosa infection (PPa. Median APACHE II score on the day of BSI was 22 for MPa and 23 for PPa BSIs. Septic shock occurred in 33.3% of PPa and in 39.0% of MPa (p = 0.64. Progression to septic shock was associated with death more frequently in PPa (OR 38.5, CI95 2.9–508.5 than MPa (OR 4.5, CI95 1.7–12.1. Maximal SIR (severe sepsis, septic shock or death was seen on day 0 for PPa BSI vs. day 1 for MPa. No significant difference was noted in the incidence of organ failure, 7-day or overall mortality between the two groups. Univariate analysis revealed that APACHE II score ≥20 at BSI onset, Charlson weighted comorbidity index ≥3, burn injury and respiratory, cardiovascular, renal and hematologic failure were associated with death, while age, malignant disease, diabetes mellitus, hepatic failure, gastrointestinal complications, inappropriate antimicrobial therapy, infection with imipenem resistant P. aeruginosa and polymicrobial nBSI were not. Multivariate analysis revealed that hematologic failure (p Conclusion In this historical cohort study of nBSI with P. aeruginosa, the incidence of septic shock and organ failure was high in both groups. Additionally, patients with PPa BSI were not more acutely ill, as judged by APACHE II

  17. Causes of nosocomial infections after laparoscopy surgery for rectal cancer and nursing%腹腔镜下直肠癌根治术后医院感染的原因分析及护理

    Institute of Scientific and Technical Information of China (English)

    陈幼燕; 叶平江

    2012-01-01

    目的 探讨腹腔镜下直肠癌根治术患者医院感染的围手术期护理对策.方法 采用回顾性调查方法对2005年8月-2011年9月腹腔镜下直肠癌根治术患者资料进行分析研究.结果 患者有糖尿病、慢性支气管炎等基础疾病,长时间的手术是引起术后感染主要因素,而患者的一般情况、癌症的临床分期、手术方式与术后感染无明显关系.结论 术前准备工作、手术室空气质量、室温、无菌操作规程及手术时间的长短、术后切口的管理均是影响术后医院感染的主要因素.%OBJECTIVE To study the nursing measurement for hospital infections during perioperative period after laparoscopy surgery for rectal cancer. METHODS A retrospective method was taken to investigate the data of patients who received laparoscopy surgery for rectal cancer from 2005 to 2011. RESULTS The study showed that the main risk factors for the infection after the surgery were the underlying diseases such as diabetes mellitus and hemorrhoids and the long duration of operation, however m there was no significant correlation between the pathological stages of cancer, the general information of the patient, surgery approach and the postoperative infections. CONCLUSION The preparation before the surgery,the air quality and temperature in operating room, the regulations on aseptic operation,as well as postoperative incision and the duration of the surgery are the major factors that may affect the postoperative infections.

  18. Low Compliance to Handwashing Program and High Nosocomial Infection in a Brazilian Hospital

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    Lizandra Ferreira de Almeida e Borges

    2012-01-01

    Full Text Available Background. It is a fact that hand hygiene prevents nosocomial infection, but compliance with recommended instructions is commonly poor. The purpose of this study was to implement a hand hygiene program for increase compliance with hand hygiene and its relationship with nosocomial infection (NI and MRSA infection/colonization rates. Methods. Compliance to hand hygiene was evaluated in a hospital by direct observation and measured of health care-associated infections, including methicillin resistant Staphylococcus aureus, before and after an educational intervention, using visual poster, colorful stamps, and feedback of the results. Results. Overall compliance did not increase during intervention, only handwashing before and after patient contact has improved from 40% to 76% (=0.01 for HCWs, but NI and MRSA rates remained high and stable. Conclusion. In a combination of high prevalence of NI and low compliance to hand hygiene, the programme of measure does not motivate the HCW hand hygiene. Future interventions should employ incremental evaluation to develop effective hand hygiene initiatives.

  19. Analysis of Nosocomial Infection and Nursing in Intensive Care Unit%重症监护室院内感染及护理探析

    Institute of Scientific and Technical Information of China (English)

    朱晓红

    2016-01-01

    Objective To explore the analysis of the icu nosocomial infection factors, and put forward corresponding nursing countermeasures. Methods 90 patients of during the period of intensive care unit for treatment were chosen as the research object from January 2014 to July 2015 in our hospital, analyzed retrospectively the clinical data of patients, into the situation of nosocomial infection in patients with statistics, analysis of the cause patient infection factors, and puts forward a corresponding nursing countermeasures.Results This group of patients with nosocomial infection 21 cases, the incidence was 23.3%, the incidence of infections parts from high to low in turn is respiratory tract infection, gastrointestinal infection, infection of incision, urinary tract infection.Conclusion The analysis of intensive care unit the occurrence of nosocomial infection factors, based on this, according to the corresponding nursing countermeasures to control the incidence of nosocomial infection is of great signiifcance.%目的:探索分析重症监护室院内感染因素,并提出相应的护理对策。方法选择2014年1月~2015年7月在我院重症监护室进行治疗的90例患者为研究对象,回顾分析患者的临床资料,统计纳入患者发生院内感染的情况,分析导致患者感染因素,并提出具有针对性的护理对策。结果本组患者出现院内感染者21例,发生率为23.3%,感染发生部位发生率从高到低依次为呼吸道感染、肠胃道感染、切口感染、泌尿道感染。结论分析重症监护室院内感染的发生因素,以此为据提出对应的护理对策,对控制院内感染发生率意义重大。

  20. 医院感染铜绿假单胞菌的耐药性变迁分析%Analysis on changes of antimicrobial resistance of Pseudomonas aeruginosa causing nosocomial infections

    Institute of Scientific and Technical Information of China (English)

    蔡兰兰; 管有理; 谭萍

    2015-01-01

    目的:调查医院感染标本中分离的铜绿假单胞菌(PAE)的感染部位分布及耐药性变迁,为临床治疗感染性疾病选择抗菌药物提供参考依据。方法采集两所医院2011年1月-2013年12月收治的感染患者不同部位标本,分析分离出的617株 PAE分布及其耐药性,数据采用WHONET5.5‐5.6软件进行分析。结果共分离617株PAE ,以呼吸道标本为主,共333株占54.0%;3年PAE对多数抗菌药物的耐药率呈逐年上升态势,泛耐药PA E阳性检出率分别为9.3%、10.2%、14.6%;PA E对亚胺培南的耐药率分别为22.1%、22.8%、25.5%;耐药率<20.0%的有阿米卡星、妥布霉素、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦;3年耐药率最高,且对磺胺甲噁唑/甲氧苄啶的耐药率均>60.0%。结论3年PAE临床分离株对抗菌药物的耐药率总体呈现明显上升态势,医院行政管理领导应加大监管执行力,扭转国内细菌耐药性快速上升的恶劣倾向。%OBJECTIVE To investigate the distribution of infection sites and changes of antimicrobial resistance of Pseudomonas aeruginosa (PAE) isolated from infective specimens in our hospital during 3 years ,so as to provide evidence for clinical use of antimicrobial agents .METHODS Infective specimens from different infected sites of pa‐tients admitted and treated during Jan .2011 to Dec .2013 were collected ,617 isolated strains of PAE and their re‐sistance were analyzed .The testing results were analyzed by WHONET 5 .5‐5 .6 software .RESULTS The 617 PAE were mainly from respiratory tract specimens (333 ,54 .0% ) .During the 3 years ,the resistance of PAE to most antimicrobial agents was increasing and the detection rate of pan‐resistant PAE was 9 .3% ,10 .2% and 14 .6% in each year ,respectively .The resistance of PAE to imipenem was 22 .1% ,22 .8% and 25 .5% in the three years ,respectively .Antimicrobial agents

  1. The level of knowledge of students of medical faculty kragujevac about nosocomial infections

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    Ilić Milena D.

    2003-01-01

    Full Text Available OBJECTIVE: To investigate differences in clinical and pre-clinical medical students' knowledge of nosocomial infections (NI. DESIGN: Cross-sectional survey. RESULTS: Questionnaires were answered and returned by 352 of 453 student (77.7 %. The results indicated that students knew the definition of NI (70.1 % correct answers and their reservoirs (86 %. The bacteria as etiological agents was the most frequent answer (76.4 %, but 30.9 % students did not knew at least one multidrug-resistant bacteria. About one half of the students (54.4 % knew that contact was the most frequent mode of NI transmission, but hand washing as preventive measure was cited by only 18.8 % of students. Significantly statistical differences about NI in our country, etiology NI and preventive measures, and perception of risk for transmission of hepatitis B for health-care personnel were founded by year of training, by expectation that final-year medical students as more successfully, while pre-clinical students knew more about mode of NI transmission. Pre-clinical students who had previously finished nursing school knew more about multidrug-resistant bacteria than those who had finished some other secondary school, but showed a lower knowledge about definition and most important preventive measures of NI. Clinical students who had previously finished nursing school knew more about frequency NI in our country, reservoirs and preventive measures of NI than those who had finished some other secondary school. CONCLUSION: Data support the need for additional information about nosocomial infections, especially practical work in prevention, in order to get complete knowledge about nosocomial infections.

  2. A Descriptive Study of Nosocomial Infections in an Adult Intensive Care Unit in Fiji: 2011-12

    Directory of Open Access Journals (Sweden)

    Keshni Naidu

    2014-01-01

    Full Text Available Nosocomial infections in an intensive care unit (ICU are common and associated with a high mortality but there are no published data from the Oceania region. A retrospective study in Fiji’s largest ICU (2011-12 reported that 114 of a total 663 adult ICU admissions had bacteriological culture-confirmed nosocomial infection. The commonest sites of infection were respiratory and bloodstream. Gram negative bacteria were the commonest pathogens isolated, especially Klebsiella pneumoniae (extended-spectrum β-Lactamase-producing, Acinetobacter, and Pseudomonas species. Mortality for those with a known outcome was 33%. Improved surveillance and implementation of effective preventive interventions are needed.

  3. Risk factors and clinical outcomes for carbapenem-resistant Enterobacteriaceae nosocomial infections.

    Science.gov (United States)

    Wang, Q; Zhang, Y; Yao, X; Xian, H; Liu, Y; Li, H; Chen, H; Wang, X; Wang, R; Zhao, C; Cao, B; Wang, H

    2016-10-01

    This study was aimed to determine the risk factors of Carbapenem-resistant Enterobacteriaceae (CRE) nosocomial infections and assess the clinical outcomes. A case-case-control design was used to compare two groups of case patients with control patients from March 2010 to November 2014 in China. Risk factors for the acquisition of CRE infections and clinical outcomes were analyzed by univariable and multivariable analysis. A total of 94 patients with CRE infections, 93 patients with Carbapenem-susceptible Enterobacteriaceae (CSE) infections, and 93 patients with organisms other than Enterobacteriaceae infections were enrolled in this study. Fifty-five isolates were detected as the carbapenemase gene. KPC-2 was the most common carbapenemase (65.5 %, 36/55), followed by NDM-1 (16.4 %, 9/55), IMP-4 (14.5 %, 8/55), NDM-5 (1.8 %, 1/55), and NDM-7 (1.8 %, 1/55). Multivariable analysis implicated previous use of third or fourth generation cephalosporins (odds ratio [OR], 4.557; 95 % confidence interval [CI], 1.971-10.539; P Enterobacteriaceae with a high meropenem MIC (≥8 mg/L) was shorter than that of patients with a low meropenem MIC (2,4, and ≤ 1 mg/L). In conclusion, CRE nosocomial infections are associated with prior exposure to third or fourth generation cephalosporins and carbapenems. Patients infected with CRE had poor outcome and high mortality, especially high meropenem MIC (≥8 mg/L). Appropriate definitive treatment to CRE infections in the patient is essential.

  4. Incidence of nosocomial rotavirus infections, symptomatic and asymptomatic, in breast-fed and non-breast-fed infants.

    Science.gov (United States)

    Gianino, P; Mastretta, E; Longo, P; Laccisaglia, A; Sartore, M; Russo, R; Mazzaccara, A

    2002-01-01

    Rotavirus is one of the most important aetiological agents of nosocomial infections in childhood. We studied the incidence of nosocomial rotavirus infections in 420 patients (age range 1-18 months) consecutively admitted from 1 December 1999 to 31 May 2000 to the infant ward of the Department of Paediatrics, University of Turin. We also evaluated the protective effect of breast feeding. Faecal specimens were collected from every child (whether developing diarrhoeic symptoms or not) and tested for rotavirus during hospitalization and 72 h after discharge. The incidence of rotavirus nosocomial infections was 27.7%. The incidence of symptomatic nosocomial infections was 16.8%, and the incidence of asymptomatic infections was 10.9%. The attack rate of the infections that occurred during hospitalization was 11.8%, while for those occurring after discharge, it was 15.9%. Rotavirus infection, on average, prolonged hospital stay from 5.2 to 6.4 days. 10.6% of breast-fed infants and 32.4% of non-breast-fed infants contracted rotavirus infection (P<0.005). None of the breast-fed infants who contracted rotavirus infection developed diarrhoeic symptoms.

  5. Nosocomial pneumonia caused by a glucose-metabolizing strain of Neisseria cinerea.

    Science.gov (United States)

    Boyce, J M; Taylor, M R; Mitchell, E B; Knapp, J S

    1985-01-01

    We describe what appears to be the first reported case of nosocomial pneumonia caused by Neisseria cinerea. The isolate metabolized glucose when tested in BACTEC Neisseria Differentiation Kits (Johnston Laboratories), but did not produce detectable acid in cystine-Trypticase (BBL Microbiology Systems) agar medium or in modified oxidation-fermentation medium. Clinical laboratories that rely on the BACTEC method for differentiation of pathogenic neisseriae should be aware of the fact that N. cinerea may mimic N. gonorrhoeae when tested in BACTEC Neisseria Differentiation kits. The ability of N. cinerea to grow well on tryptic soy and Mueller-Hinton agars and its inability to grow on modified Thayer-Martin medium are characteristics which help to distinguish N. cinerea from N. gonorrhoeae.

  6. Multidrug resistance in Pseudomonas aeruginosa isolated from nosocomial respiratory and urinary infections in Aleppo, Syria.

    Science.gov (United States)

    Mahfoud, Maysa; Al Najjar, Mona; Hamzeh, Abdul Rezzak

    2015-02-19

    Pseudomonas aeruginosa represents a serious clinical challenge due to its frequent involvement in nosocomial infections and its tendency towards multidrug resistance. This study uncovered antibiotic susceptibility patterns in 177 isolates from inpatients in three key hospitals in Aleppo, the largest city in Syria. Exceptionally low susceptibility to most routinely used antibiotics was uncovered; resistance to ciprofloxacin and gentamicin was 64.9% and 70.3%, respectively. Contrarily, susceptibility to colistin was the highest (89.1%). Multidrug resistance was rife, found at a rate of 53.67% among studied P. aeruginosa isolates.

  7. Nosocomial infections-a new approach towards preventive medicine using plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Morfill, G E; Shimizu, T; Steffes, B; Schmidt, H-U [Max-Planck Institute for extraterrestrial physics, Giessenbachstrasse, D-85748 Garching (Germany); Hospital Munich Schwabing, Koelner Platz 1, D-80804 Muenchen (Germany)], E-mail: gem@mpe.mpg.de

    2009-11-15

    A new, very efficient, large area scalable and robust electrode design for plasma production in air at atmosphere pressures has been developed and tested. This has made the development of a 'plasma dispenser' for hospital disinfection possible, which has certain advantages over current fluid disinfection systems. The properties of this device are presented, in particular the bactericidal and fungicidal efficiency, and the advantages are described. Such plasma dispensers could play an important role in the future fight against the alarming and growing threat posed by nosocomial (=hospital and community associated) bacterial infections.

  8. 多药耐药铜绿假单胞菌医院感染的高危因素及药物敏感性分析%High risk factors of nosocomial infection caused by multidrug-resistant Pseudomonas aeruginosa and analysis of drug sensitivity

    Institute of Scientific and Technical Information of China (English)

    曹利君; 王春萍

    2011-01-01

    OBJECTIVE To investigate the risk factors for nosocomial infection caused by multidrug-resistant Pseudomonas aeruginosa and analyze the drug sensitivity. METHODS A total of 98 cases of patients with P. Aeruginosa infection in our hospital from Jan 2007 to May 2011 were selected in this study and divided them into control group (sensitive group) with 48 cases and observation group (multi-drug resistant group) with 50 patients. The age, length of stay, mechanical ventilation rate associated with lung-based diseases, APACHE TJ score and so on for the two groups were compared, and statistics and analysis for the observation group of departments and MIC distribution were performed. RESULTS The age of the observed group (60. 25±5. 66)years was older than the control group (53. 14±6. 13)years, length of stay (35. 28±6. 89)d was longer than the control group (26. 52±6. 37)d, mechanical ventilation rate (50. 0%) was higher than control group (25. 0%) , associated with lung disease (28.0%) was proportion (12. 5%} higher than the control group, APACHE II score (20. 5± 3.1) points was (15. 4i2, 9) points higher than the control group. The highest proportion in distributed departments were ICU and neurology, and they were 24. 0% and 20. 0% respectively, There were significantly different (P<0. 05). CONCLUSION There are characteristics of the nosocomial infection in risk factors and drug sensitivity of multi-drug resistant P. Aeruginosa, which are is worthy of the attention in clinic.%目的 探讨分析多药耐药性铜绿假单胞菌医院感染的高危因素及药物敏感性.方法 选取2007年1月-2011年5月检测出的98例铜绿假单胞菌感染患者为研究对象,将其分为对照组(敏感组)48例和观察组(多药耐药组)50例,对两组年龄、住院时间、机械通气率、伴有肺部基础疾病、APACHEⅡ评分等进行统计及比较,并对观察组的科室分布及MIC进行统计及分析.结果 观察组平均年龄(60.25±5.66)

  9. [Long-term follow-up of nosocomial rotavirus infections at the Infectious Diseases Clinic of the Medical School Hospital in Plzen (1987-1994)].

    Science.gov (United States)

    Pazdiora, P; Táborská, J; Svecová, M

    1996-09-01

    The authors evaluated in 1987-1994 the incidence of nosocomial rotavirus infections during hospitalization in 1718 junior children, 450 senior children and adults admitted with diarrhoeal diseases. Rotavirus infection was revealed in 6.2 and 1.3% of the patients resp. During hospitalization the rotaviruses were the most frequent causal agent of nosocomial infections. Hospital infection was contracted regardless of the initial diagnosis most frequently by patients aged 0-12 months. The majority of nosocomial rotavirus infections was associated with symptoms of diarrhoeal disease, on average symptomatic infections prolonged the hospitalization period by 4.2 days. The authors discuss the possibility to influence the incidence of these infections.

  10. 血液病患者医院感染病原菌分布及耐药性分析%Distribution and drug resistance of pathogenic bacteria causing nosocomial infection in patients with hematological disease

    Institute of Scientific and Technical Information of China (English)

    郝建萍; 郭新红; 哈力达·亚森

    2011-01-01

    目的 了解血液科住院患者医院感染临床分离菌的分布及耐药性,指导临床经验性用药.方法 对医院血液科2007年1月-2010年12月住院患者临床分离的病原菌分布及耐药性进行分析.结果 分离到455株病原菌,以革兰阴性菌为主,革兰阳性菌感染呈逐渐下降趋势;大肠埃希菌为主要病原菌,大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶的检出率分别为61.1%和38.3%,肠杆菌科细菌对碳青霉烯类和β-内酰胺酶抑制剂复合制剂(BLICs)的敏感性高,鲍氏不动杆菌和铜绿假单胞菌对碳青霉烯类的耐药率约为12.0%,对BLICs的敏感性高;耐甲氧西林凝固酶阴性葡萄球菌和耐甲氧西林金黄色葡萄球菌的分离率分别为94.7%和70.4%,未检出耐万古霉素葡萄球菌和肠球菌.结论 分析血液病患者医院感染的病原菌分布特点及耐药性对临床经验性用药有一定的参考价值.%OBJECTIVE To investigate the distribution and drug resistance of pathogens in hematology wards, as well as for better empirical antibiotic therapy. METHODS The distribution of clinical isolated pathogen of the patients in hematological wards from Jan 2007 to Dec 2010 were analyzed. RESULTS Totally 455 strains of pathogens were isolated, Gram-negative bacteria remained the predominant pathogen.Gram-positive cocci infection decreased gradually during the four years. Escherichia coli was the most common pathogenic bacteria. Extended spectrum betalactamase(ESBLs) producing rates of Escherichia coli and Klebsiella pneumoniae were 61. 1% and 38. 3% , respectively. Carbapenems and J3-Lactamase inhibitors had high activity for E. Coli, the drug resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to carbapenems were 12. 0% , but susceptible to |3-Lactamase inhibitors. The detected rates of the coagulase-negative Staphylococci and methicillin-resistant S. Au-reus were 94. 7% and 70. 4%. Respectively, Neither

  11. Transfusion of platelets, but not of red blood cells, is independently associated with nosocomial infections in the critically ill

    NARCIS (Netherlands)

    Engele, Leo J.; Straat, Marleen; van Rooijen, Ingeborg H M; de Vooght, Karen M K; Cremer, Olaf L.; Schultz, Marcus J.; Bos, Lieuwe D J; Juffermans, Nicole P.

    2016-01-01

    Background: Red blood cell (RBC) transfusion has been associated with nosocomial infection in the critically ill patients. However, this association may be confounded by length of stay, as prolonged intensive care unit (ICU stay) increases both risk of infection and risk of transfusion. Also, it is

  12. Distribution and drug resistance of Gram-negative bacilli causing nosocomial infections from 2005 to 2009%2005-2009年医院感染革兰阴性杆菌的分布及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    胡莹; 杨红英; 马润; 杨旭; 吴舫; 刘晓莉

    2012-01-01

    important for infection control.

  13. [Changes of pathogens for nosocomial infection of patients with hematological diseases].

    Science.gov (United States)

    Wang, Ji-Jun; Hu, Kai; Wang, Zheng-Hui; Wang, Jing; Jing, Hong-Mei; Zhao, Wei; Liu, Yan; Chen, Yu-Ping; Ke, Xiao-Yan

    2010-08-01

    In order to investigate the distribution of nosocomial infection in patients with hematological diseases in our hospital, and to explore the changes of the pathogens isolated. The method of retrospective investigation and analysis was employed. 1164 strain pathogens were isolated from the patients with hematological diseases during the period of 1997-2009. The results showed that the Gram-positive cocci infection increased gradually during the 13 years, but has been stable in the last 4 years. The Gram-negative bacteria showed a trend decrease. The fungi increased during these years. The rates of infection with gram-positive cocci, gram-negative bacteria and fungus were 28.2%, 59.8% and 12.0% respectively. For the details, Escherichia coli infection rate was the highest: 12.1%, followed by Pseudomonas aeruginosa (9.1%), Enterobacter (8.4%), Klebsiella pneumoniae (7.4%), Staphylococcus epidermidis (6.3%) and Enterococci (6.6%). The distribution of G(+)- and G⁻ pathogens showed obvious change on end of 1990's and beginning of this century, but it was tending towards stability on recent years; the incidence of fungus was tending towards increase, which was related to wide application of strong broad-spectrum antibiotics. In conclusion, the patients with hematological diseases, as the high-risk group of nosocomial infection, should be monitored strictly. Infection is related to many factors, and the main factor is dysfunction of autoimmunity. The strategies should be explored to strengthen the immune protection and set up a reasonable scheme of antibiotics.

  14. Nosocomial bloodstream infections: organisms, risk factors and resistant phenotypes in the Brazilian University Hospital

    Directory of Open Access Journals (Sweden)

    Rosineide M. Ribas

    2007-06-01

    Full Text Available Bacteremia is one of the most frequent and challenging hospital-acquired infection and it is associated with high attributable morbidity and mortality and additional use of healthcare resources. The objective of this work was to determine the frequencies of its occurrence, organisms and resistance phenotypes associated to nosocomial acquired bloodstream infections. A total number of 51 nosocomial bacteremia by Gram-negative and 99 by Gram-positive were evaluated and compared during a 15-month period. The risk factors associated with these bacteremias were analyzed and antibiotic use and surgery were associated with bacteremia by Gram-negative and > 2 invasive devices with Gram-positive. The resistance phenotypes ESBL (extended-spectrum beta-lactamases (23.5% and AmpC/others (17.6% correspond to 41.2 % with predominance of E. agglomerans among AmpC (44.4% and K. pneumoniae among ESBLs (38.5%. Among S. aureus bacteremia, approximately 40% were associated to MRSA (methicillin-resistant Staphylococcus aureus.

  15. Evaluation of Cellular Phones for Potential Risk of Nosocomial Infection amongst Dental Operators and Auxiliary Staff.

    Science.gov (United States)

    Nasim, V S; Al-Hakami, Ahmed; Bijle, Mohammed Nadeem Ahmed; Al-Manea, Sulthan Ahmed; Al-Shehri, Mohammed Dahman; Al-Malki, Saleh Mohammed

    2015-04-01

    This study evaluates cellular phones for potential risk of nosocomial infection amongst dental operators and auxiliary staff in a dental school. Each participant's mobile phone was first cleaned with 70% isopropyl alcohol swab. Following the cleansing protocol, the partakers were asked to make a short phone call. The mobile phones were then washed aseptically by rotating damp cotton swabs with sterile normal saline. Bacterial growth was identified on sheep blood agar and McConkey's agar plates. Sabouraud dextrose agar media was used for fungi species. Descriptive statistics was established with the data statistically explored with SPSS version 17.0. About 50% of dental professionals had shown active bacterial and fungal growth in which 35% (n=35) were dental operators and 15% (n=15) were dental nurses. 53% Gram-positive organisms, 2% Gram-negative organisms, and 3% fungi were identified growths on cellular phones. Thus, it can be concluded that the cellular phones of dental operators as compared to auxiliaries can act as a potential source of nosocomial infection.

  16. Nosocomial imipenem-resistant Acinetobacter baumannii infections: epidemiology and risk factors.

    Science.gov (United States)

    Dizbay, Murat; Tunccan, Ozlem Guzel; Sezer, Busra Ergut; Hizel, Kenan

    2010-10-01

    The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of nosocomial imipenem-resistant A. baumannii (IRAB) infections during a 5-y period (2003-2007) were retrospectively analyzed. A total of 720 patients with 925 episodes of A. baumannii infection were included in the study. A. baumannii infections were seen mostly in intensive care units. The incidence was 6.2 per 1000 admissions. The most common infections were pneumonias and bloodstream infections. Imipenem resistance among Acinetobacter strains increased significantly each y of the study (from 43.3% to 72.9%). Mortality was related to the presence of imipenem resistance, stay in intensive care unit, female gender, old age, and pneumonia. Haemodialysis, malignancy, and mechanical ventilation were significant risk factors for IRAB infections. Imipenem resistance was higher in strains isolated from patients with pneumonia. IRAB strains showed higher resistance rates to other antibiotics than imipenem-susceptible strains. The most active antimicrobial agents against A. baumannii were cefoperazone-sulbactam and netilmicin. The incidence of A. baumannii infections and imipenem resistance increased during the study period. IRAB infections should be considered in patients on mechanical ventilation and haemodialysis and in patients with malignancies.

  17. Neonatal nosocomial bloodstream infections at a referral hospital in a middle-income country: burden, pathogens, antimicrobial resistance and mortality.

    Science.gov (United States)

    Dramowski, Angela; Madide, Ayanda; Bekker, Adrie

    2015-08-01

    Data on nosocomial bloodstream infection (BSI) rates, pathogens, mortality and antimicrobial resistance in African neonates are limited. Nosocomial neonatal BSI at Tygerberg Hospital, Cape Town were retrospectively reviewed between 1 January 2009 and 31 December 2013. Laboratory and hospital data were used to determine BSI rates, pathogen profile, mortality and antimicrobial resistance in selected nosocomial pathogens. Of 6521 blood cultures taken over 5 years, 1145 (17.6%) were culture-positive, and 717 (62.6%) discrete nosocomial BSI episodes were identified. Nosocomial BSI rates remained unchanged over time (overall 3.9/1000 patient days, 95% CI 3.6-4.2, χ(2) for trend P = 0.23). Contamination rates were relatively high (5.1%, 95% CI 4.6-5.7%). Among BSI pathogens, Gram-negatives predominated (65% vs 31% Gram-positives and 4% fungal); Klebsiella pneumoniae (235, 30%), Staphylococcus aureus (112, 14%) and Enterococci (88, 11%) were most prevalent. Overall crude BSI mortality was 16% (112/717); Gram-negative BSI was significantly associated with mortality (P = 0.007). Mortality occurred mostly in neonates of very low (33/112, 29%) or extremely low (53/112, 47%) birthweight. Deaths attributed to nosocomial BSI declined significantly over time (χ(2) for trend P = 0.01). The prevalence of antibiotic-resistant pathogens was high: methicillin-resistant Staphylococcus aureus 66%, multidrug-resistant A. baumanni 90% and extended-spectrum β-lactamase-producing K. pneumoniae 73%. The burden of nosocomial neonatal BSI at this middle-income country referral neonatal unit is substantial and remained unchanged over the study period, although attributable mortality declined significantly. Nosocomial BSI pathogens exhibited high levels of antimicrobial resistance.

  18. Nosocomial infections in 4022 patients after fracture surgery%4022例骨折术后医院感染的调查与分析

    Institute of Scientific and Technical Information of China (English)

    臧传义

    2012-01-01

    , hospitalization duration, and fracture type were the risk factors for nosocomial infections after the fracture surgery. CONCLUSION The postoperative infections after fracture surgery are caused by multiple factors, it is necessary to grasp the primary surgery technique, aseptic operation technique as well as the basic theories and nursing experience of disease treatment;it is a important link to prevent nosocomial infections to prevent the infections after the fracture surgery, to strictly implement the safe measures and attach importance to the quality control of the links can contribute to the reduction of nosocomial infections in the fracture patients.

  19. Infective endocarditis caused by Stenotrophomonas maltophilia: A report of two cases and review of literature.

    Science.gov (United States)

    Subhani, Shaik; Patnaik, Amar N; Barik, Ramachandra; Nemani, Lalita

    2016-09-01

    Stenotrophomonas maltophilia is known for nosocomial habitat. Infective endocarditis due to this organism is rare and challenging because of resistance to multiple broad-spectrum antibiotic regimens. Early detection and appropriate antibiotic based on culture sensitivity reports are the key to its management. We report the diagnosis, treatment, and outcome of two cases of infective endocarditis caused by S. maltophilia.

  20. [THE SPECTRUM AND ANTIBIOTIC RESISTANCE OF AGENTS OF NOSOCOMIAL INFECTION OF OPERATION WOUNDS AND ORGANS OF URINARY EXCRETION SYSTEM IN SURGERY PATIENTS].

    Science.gov (United States)

    Omarova, S M; Mollaeva, A M; Alieva, A I; Saidova, P C; Alieva, S F; Kasumova, A M

    2015-05-01

    In risk group of development of nosocomial infections related to medical care provision, prevailed weakened patients after various surgical interferences and cauterization. The nosocomial infections related to medical care provision develop up to 20% of patients of surgical profile (infections of soft tissues - 9.5%, intra-abdominal infections - 22% and infections of urinary tracts - 4.8%). The Gram-negative bacilli Enerobacteriaceae and Gram-negative nonfermenters.

  1. Bacteriocins active against multi-resistant gram negative bacteria implicated in nosocomial infections.

    Science.gov (United States)

    Ghodhbane, Hanen; Elaidi, Sabrine; Sabatier, Jean-Marc; Achour, Sami; Benhmida, Jeannette; Regaya, Imed

    2015-01-01

    Multiresistant Gram-negative bacteria are the prime mover of nosocomial infections. Some are naturally resistant to antibiotics, their genetic makes them insensitive to certain families of antibiotics and they transmit these resistors to their offspring. Moreover, when bacteria are subjected to antibiotics, they eventually develop resistance against drugs to which they were previously sensitive. In recent years, many bacteriocins active against gram-negative bacteria have been identified proving their efficacy in treating infections. While further investigation remains necessary before the possibilities for bacteriocins in clinical practice can be described more fully, this review provides an overview of bacteriocins acting on the most common infectious gram negative bacteria (Klebsiella, Acinetobacter, Pseudomonas aeruginosa and E. coli).

  2. Nosocomial rotavirus infection: An up to date evaluation of European studies

    Science.gov (United States)

    Gervasi, G.; Capanna, A.; Mita, V.; Zaratti, L.; Franco, E.

    2016-01-01

    ABSTRACT Rotavirus (RV) is worldwide considered as the most important viral agent of acute gastroenteritis in children less than 5 y. Since 2006, the availability of anti-RV vaccines has deeply modified the incidence and economic burden of RV infection. In Europe, some countries have introduced an anti-RV vaccination program in the last 10 y. Although community acquired RV (CARV) disease is the most studied condition of RV infection, recently some authors have highlighted the importance of nosocomial RV (nRV) disease as an emerging public health issue. The aim of this review is to summarize the epidemiology of both CARV and nRV, in order to discuss the difficulty of a clear evaluation of the burden of the disease in absence of comparable data. In particular, we focused our attention to European studies regarding nRV in terms of divergences related to definition, report of incidence rate and methodological issues. PMID:27185183

  3. Prevention of nosocomial infections and standard precautions: knowledge and practice among radiographers in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Ruwan Duminda Jayasinghe

    2014-02-01

    Full Text Available Nosocomial infection is an infection if it becomes positive 48 hours or more after admission to the hospital or within 30 days of discharge. Health care workers can be a major source of vectors for pathogens. Nowadays, interventional radiology and other radiological imaging mo-dalities have undergone vast development and the tendency for acci-dental exposure to blood and other infectious pathogens are on the increase. Therefore, all the health care works are expected to follow the standard precautions to prevent accidental injuries during the service. This study was carried out to assess the knowledge and the practice of radiographers on nosocomial infection control and standard precau-tions. A postal survey was conducted to all registered practicing radiographers in Sri Lanka. A pre-designed, pre-tested, anonymous self-administered, structured questionnaire was circulated among radiographers and for each correct answer one point was assigned. In the knowledge section scores 75% were considered as weak, moderate, good, and excellent knowledge, respectively. In the practice section scores 75 % was considered as bad moderate and good practice, respectively. The good practice was considered as professional practice for the clinical radiology units. Data entry, management and analysis were carried out using MS excel and SPSS statistical software package. The total response rate was 37.9 %. The mean overall age of the respondents was 30 to 39 years and males composed (72.3% the majority of study population. Most of the respondents (84.98 % were qualified as diploma radiographers and 78.87 % of the respondents were practicing in government hospitals. More than half (51.6% of the respondents have worked for < 10 years and 93.4% have never attended any occupational training program regarding infection control. Majority (43.19% of the respondents have scored 50% from the total knowledge score and more than half (73.2% believed that the environment is the

  4. Nosocomial rotavirus infection: An up to date evaluation of European studies.

    Science.gov (United States)

    Gervasi, G; Capanna, A; Mita, V; Zaratti, L; Franco, E

    2016-09-01

    Rotavirus (RV) is worldwide considered as the most important viral agent of acute gastroenteritis in children less than 5 y. Since 2006, the availability of anti-RV vaccines has deeply modified the incidence and economic burden of RV infection. In Europe, some countries have introduced an anti-RV vaccination program in the last 10 y. Although community acquired RV (CARV) disease is the most studied condition of RV infection, recently some authors have highlighted the importance of nosocomial RV (nRV) disease as an emerging public health issue. The aim of this review is to summarize the epidemiology of both CARV and nRV, in order to discuss the difficulty of a clear evaluation of the burden of the disease in absence of comparable data. In particular, we focused our attention to European studies regarding nRV in terms of divergences related to definition, report of incidence rate and methodological issues.

  5. Nosocomial infection in patients with brain metastasis%脑转移瘤患者医院感染分析

    Institute of Scientific and Technical Information of China (English)

    丁维军; 杨伟芳; 于长辉

    2012-01-01

    目的 探讨脑转移瘤患者医院感染的相关因素.方法 回顾性分析510例脑转移瘤患者医院感染的临床资料.结果 78例患者并发医院感染,感染率为15.3%;其中呼吸道感染53例,占67.9%.结论 脑转移瘤患者年龄大、血糖增高、留置导尿易导致医院感染,必须加强医院感染的管理,积极控制血糖,减少留置导尿,规范抗菌药物的应用,减少医院感染的发生.%OBJECTIVE To analyze the clinical features of nosocomial infection in patients with brain metastasis. METHODS The clinical data of 510 brain metastasis tumor patients were retrospectively analyzed. RESULTS Nosocomial infection occurred in 78 patients with the infection rate of 15. 3%. The respiratory infection was the major infection which accounting for 67. 9%. CONCLUSION The incidence of nosocomial infection in brain metastasis patients is high. The elder age, hyperglycemia, and indwelling catheterization are important risk factors for nosocomial infection. To reduce the occurrence of nosocomial infection, the following strategies need to be strengthened including treating hyperglycemia with standard care, reducing indwelling caterterization and rationally using the antibiotics.

  6. Investigation and analysis of prevalence of nosocomial infections in patients of mental hospital%精神病院患者医院感染调查分析

    Institute of Scientific and Technical Information of China (English)

    张英杰; 张丹; 邹吉敏; 耿贺梅; 张淑青; 岳玲梅; 侯荣伟

    2015-01-01

    .06% ;the incidence of nosocomial infections was the highest in the patients with schizophrenia (66 .67% ) ,the nosocomial infections occurred in 23 (17 .42% ) patients complicated with dia‐betes ;the patients with respiratory tract infections were dominant ,accounting for 78 .79% .The gram‐negative bacteria accounted for 70 .51% of the pathogens causing nosocomial infections ;the submission rate of bacterial culture was 65 .15% .CONCLUSION The incidence of nosocomial infections is low in the mental hospital ;the pa‐tients with schizophrenia are the major population of infections .The incidence of nosocomial infections is signifi‐cantly higher in the mental disease patients complicated with other somatic diseases than in the patients with single mental disease ,and it is particularly high in the patients complicated with diabetes .The submission rate of bacte‐rial culture for the nosocomial infections cases is high in the mental hospital .

  7. Related factors for nosocomial infections in ICU%ICU医院感染相关因素分析

    Institute of Scientific and Technical Information of China (English)

    周燕飞

    2012-01-01

    OBJECTIVE To explore the factors and nursing countermeasures for nosocomial infections in ICU.METHODS A total of 460 patients in ICU were selected as research objects and divided into, in 1 : 1 ratio, the observation group ( the patients with nosocomial infections ) and the control group (the patients without nosocomial infections).The possible related factors for nosocomial infections of the two groups were compared.RESULTS Nosocomial infections occurred in 46 of 80 patients with the infection rate of 17.39%, including respiratory tract infections, urinary tract infections, and catheter-relaced infections.Univariate analysis indicated that there were 10 variables that were associated with nosocomial infections(P<0.05) ; logistic regression analysis showed that the risk factors for nosocomial infections were as follows: the senior age, invasive operation, high APACHE Ⅱ scores, and prophylactic use of antibiotics, whose OR values were 3.29, 3.04, 2.94, and 2.45.CONCLUSION The incidence of nosocomial infections in ICU is relatively high and is associated with various factors.To improve the condition of the elderly patients, intensify the treatment of critically ill patients, reasonably use antibiotics, and strictly perform the aseptic operation can contribute to the prevention of nosocomial infection, as well as the decrease of nosocomial infections in ICU.%目的 探讨重症监护病房(ICU)合并医院感染影响因素及护理对策.方法 选择重症监护病房460例患者作为研究对象,以医院感染患者为观察组,按照1∶1比例选择未合并医院感染患者作为对照组,比较两组可能影响医院感染因素差异.结果 460例患者中发生医院感染80例,感染率17.39%,包括呼吸道感染、泌尿系统感染、导管相关性感染,单因素检验结果显示,10个变量是医院感染的相关因素(P<0.05),logistic回归分析引起医院感染的危险因素为:年龄大、实施侵入性操作、APACHEⅡ评分高

  8. Nosocomial infections in hospitalized patients in the burn unit of Hospital Universitario San José, Popayán - Colombia

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    Yeni Arroyave

    2014-08-01

    Full Text Available Objective. To determine the prevalence and microbiological behavior of the infections in hospitalized patients in the burn unit of the University Hospital San José ( HUSJ at Popayan, Colombia, 2010-2011. Methods: A retrospective cross-sectional study was conducted in patients admitted to the burn unit of HUSJ between the years 2010–2011. Patients were characterized sociodemographic and clinically. The prevalence of nosocomial infections was estimated. Frequency and antibiotic resistance of microorganisms isolated was described. Data were analyzed using SPSS version 15. Results. 113 patients was enrolled, the average age was 17.7 years and male gender predominated (55.8%. Hot liquids (64.6% were the principal cause, the average of body surface area burned was 11.3% and the average hospital stay was 19.8 days. 13.3% of the patients had some nosocomial infection. The most frequently diagnosed infections were sepsis (24%, urinary tract infection (20% and pneumonia (20%. Staphylococcus aureus was the most frequent bacteria (41.7% followed by Staphylococcus epidermidis, mostly meticilino-resistant. The mean length of hospital stay and burned surface area (BSA in patients with diagnosis of infection was 36.6 days and 17.3% respectively. Conclusions. The prevalence of infection is similar to that reported in Colombia. The resistance of the isolates was high. The meticilinoresistance of Staphylococcus was associated with clindamicina resistance.

  9. The gene bap, involved in biofilm production, is present in Staphylococcus spp. strains from nosocomial infections.

    Science.gov (United States)

    Potter, Amina; Ceotto, Hilana; Giambiagi-Demarval, Marcia; dos Santos, Kátia Regina Netto; Nes, Ingolf F; Bastos, Maria do Carmo de Freire

    2009-06-01

    This study analyzed ten strains of coagulase-negative staphylococci (CNS) involved in nosocomial infections in three Brazilian hospitals. Their antibiotic susceptibility profile showed that most strains exhibited multiple antibiotic resistance and possessed the mecA gene. The ability of these strains to adhere to polystyrene microtiter plates was also tested and nine of them proved to be biofilm producers at least in one of the three conditions tested: growth in TSB, in TSB supplemented with NaCl, or in TSB supplemented with glucose. The presence of the bap gene, which codes for the biofilm-associated protein (Bap), was investigated in all ten strains by PCR. AU strains were bop-positive and DNA sequencing experiments confirmed that the fragments amplified were indeed part of a bap gene. The presence of the icaA gene, one of the genes involved in polysaccharide intercellular adhesin (PIA) formation, was also detected by PCR in eight of the ten strains tested. The two icaA-negative strains were either weak biofilm producer or no biofilm producer, although they were bop-positive. To our knowledge, this is the first report demonstrating the presence of the bap gene in nosocomial isolates of CNS, being also the first report on the presence of this gene in Staphylococcus haemolyticus and S. cohnii.

  10. [Sensitivity of nosocomial purulent-septic infection causative agents to disinfection agents and antibiotics].

    Science.gov (United States)

    Sergevnin, V I; Kliukina, T V; Kliuchareva, N M; Volkova, E O; Kudriavtseva, L G

    2014-01-01

    Study the sensitivity of nosocomial purulent-septic infection (PSI) causative agents to disinfectants (DA) and antibiotics (AB). Sensitivity to DA and AB of 209 PSI causative agent strains isolated from patients and the environment of 2 obstetric and 3 surgical hospitals was studied in 2009-2011. Sensitivity to DA of 94 strains and to AB of 189 strains of Pseudomonas aeruginosa isolated from patients with signs of PSI of reanimation and intensive therapy and surgical departments of a multi-field hospital was studied in 2012. Sensitivity to DA was determined on test-surfaces and in solution according to guidelines by V.V. Shkarin et al., 2010; sensitivity to AB - by disc-diffusion method. Among PSI causative agents resistant to DA the portion of poly-antibiotic resistant strains is higher than among microorganisms sensitive to DA, and among antibiotic resistant bacteria the number of strains resistant to DA is higher than among sensitive to antibiotics. The increase of resistance to DA and AB of P. aeruginosa strains is observed in parallel to the increase of volume of the antibacterial preparations used. The results obtained give evidence of the possibility of formation of combined (associated) resistance to DA and AB by nosocomial PSI causative agents against the background of increase of their consumption.

  11. 22O例医院感染病例分析%Analysis of 220 cases of nosocomial infections

    Institute of Scientific and Technical Information of China (English)

    翟红岩; 李小宝; 白玉红; 蒋静; 艾建红; 左大鹏

    2011-01-01

    infection were nosocomial infection pneumonia 43.82%, infectious fever 11.98%, sepsis 10.49%, urinary tract infection 7.87%, upper respiratory tract infection and oral infection 7.87%, respectively. The top 5 pathogens causing nosocomial infections in turn were Pseudomonas aeruginosa , Acinetobacter baumannii , Streptococcus viridans , Staphylococcus aureus, Candida albicans and E. coli; with the constituent ratios 14.54%, 10.57%, 8.81%, 7.49% and 6.61%, respectively. CONCLUSION The patients of blood and cancer receiving and treatment objects are mainly in our hospital, presenting the characteristic of bone marrow transplantation, Therefore, Laminar flow unit, blood ward and intensive care unit are the departments with higher incidences of nosocomial infection. Hospital acquired pneumonia, infectious fever and sepsis listed in the top three diseases. To strengthen the management of the patients with infections and actively take effective measures to prevent nosocomial infection is very important,especially when the patients occurred agranulocytosis.

  12. An outbreak of adult measles by nosocomial transmission in a high vaccination coverage community

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    Fen-juan Wang

    2014-09-01

    Conclusions: Hospital exposure 1–2 weeks before infection with measles was the main cause of the measles outbreak. We must be fully aware of the possibility of nosocomial infection in an outbreak of measles; controlling nosocomial infections is a vital step in the prevention and control of the propagation of measles.

  13. OLD WINE IN A NEW BOTTLE – ENTEROCOCCAL URINARY TRACT INFECTION IN NOSOCOMIAL SETUP

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    Indrani

    2013-10-01

    Full Text Available ABSTRACT : Enterococc al UTI is a well - known source of fatal bacteraemia & endocarditis. OBJECTIVE : Identification of different species of Enterococci causing nosocomial urinary tract infection in a tertiary care hospital along with antibiotic susceptibility pattern. METHODS : A dmitted patients developing symptoms of UTI atleast after 48 hours of admission were included in this study over a period from January - June 2013.Urine samples collected in appropriate sterile manner were screened for pus cells and bacteria followed by spec iation according to Facklam - Collins scheme. Enterococcal isolates were preserved in CTA until tested by VITEK2 (bioMerieux with AES to confirm the speciation. Antibiogram was performed by disk diffusion method (modified Kirby - Bauer technique on Muller - Hi nton agar and blood agar media. MIC of the tested antibiotics was detected by VITEK 2 with AES which provides accurate “fingerprint” recognition of bacterial resistance. RESULTS : Out of total 187 urine samples, 34 were culture positive (18% of which Enter ococci were isolated in 9 cases (26.4%; E nterococ cus f aec alis & Enteroc occ us f aec ium four each along with one E nteroc occ us gallinarum strain. Isolated E nterococc us gallinarum and all isolated E nterococc us f aec alis were sensitive to Penicillin group of dru gs, although all isolated Enterococcus faecium were resistant to them. None of the Enterococcal isolates produced β - lactamase. In isolated Enterococcus gallinarum and one Enterococcus faecalis isolate, MIC value of Ampicillin was double that of Benzyl - penicillin. Isolated Enterococcus gallinarum was t he only Vancomycin resistant Enterococcus strain. According to VITEK2 AEC, it was of vanA type with MIC ≥32μg/ml. All four Enterococcus faecalis isolates were resistant to Quinupristin & Dalfopristin whereas isolated Enterococcus faecium were sensitive to those antimicrobials. All of the isolates were sensitive to Nitrofurantoin

  14. Antimicrobial activities of bacteriocins E50-52 and B602 against MRSA and other nosocomial infections

    Science.gov (United States)

    Our objective was to determine the antimicrobial activities of previously published bacteriocins E50-52 and B602 against methicillin resistant Staphylococcus aureus (MRSA) and other prominent nosocomial bacterial infections. methods: Several Russian hospitals were enlisted into the study from 2003 ...

  15. Environmental control and nosocomial infections in pediatric intensive care unit%PICU环境控制与院内感染

    Institute of Scientific and Technical Information of China (English)

    党红星; 许峰

    2012-01-01

    Nosocomial infections take a tremendous impact to patients and curative activities in PICU.The occuring and developing of nosocomial infections are in close relation to the different internal and external environments of the patients.The incidence rate of nosocomial infections can be effectively reduced by the control of environmental factors in timely and reasonably.This paper reviewed the related internal and external environment factors and control measures in PICU nosocomial infections.%院内感染给PICU患儿健康和医疗工作造成巨大影响.院内感染的发生与患儿体内外环境关系密切,及时合理控制环境因素可有效降低院内感染的发生率.本文对与PICU院内感染发生相关的环境因素和防治措施进行综述.

  16. [Nosocomial infections associated to invasive devices in the intensive care units of a national hospital of Lima, Peru].

    Science.gov (United States)

    Chincha, Omayra; Cornelio, Elia; Valverde, Violeta; Acevedo, Mónica

    2013-01-01

    In order to describe the incidence of nosocomial infections associated to invasive devices in intensive care units (UCI) of the National Hospital Cayetano Heredia, a retrospective observational study was conducted using the data from the Office of Epidemiology and Environmental Health from 2010 to 2012. A total number of 222 nosocomial infections were reported; the general medicine UCI reported the highest incidence of pneumonia cases associated to a mechanical ventilator in 1000 days of use of the device (28.6); infection of the blood stream associated to central venous catheter (11.9), and infection of the urinary tract associated to a catheter (8,1). The main infectious agents isolated were Pseudomona sp. (32.3%) in the emergency UCI, negative Staphylococcus coagulasa (36%) in the general medicine UCI and Candida sp (69.2%) in the Surgery UCI. The rates of infections associated to invasive devices were high as in other national hospitals with limited resources and infrastructure.

  17. Nosocomial pneumonia caused by carbapenem-resistant Raoultella planticola: a case report and literature review.

    Science.gov (United States)

    Xu, M; Xie, W; Fu, Y; Zhou, H; Zhou, J

    2015-04-01

    Raoultella planticola is a rare opportunistic pathogen usually invaded immunocompromised patients and sometimes even causes fatal infections. Recently, there is growing concern about the emergence of carbapenem resistance in this species. Here, we describe one case of hospital-acquired pneumonia due to a carbapenem-resistant R. planticola (CRRP) co-producing Klebsiella pneumoniae carbapenemase and extended-spectrum β-lactamase. A literature review was performed to indicate the microbiological and clinical features of infections caused by CRRP.

  18. N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project

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    Meaghen Hyland

    2001-01-01

    Full Text Available BACKGROUND: A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC sites revealed variations in the prevention, detection, management and surveillance of Clostridium difficile-associated diarrhea (CDAD. Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.

  19. Epidemiology of nosocomial and community-onset infections caused by methicillin-resistant staphylococcus aureus%耐甲氧西林金黄色葡萄球菌医院感染及社区感染的流行特点

    Institute of Scientific and Technical Information of China (English)

    林金兰; 李六亿

    2011-01-01

    目的 了解住院患者中耐甲氧西林金黄色葡萄球菌(MRSA)医院感染及社区感染的流行特点,为积极预防和控制MRSA的感染与传播提供科学依据.方法 2008年7月1日-2010年12月31日,由专职人员每天根据细菌培养结果按照统一的方法到病房对患者进行前瞻性调查,2005年1月1日-2008年6月30日对金黄色葡萄球菌培养阳性住院患者进行回顾性调查.结果 MRSA医院感染率为0.10‰,人院患者中MRSA社区发病的感染率为1.40‰;医院感染中MRSA感染率为70.40%,显著高于社区感染感染率为46.04%(P<0.001);MRSA感染主要发生在重症监护病房(ICU)、内科及干部病房,呼吸系统的感染;MRSA感染率最高的是ICU和干部病房,>80.0%,呼吸系统和泌尿系统的感染.结论 金黄色葡萄球菌耐药状况在医院内形势依然严峻,预防与控制MRSA感染重点在ICU、内科及干部病房,主要发生在呼吸系统的感染.%OBJECTIVE To understand the epidemiology of methicillin-resistant staphylococcus aureus (MRSA) in nosocomial and community-acquired infections among inpatients, to provide scientific basis for the prevention and control of MRSA infection and transmission. METHODS From Jul 1, 2008 to Dec 31, 2010, a prospective survey was conducted by full-time staff, who went to wards investigate the patients everyday according to the results of bacterial culture. From Jan 1, 2005 to Jun 30, 2008, the inpatients with S. aureus culture-positive were investigated retrospectively. RESULTS MRSA incidence of nosocomial infection was 0.10%, MRSA prevalence of community infection among admissions was 1.40‰; MRSA proportion in nosocomial infections (70. 40%) was significantly higher than that in community-onset infections (46.04%) (P<0. 001); MRSA infections, mainly respiratory infections, mostly occurred in intensive care unit (ICU), internal medicine and cadres wards; The highest MRSA proportion were mainly respiratory and urinary

  20. Nosocomial blood stream infection in intensive care units at Assiut University Hospitals (Upper Egypt with special reference to extended spectrum β-lactamase producing organisms

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    Mahmoud Mohammed A

    2009-05-01

    Full Text Available Abstract Aim This study investigated the nosocomial blood stream infection (BSI in the adult ICUs in Assiut university hospitals to evaluate the rate of infection in different ICUs, causative microorganisms, antimicrobial resistance, outcome of infection, risk factors, prevalence of extended spectrum B-lactamase producing organisms and molecular typing of Klebsiella pneumoniae strains to highlight the role of environment as a potential source of nosocomial BSI. Methods This study was conducted over a period of 12 months from January 2006 to December 2006. All Patients admitted to the different adult ICUs were monitored daily by attending physicians for subsequent development of nosocomial BSI. Blood cultures were collected from suspected patients to detect the causative organisms. After antimicrobial susceptibility testing, detection of ESBLs was conducted among gram negative isolates. Klebsiella pneumoniae isolates were tested by PCR to determine the most common group of B-lactamase genes responsible for resistance. Klebsiella pneumoniae isolates from infected patients and those isolated from the environment were typed by RAPD technique to investigate the role of environment in transmission of infection. Results The study included 2095 patients who were admitted to different ICUs at Assiut University Hospitals from January 2006 to December 2006. Blood samples were collected from infected patients for blood cultures. The colonies were identified and antibiotic sensitivities were performed. This study showed that the rate of nosocomial BSI was 75 per 1000 ICU admissions with the highest percentages in Trauma ICU (17%. Out of 159 patients with primary bloodstream infection, 61 patients died representing a crude mortality rate of 38%. Analysis of the organisms causing BSI showed that Gram positive organisms were reported in 69.1% (n = 121; MRSA was the most prevalent (18.9%, followed by methicillin resistant coagulase negative Staphylococci (16

  1. Sulfhydryl variable-5 extended spectrum β-lactamase in nosocomial enteric bacteria causing sepsis in mexican children

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    Angélica Flores-Pérez

    2015-10-01

    Full Text Available Introduction: Enteric bacteria causing nosocomial infections are often resistant to third-generation cephalosporins due to the production of extended-spectrum β-lactamases (ESBLs. Objective: To describe and characterize the ESBLs pattern present in Klebsiella pneumoniae and Serratia marcescens strains, isolated as causative of nosocomial sepsis in pediatric patients at Instituto Nacional de Pediatría (National Institute of Pediatrics. Material and methods: We analyzed 94 strains of K. pneumoniae and 7 of S. marcescens isolated from clinical specimens from 2002-2005, causative of sepsis in a children’s hospital. We evaluated antibiotic susceptibility and detection of ESBL phenotypes by disk diffusion methods; ceftazidime-resistant isolates were further characterized by pulsed field gel electrophoresis (PFGE; and ESBLs were phenotypically and genotypically characterized by isoelectric focusing, polymerase chain reaction (PCR and sequencing. We also assed for presence of conjugative plasmids bearing the ESBL gene. Results: 51/94 (54% of K. pneumoniae isolates, and 5/7 (71% of S. marcescens isolates were resistant to ceftazidime; all carried a blaSHV-5 gene. All K. pneumoniae isolates had a distinct PFGE profile, yet all carried a ~48-Kb plasmid, that was conjugatively transferable to an Escherichia coli receptor, which expressed the resistance phenotype. On the other hand, all S. marcescens isolates had a similar PFGE profile, were unable to transfer the ceftazidime-resistance phenotype, and were isolated from the same ward in a short time-span suggesting an outbreak. Conclusions: The overall prevalence of ESBL-producing enteric bacteria in this hospital is high but similar to other Latin American reports. The sulfhydryl variable-5 (SHV-5 ESBL gene appears to reside in a highly mobile plasmid, capable of spreading among different K. pneumoniae clones and perhaps even to S. marcescens.

  2. An outbreak of multidrug-resistant Serratia marcescens: The importance of continuous monitoring of nosocomial infections

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    Maida Šiširak

    2013-05-01

    Full Text Available Objectives. Serratia marcescens is a well-established as a nosocomial pathogen, resulting in considerable morbidity and mortality in immunocompromised patients. The aim of this study was to investigate an outbreak of Serratia marcescens at the Orthopaedic Clinic of the Clinical Center University of Sarajevo. Methods. A total of 96 strains from 79 patients were isolated. The isolates were identified by conventional methods. Susceptibility testing was performed by the discdiffusion method following CLSI guidelines. Results were confirmed by VITEC-2 Compact. Results. From January to December 2010, 96 strains from 79 patients were isolated at the Orthopaedic Clinic of the Clinical Center, University of Sarajevo.The strains were isolated from wound swabs, blood cultures and cerebrospinal fluid. The strains were identifed using current phenotypic methods as Serratia marcescens with identical biochemical characteristics and antibiotic susceptibility patterns. All strains were susceptible to imipenem, meropenem, amikacin, ciprofloxacin, levofloxacin and piperacillin/tazobactam. The infection control team was alerted and after investigation they discovered the same phenotype of Serratia marcescens in the anaesthetic vials used in procedures. This outbreak was extremely difficult to terminate, even with cohorting of patients, sterilisation of equipment, reinforcement of handwashing and deep-cleaning of facilities. The implementation of new control measures terminated the outbreak in February 2011. Conclusion. Continuous monitoring of nosocomial infections is indispensable. Phenotypic characterization of the isolates is useful for studying the relationship of microbial pathogens. The relationship of one clinical isolate to another during an outbreak is important in motivating the search for a common source or mode of transmission.

  3. Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups

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    Julia M.M. Lopes

    Full Text Available Nosocomial infections (NI are frequent events with potentially lethal outcomes. We identified predictive factors for mortality related to NI and developed an algorithm for predicting that risk in order to improve hospital epidemiology and healthcare quality programs. We made a prospective cohort NI surveillance of all acute-care patients according to the National Nosocomial Infections Surveillance System guidelines since 1992, applying the Centers for Disease Control and Prevention 1988 definitions adapted to a Brazilian pediatric hospital. Thirty-eight deaths considered to be related to NI were analyzed as the outcome variable for 754 patients with NI, whose survival time was taken into consideration. The predictive factors for mortality related to NI (p < 0.05 in the Cox regression model were: invasive procedures and use of two or more antibiotics. The mean survival time was significantly shorter (p < 0.05 with the Kaplan-Meier method for patients who suffered invasive procedures and for those who received two or more antibiotics. Applying a tree-structured survival analysis (TSSA, two groups with high mortality rates were identified: one group with time from admission to the first NI less than 11 days, received two or more antibiotics and suffered invasive procedures; the other group had the first NI between 12 and 22 days after admission and was subjected to invasive procedures. The possible modifiable factors to prevent mortality involve invasive devices and antibiotics. The TSSA approach is helpful to identify combinations of predictors and to guide protective actions to be taken in continuous-quality-improvement programs.

  4. Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups

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    Julia M.M. Lopes

    2009-04-01

    Full Text Available Nosocomial infections (NI are frequent events with potentially lethal outcomes. We identified predictive factors for mortality related to NI and developed an algorithm for predicting that risk in order to improve hospital epidemiology and healthcare quality programs. We made a prospective cohort NI surveillance of all acute-care patients according to the National Nosocomial Infections Surveillance System guidelines since 1992, applying the Centers for Disease Control and Prevention 1988 definitions adapted to a Brazilian pediatric hospital. Thirty-eight deaths considered to be related to NI were analyzed as the outcome variable for 754 patients with NI, whose survival time was taken into consideration. The predictive factors for mortality related to NI (p < 0.05 in the Cox regression model were: invasive procedures and use of two or more antibiotics. The mean survival time was significantly shorter (p < 0.05 with the Kaplan-Meier method for patients who suffered invasive procedures and for those who received two or more antibiotics. Applying a tree-structured survival analysis (TSSA, two groups with high mortality rates were identified: one group with time from admission to the first NI less than 11 days, received two or more antibiotics and suffered invasive procedures; the other group had the first NI between 12 and 22 days after admission and was subjected to invasive procedures. The possible modifiable factors to prevent mortality involve invasive devices and antibiotics. The TSSA approach is helpful to identify combinations of predictors and to guide protective actions to be taken in continuous-quality-improvement programs.

  5. Nutritional status and nosocomial infections among adult elective surgery patients in a Mexican tertiary care hospital.

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    Judith Rodríguez-García

    Full Text Available Controversy exists as to whether obesity constitutes a risk-factor or a protective-factor for the development of nosocomial Infection (NI. According to the obesity-paradox, there is evidence that moderate obesity is a protective-factor. In Mexico few studies have focused on the nutritional status (NS distribution in the hospital setting.The aim of this study was to estimate the distribution of NS and the prevalence of nosocomial infection NI among adult elective surgery (ES patients and to compare the clinical and anthropometric characteristics and length of stays (LOS between obese and non-obese patients and between patients with and without NI.We conducted a cross-sectional study with a sample (n = 82 adult ES patients (21-59 years old who were recruited from a tertiary-care hospital. The prevalences of each NS category and NI were estimated, the assessments were compared between groups (Mann-Whitney, Chi-squared or the Fisher's-exact-test, and the association between preoperative risk-factors and NI was evaluated using odds ratios.The distribution of subjects by NS category was: underweight (3.66%, normal-weight (28.05%, overweight (35.36%, and obese (32.93%. The prevalence of NI was 14.63%. The LOS was longer (p<0.001 for the patients who developed NI. The percentages of NI were: 33.3% in underweight, 18.52% in obese, 17.39% in normal-weight, and 6.90% in overweight patients.The prevalence of overweight and obesity in adult ES patients is high. The highest prevalence of NI occurred in the underweight and obese patients. The presence of NI considerably increased the LOS, resulting in higher medical care costs.

  6. Prevalence of nosocomial infections in acute care hospitals in Catalonia (VINCat Program).

    Science.gov (United States)

    Olona, Montserrat; Limón, Enric; Barcenilla, Fernando; Grau, Santiago; Gudiol, Francesc

    2012-06-01

    The first objective of the Catalonian Nosocomial Infection Surveillance Program (VINCat) is to monitor the prevalence (%) of patients with nosocomial infections (NI), patients undergoing urinary catheterization with closed circuit drainage (%) and patients undergoing antibiotic treatment (%). We present the results for the period 2008-2010. Comprehensive and point annual prevalence surveys were conducted that included conventionally hospitalized patients in acute care hospitals belonging to the VINCat Program. The number of participating hospitals was 46 (2008), 48 (2009) and 61 (2010), most belonging to the Network of Public Use Hospitals of Servei Català de la Salut. The results are presented globally and by hospital size (500 beds). The prevalence of patients with active NI acquired during the current or the previous hospitalization (global NI/P%) was 7.6 (2008), 6.2 (2009) and 6.3 (2010). The prevalence of patients with active NI acquired during the current (actual NI/P%) was 6.2 (2008), 4.7 (2009) and 4.6 (2010).The results by hospital size shows that the variation occurred mainly in <200 beds hospitals. The proportion of closed circuit urinary catheterization use was 90.2%. The use of antibiotics varied between 34.6% and 37.6%, with no differences due to hospital size. The global prevalence of NI provides information on the burden of NI at the institutional and regional level. Between 17.3% and 26.9% of patients with NI at the time of the study had acquired it in a previous hospitalization at the same institution.

  7. Incidence and risk factors of nosocomial infections after cardiac surgery in Georgian population with congenital heart diseases.

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    Lomtadze, M; Chkhaidze, M; Mgeladze, E; Metreveli, I; Tsintsadze, A

    2010-01-01

    Nosocomial infections still remain a serious problem in patients undergoing open heart surgery. The aim of the study was to determine the incidence, etiology and main risk factors of nosocomial infections (NI) following cardiac surgery in congenital heart diseases population. Retrospective case study was conducted. 387 patients with congenital heart disease (CHD), who underwent cardiac surgery from January 2007 to December 2008 were studied. The age of the most patients varied between 1 day to 15 years, 73 patients (18,8%) were older than 15 years. All 387 patients underwent cardiac surgery. The rate of NI was 16%. The most common infections were bloodstream infections (BSI) (7,75%) and respiratory tract infections (7%) respectively. The rate of NI was higher in patients under 1 year of age, after urgent surgery and urgent reoperation, long cardiopulmonary bypass (CPB) and aortic cross-clamp time, also in patients with prolonged mechanical ventilation, massive haemotransfusion, with open heart bone after surgery, reintubation, hospitalization in another hospital during last three month. It was concluded that the most common nosocomial infection after cardiac surgery congenital heart diseases in Georgian population was blood stream infection. The main risk factors of NI in the same setting were age under 1 year, urgent surgery, urgent reoperation, long CPB and aortic cross-clamp time, long duration of mechanical ventilation, massive haemotransfusion, open heart bone after surgery, reintubation, hospitalization in another hospital during last three month.

  8. Nosocomial infections due to methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus: relationships with antibiotic use and cost drivers.

    Science.gov (United States)

    Mauldin, Patrick D; Salgado, Cassandra D; Durkalski, Valerie L; Bosso, John A

    2008-03-01

    Increased incidence of nosocomial infections due to methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) has been associated with the use of certain antibiotics and has resulted in increased morbidity, mortality, and costs of care. To describe relationships between vancomycin and linezolid use and incidence of these nosocomial infections over time and to determine factors associated with the increased costs of care (cost drivers) associated with affected patients. The association between institution-wide antibiotic use and the rate of nosocomial MRSA and VRE infections was assessed using segmented regression analysis for interrupted time series. The effect that patient characteristics and procedures, as well as certain antibiotic use, had on costs and length of stay of patients with MRSA or VRE nosocomial infection was also assessed and cost drivers for the 2 types of infections were compared. Our analysis included 206 patients who developed MRSA (n = 187) or VRE (n = 19) nosocomial infection. Although small numbers of VRE nosocomial infection may limit generalizations from our results, we found no significant relationship between vancomycin or linezolid use and the rate of either infection. While mean hospital costs were similar, cost drivers varied somewhat between infection types. The incidence of MRSA or VRE infections does not appear to be related to the use of vancomycin or linezolid. Costs of care are quite high in some affected patients and, while mean total hospital costs are similar, cost drivers appear to differ between the 2 infection types.

  9. Analysis of multi-factors after total knee arthroplasty with nosocomial infection%全膝关节置换术后患者院内感染的多因素分析

    Institute of Scientific and Technical Information of China (English)

    赵金柱; 宋展昭; 曲良

    2011-01-01

    Objective To survey the status of nosocomial infection after total knee arthroplasty,analyze the risk factors of nosocomial infection and possible prevention measures.Methods Datas were collected retrospectively on 80pmients (80 knee joints) who were treated by total knee arthrophsly,the patients were divided into two groups,group A with nosocomial infection and group B without nosocomial infection.Statistic patient's age,basic diseases situation,preoperative hemoglobin content,serum albumin,operation time,blood transfusions,indwelling urethral catheter time,antibiotic treatment time of the two groups.And study the location,pathogenic bacteria and outcomes of the nosocomial infection patients.Results 10 patients occured nosocomial infection,the infected site in turn is urinary tract in 5 cases,respiratory tract 4 cases,skin infections in 1 case,the incidence of nosocomial infection is 12.5%.In noscomial infection group,patient's age,blood transfusions,operation time and postoperative indwelling urinary canal time significantly higher than no nosocomial infection group,anemia,hypoalbuminemia have relevance of nosocomial infection,there is no difference between the two groups in basic diseases situation.Conclusions The nosocomial infection after total knee arthroplasty caused by multiple factors,patient's age,hypoalbuminemia,anemia,operation time and indwelling urethral catheter time is closely related with nosocomial infection%目的 调查全膝关节置换术患者院内感染情况,分析该类患者院内感染的易感因素及可能的预防措施.方法 回顾性分析行全膝关节置换术患者80例(80膝),按照有无院内感染分为院内感染组(A组)、无院内感染组(B组),比较两组患者的年龄、基础疾病情况、血红蛋白、血清白蛋白、手术时间、输血量、尿管留置时间、抗生素使用时间,同时对发生院内感染的患者统计院内感染的部位、病原菌及转归情况.结果80

  10. First Description of the Extended Spectrum-Beta-Lactamase Gene blaCTX-M-109 in Salmonella Grumpensis Strains Isolated from Neonatal Nosocomial Infections in Dakar, Senegal.

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    Amadou Diop

    Full Text Available Nosocomial infections are very common in African hospitals, particularly in neonatal units. These infections are most often caused by bacteria such as Escherichia coli, Klebsiella spp and Staphylococcus spp. Salmonella strains are rarely involved in nosocomial infections. Here, we report the first description of S. Grumpensis in neonatal infections in Senegal. Seventeen Salmonella strains were isolated from hospitalized infants' stool samples. The following resistance phenotype was described in strains: AMXRTICRCFR FOXRCFXRCTXRCAZRIMPSATMRNARNORRCIPRTMRGMRTERSXTR. All isolates were susceptible to imipenem, 15 out of 17 produced an extended spectrum ß-lactamase (ESBL. blaOXA-1, blaSHV-1, blaTEM-1, blaCTX-M1 genes were detected in strains 8, 13, 5 and 8, respectively. blaCTX-M1 sequencing revealed the presence of blaCTX-M-109. Thirteen of the 17 Salmonella Grumpensis strains were analyzed by PFGE. These 13 isolates belonged to a single pulsotype and were genotypically identical. This is the first report of neonatal S. Grumpensis infections in Senegal, and the first report of blaCTX-M-109 in the genus Salmonella.

  11. Validación de un programa de vigilancia de infecciones nosocomiales Validation of a nosocomial infections surveillance program

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    M. Sigfrido Rangel-Frausto

    1999-01-01

    Full Text Available OBJETIVO. Validar el programa de vigilancia de infecciones nosocomiales y conocer la morbilidad y la mortalidad. MATERIAL Y MÉTODOS. Un médico especialmente capacitado, realizó vigilancia intensiva de todos los pacientes admitidos en el hospital. Los casos de infección fueron discutidos con otros dos médicos y el resultado se comparó con la vigilancia rutinaria. Se incluyó a todos los pacientes hospitalizados del 11 de julio al 12 de agosto de 1995, que no tenían un proceso infeccioso activo o que no manifestaban un periodo de incubación a su ingreso. Se siguieron diariamente y se registraron datos de: edad, sexo y padecimiento de ingreso. Se recabó información sobre tratamiento antimicrobiano, microrganismo aislado y susceptibilidad. Se evaluó el estado clínico final y se estimó el tiempo de estancia hospitalaria. RESULTADOS. De 429 pacientes, 45 desarrollaron infección nosocomial (casos y 384 no lo hicieron (controles. La incidencia de infecciones nosocomiales fue de 10.48/100. La sensibilidad y la especificidad del programa fueron de 93.3 y 98.7%, respectivamente. La mortalidad en los infectados fue de 11.11%, y en el grupo de los no infectados, de 2.4%. El promedio de estancia hospitalaria fue de 20 y 11 días, para infectados y no infectados, respectivamente (pOBJECTIVES. To validate the nosocomial infections surveillance system, establish its impact in morbi-mortality. MATERIAL AND METHODS. Surveillance of every single patient admited during a one month period was done by one of us (DMG. Each posibile case was discussed with two other hospital epidemiologists (SPLR, MSRF. This intensive surveillance was compared against the routinely surveillance performed by the nurses. We included all hospitalized patients between 11th July and 12th of August according to CDC (Atlanta, GA nosocomial infections definitions. Patients were followed everyday and information about age, gender, underlying diagnosis, microorganisms responsible

  12. Crimean-Congo hemorrhagic fever nosocomial infection in a immunosuppressed patient, Pakistan: case report and virological investigation.

    Science.gov (United States)

    Hasan, Zahra; Mahmood, Faisal; Jamil, Bushra; Atkinson, Barry; Mohammed, Murtaza; Samreen, Azra; Altaf, Lamia; Moatter, Tariq; Hewson, Roger

    2013-03-01

    Crimean-Congo hemorrhagic fever (CCHF) is endemic in the Baluchistan province, Pakistan. Sporadic outbreaks of CCHF occur throughout the year especially in individuals in contact with infected livestock. Nosocomial transmission remains a risk due to difficulties in the diagnosis of CCHF and limited availability of facilities for the isolation of suspected patients. Rapid diagnosis of CCHF virus infection is required for early management of the disease and to prevent transmission. This study describes the case of a 43-year-old surgeon who contracted CCHF during a surgical procedure in Quetta, Baluchistan and who was transferred to a tertiary care facility at the Aga Khan University Hospital, Karachi within 1 week of contracting the infection. Diagnosis of CCHF was made using a rapid real-time reverse transcription polymerase chain reaction (RT-PCR) assay for CCHF viral RNA. The patient had chronic hepatitis B and hepatitis D infection for which he had previously received a liver transplant. He proceeded to develop classic hemorrhagic manifestations and succumbed to the infection 14 days post-onset of disease. There was no further nosocomial transmission of the CCHF during the hospital treatment of the surgeon. Early diagnosis of CCHF enables rapid engagement of appropriate isolation, barrier nursing and infection control measures thus preventing nosocomial transmission of the virus.

  13. Risk factors for nosocomial infection in a Brazilian neonatal intensive care unit

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    Ana Carolina Vieira Costa Fernandes Távora

    2008-02-01

    Full Text Available This study was designed to describe the epidemiology and risk factors for nosocomial infection (NI in a Brazilian neonatal intensive care unit (NICU. This study was a retrospective cohort from January to December, 2003. All neonates admitted to the NICU. Infection surveillance was conducted according to the NNIS, CDC. Chi-square test and logistic regression model were performed for statistical analyses. The study was conducted at a public, tertiary referral NICU of a teaching hospital in the Northeast of Brazil. A total of 948 medical records were reviewed. Overall NI incidence rate was 34%. The main neonatal NI was bloodstream infection (68.1%, with clinical sepsis accounting for 47.2%, and pneumonia was the second most common NI (8.6%. Multivariate analysis identified seven independent risk factors for NIs: birth weight, exposure to parenteral nutrition, percutaneous catheter, central venous catheter or mechanical ventilation, abruptio placentae and mother's sexually transmitted disease (STD. Neonates from mothers with STD or abruptio placentae, those weighing less than 1,500 g at birth or those who used invasive devices were at increased risk for acquiring NI.

  14. Nosocomial infections and risk factors in intensive care unit of a university hospital

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    Zuhal Yesilbağ

    2015-09-01

    Full Text Available Objective: The aim of this study is to evaluate nosocomial infections (NIs in intensive care unit (ICU in terms of site of infection, distribution of pathogens and risk factors for developing infection. Methods: 80 patients staying for more than 48 hours in the ICU were included in the study. Epidemiologic characteristics of the patients, invasive procedures and other risk factors were noted. Cultures, identification of isolates and antibiotic susceptibility tests were made by standard microbiologic methods. Results: Of 56 patients who have developed NIs, 26 (50% had pneumonia, 15 (28.8% had bloodstream infections and 6 (11.5% had urinary tract infections. Klebsiella pneumoniae (23.5%, Pseudomonas aeruginosa (19.6%, and Acinetobacter spp. (15.6% were the most frequently isolated microorganisms, respectively. For Klebsiella pneumoniae isolates, extended spectrum beta lactamase (ESBL rate was 91.6%, carbapenem resistance rate was 15.6% and for Pseudomonas aeruginosa and Acinetobacter spp. carbapenem resistance rates were 60% and 100% respectively. Hemodialysis, enteral nutrition, total parenteral nutrition and prolonged hospitalization for more than 10 days were determined as independent risk factors for developing NI. Additionally Acute Physiology and Chronic Health Evaluation (APACHE II score, length of ICU stay and lenght of hospital stay before ICU were found to be high in the NI group. Conclusion: Pneumonia is the most common NI and carbapenem resistance in Gram-negative bacilli was remarkably high in our ICU. It was considered that infection control measures must be applied carefully, invasive procedures should be used in correct indications and we should avoid long-term hospitalization if unnecessary. J Clin Exp Invest 2015; 6 (3: 233-239

  15. Nosocomial infections in a neonatal intensive care unit during 16 years: 1997-2012

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    Jane Eire Urzedo

    2014-06-01

    Full Text Available Introduction Surveillance of nosocomial infections (NIs is an essential part of quality patient care; however, there are few reports of National Healthcare Safety Network (NHSN surveillance in neonatal intensive care units (NICUs and none in developing countries. The purpose of this study was to report the incidence of NIs, causative organisms, and antimicrobial susceptibility patterns in a large cohort of neonates admitted to the NICU during a 16-year period. Methods The patients were followed 5 times per week from birth to discharge or death, and epidemiological surveillance was conducted according to the NHSN. Results From January 1997 to December 2012, 4,615 neonates, representing 62,412 patient-days, were admitted to the NICU. The device-associated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonia infections per 1,000 ventilator-days. A total of 1,182 microorganisms were isolated from sterile body site cultures in 902 neonates. Coagulase-negative staphylococci (CoNS (34.3% and Staphylococcus aureus (15.6% were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and Staphylococcus aureus were 86.4% and 28.3%, respectively. Conclusions The most important NI remains bloodstream infection with staphylococci as the predominant pathogens, observed at much higher rates than those reported in the literature. Multiresistant microorganisms, especially oxacillin-resistant staphylococci and gram-negative bacilli resistant to cephalosporin were frequently found. Furthermore, by promoting strict hygiene measures and meticulous care of the infected infants, the process itself of evaluating the causative organisms was valuable.

  16. High risk HPV contamination of endocavity vaginal ultrasound probes: an underestimated route of nosocomial infection?

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    Jean-sebastien Casalegno

    Full Text Available BACKGROUND: Endocavity ultrasound is seen as a harmless procedure and has become a common gynaecological procedure. However without correct disinfection, it may result in nosocomial transmission of genito-urinary pathogens, such as high-risk Human Papillomavirus (HR-HPV. We aimed to evaluate the currently recommended disinfection procedure for covered endocavity ultrasound probes, which consists of "Low Level Disinfection" (LLD with "quaternary ammonium compounds" containing wipes. METHODS: From May to October 2011 swabs were taken from endovaginal ultrasound probes at the Gynecology Department of the Lyon University Hospital. During the first phase (May-June 2011 samples were taken after the ultrasound examination and after the LLD procedure. In a second phase (July-October 2011 swab samples were collected just before the probe was used. All samples were tested for the presence of human DNA (as a marker for a possible transmission of infectious pathogens from the genital tract and HPV DNA with the Genomica DNA microarray (35 different HPV genotypes. RESULTS: We collected 217 samples before and 200 samples after the ultrasound examination. The PCR was inhibited in two cases. Human DNA was detected in 36 (18% post-examination samples and 61 (28% pre-examination samples. After the ultrasound LLD procedure, 6 (3.0% samples contained HR-HPV types (16, 31, 2×53 and 58. Similarly, HPV was detected in 6 pre-examination samples (2.7%. Amongst these 4 (1.9% contained HR-HPV (types 53 and 70. CONCLUSION: Our study reveals that a considerable number of ultrasound probes are contaminated with human and HR-HPV DNA, despite LLD disinfection and probe cover. In all hospitals, where LLD is performed, the endovaginal ultrasound procedure must therefore be considered a source for nosocomial HR-HPV infections. We recommend the stringent use of high-level disinfectants, such as glutaraldehyde or hydrogen peroxide solutions.

  17. 医院感染目标性监测报告分析%Target surveillance report of nosocomial infections

    Institute of Scientific and Technical Information of China (English)

    刘卫平; 闫志刚; 苏日娜; 邢慧敏; 杨旭

    2012-01-01

    OBJECTIVE To develop the surveillance of high risk population and infection sites as well as the risk factors so as to control the prevalence of nosocomial infections. METHODS According to the standards for nosocomial infection surveillance, the surveillance of nosocomial infections was performed by reviewing the medical records in combination with clinical ward rounds. RESULTS The nosocomial infection rate was 10. 70% in ICU, the utilization rate of the catheter was 53. 56%, the daily incidence rate of the urinary tract catheter-related infections was 2. 73‰; the utilization rate of central venous catheterization was 99. 09% , the daily infection rate of central venous catheter-related bloodstream infections was 1. ll‰;the utilization rate of ventilator was 46. 25%, the daily incidence rate of ventilator-associated pneumonia was 13. 44‰; the total equipment utilization rate was 198. 90% ; the incidence of nosocomial infections was 0. 86% in the neonates with the daily infection rate of 1. 76‰ ; the incidence of the class Ⅰ surgical incision infections was 1. 02% , class Ⅱ surgical incision infections 2. 35% , class Ⅲ surgical incision infections 20. 00%. CONCLUSION The target surveillance. as a scientific surveillance of nosocomial infections, is flexible and can predict the sources of infections in early stage as well as control the outbreak and prevalence of nosocomial infections.%目的 针对高危人群、高发感染部位等开展医院感染及其危险因素的监测,及时控制医院感染暴发流行.方法 2011年1-6月根据《医院感染监测规范》,采用查看病历与临床查房相结合进行感染监测.结果 ICU医院感染率10.70%,导尿管使用率53.56%,导尿管相关泌尿道感染日感染率2.73‰;中心静脉插管使用率99.09%,中心静脉插管相关血流日感染率1.11‰;呼吸机使用率46.25%,呼吸机相关肺炎日感染率13.44%;总器械使用率198.90%;新生儿医院感染发生率为0

  18. Strengthening the control of nosocomial infections to reduce the incidence of surgical incision infections%加强手术室内感染的控制措施降低手术切口感染率

    Institute of Scientific and Technical Information of China (English)

    江媚霞

    2013-01-01

    OBJECTIVE To explore the effective measures for the control of infections in the operating rooms so as to prevent the nosocomial infections. METHODS The causes of nosocomial infections and the infection routes were analyzed, the operation procedure was optimized, the rules and regulations of the operating rooms were improved, at the same time, the aseptic principle and technology of medical staff was strengthened, and the management of surgical instrument was improved, and the monitoring of the nosocomial infections was made to be perfect, and the reward and punishment measures were implemented. RESULTS After the control measures were implemented in the operating rooms, the incidence rate of the incision infections was significantly decreased, both the average hospitalization duration and the hospitalization cost were decreased, and the aseptic concept of the medical staff was significantly improved; the healing rate of the class A surgical incision was higher than 98. 0% in 5 consecutive years. CONCLUSION It is an effective way to prevent the nosocomial infections by strengthening the infection control in the operating rooms, strictly implementing the rules and regulations, regularly monitoring the nosocomial infections, and finding out the problems in timely manner to correct it.%目的 探讨控制手术室内感染的有效措施,以预防医院感染.方法 分析引起医院感染发生的源头以及感染的途径,优化手术室操作流程,完善手术室的规章制度,加强医务人员的无菌原则,提高手术物品的管理,健全医院感染的监控和奖惩措施.结果 加强手术室内感染控制措施后,医院手术患者切口感染率较前显著下降,患者平均住院天数和住院费用均有所降低,医务人员的无菌观念得到明显提高;医院连续5年无菌手术切口甲级愈合率>98.0%.结论 加强手术室的感染控制,严格执行手术室规章制度,定期监测医医院感染,及时发现问题并纠

  19. Risk factors for device-associated infection related to organisational characteristics of intensive care units: findings from the Korean Nosocomial Infections Surveillance System.

    Science.gov (United States)

    Kwak, Y G; Lee, S-O; Kim, H Y; Kim, Y K; Park, E S; Jin, H Y; Choi, H J; Jeong, S Y; Kim, E S; Ki, H K; Kim, S R; Lee, J Y; Hong, H K; Kim, S; Lee, Y S; Oh, H-B; Kim, J M

    2010-07-01

    Device-associated infections (DAIs) have been the major causes of morbidity and mortality of patients in intensive care units (ICUs). This study evaluated the risk factors for DAIs in ICUs. Ninety-six medical or surgical ICUs of 56 hospitals participated in the Korean Nosocomial Infections Surveillance System between July 2007 and June 2008. The occurrence of catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CABSI), and ventilator-associated pneumonia (VAP) were monitored and DAI rates were calculated. Data associated with ICU characteristics were collected and Poisson regression was used for statistical analysis. Rates of CAUTI, CABSI, and VAP were 3.87 per 1000 urinary catheter days, 2.23 per 1000 central line days, and 1.89 per 1000 mechanical ventilator days, respectively. Rates of CAUTI were higher in ICUs in Seoul (P=0.032) and ICUs of major teaching hospitals (P=0.010). The ICUs of university-affiliated hospitals showed lower CAUTI rates (P=0.013). CABSI rates were higher in Seoul (P=0.001) and in medical ICUs (P=0.026). VAP rates were lower in ICUs of hospitals with more than 900 beds compared with hospitals with 400-699 beds (P=0.026). VAP rates were higher in surgical ICUs (Pinfection control professional (P=0.003). The organisational and institutional characteristics of ICUs may influence DAI rates and there is a need for improvement in the incidence of VAP, CAUTI or CABSI.

  20. Incremental cost of nosocomial bacteremia according to the focus of infection and antibiotic sensitivity of the causative microorganism in a university hospital.

    Science.gov (United States)

    Riu, Marta; Chiarello, Pietro; Terradas, Roser; Sala, Maria; Garcia-Alzorriz, Enric; Castells, Xavier; Grau, Santiago; Cots, Francesc

    2017-04-01

    To estimate the incremental cost of nosocomial bacteremia according to the causative focus and classified by the antibiotic sensitivity of the microorganism.Patients admitted to Hospital del Mar in Barcelona from 2005 to 2012 were included. We analyzed the total hospital costs of patients with nosocomial bacteremia caused by microorganisms with a high prevalence and, often, with multidrug-resistance. A control group was defined by selecting patients without bacteremia in the same diagnosis-related group.Our hospital has a cost accounting system (full-costing) that uses activity-based criteria to estimate per-patient costs. A logistic regression was fitted to estimate the probability of developing bacteremia (propensity score) and was used for propensity-score matching adjustment. This propensity score was included in an econometric model to adjust the incremental cost of patients with bacteremia with differentiation of the causative focus and antibiotic sensitivity.The mean incremental cost was estimated at &OV0556;15,526. The lowest incremental cost corresponded to bacteremia caused by multidrug-sensitive urinary infection (&OV0556;6786) and the highest to primary or unknown sources of bacteremia caused by multidrug-resistant microorganisms (&OV0556;29,186).This is one of the first analyses to include all episodes of bacteremia produced during hospital stays in a single study. The study included accurate information about the focus and antibiotic sensitivity of the causative organism and actual hospital costs. It provides information that could be useful to improve, establish, and prioritize prevention strategies for nosocomial infections.

  1. The ORION statement: guidelines for transparent reporting of outbreak reports and intervention studies of nosocomial infection.

    Science.gov (United States)

    Stone, Sheldon P; Cooper, Ben S; Kibbler, Chris C; Cookson, Barry D; Roberts, Jenny A; Medley, Graham F; Duckworth, Georgia; Lai, Rosalind; Ebrahim, Shah; Brown, Erwin M; Wiffen, Phil J; Davey, Peter G

    2007-04-01

    The quality of research in hospital epidemiology (infection control) must be improved to be robust enough to influence policy and practice. In order to raise the standards of research and publication, a CONSORT equivalent for these largely quasi-experimental studies has been prepared by the authors of two relevant systematic reviews, following consultation with learned societies, editors of journals, and researchers. The ORION (Outbreak Reports and Intervention Studies Of Nosocomial infection) statement consists of a 22 item checklist, and a summary table. The emphasis is on transparency to improve the quality of reporting and on the use of appropriate statistical techniques. The statement has been endorsed by a number of professional special interest groups and societies. Like CONSORT, ORION should be considered a "work in progress", which requires ongoing dialogue for successful promotion and dissemination. The statement is therefore offered for further public discussion. Journals and research councils are strongly recommended to incorporate it into their submission and reviewing processes. Feedback to the authors is encouraged and the statement will be revised in 2 years.

  2. Risk factors for nosocomial infections in patients receiving extracorporeal membrane oxygenation supportive therapy.

    Science.gov (United States)

    Sun, Geqin; Li, Binfei; Lan, Haili; Wang, Juan; Lu, Lanfei; Feng, Xueqin; Luo, Xihua; Yan, Haizhong; Mu, Yuejing

    2017-06-22

    The aim of this study was to analyze risk factors for nosocomial infection (NI) in patients receiving extracorporeal membrane oxygenation (ECMO) support. Clinical NI data were collected from patients who received ECMO support therapy, and analyzed retrospectively. Among 75 ECMO patients, 20 were found to have developed NI (infection rate 26.7%); a total of 58 pathogens were isolated, including 43 strains of gram-negative bacteria (74.1%) and 15 strains of gram-positive bacteria (25.9%). Multi-drug resistant strains were highly concentrated and were mainly shown to be Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Incidence of NI was related to the duration of ECMO support therapy and the total length of hospital stay, and the differences were statistically significant (P<.05). A prolonged period of ECMO support extended the hospital stay, but it did not increase the mortality rate. However, an elevated level of lactic acid increased the mortality rate in this study population. ECMO-associated secondary NIs correlated significantly with the length of hospital stay and with the duration of ECMO support. Therefore, to reduce the incidence of ECMO-associated NIs, preventive strategies that aim to shorten the duration of ECMO support therapy and avoid lengthy hospitalization should be applied, wherever possible. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  3. Hygiene training of food handlers in hospital settings: important factor in the prevention of nosocomial infections.

    Science.gov (United States)

    Lazarević, Konstansa; Stojanović, Dusica; Bogdanović, Dragan; Dolićanin, Zana

    2013-09-01

    The aim of this study was to evaluate the effects of food hygiene training of food handlers on sanitary-hygienic conditions in hospital kitchens, based on microbiological analysis of smears taken in hospital kitchens. The study was conducted in the 1995-2009 period at the Clinical Centre Nis, Serbia. The food hygiene training was conducted in February 2005, by an infection control officer. 1,076 smears in the central kitchen and 4,025 smears in distributive kitchens were taken from hands and work clothes, work surfaces, equipment, and kitchen utensils. Microbiological analysis of smears was carried out in an accredited laboratory of the Public Health Institute Nis (Serbia). A significantly lower percentage of smears with isolates of bacteria (p safety education programme (2005-2009). The most commonly isolated bacteria was: Enterobacter spp., Acinetobacter spp., Citrobacter spp., and E. coli. Our results confirmed that food hygiene training improved hygiene and is also an important component for the prevention of nosocomial infection.

  4. Determining the Independent Risk Factors and Mortality Rate of Nosocomial Infections in Pediatric Patients.

    Science.gov (United States)

    Aktar, Fesih; Tekin, Recep; Güneş, Ali; Ülgen, Cevat; Tan, İlhan; Ertuğrul, Sabahattin; Köşker, Muhammet; Balık, Hasan; Karabel, Duran; Yolbaş, Ilyas

    2016-01-01

    The objective of this study was to determine the rate, independent risk factors, and outcomes of healthcare-associated infections in pediatric patients. This study was performed between 2011 and 2014 in pediatric clinic and intensive care unit. 86 patients and 86 control subjects were included in the study. Of 86 patients with nosocomial infections (NIs), there were 100 NIs episodes and 90 culture growths. The median age was 32.0 months. The median duration of hospital stay of the patients was 30.0 days. The most frequent pathogens were Coagulase-negative Staphylococcus, Acinetobacter spp., Klebsiella spp., and Candida spp. Unconsciousness, prolonged hospitalization, transfusion, mechanical ventilation, use of central venous catheter, enteral feeding via a nasogastric tube, urinary catheter, and receiving carbapenems and glycopeptides were found to be significantly higher in NIs patients. Multivariate logistic regression analysis showed prolonged hospitalization, neutropenia, and use of central venous catheter and carbapenems as the independent risk factors for NIs. In the univariate analysis, unconsciousness, mechanical ventilation, enteral feeding, use of enteral feeding via a nasogastric tube, H2 receptor blockers, and port and urinary catheter were significantly associated with mortality. In the multiple logistic regression analysis, only mechanical ventilation was found as an independent predictor of mortality in patients with NIs.

  5. Determining the Independent Risk Factors and Mortality Rate of Nosocomial Infections in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Fesih Aktar

    2016-01-01

    Full Text Available The objective of this study was to determine the rate, independent risk factors, and outcomes of healthcare-associated infections in pediatric patients. This study was performed between 2011 and 2014 in pediatric clinic and intensive care unit. 86 patients and 86 control subjects were included in the study. Of 86 patients with nosocomial infections (NIs, there were 100 NIs episodes and 90 culture growths. The median age was 32.0 months. The median duration of hospital stay of the patients was 30.0 days. The most frequent pathogens were Coagulase-negative Staphylococcus, Acinetobacter spp., Klebsiella spp., and Candida spp. Unconsciousness, prolonged hospitalization, transfusion, mechanical ventilation, use of central venous catheter, enteral feeding via a nasogastric tube, urinary catheter, and receiving carbapenems and glycopeptides were found to be significantly higher in NIs patients. Multivariate logistic regression analysis showed prolonged hospitalization, neutropenia, and use of central venous catheter and carbapenems as the independent risk factors for NIs. In the univariate analysis, unconsciousness, mechanical ventilation, enteral feeding, use of enteral feeding via a nasogastric tube, H2 receptor blockers, and port and urinary catheter were significantly associated with mortality. In the multiple logistic regression analysis, only mechanical ventilation was found as an independent predictor of mortality in patients with NIs.

  6. Isolation and survey of antibiotic sensitivity in nosocomial infections in north Maharashtra region.

    Science.gov (United States)

    Patil, Arun; Patil, Kavita; Pawar, Pankaj; Maheshwari, Vijay

    2013-07-01

    The present work was aimed to study the prevalence of the drug resistance among Gram positive and Gram negative organisms isolated from clinical samples obtained from various private nursing homes of Jalgaon city and surrounding areas in the state of Maharashtra. Different pathogenic organisms were isolated from one thousand seven hundred and ninety clinical samples obtained from various nursing homes of Jalgaon region of North Maharashtra, MS, India during the period of August, 2010 to July, 2011. Antibiotic sensitivity testing of isolated pathogenic organisms was done with fifty different antibiotics of 13 different groups by the disk diffusion technique using Mueller Hinton Agar Plates according to CLSI (formerly NCCLS) guidelines. Out of total samples analyzed 1171 samples showed the presence of infection while in 619 samples no growth of organisms was seen on culture medium. Microbial growth revealed presence of 11 different organisms (E. coli, Klebsiella spp., Proteus spp., Pseudomonas spp., Enterobacter spp., Salmonella spp., Acinetobater spp., Streptococccus spp., Staphylococcus aureus (MRSA and MSSA)) including Candida spp. Sensitivity profile of these organisms towards different antibiotics is reported here. The study resulted in generation of representative status of the antibiotic sensitivity pattern of commonly found organisms in nosocomial infections in the region. This could be useful for the clinicians to choose correct antibiotic and ensure the judicious use of the same for their patients.

  7. Nosocomial rapidly growing mycobacterial infections following laparoscopic surgery: CT imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Volpato, Richard [Cassiano Antonio de Moraes University Hospital, Department of Diagnostic Radiology, Vitoria, ES (Brazil); Campi de Castro, Claudio [University of Sao Paulo Medical School, Department of Radiology, Cerqueira Cesar, Sao Paulo (Brazil); Hadad, David Jamil [Cassiano Antonio de Moraes University Hospital, Nucleo de Doencas Infecciosas, Department of Internal Medicine, Vitoria, ES (Brazil); Silva Souza Ribeiro, Flavya da [Laboratorio de Patologia PAT, Department of Diagnostic Radiology, Unit 1473, Vitoria, ES (Brazil); Filho, Ezequiel Leal [UNIMED Diagnostico, Department of Diagnostic Radiology, Unit 1473, Vitoria, ES (Brazil); Marcal, Leonardo P. [The University of Texas M D Anderson Cancer Center, Department of Diagnostic Radiology, Unit 1473, Houston, TX (United States)

    2015-09-15

    To identify the distribution and frequency of computed tomography (CT) findings in patients with nosocomial rapidly growing mycobacterial (RGM) infection after laparoscopic surgery. A descriptive retrospective study in patients with RGM infection after laparoscopic surgery who underwent CT imaging prior to initiation of therapy. The images were analyzed by two radiologists in consensus, who evaluated the skin/subcutaneous tissues, the abdominal wall, and intraperitoneal region separately. The patterns of involvement were tabulated as: densification, collections, nodules (≥1.0 cm), small nodules (<1.0 cm), pseudocavitated nodules, and small pseudocavitated nodules. Twenty-six patients met the established criteria. The subcutaneous findings were: densification (88.5 %), small nodules (61.5 %), small pseudocavitated nodules (23.1 %), nodules (38.5 %), pseudocavitated nodules (15.4 %), and collections (26.9 %). The findings in the abdominal wall were: densification (61.5 %), pseudocavitated nodules (3.8 %), and collections (15.4 %). The intraperitoneal findings were: densification (46.1 %), small nodules (42.3 %), nodules (15.4 %), and collections (11.5 %). Subcutaneous CT findings in descending order of frequency were: densification, small nodules, nodules, small pseudocavitated nodules, pseudocavitated nodules, and collections. The musculo-fascial plane CT findings were: densification, collections, and pseudocavitated nodules. The intraperitoneal CT findings were: densification, small nodules, nodules, and collections. (orig.)

  8. Infections caused by Chlamydophila pneumoniae.

    Science.gov (United States)

    Choroszy-Król, Irena; Frej-Mądrzak, Magdalena; Hober, Martyna; Sarowska, Jolanta; Jama-Kmiecik, Agnieszka

    2014-01-01

    High affinity to the epithelial lining of the airways makes Chlamydophila pneumoniae a common etiological agent of respiratory tract infections (RTI). It causes among others: pharyngitis, tracheitis, sinusitis, otitis media, bronchitis and bronchiolitis, and pneumonia. It is estimated that Chlamydophila pneumoniae infection is responsible for about 20% of lower respiratory tract infections. Chlamydophila pneumoniae infection may play an important role in the pathogenesis and course of bronchial asthma. The recent results indicate that Chlamydophila pneumoniae infection may be a factor responsible for 4-16% of COPD (Chronic obstructive pulmonary disease) exacerbations. A relationship of chlamydial infection with atherosclerosis raises huge interest. A connection of Chlamydophila pneumoniae infection with other non-communicable diseases such as lung cancer, arthritis, Alzheimer's disease, multiple sclerosis, sarcoidosis and erythema nodosum is also recognized, although the role of these bacteria has not been fully understood in any of the listed diseases.

  9. Bacteremic nosocomial pneumonia caused by Acinetobacter baumannii and Acinetobacter nosocomialis: a single or two distinct clinical entities?

    Science.gov (United States)

    Lee, Y-T; Kuo, S-C; Yang, S-P; Lin, Y-T; Chiang, D-H; Tseng, F-C; Chen, T-L; Fung, C-P

    2013-07-01

    The phenotypically indistinguishable Acinetobacter baumannii and Acinetobacter nosocomialis have become leading pathogens causing nosocomial pneumonia in critically ill patients. A. baumannii and A. nosocomialis nosocomial pneumonias were grouped as a single clinical entity previously. This study aimed to determine whether they are the same or a different clinical entity. A total of 121 patients with A. baumannii and 131 with A. nosocomialis bacteremic nosocomial pneumonia were included during an 8-year period. Despite the similar Charlson co-morbidity scores at admission, patients with A. baumannii pneumonia were more likely to have abnormal haematological findings, lobar pneumonia, significantly higher Acute Physiology and Chronic Health Evaluation II scores and higher frequency of shock at the onset of bacteraemia than those with A. nosocomialis pneumoni. A. baumannii isolates were resistant to more classes of antimicrobials, except colistin, and therefore the patients with A. baumannii pneumonia were more likely to receive inappropriate antimicrobial therapy. The 14-day mortality was significantly higher in patients with A. baumannii pneumonia (34.7% vs. 15.3%, p 0.001). A. baumannii was an independent risk factor for mortality (OR, 2.03; 95% CI, 1.05-3.90; p 0.035) in the overall cohort after adjustment for other risk factors for death, including inappropriate antimicrobial therapy. The results demonstrated the difference in clinical presentation, microbial characteristics and outcomes between A. baumannii and A. nosocomialis nosocomial pneumonia, and supported that they are two distinct clinical entities.

  10. 呼吸内科医院感染干预的临床研究%A clinical study on interventions in nosocomial infections in respiratory department

    Institute of Scientific and Technical Information of China (English)

    孙维敏

    2012-01-01

    OBJECTIVE To investigate the high risk factors for nosocomial infections in respiratory department and explore interventions in nosocomial infections so as to decrease the incidence of nosocomial infections. METHODS The standards of management of nosocomial infections in respiratory department were established and supervised by the nosocomial infection administration department, the targeted surveillance was implemented. RESULTS By means of the inventions in nosocomial infections, the incidence of nosocomial infections and the case-time infection rate in respiratory department were 3. 63% and 3. 81% in 2008, decreasing to 1. 81% and 1. 92% in 2010, respectively. CONCLUSION It ensures the medical quality and the safety of the patients in respiratory department through multiple-approach interventions to strengthen the management of nosocomial infections in respiratory department.%目的 针对呼吸内科医院感染发生的高危因素,探讨干预医院感染的方法,减少呼吸内科医院感染的发生率.方法 医院感染管理部门建立呼吸内科医院感染管理规范并予督查,实施目标性监测.结果 通过对医院感染的干预,呼吸内科的医院感染率与例次感染率分别从2008年的3.63%与3.81%下降至2010年的1.81%与1.92%.结论 多途径加强呼吸科医院感染管理,是提高医疗质量、确保呼吸内科患者安全的可靠保证.

  11. Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India

    OpenAIRE

    2015-01-01

    Background: The increased morbidity and mortality associated with nosocomial infections in the intensive care unit (ICU) is a matter of serious concern today. Aims: To determine the incidence of nosocomial infections acquired in the ICU, their risk factors, the causative pathogens and the outcome in a tertiary care teaching hospital. Materials and Methods: This was a prospective observational study conducted in a 12 bedded combined medical and surgical ICU of a medical college hospital. The s...

  12. Clinical study on intervention of nosocomial infection in department of neurology%神经内科医院感染干预的临床研究

    Institute of Scientific and Technical Information of China (English)

    管晓芸; 张素梅; 孙健龙; 张仁仙

    2012-01-01

    OBJECTIVE To discuss high-risk factors for nosocomial infections in department of neurology and to explore intervention methods so as to decrease nosocomial infections. METHODS Nosocomial infection administration department established management protocols of nosocomial infection in department of neurology. Targeted surveillance of nosocomial infections was performed. RESULTS By means of intervening nosocomial infections, the rate of nosocomial infections in department of neurology decreased gradually from 2007 to 2010. CONCLUSION It ensures medical quality and patient safety in department of neurology if multiple ways are implemented to strengthen the management of nosocomial infections in neurology department.%目的 针对神经内科医院感染发生的高危因素,探讨干预方法,减少神经内科医院感染的发生.方法 医院感染管理部门,建立神经内科医院感染管理规范并予督查,实施目标性监测,干预医院感染的发生.结果 通过对神经内科医院感染的干预,2007-2010年神经内科的医院感染率逐年下降.结论 多途径加强神经内科医院感染管理,是提高医疗护理质量、确保神经内科患者安全的可靠保证.

  13. Resistance Pattern of Antibiotics in Patient Underwent Open Heart Surgery With Nosocomial Infection in North of Iran.

    Science.gov (United States)

    Davoudi, Alireza; Najafi, Narges; Alian, Shahriar; Tayebi, Atefe; Ahangarkani, Fatemeh; Rouhi, Samaneh; Heydari, Amirhosein

    2015-08-06

    Patients who undergo cardiac surgery appear to be at increased risk for the development of Nosocomial infections (NIs). The development of antibiotic-resistant infections has been associated with significantly greater hospital mortality rates compared to similar infections caused by antibiotic-sensitive pathogens. The purpose of this study is survey of Nis and antibiotic resistance patterns of causative bacteria among patients who underwent open heart surgery in the north of Iran during a 2-year period between September 2012 and September 2014. In this cross-sectional study we evaluated 187 patients that underwent open heart surgery with NIs. Demographic feature, clinical characteristics and risk factors of each infection were recorded. The antibiotic susceptibility test was performed using the Minimum inhibitory concentration (MIC) method according to the standard protocol of Clinical & Laboratory Standards Institute (CLSI). Detection of Extended-spectrum beta-lactamase (ESBL) producing bacteria was performed by the double-disk synergy (DDS) test; also Methicillin-resistant Staphylococcus (MRSA) strains were identified by MRSA Screen Agar. The collected data were analyzed using the SPSS software (ver. 16) and, descriptive statistics were used. Out Of total of 2253 hospitalized patients who underwent open heart surgery, 187(5.05%) patients had NIs. 51.9% of the patients were female. The rates of surgical site infection (SSI), respiratory tract infection, endocarditis, Urinary tract infection (UTI), blood Infection and mediastinitis were 27.80, 25.66%, 17.64, 17.11% 8.55% and 3.20% respectively. E.coli and S.aureus were the most causative agents of NIs. The rate of ESBL-producing bacteria was 14.28- 71.42% among enterobacteriaceae and the rate of MRSA was 54.2% among S.aureus strains. All isolated Acinetobacter.spp were Multi-drug resistance (MDR). We showed that the rate of NIs among these high-risk patients was in the average level. But the emergence of MRSA and

  14. Trend of drug resistance andβ-lactamase genes in Klebsiella pneumoniae causing nosocomial infection%医院感染肺炎克雷伯菌耐药趋势及β-内酰胺酶基因型分析

    Institute of Scientific and Technical Information of China (English)

    张虎; 闫中强; 曹晋桂; 杨得明; 吴镝; 刘芳; 马文杰; 刘运喜

    2014-01-01

    目的:了解医院重症监护病房2009-2013年医院感染肺炎克雷伯菌的耐药趋势以及10种β-内酰胺酶耐药基因的分布,为临床正确选择抗菌药物提供依据。方法 K-B法检测165株肺炎克雷伯菌对20种抗菌药物的耐药性,PCR方法检测:CTX-M、TEM、SHV、GES、KPC、IMI、IMP、VIM、NDM、GIM耐药基因。结果 ICU 5年共分离165株肺炎克雷伯菌,产ESBLs菌株88株,KPN对三代头孢菌素的耐药率逐年升高;自2011年出现碳青霉烯耐药的菌株,耐药率约10.0%;114株扩增到耐药基因片段,检测出 CTX-M、TEM、SHV、KPC共4种耐药基因,165个基因片段;最主要的耐药基因型为 SHV型,占46.5%。结论产ESBLs菌株的增加和耐碳青霉烯肺炎克雷伯菌的出现,应引起高度重视,关注细菌的变迁和耐药性变化,并合理选用抗菌药物治疗。%OBJECTIVE To understand the trend of drug resistance and the distribution of 10 kinds of β-lactamase drug resistance genes in the K lebsiella pneumoniae causing nosocomial infection in intensive care unit from 2009 to 2013 so as to provide guidance for reasonable clinical use of antibiotics .METHODS The drug resistance of 165 strains of K . pneumoniae to 20 antibiotics was determined by using K-B method ,and the PCR method was employedtodetectthedrugresistancegenes,includingCTX-M,TEM,SHV,GES,KPC,IMI,IMP,VIM, NDM ,and GIM .RESULTS A total of 165 strains of K .pneumoniae have been isolated from ICUs in the 5 years , including 88 ESBLs-producing strains . The drug resistance rate of the K . pneumoniae strains to the third generation cephalosporins was increased year by year .The carbapenem-resistant strains have emerged since 2011 , and the drug resistance rate was about 10 .0% .The drug resistance gene fragments were amplified for 114 strains , and 4 kinds of drug resistance genes were detected ,including CTX-M , TEM , SHV ,and KPC ,165 gene fragments in total; the SHV was the

  15. 老年患者医院感染产ESBLs及AmpC酶肺炎克雷伯菌检测及耐药性分析%Detection of ESBLs-and AmpC-producing Klebsiella pneumoniae causing nosocomial infections in eldely hospitalized patients and analysis of drug resistance

    Institute of Scientific and Technical Information of China (English)

    郑素君

    2013-01-01

    OBJECTIVE To understand the status of ESBLs- and AmpC-producing Klebsiella pneumoniae causing nosocomial infections in the elderly hospitalized patients so as to guide the clinical medication. METHODS The case-control study was conducted for the elderly hospitalized patients in 2011, and the ESBLs- and AmpC-producing K. pneumoniae isolated from various clinical specimens were collected, then the detection rate and the drug resistance were analyzed. RESULTS There were totally 97 strains of K. pneumoniae isolated from various specimens obtained from the elderly hospitalized patients, among which there were 29 (29. 9%) strains of ESBLs-producing isolates and 16 (16. 5%) strains of AmpC-producing isolates, and there were 8 (8. 3%) strains of ESBLs- and AmpC-producing isolates. The drug susceptibility testing result indicated that the enzyme-producing and non-anzyme-producing strains were 100% sensitive to imipenem and were highly resistant to the rest of the beta-lactam antibacterials cephalosporins, the drug resistance rate of the enzyme-producing strains was higher than that of the non-enzyme-producing strains,and the drug resistance rate of the ESBLs- and AmpC-producing stains was higher than that of the ESBLs-producing or AmpC-producing strains. CONCLUSION The detection rates of the ESBLs-producing K. pneumoniae and the AmpC-producing K. pneumoniae as well as the ESBLs-and AmpC-producing strains are high,and the enzyme-producing strains are multidrug-resistant.%目的 了解老年住院患者在医院感染肺炎克雷伯菌产ESBLs及AmpC酶的情况,为临床用药提供参考.方法 对2011年高龄住院患者进行病例剖析,整理出各类标本中分离的肺炎克雷伯菌单产ESBLs、AmpC酶和同产ESBLs及AmpC酶菌株的检出率及耐药性.结果 从老年住院患者各类标本中共分离到肺炎克雷伯菌97株,单产ESBLs 29株,占29.9%,单产AmpC酶16株,占16.5%,同产ESBLs及AmpC酶8株,占8.3%;产酶与非产酶菌

  16. Epidemiology of nosocomial infections and mortality following congenital cardiac surgery in Cairo University, Egypt.

    Science.gov (United States)

    El Tantawy, Amira Esmat; Seliem, Zeinab Salah; Agha, Hala Monir; El-Kholy, Amany Ali; Abdelaziz, Doaa Mohamed

    2012-08-01

    Nosocomial infections (NI) have been associated with significant morbidity and attributed mortality, as well as increased healthcare costs. Relatively few data on congenital cardiac surgical ICU NI have been reported from developing countries. Little is known about the epidemiology of NI following congenital cardiac surgery in Egypt. The aims of the present study were: (a) to estimate the incidence rate and types of NI among children admitted to Pediatric Surgical Cardiac ICU in Cairo University Children's Hospital (Egypt) and (b) to estimate the mortality rate related to congenital cardiac surgery and identify its contributing risk factors. A follow-up study in the period between 1 January 2009 and 1 January 2010 included all patients admitted to the Pediatric Surgical Cardiac ICU in Cairo University, Abo El Reesh Children's Specialized Hospital (Egypt). Data were collected for each patient during the preoperative, intraoperative, and postoperative periods. Certain infection control procedures were carried out in certain months. Of 175 patients, NI were identified in 119 (68%). Poor hand hygiene was associated with increased NI in certain months of the study duration. NI were significantly higher at a younger age [median 9 (5-30) months, Plesions, prolonged cardiopulmonary bypass and ischemic times, NI, prolonged mechanical ventilation, prolonged central line insertion, and the use of total parenteral nutrition. Mortality among the NI patients was found in 44 of 119 (37%). On carrying out a multivariate analysis, Acute Physiology and Chronic Health Evaluation II score [PUniversity Children's Hospital (Cairo, Egypt). Early surgical interference, enforcement of proper infection control practices, especially hand hygiene, can reduce NI and trials for early extubation from mechanical ventilation might improve outcome following congenital cardiac surgery in pediatrics.

  17. Hepatitis B and C virus infection among hemodialysis patients in Yogyakarta, Indonesia: Prevalence and molecular evidence for nosocomial transmission.

    Science.gov (United States)

    Rinonce, Hanggoro Tri; Yano, Yoshihiko; Utsumi, Takako; Heriyanto, Didik Setyo; Anggorowati, Nungki; Widasari, Dewiyani Indah; Lusida, Maria Inge; Soetjipto; Prasanto, Heru; Hotta, Hak; Hayashi, Yoshitake

    2013-08-01

    Hemodialysis patients are at an increased risk of acquiring hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. However, the prevalence of hepatitis viral infection and its genotype distribution among hemodialysis patients in Indonesia are unclear. In order to investigate these issues and the possibility of nosocomial transmission, 161 hemodialysis patients and 35 staff members at one of the hemodialysis unit in Yogyakarta, Indonesia, were tested for serological and virological markers of both viruses. HBV surface antigen (HBsAg) was detected in 18 patients (11.2%) and in two staff members (5.7%). Anti-HCV was detected in 130 patients (80.7%) but not in any staff members. Occult HBV and HCV infection were detected in 21 (14.7%) and 4 (12.9%) patients, respectively. The overall prevalence rates of HBV and HCV infection among patients were 24.2% and 83.2%, respectively. HCV infection was independently associated with hemodialysis duration and the number of blood transfusions. Phylogenetic analysis revealed that 23 of 39 tested HBV strains (59%) were genotype B, 11 (28.2%) were genotype C, and 5 (12.8%) were genotype A. HCV genotype 1a was dominant (95%) among 100 tested HCV strains. Nosocomial transmission was suspected because the genotype distribution differed from that of the general population in Indonesia, and because the viral genomes of several strains were identical. These findings suggest that HBV and HCV infection is common among hemodialysis patients in Yogyakarta, and probably occurs through nosocomial infection. Implementation of strict infection-control programs is necessary in hemodialysis units in Indonesia.

  18. 儿内科医院感染的调查分析%Investigation of nosocomial infections in pediatric department

    Institute of Scientific and Technical Information of China (English)

    谢妙金; 冯奂

    2012-01-01

    目的 了解2006-2010年儿内科医院感染的部位及抗菌药物应用情况,调查感染因素和医院感染管理中存在问题,为较好控制医院感染提供科学依据.方法 回顾性调查分析2006-2010年发生医院感染住院患儿临床资料.结果 13701例住院患儿医院感染211例,感染率为1.54%;以上呼吸道感染居首位,占61.61%,其次为胃肠道、口腔和下呼吸道感染等,占17.06%、13.75%、4.74%;211例发生医院感染患儿中1月龄~1岁的患儿占47.39%、1~2岁占34.12%、>2岁占18.49%;住院天数<7d的占13.75%,7~10 d占31.75%,≥10 d占54.50%;211例患儿中,170例使用抗菌药物,使用率为80.57%.结论 加强儿内科医院感染控制,缩短住院时间,提高患儿住院周转率,增强手卫生意识,控制好环境卫生,合理应用抗菌药物,根据病原学特点和药敏试验选择抗菌药物.%OBJECTIVE To explore the nosocomial infection sites and the infection status as well as the use of antibiotics in pediatric department from 2006 to 2010 and investigate the related factors and the problems in management of nosocomial infections so as to provide basis for the control of nosocomial infections. METHODS The hospitalized children with nosocomial infections from 2006 to 2010 were retrospectively analyzed. RESULTS There were 211 case-times of patients with nosocomial infections among 13 701. hospitalized children, the case-time infection rate was 1. 54%; the major infection site was upper respiratory tract, accounting for 61. 61%, followed by gastrointestinal tract (17. 06%) , oral cavity (13. 75%) and lower respiratory tract (4. 74%) ; of 211 children with nosocomial infections, the children aged from 1 month to lyear old accounted for 47. 39%, 1 - 2 years old 34. 12% , more than 2 years old 18. 49% ; the children with the hospital stay less than 7 days accounted for 13. 75% , 7 - 10 days 54. 50% , more than 10 days 54. 50%; of 211 children, 170

  19. Resistance patterns of nosocomial urinary tract infections in urology departments: 8-year results of the global prevalence of infections in urology study.

    Science.gov (United States)

    Tandogdu, Zafer; Cek, Mete; Wagenlehner, Florian; Naber, Kurt; Tenke, Peter; van Ostrum, Edgar; Johansen, Truls Bjerklund

    2014-06-01

    To present the worldwide antibiotic resistance rates of uropathogens reported in nosocomial urinary tract infections (NAUTI) during the period of 2003-2010. Data from the Global Prevalence Study of Infections in Urology from the period of 2003-2010 were analyzed to evaluate the resistance rates of pathogens causing NAUTI. The web-based application was used to record data of investigators from urology departments participating in the study every year during the days allocated in November. Each center was allowed to enter data on a single day of the study. The point prevalence data was used to find differences among geographic regions and years by utilizing multiple logistic regression analysis. A total of 19,756 patients were hospitalized during the study period, and in 1,866 of them, NAUTI was reported. Proof of infection was reported in 1,395 patients. Resistance rates of all antibiotics tested other than imipenem against the total bacterial spectrum were higher than 10 % in all regions. Resistance to almost all pathogens was lowest in North Europe, and there is no single year where an outbreak of resistance has been detected. The resistance rates of most of the uropathogens against the antibiotics tested did not show significant trends of increase or decrease with Asia exhibiting the highest rates in general. The only antibiotic tested with an overall resistance rate below 10 % was imipenem. Knowledge of regional and local resistance data and prudent use of antibiotics are necessary to optimize antibiotic therapy in urological patients with NAUTI.

  20. Predictive value of oral colonization by Candida yeasts for the onset of a nosocomial infection in elderly hospitalized patients.

    Science.gov (United States)

    Fanello, S; Bouchara, J P; Sauteron, M; Delbos, V; Parot, E; Marot-Leblond, A; Moalic, E; Le Flohicc, A M; Brangerd, B

    2006-02-01

    The incidence of nosocomial yeast infections has increased markedly in recent decades, especially among the elderly. The present study was therefore initiated not only to determine the predictive value of oral colonization by yeasts for the onset of a nosocomial Candida infection in elderly hospitalized patients (> 65 years), but also to clarify the factors that promote infection and to establish a relationship between the intensity of oral carriage and the onset of yeast infection. During this prospective cohort study, 256 patients (156 women and 100 men with a mean age of 83 +/- 8 years) were surveyed for yeast colonization or infection. Samples were collected every 4 days from day 0 to day 16 from four sites in the mouth, and intrinsic and extrinsic factors that might promote infection were recorded for each patient. Pulsed field gel electrophoresis was performed on Candida albicans isolates from all infected patients. Poor nutritional status was observed in 81 % of the patients and hyposalivation in 41 %. The colonization level was 67 % on day 0 (59 % C. albicans) and a heavy carriage of yeasts (> 50 c.f.u.) was observed for 51 % of the patients. The incidence of nosocomial colonization reached 6.9 % on day 4 (6.1 % on day 8 and 2.7 % on day 12), and that of nosocomial infection was 3.7 % on day 4 (6.8 % on day 8, 11.3 % on day 12 and 19.2 % on day 16). Of the 35 patients infected, 57 % were suffering from oral candidiasis. The principal risk factors for colonization were a dental prosthesis, poor oral hygiene and the use of antibiotics. The risk factors for infection, in addition to those already mentioned for colonization, were endocrine disease, poor nutritional status, prolonged hospitalization and high colony counts. Genotyping revealed person-to-person transmission in two patients. Thus, this study demonstrates a significant association between oral colonization and the onset of yeast infections in elderly hospitalized patients. Therefore, oral samples

  1. [Quality indicators pertinence and limits in medicine: example of nosocomial infections].

    Science.gov (United States)

    Petitmermet, D; Troillet, N; Wasserfallen, J B

    2001-11-01

    Insuring that quality indicators really measure quality of care and not other factors, such as the type of intervention or the patients' characteristics, is notoriously difficult. In order to avoid as much as possible these potential methodological pitfalls, the association FoQual (www.hospvd.ch/quality/foqual) requested in the year 2000 the opinion of experts on the scientific value of some indicators, considered for introduction into practice by the commission on quality of care representing the Swiss hospital association and the health insurers' association (H+/CAMS), as well as on theoretical and practical aspects essential to guarantee their efficiency. The expert group Swiss-NOSO (www.hospvd.ch/swiss-noso) was asked to assess the indicator "nosocomial infection". This example illustrates some pitfalls to avoid, the importance of including infectious surveillance into a global prevention program and ask professionals with a specific training and independence from hospital wards to perform this activity. It shows the complexity of setting up and exploiting quality indicators in health care and the side effects that they might have.

  2. 2014年医院感染现患率调查分析%Investigation and analysis of prevalence rate of nosocomial infections in 2014

    Institute of Scientific and Technical Information of China (English)

    朱小芳; 赵霞; 郑润菊; 郭改平; 吴艳芳

    2015-01-01

    .00% .The nosocomial infections occurred in 29 (30 case‐times) cases with the infection rate of 3 .29% and the case‐time infection rate of 3 .40% .The utilization rate of an‐tibiotics was 30 .50% ,and the submission rate of microorganisms was 49 .80% .Of the patients with infections , 31 .00% had the lower respiratory tract infections ,and 27 .50% had the urinary tract infections .The Pseudomonas aeruginosa and Acinetobacter baumannii were the predominant species of pathogens causing infections ,and both accounted for 18 .20% ,respectively .Of the 882 patients ,269 have used antibiotics ,with the utilization rate of 30 .50% ;the patients who used antibiotics for treatment accounted for 66 .54% ,the patients who used antibiotics for prophylaxis accounted for 22 .30% ,and the patients who used antibiotics for treatment plus prophylaxis ac‐counted for 11 .15% ;the patients who received one‐drug therapy accounted for 81 .04% ,the patients who received two‐drug therapy accounted for 18 .59% ,and the patients who received three‐drug therapy accounted for 0 .37% ;the submission rate was 49 .80% .CONCLUSION The survey of prevalence rate of nosocomial infections may reflect the actual status and development trend of the nosocomial infections and guide the targeted monitoring of predispo‐sing factors so as to reduce the infection rate and prevent the nosocomial infections .

  3. CURRENT ASPECTS OF NOSOCOMIAL LEGIONELLOSIS PROFILAXIS

    Directory of Open Access Journals (Sweden)

    I. S. Tartakovsky

    2010-01-01

    Full Text Available The nosocomial or hospital acquired infections is one of the most important medical and social problem. Mo- dern strategy of nosocomial infections prevention include prevention of nosocomial legionellosis. Epidemic outbreaks of nosocomial legionellosis with high mortality rate (20–40% were recognized last years in different countries. The contaminated by Legionella hospital hot water supply system is a source of Legionella infection outbreaks. A risk reduction strategy of waterborne pathogens in hospital water system is important part of mo- dern conception of nosocomial infection prevention, especially among immune compromised patient including transplant patients. In revue discussed different aspects of epidemiology, laboratory diagnostic and prevention of nosocomial legionellosis. 

  4. Role of nursing management in control of nosocomial infection%护理管理在医院感染控制中的作用

    Institute of Scientific and Technical Information of China (English)

    杨风萍; 吴文

    2011-01-01

    目的 探讨护理管理在医院感染控制中的作用,确保医院感染控制措施在临床工作中的实施,提高护理质量.方法护理部与医院感染科配合,制定完善制度和质量标准,将医院感染知识培训和教育纳入常规业务学习计划,规范护理行为;并把医院感染控制工作纳入护理管理,作为护理质量的评价指标之一.结果护理人员对医院感染控制知识及重视程度有较大提高,执行医院感染防控各项制度、措施的自觉性增强.结论护理工作贯穿于预防医院感染控制的各环节,抓好护理管理是控制医院感染的有效手段,加强护理管理对控制医院感染具有重要的促进作用,并能规范护士行为,可有效预防医院感染的发生.%OBJECTIVE To study the role of nursing management in the nosocomial infection control, ensure the implementation of nosocomial infection control measures in the clinical work, and improve the quality of care. METHODS Nursing department collaborated with department of nosocomial infection to formulate and improve regulations and quality standards, to put the training and education of nosocomial infection knowledge into the routine business learning program, and regulate nursing behavior. The nosocomial infection work was put into the whole process of nursing managements and made it one of the q-ualities of care evaluation. RESULTS The knowledge and attention on nosocomial infection control greatly, and improved the consciousness of implementation of nosocomial infection prevention and control measures were improved. CONCLUSION Putting nursing work into the various aspects of infection control and grasping of nursing management are effective means of control of nosocomial infection. Enhanced care management has an important role in promoting the control of nosocomial infection, regulating nurse behavior, and effectively preventing the occurrence of nosocomial infection.

  5. Risk factors for nosocomial infections due to carbapenem-resistant Acinetobacter baumannii%耐碳青霉烯类鲍氏不动杆菌医院感染风险分析

    Institute of Scientific and Technical Information of China (English)

    孙吉花; 于苏国; 赵爱荣; 姜雪锦; 邱会芬; 陈建伟; 纪冰; 邢敏

    2015-01-01

    OBJECTIVE To identify the risk factors for nosocomial infections caused by carbapenem-resistant Acine-tobacter baumannii (CRAB) so as to provide guidance for the effective prevention and treatment .METHODS By means of case control study ,the clinical data were collected from 37 patients with CRAB nosocomial infections and 30 patients with carbapenem-sensitive Acinetobacter baumannii (CSAB) nosocomial infections who were treated in the hospital from May 2014 to May 2015 .The non-conditional logistic regression model was established to predict the risk for the CRAB nosocomial infections .RESULTS Of 68 strains of A .baumannii causing the nosocomial infec-tions ,38 were CRAB ,accounting for 55 .88% .Among the patients with CRAB nosocomial infections ,48 .64%were from the ICU ,and 43 .24% were from the neurosurgery department ;the patients with lower respiratory tract infections accounted for 71 .05% .The incidence of CRAB nosocomial infections was associated with the ICU stay (OR= 26 .244)and use of carbapenems before the patients had the infections (OR= 9 .488)(P< 0 .05) . CONCLUSION The ICU stay and use of carbapenems before the infections are the independent risk factors for the CRAB nosocomial infections .It is important to intensify the prevention measures of nosocomial infections in the ICU and reasonably use carbapenems so as to prevent the CRAB .%目的 识别耐碳青霉烯类鲍氏不动杆菌(CRAB)医院感染的风险关键控制点 ,为有效预防控制及治疗提供参考依据.方法 采用病例对照研究 ,收集2014年5月-2015年5月CRAB医院感染患者37例以及碳青霉烯类敏感鲍氏不动杆菌(CSAB)医院感染患者30例的临床资料 ,构建非条件 logistic回归模型分析 ,预测CRAB医院感染风险.结果 68株医院感染鲍氏不动杆菌中CRAB 38株占55 .88% ;CRAB感染的科室及感染部位分布均比较集中 ,ICU及神经外科在48 .64% 和43 .24% ,下呼吸道感染占71 .05% ;入住ICU (OR=26 .244)和感染前

  6. Hospital-acquired influenza: a synthesis using the Outbreak Reports and Intervention Studies of Nosocomial Infection (ORION) statement.

    Science.gov (United States)

    Voirin, N; Barret, B; Metzger, M-H; Vanhems, P

    2009-01-01

    Nosocomial influenza outbreaks occur in almost all types of hospital wards, and their consequences for patients and hospitals in terms of morbidity, mortality and costs are considerable. The source of infection is often unknown, since any patient, healthcare worker (HCW) or visitor is capable of transmitting it to susceptible persons within hospitals. Nosocomial influenza outbreak investigations should help to identify the source of infection, prevent additional cases, and increase our knowledge of disease control to face future outbreaks. However, such outbreaks are probably underdetected and underreported, making routes of transmission difficult to track and describe with precision. In addition, the absence of standardised information in the literature limits comparison between studies and better understanding of disease dynamics. In this study, reports of nosocomial influenza outbreaks are synthesised according to the ORION guidelines to highlight existing knowledge in relation to the detection of influenza cases, evidence of transmission between patients and HCWs and measures of disease incidence. Although a body of evidence has confirmed that influenza spreads within hospitals, we should improve clinical and virological confirmation and initiate active surveillance and quantitative studies to determine incidence rates in order to assess the risk to patients.

  7. Nosocomial infections and fever of unknown origin in pediatric hematology/oncology unit: a retrospective annual study.

    Science.gov (United States)

    Al-Tonbary, Youssef A; Soliman, Othman E; Sarhan, Mohammed M; Hegazi, Moustafa A; El-Ashry, Rasha A; El-Sharkawy, Ashraf A; Salama, Osama S; Yahya, Raida

    2011-02-01

    pediatric hematology/oncology patients are faced with an increased risk of nosocomial infections (NIs) that vary in different populations and different institutions with considerable morbidity and mortality. This study was undertaken to assess the frequency and patterns of NIs in 1564 pediatric patients and to determine the prevalence of causative organisms and their antimicrobial sensitivity. a retrospective analysis was made in the patients admitted between January 2007 and January 2008 to the pediatric hematoloy/oncology unit of Mansoura University, Egypt. The 1564 patients showed 2084 admissions and 27 092 inpatient days. The Centers for Disease Control and Prevention criteria were used as a standard definition for NI. the overall rate of NIs in all patients and neutropenic patients was 8.6 and 25.3 per 1000 patient-days respectively. The frequent sites of NIs were blood stream (42.7%), the respiratory system (25.3%), the urinary system (22.2%) and the central nervous system (9.8%), whereas nosocomial fever of unknown origin constituted 52.9% of cases. The incidence of NIs was significantly higher during neutropenic days (Pfever of unknown origin are the most common nosocomial infections in pediatric hematology/oncology patients with a higher risk during neutropenic days. Isolated organisms are multi-drug resistant, predominantly Gram-positive pathogens with a high incidence of methicillin-resistant S. aureus, extended spectrum beta lactamase and vancomycin resistant enterococci organisms.

  8. Extended-spectrum beta-lactamase-producing Escherichia coli infections in children: are community-acquired strains different from nosocomial strains?

    Science.gov (United States)

    Morgand, Marjolaine; Vimont, Sophie; Bleibtreu, Alexandre; Boyd, Anders; Thien, Hoang Vu; Zahar, Jean-Ralph; Denamur, Erick; Arlet, Guillaume

    2014-11-01

    Infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli are an important cause of morbidity and mortality, especially in children. We compared 58 epidemiologically unrelated ESBL-producing E. coli strains that caused infections. They were isolated between 2008 and 2012 in two Parisian pediatric hospitals and grouped according to their origin into either community-acquired (CA) (n=37) or nosocomially acquired (NA) (n=21) strains. Molecular characteristics of the ESBLs, phylogenetic traits of the strains including their belonging to clone O25b-ST131, prevalence of associated virulence genes, growth capacities in different media, metabolic phenotype and biofilm formation abilities were studied. ESBL type, associated resistance and distribution of phylogenetic groups were similar in the CA and NA groups. More than 60% of the B2 phylogroup strains in both groups belonged to the ST131 clone. Interestingly, CA strains possessed more genes encoding virulence factors and the distribution of these genes differed significantly between the two groups: fyuA, hlyC, papC and papGII were more frequent in the CA group, whereas iroN was more frequent in the NA group. CA strains also showed enhanced growth capacities in Luria Bertani rich medium. They tended to produce more biofilm but the difference was not significant. This study confirms the wide spread of clone ST131 among infected children, regardless of whether their infections were community- or nosocomially acquired. It highlights genotypic and phenotypic differences according to the origin of the strains that could indicate adaptability of these multi-resistant bacteria to specific environmental and host factors. Copyright © 2014 Elsevier GmbH. All rights reserved.

  9. [Guidelines for a prevalence survey of nosocomial infections in the University Hospital "Madre Teresa" in Tirana, Albania].

    Science.gov (United States)

    Sodano, L; Faria, S; Gjata, A; Kasneci, A; Byku, B; Schinaia, N

    2003-01-01

    The authors present guidelines for the first prevalence survey of nosocomial infections in the University Hospital "Madre Teresa" in Tirana (almost 1,600 beds), the only tertiary health-care centre in Albania. The survey is a joint project involving Italy and Albania, to be coordinated by the Italian National Health Institute. The paper describes goals, methodology and organization of the prevalence survey. The improvement of local expertise in epidemiology and microbiology is one of the most important goals. Therefore, Albanian personnel training and improvement of the infection microbiological diagnosis are fundamental aspects of the project.

  10. Clinical analysis of nosocomial infection in cancer patients%恶性肿瘤患者院内感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈银巧; 黄金莲

    2009-01-01

    Objective To investigate the characteristics of nosocomial infection in cancer patients. Methods 329 cases of patients of cancer with nosocomial infection were analysed retrospectively. Results The rates of nosocomial infection were high in the cancer patients of long time in hospital, old patients and advanced stage disease. The primary site of infection was respiratory canal. The conditioned pathogenic bacteria were the main pathogens in nosocomial infection with cancer, and the bacterial drug resistance was not optimisficai. Conclusions Nosocomial infections should be moni-tored among the hospitalized patients. The characteristics of nosocomial infections should be observed, and antibiotic drug should be used rationally, so as to reduce the incidence of nosocomial infections.%目的 探讨恶性肿瘤患者发生院内感染的特点.方法 对恶性肿瘤发生院内感染的329例患者进行回顾性分析.结果 住院日长、老年人和晚期肿瘤患者院内感染的比例较高,感染部位以呼吸系统多见,病原菌主要为条件致病菌,其耐药情况不容乐观.结论 对住院的恶性肿瘤患者应监测有无院内感染的发生,注意其特点,合理使用抗生素,减少院内感染的发生率.

  11. Bugs, hosts and ICU environment: countering pan-resistance in nosocomial microbiota and treating bacterial infections in the critical care setting.

    Science.gov (United States)

    Maseda, Emilio; Mensa, José; Valía, Juan-Carlos; Gomez-Herreras, José-Ignacio; Ramasco, Fernando; Samso, Enric; Chiveli, Miguel-Angel; Pereira, Jorge; González, Rafael; Aguilar, Gerardo; Tamayo, Gonzalo; Ojeda, Nazario; Rico, Jesús; Giménez, María-José; Aguilar, Lorenzo

    2014-03-01

    ICUs are areas where resistance problems are the largest, and these constitute a major problem for the intensivist's clinical practice. Main resistance phenotypes among nosocomial microbiota are (i) vancomycin-resistance/heteroresistance and tolerance in grampositives (MRSA, enterococci) and (ii) efflux pumps/enzymatic resistance mechanisms (ESBLs, AmpC, metallo-betalactamases) in gramnegatives. These phenotypes are found at different rates in pathogens causing respiratory (nosocomial pneumonia/ventilator-associated pneumonia), bloodstream (primary bacteremia/catheter-associated bacteremia), urinary, intraabdominal and surgical wound infections and endocarditis in the ICU. New antibiotics are available to overcome non-susceptibility in grampositives; however, accumulation of resistance traits in gramnegatives has led to multidrug resistance, a worrisome problem nowadays. This article reviews microorganism/infection risk factors for multidrug resistance, suggesting adequate empirical treatments. Drugs, patient and environmental factors all play a role in the decision to prescribe/recommend antibiotic regimens in the specific ICU patient, implying that intensivists should be familiar with available drugs, environmental epidemiology and patient factors.

  12. Epidemiological characteristics of nosocomial diarrhea caused by Clostridium difficile in a tertiary level hospital in Serbia

    Directory of Open Access Journals (Sweden)

    Šuljagić Vesna

    2013-01-01

    Full Text Available Introduction. Among the most important causes of diarrhea in modern hospitals is Clostridium difficile (C. difficile. A wide spectrum of diseases caused by this bacterium is now known as C. difficile associated disease (CDAD. The development of CDAD is usually preceded by the administration of antimicrobial therapy and fecal-oral infections with C. difficile. Over the last years epidemiology of CDAD has significantly changed. Recently, a hypervirulent BI/NAP1/027 strain, the cause of severe epidemics in North America and Western Europe, has been identified. Objective. The aim of this study was to identify risk factors for CDAD in patients operated on at the Military Medical Academy (MMA. Methods. The study included all patients who underwent surgery at the MMA during 2010. Nested case-control study design was used. The subjects were divided into groups of operated patients with and without CDAD. The patients were under prospective follow-up, while their data were collected using a questionnaire during a routine epidemiological control. Results. During 2010 the incidence rate of CDAD was 3.3 per 10,000 hospital days. Univariate regression analysis showed that the length of administration of one or two antibiotics, as well as concurrent administration of two antibiotics, were far more frequently observed in the patients with than in the patients without CDAD. Independent risk factor for the development of CDAD was the length of the administration of one antibiotic. Conclusion Reduction in the incidence rate of CDAD can be achieved by using reliable measures of prevention and control; the rational use of antibiotics, early diagnosis and therapy of infected patients, contact isolation of infected persons, proper disinfection, and continued education of medical and non-medical personnel.

  13. Nosocomial infection after laparoscopic radical resection of rectal cancer and related nursing strategies%腹腔镜下直肠癌根治术后医院感染的临床分析及护理对策

    Institute of Scientific and Technical Information of China (English)

    刘圣芳; 刘新国

    2014-01-01

    Objective To analyze the factors causing nosocomial infection after laparoscopic radical resection of rectal caner ,and to summarize relevant nursing strategies .Methods A total of 152 patients with nosocomial infection after laparoscopic radical resection of rectal caner (observation group) and 150 patients without nosocomial infection after laparoscopic radical resection of rectal caner (control group) were enrolled and the related clinical data were ret-rospectively analyzed .Results The main factors causing nosocomial infection after laparoscopic radical resection of rectal caner included age (more than 60 years old ,accounting for 88 .2% ) ,primary disease (accounting for 69 .1% ) and surgery time (more than 3 h ,accounting for 71 .1% ) .Conclusion Advanced age ,primary disease and surgery time could be main factors causing nosocomial infection after laparoscopic radical resection of rectal caner ,and targe-ted treatment and care should be taken to reduce the incidence rate of nosocomial infection .%目的:观察分析腹腔镜下直肠癌根治术后医院感染情况及感染因素,总结相关护理对策。方法选取奉节县人民医院直肠癌医院感染患者152例为观察组。选择同期没有并发医院感染的150例腹腔镜直肠癌根治术手术患者作为对照组,比较两组患者临床资料。结果导致腹腔直肠癌根治术后医院感染的高危因素包括:年龄大于60岁占88.2%,具有基础疾病占69.1%,手术时间超过3 h占71.1%。结论高龄、具有基础疾病、住院时间长、手术时间长等是导致腹腔镜直肠癌根治术患者发生医院感染的高危因素,临床治疗中应针对上述高危因素采取针对性治疗护理措施,以期降低医院感染率。

  14. FACTORS OF NOSOCOMIAL INFECTION IN INTENSIVE CARE UNIT AND INTERVENTION%重症监护病房医院感染因素分析及干预

    Institute of Scientific and Technical Information of China (English)

    安辉

    2011-01-01

    [Objective]To investigate the intensive care unit (ICU) patients with features of nosocomial infection, and provide reliable basis for effective hospital infection prevention and control in ICU.[Methods]By retrospective survey methods, we collected 380 cases of hospitalized patients with nosocomial infection from February 2008 - February 2009 in the ICU department of our hospital.[Results]Among 380 patients, 112 cases occurred nosocomial infection, the infectious rate was 29.47%; The incidence of nosocomial infections showed different in different diseases.The cerebral vascular diseases and respiratory diseases had the highest incidence of nosocomial infection, followed by respiratory tract infection, which accounted for 54.46%.The followed diseases were urinary tract and digestive tract; hospital stay, invasive procedures and hospital infections were closely related to nosocomial infection.[Conclusion]The incidence of nosocomial infection showed high in ICU patients, it is necessary to make clear of the risk factors of ICU-related nosocomial infection, and is beneficial to take further effective measures to reduce the incidence of ICU patients with nosocomial infection.%[目的]探讨重症监护病房(ICU)患者医院感染特点,为有效预防与控制ICU医院感染提供可靠依据.[方法]采用回顾性调查的方法,对2008年2月~2009年2月于我院ICU住院治疗的380例患者进行医院感染因素分析.「结果]380例患者中发生医院感染112例次,例次感染率为29.47%;不同基础疾病院内感染发生率不同,其中以脑血管疾病和呼吸系统疾病医院感染发生率最高;感染的部位以下呼吸道感染最多占54.46%,其次为泌尿道及消化道;住院时间、侵入性操作与医院感染关系密切.[结论]ICU息者医院感染发生率高,明确ICU医院感染相关危险因素,有利于进一步采取有效措施,减少ICU患者医院感染的发生.

  15. SHEL 事故分析模型对预防小儿术后医院感染的可行性分析%Study on feasibility of SHEL model in prevention of postoperative nosocomial infections in children

    Institute of Scientific and Technical Information of China (English)

    周叶青; 王慧聪; 何佳; 骆燕燕

    2015-01-01

    OBJECTIVE To investigate the effect of SHEL model on prevention of postoperative nosocomial infec‐tions in children so as to find out the causes of the nosocomial infections and provide guidance for the prevention and control .METHODS A total of 500 children who underwent surgeries from Jan 2011 to Jun 2012 were chosen as the control group ,then the SHEL model was employed to analyze the causes of the nosocomial infections;totally 500 children who underwent surgeries from Jul 2012 to Dec 2013 were set as the observation group ,and the targe‐ted interventions were taken according the results of the SHEL model;the incidence of nosocomial infections was compared between the two groups of children .RESULTS The incidence of nosocomial infections was 2 .60% in the observation group ,significantly lower than 5 .40% of the control group(P<0 .05) .The poor awareness of health care workers to the nosocomial infections was the leading cause of the nosocomial infections in the children ,which accounted for 48 .15% in the control group ,15 .38% in the observation group ,and there was significant difference between the two groups (P<0 .05) .CONCLUSION The poor awareness of health care workers to the nosocomial infections is the leading cause of the nosocomial infections in the children undergoing surgeries .The use of the SHEL model can help to find out the causes of the nosocomial infections and existing problems in the control of nosocomial infections in a timely manner ,promote the scientific and standardized management of the nosocomial infections ,and improve the awareness of the ward health care workers to the nosocomial infections ,and it is an ef‐fective way to reduce the incidence of nosocomial infections in the children undergoing surgeries .%目的:探讨S H EL事故分析模型对预防手术患儿医院感染的效果,为寻找医院感染的发生原因和制定预防控制措施提供参考依据。方法选取2011年1月-2012年6月收治的500例手

  16. Regression analysis of the risk factors for postoperative nosocomial infection in patients with abdominal tumors: experience from a large cancer centre in China.

    Science.gov (United States)

    Sun, Zhipeng; Zhu, Yubing; Xu, Guangzhong; Aminbuhe; Zhang, Nengwei

    2015-12-01

    Nosocomial infection is a common complication after abdominal oncology surgery. Aimed at finding its independent risk factors for prevention, all the patients who underwent abdominal oncology surgery were summarized from March 1(st), 2010 to March 1(st), 2013 from the oncology surgery department, Beijing Shijitan Hospital. The investigated variances were patients' information including admission number, sex, age, diabetes, diagnosis, length of stay, American society of anesthesiologists (ASA) grade, surgery time, number of drainage tubes. Comparisons were taken between the infected cases and non-infected cases for retrospective logistic regression analysis. 4 variances including diabetes, preoperative hospitalization time ≥ 6 days, surgery time ≥ 230 minutes, ASA grade ≥ III were found out to be related to nosocomial infection after surgery. The 4 variances mentioned above were risk factors for nosocomial infection after surgery.

  17. Nosocomial tuberculosis exposures at a tertiary care hospital: a root cause analysis.

    Science.gov (United States)

    Uppal, Navjeet; Batt, Jane; Seemangal, Julie; McIntyre, Susan A; Aliyev, Nemat; Muller, Matthew P

    2014-05-01

    Exposure of health care workers (HCWs) to patients with active TB continues to occur despite implementation of TB control policies. We conducted a root-cause analysis of TB exposures at a tertiary care hospital. Clinical and management details of all confirmed cases identified in 2011 were summarized. Cases were independently reviewed by an expert panel that determined the type (ie, delay in initiating, incorrect use of or premature removal of control measures), preventability, and root cause(s) of each error (exposure). Fifteen cases were reviewed. Ten errors were identified in 7 (47%) cases. Cases associated with errors were older than those without errors (68 y vs 40 y; P = .037). Most cases (12/15) were foreign born. A delay in initiating airborne precautions accounted for 70% (7/10) of the errors. The expert panel determined that 80% (8/10) of the errors were preventable or possibly preventable. The most common root causes were failure to consider TB and failure to obtain and interpret imaging. Advanced age, atypical presentation, and presence of comorbid illnesses were common among the preventable cases. TB control policies do not prevent all exposures. Our findings suggest that consideration of TB in elderly patients with risk factors, even if their signs and symptoms can be explained by an alternative diagnosis or are atypical, followed by a review of imaging studies, can further reduce this risk. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  18. Sarcopenia is predictive of nosocomial infection in care of the elderly.

    Science.gov (United States)

    Cosquéric, Gaëlle; Sebag, Aline; Ducolombier, Cyril; Thomas, Caroline; Piette, François; Weill-Engerer, Sébastien

    2006-11-01

    Protein-energy malnutrition and nosocomial infection (NI) are frequent in elderly patients, and a causal link between the two has often been suggested. The aim of the present study was to identify the nutritional parameters predictive of NI in elderly patients. We assessed on admission 101 patients (sixty-six women, thirty-five men, aged over 65 years) admitted to an acute care of the elderly department. Sarcopenia was detected by dual-energy X-ray absorptiometry, with appendicular skeletal muscle mass expressed with respect to body area. Weight, BMI, albuminaemia, serum transthyretin and C-reactive protein values were also determined on admission, and known risk factors, such as functional dependence and invasive biomedical material, were also evaluated. After up to 3 weeks of hospitalisation, patients were classified according to whether they had developed an NI. After 3 weeks of hospitalisation, we found that twenty-nine patients had suffered an NI, occurring after a mean of 16.1 d. Patients who were sarcopenic on admission had a significantly higher risk of contracting an NI (relative risk 2.1, 95 % CI 1.1, 3.8). None of the other morphometric or biological parameters differed significantly between the two groups of patients on admission. Patients who experienced an NI were also more likely, on admission, to have a medical device (P=0.02 to P=0.001 depending on the device), to have swallowing problems (P=0.002) or to have restricted autonomy (Prisk of NI during the first 3 weeks of hospitalisation.

  19. Comparison of the Pattern of Nosocomial Infection Between the Neonatal Intensive Care Units of Hospitals Kuala Terengganu and Universiti Sains Malaysia, Kelantan

    Science.gov (United States)

    Wan Hanifah, WH; Lee, JKF; Quah, BS

    2000-01-01

    Nosocomial infection is a common problem in the Neonatal Intensive Care Unit (NICU) and a knowledge of the pattern of nosocomial infection will contribute greatly to the intensification of infection control measures and the development of antibiotic policies in the NICU. This study aims to compare the incidence and clinical characteristics of neonates with nosocomial infection in NICU of both Kuala Terengganu Hospital (HKT) and Universiti Sains Malaysia Hospital (HUSM). Neonates who had both clinical signs of sepsis and positive blood cultures, 48 hours after admission to NICU, from 1st January to 31st December 1998, in both hospitals were retrospectively studied. Among neonates admitted to NICU, 30 (5.4%) in HKT and 65 (3.6%) in HUSM had nosocomial infection (p = 0.07). The mean duration of hospitalisation was shorter (HUSM 37 days, HKT 49 days; p = 0.02), and the number of neonates with predisposing factors for infection is higher (HUSM 100%, HKT 73.3%; p < 0.001) in HUSM compared with HKT. There were no differences in gestation, mean age of onset of infection and mortality between both hospitals. The most common organism isolated from the blood in HKT was Klebsiella pneumoniae (33.3%), and in HUSM Klebsiella aerogenes (24.6%). Half of Klebsiella pneumoniae isolates were resistant to cephalosporins and aminoglycosides in HKT and a similar number of Klebsiella aerogenes isolates were resistant to piperacillin and aminoglycosides in HUSM. In conclusion nosocomial infection is a common problem in both hospitals. Except for more frequent predisposing factors for infection in HUSM, and a longer duration of hospital stay among neonates in HKT, the clinical characteristics of neonates with nosocomial infection in both hospitals were similar. PMID:22844213

  20. Related factors and countermeasures of nosocomial infection of patients with mental disorders caused by alcohol combined with diabetes%乙醇致精神障碍合并糖尿病患者发生医院感染的相关因素与对策

    Institute of Scientific and Technical Information of China (English)

    刘卫; 严艳莲

    2016-01-01

    目的:探讨乙醇所致精神障碍合并糖尿病患者发生医院感染的相关因素分析与对策,为预防医院感染提供依据。方法回顾性分析2010年6月至2014年12月本科室收治的63例乙醇所致精神障碍合并糖尿病患者的临床资料。结果63例乙醇所致精神障碍合并糖尿病患者,感染发生率为18.37%;感染部位居前3位的是上呼吸道、胃肠道和下呼吸道感染,分别占53.97%、22.22%和9.52%。其中以震颤谵妄患者医院感染次数发生率最高(占30.43%),与其他临床亚型比较差异具有统计学意义(χ2=11.23、P<0.05)。结论乙醇所致精神障碍合并糖尿病患者感染发生率相对较高,感染部位主要集中在呼吸道,与患者血糖、精神疾病有关,应积极进行降血糖治疗,加强老年患者的精神康复护理工作。%ObjectiveTo investigate the related factors of nosocomial infection for ethanol-induced mental disorders in patients with diabetes, and to provide a basis for the prevention of hospital infection. Methods The data of 63 patients with mental disorders due to alcohol induced mental disorders from June 2010 to December 2014 in our hospital were analyzed, retrospectively.ResultsAll the 63 cases with mental disorder induced by ethanol in patients with diabetes mellitus and the incidence of infection was 18.37%. Infection of the top three were upper respiratory tract, gastrointestinal tract and lower respiratory tract infections, accounting for 53.97%, 22.22% and 53.97%, respectively. In delirium tremens number of hospital infection in patients with the highest rate (30.43%), with significant differences compared with the other clinical subtypes (χ2 = 11.23,P < 0.05).Conclusions The infection incidence rate is relatively high among patients with mental disorders induced by alcohol complicated with diabetes mellitus, the site of infection mainly concentrated in the respiratory tract, which was related with

  1. 2014年医院感染现患率调查分析%Prevalence rate of nosocomial infection in 2014

    Institute of Scientific and Technical Information of China (English)

    刘卫平; 田勇泉; 郑志楠; 李振华; 秦露露

    2015-01-01

    OBJECTIVE To understand the current status and characteristics of nosocomial infections ,use of antibi-otics ,and isolation rates of pathogens in Inner Mongolia area in 2014 so as to provide guidance for development of effective prevention measures ,reasonable use of antibiotics ,and reduction of incidence of nosocomial infections . METHODS A survey day was picked from Apr 1 ,2014 to Sep 30 ,2014 by the hospitals that participated the sur-vey ,then the prevalence rate of nosocomial infections in the hospitalized patients was investigated on the survey day by means of bedside survey combined with review of medical records .RESULTS A total of 118 hospitals were included in the survey ,43 463 patients involved ,and the nosocomial infections occurred in 871 cases ,with the prevalence rate of 2 .00% .The lower respiratory tract was the predominant infection site ,followed by the urinary tract and the upper respiratory tract .The incidence of nosocomial infections was highest in the general ICU ,fol-lowed by the neurosurgery department and the blood diseases department .The utilization rate of antibiotics was 32 .81% ,the patients who were treated with one-drug therapy accounted for 75 .18% ,the patients who were trea-ted with two-drug therapy accounted for 23 .20% ,the patients who were treated with no less than three-drug ther-apy accounted for 1 .62% ;the patients who used antibiotics for treatment accounted for 58 .25% ,the patients who used antibiotics for prevention accounted for 32 .72% ,and the patients who used antibiotics for treatment plus pre-vention accounted for 9 .02% .The submission rate of specimens of the patients who used antibiotics for treatment was 31 .99% .The Escherichiacoli ,Pseudomonas aeruginosa ,and Klebsiella pneumoniae were dominant among the pathogens causing the nosocomial infections .CONCLUSION The investigation of prevalence rate of nosocomial infections is conducive to finding out the problems in the control of nosocomial infections so

  2. Fact-finding Survey of Nosocomial Infection Control in Hospitals in Kathmandu, Nepal-A Basis for Improvement.

    Science.gov (United States)

    Ohara, Hiroshi; Pokhrel, Bharat M; Dahal, Rajan K; Mishra, Shyam K; Kattel, Hari P; Shrestha, Dharma L; Haneishi, Yumiko; Sherchand, Jeevan B

    2013-09-01

    The purpose of this study was to investigate the actual conditions of nosocomial infection control in Kathmandu City, Nepal as a basis for the possible contribution to its improvement. The survey was conducted at 17 hospitals and the methods included a questionnaire, site visits and interviews. Nine hospitals had manuals on nosocomial infection control, and seven had an infection control committee (ICC). The number of hospitals that met the required amount of personal protective equipment preparation was as follows: gowns (13), gloves (13), surgical masks (12). Six hospitals had carried out in-service training over the past one year, but seven hospitals responded that no staff had been trained. Eight hospitals were conducting surveillance based on the results of bacteriological testing. The major problems included inadequate management of ICC, insufficient training opportunities for hospital staff, and lack of essential equipment. Moreover, increasing bacterial resistance to antibiotics was recognized as a growing issue. In comparison with the results conducted in 2003 targeting five governmental hospitals, a steady improvement was observed, but further improvements are needed in terms of the provision of high quality medical care. Particularly, dissemination of appropriate manuals, enhancement of basic techniques, and strengthening of the infection control system should be given priority.

  3. Natural and nosocomial infection in a patient with West Nile encephalitis and extrapyramidal movement disorders.

    Science.gov (United States)

    Solomon, Tom; Fisher, Ann F; Beasley, David W C; Mandava, Pitchaiah; Granwehr, Bruno P; Langsjoen, Hans; Travassos Da Rosa, Amelia P; Barrett, Alan D T; Tesh, Robert B

    2003-06-01

    Since its first recognition in North America in 1999, West Nile virus (WNV) has spread rapidly across the continent, but in many communities, rapid diagnostic tests for detection of WNV infection are not fully available. We describe a patient with extrapyramidal movement disorders and changes in the basal ganglia noted on magnetic resonance images that are characteristic of other flavivirus encephalitides and may help in the recognition of patients with West Nile encephalitis. Detailed molecular analysis suggested that, although our patient received a blood transfusion infected with WNV, the virus that caused his initial infection and encephalitis was probably acquired naturally from a mosquito.

  4. Early Expansion of Circulating Granulocytic Myeloid-derived Suppressor Cells Predicts Development of Nosocomial Infections in Patients with Sepsis.

    Science.gov (United States)

    Uhel, Fabrice; Azzaoui, Imane; Grégoire, Murielle; Pangault, Céline; Dulong, Joelle; Tadié, Jean-Marc; Gacouin, Arnaud; Camus, Christophe; Cynober, Luc; Fest, Thierry; Le Tulzo, Yves; Roussel, Mikael; Tarte, Karin

    2017-08-01

    Sepsis induces a sustained immune dysfunction responsible for poor outcome and nosocomial infections. Myeloid-derived suppressor cells (MDSCs) described in cancer and inflammatory processes may be involved in sepsis-induced immune suppression, but their clinical impact remains poorly defined. To clarify phenotype, suppressive activity, origin, and clinical impact of MDSCs in patients with sepsis. Peripheral blood transcriptomic analysis was performed on 29 patients with sepsis and 15 healthy donors. A second cohort of 94 consecutive patients with sepsis, 11 severity-matched intensive care patients, and 67 healthy donors was prospectively enrolled for flow cytometry and functional experiments. Genes involved in MDSC suppressive functions, including S100A12, S100A9, MMP8, and ARG1, were up-regulated in the peripheral blood of patients with sepsis. CD14(pos)HLA-DR(low/neg) monocytic (M)-MDSCs were expanded in intensive care unit patients with and without sepsis and CD14(neg)CD15(pos) low-density granulocytes/granulocytic (G)-MDSCs were more specifically expanded in patients with sepsis (P sepsis. G-MDSCs, made of immature and mature granulocytes expressing high levels of degranulation markers, were specifically responsible for arginase 1 activity. High initial levels of G-MDSCs, arginase 1, and S100A12 but not M-MDSCs were associated with subsequent occurrence of nosocomial infections. M-MDSCs and G-MDSCs strongly contribute to T-cell dysfunction in patients with sepsis. More specifically, G-MDSCs producing arginase 1 are associated with a higher incidence of nosocomial infections and seem to be major actors of sepsis-induced immune suppression.

  5. Prevalence of nosocomial infections in psychiatric department and nursing countermeasures%精神科医院感染现患率调查与护理对策

    Institute of Scientific and Technical Information of China (English)

    裴建琴

    2012-01-01

    目的 了解精神科医院感染基本情况,发现医院感染管理中存在的问题,调整控制医院感染措施.方法 采取横断面调查方法,以床旁调查与病案调查相结合,填写统一的个案调查表.结果 调查住院精神科患者750例,医院感染现患率为1.87%,感染主要科室为老年精神科;主要部位为呼吸道50.00%、泌尿道42.86%.结论 加强老年精神科医院感染管理,特别是基础护理,能有效降低医院感染发生率.%OBJECTIVE To explore the status of nosocomial infections in the psychiatric department and find out the problems existing in the nosocomial infection management so as to adjust the control of nosocomial infections. METHODS By means of the cross-sectional investigation and the bedside investigation combined with the medical records investigation, the uniform questionnaire was filled out. RESULTS Totally 750 hospitalized patients in psychiatric department were investigated,the prevalence rate of nosocomial infections was 1. 86%, the infections mainly distributed in the geriatric department of psychiatrics; the respiratory tract and the urinary tract were the predominant infection sites, accounting for 50. 00% and 42. 86%, respectively. CONCLUSION It can effectively reduce the incidence of nosocomial infections that the control of nosocomial infections in the geriatric department of psychiatrics ,especially the primary nursing,is intensified.

  6. Incidence of nosocomial infections in a big university affiliated hospital in Shiraz, Iran: A six-month experience

    Directory of Open Access Journals (Sweden)

    Mehrdad Askarian

    2013-01-01

    Conclusions: The results of this study showed that the frequency of NI in the investigated hospital was not higher than in many other reported surveillance results from other countries. This, however, might be a bias as the administration of antibiotics was very high in this study and the quality of microbiological investigation might have influenced significantly, resulting in more false-negative results than expected. Overall, the use of the Iranian National Nosocomial Infection Surveillance System Software proved to be useful and allowed both rapid data collection and detailed data analysis.

  7. Analysis and Countermeasures of Nosocomial Infection of Patients with Hematologic Diseases%血液病患者院内感染危险因素分析与对策

    Institute of Scientific and Technical Information of China (English)

    张晓香; 陶彦清; 冯涛; 张靖; 焦玉龙

    2011-01-01

    Objective: In order to provide the basis for formulating control measures, we explored the dangerous factors of hemopathy patients who fell in nosocomial infection. Method: We retrospectively investigated the incidence of nosocomial infection of 685 hemopathy patients in our hospital from March, 2009 to March, 2011, and analyzed the cause of nosocomial infection risk factors. Results: 91 cases of the 685 patients got nosocomial infection primarily in the respiratory system, skin and oral, including separated pathogen 88 strains, three gram-negative bacilli strains (60.22%), twenty gram-positive strains (31.81%) and seven fungal strains (7.95%). The decline of leucocyte, chemotherapy, hormone and the use of spectrum antibiotic were the main factors of nosocomial infection. Conclusion: We must take protective isolation to the patients with leucocyte quantity < 2×109and reasonablely use antibiotic to treat infectious diseases to reduce the incidence of nosocomial infection.%目的:探讨血液病患者院内感染危险因素,为制定控制措施提供理论依据.方法:回顾性调查我院血液科2009年3月-2011年3月间685例血液病患者发生院内感染的情况,并对引起院内感染的危险因素进行分析.结果:685例患者中有91例发生院内感染,感染部位以呼吸系统、皮肤和口腔为主.分离病原菌88株,革兰阴性杆菌53株(60.22%),革兰阳性菌28株(31.81%),真菌7株(7.95%).白细胞下降、化疗、激素和广谱抗生素的使用是院内感染的主要因素.结论:为减少医院感染发生率,必须对白细胞<2× 109/L的病人进行保护性隔离,并合理使用抗生素治疗感染性疾病.

  8. Health care-associated infections surveillance in an intensive care unit of a university hospital in China, 2010-2014: Findings of International Nosocomial Infection Control Consortium.

    Science.gov (United States)

    Peng, Hui; Tao, Xiu-Bin; Li, Yan; Hu, Qiang; Qian, Li-Hua; Wu, Qun; Ruan, Jing-Jing; Cai, Dong-Zhen

    2015-12-01

    Using a standardized methodology by the National Nosocomial Infection Surveillance System, a continuous health care-associated infections (HAIs) surveillance was conducted in our mixed intensive care unit at a Chinese teaching hospital. During the study period (2010-2014), 4,013 patients were hospitalized for 32,924 bed days and acquired 427 HAIs (482 HAI events), with an overall rate of 10.64% and 14.640 HAIs per 1,000 bed days. Ventilator-associated pneumonia was the most common device-associated health care-acquired infection, with an incidence rate of 19.561 per 1,000 mechanical ventilator days.

  9. Multidrug-Resistant Tuberculosis Complicated by Nosocomial Infection with Multidrug-Resistant Enterobacteriaceae

    NARCIS (Netherlands)

    Gröschel, Matthias I; Omansen, Till F; de Lange, Wiel; van der Werf, Tjip S; Lokate, M.; Bathoorn, Erik; Akkerman, Onno W; Stienstra, Ymkje

    2016-01-01

    Treatment of mycobacterial diseases such as tuberculosis (TB) entails long and intense antimicrobial therapy. TB patients are at risk of coinfection with other multidrug-resistant bacteria, such as those from Enterobacteriaceae family, because of antimicrobial selection pressure and nosocomial trans

  10. Treatment Failure of Nosocomial Pertussis Infection in a Very-Low-Birth-Weight Neonate

    Science.gov (United States)

    Bonacorsi, Stéphane; Farnoux, Caroline; Bidet, Philippe; Caro, Valérie; Aizenfisz, Sophie; Benhayoun, Mounir; Aujard, Yannick; Guiso, Nicole; Bingen, Edouard

    2006-01-01

    We describe a case of nosocomial maternal transmission of Bordetella pertussis to a very-low-birth-weight (VLBW) neonate in whom treatment was unsuccessful. This case underscores the need for rapid and sensitive PCR diagnosis in VLBW neonates and in parents with clinical signs of pertussis and suggests that standard treatment may not be appropriate for VLBW neonates. PMID:17021121

  11. Nurse staffing level and nosocomial infections: empirical evaluation of the case-crossover and case-time-control designs.

    Science.gov (United States)

    Hugonnet, Stéphane; Villaveces, Andrés; Pittet, Didier

    2007-06-01

    The authors compared a case-crossover design, a case-time-control design, and a cohort design to evaluate the effect of nurse staffing level on the risk of nosocomial infections. They evaluated two strategies, conditional logistic regression and generalized estimating equation, to analyze the case-crossover study. The study was performed among critically ill patients in the medical intensive care unit of the University of Geneva Hospitals, Geneva, Switzerland. Of 366 patients who stayed more than 7 days in the intensive care unit between 1999 and 2002, 144 developed an infection. The main reasons for admission were infectious (35.3%), cardiovascular (32.5%), and pulmonary (19.7%) conditions. A comparison of the three study designs showed that lower nurse staffing was associated with an approximately 50% increased risk of nosocomial infections. All analyses yielded similar estimates, except that the point estimate obtained by the conditional logistic regression used in the case-crossover design was biased away from unity; the generalized estimating equation yielded unbiased results and is the most appropriate technique for case-crossover designs. The case-crossover methodology in hospital epidemiology is a promising alternative to traditional approaches, but selection of the referent periods is challenging.

  12. Ventilator-associated pneumonia in a teaching hospital in Tehran and use of the Iranian Nosocomial Infections Surveillance Software.

    Science.gov (United States)

    Afhami, Sh; Hadadi, A; Khorami, E; Seifi, A; Bazaz, N Esmailpour

    2013-10-01

    Ventilator-associated pneumonia is the most common health-care-associated infection in the intensive care unit (ICU) and computer-assisted diagnosis and surveillance is called for. The frequency of ventilator-associated pneumonia was assessed prospectively during a 6-month period in the ICUs of a teaching hospital in Tehran, Islamic Republic of Iran. To determine the accuracy of the Iranian Nosocomial Infections Surveillance (INIS) system, patient data were input to the software and compared with physicians' judgement. The frequency of ventilator-associated pneumonia was 21.6%, or 9.96 episodes per 1000 ventilator days. The duration of admission to the ICU, duration of mechanical ventilator and number of re-intubations were significantly higher in patients who developed pneumonia. The INIS system identified 100% of cases, with no false-positive or false-negative results. Compared with developed countries, the frequency of ventilator-associated pneumonia was high in our ICUs, and INIS software was accurate in diagnosing nosocomial infection.

  13. Nosocomial infection characteristics in a burn intensive care unit: analysis of an eleven-year active surveillance.

    Science.gov (United States)

    Öncül, Oral; Öksüz, Sinan; Acar, Ali; Ülkür, Ersin; Turhan, Vedat; Uygur, Fatih; Ulçay, Asım; Erdem, Hakan; Özyurt, Mustafa; Görenek, Levent

    2014-08-01

    The objective of this study was to describe nosocomial infection (NI) rates, risk factors, etiologic agents, antibiotic susceptibility, invasive device utilization and invasive device associated infection rates in a burn intensive care unit (ICU) in Turkey. Prospective surveillance of nosocomial infections was performed according to Centers for Disease Control and Prevention (CDC) and National Healthcare Safety Network (NHSN) criteria between 2001 and 2012. The data was analyzed retrospectively. During the study period 658 burn patients were admitted to our burn ICU. 469 cases acquired 602 NI for an overall NI rate of 23.1 per 1000 patient days. 109 of all the cases (16.5%) died. Pseudomonas aeruginosa (241), Acinetobacter baumannii (186) and Staphylococcus aureus (69) were the most common identified bacteria in 547 strains. Total burn surface area, full thickness burn, older age, presence of inhalation injury were determined to be the significant risk factors for acquisition of NI. Determining the NI profile at a certain burn ICU can lead the medical staff apply the appropriate treatment regimen and limit the drug resistance. Eleven years surveillance report presented here provides a recent data about the risk factors of NI in a Turkish burn ICU. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. Monitoring of cases of nosocomial infections and analysis of risk factors%医院感染病例监测及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李彦; 李岩; 张建勇; 陈同利; 时利民

    2014-01-01

    目的:探讨医院感染发生的危险因素,总结并采取相应的控制措施,有效降低医院感染率。方法对2013年1-12月的1122例医院感染病例进行监测分析,应用 logistic回归分析评估各危险因素与医院感染关系。结果2013年1-12月全院出院患者29150例,发生医院感染1122例,医院感染率为3.85%;发生医院感染1326例次,例次感染率4.55%;医院感染率前3位的科室是军人病房、神经外科、肿瘤科,分别为19.06%、11.04%、7.69%;感染部位以下呼吸道为主,占35.75%,其次为上呼吸道和泌尿系统,分别占19.61%和12.52%;医院感染相关危险因素分析显示,性别、年龄、住院天数、抗菌药物使用天数、中心静脉插管天数、泌尿道插管天数及气管切开或插管与医院感染的发生密切相关( P<0.001)。结论监测分析医院感染的发生规律,保护易感人群,缩短住院日,合理使用抗菌药物,做好器械相关感染的监测,可有效控制医院感染的发生。%OBJECTIVE To explore the risk factors for nosocomial infections and put forward corresponding control measures so as to effectively reduce the incidence of nosocomial infections .METHODS From Jan 2013 to Dec 2013, totally 1 122 cases of nosocomial infections were monitored, and the logistic regression analysis was performed for the risk factors and the correlation with nosocomial infections .RESULTS Of 29 150 patients who were discharged from Jan 2013 to Dec 2013, the nosocomial infections occurred in 1 122 (1 326 case-times) cases with the infection rate of 3 .85% and the case-time infection rate of 4 .55% .The incidence of nosocomial infections was 19 .06% in the soldiers'ward, 11 .04% in the neurosurgery department, 7 .69% in the oncology department .Of the patients with nosocomial infections, the patients with lower respiratory tract infections accounted for 35 .75%, the patients

  15. The changing pattern of antimicrobial resistance within 42,033 Escherichia coli isolates from nosocomial, community and urology patient-specific urinary tract infections, Dublin, 1999-2009.

    LENUS (Irish Health Repository)

    Cullen, Ivor M

    2012-04-01

    To investigate the changing pattern of antimicrobial resistance in Escherichia coli urinary tract infection over an eleven year period, and to determine whether E. coli antibiotic resistance rates vary depending on whether the UTI represents a nosocomial, community acquired or urology patient specific infection.

  16. 伴院内感染早产儿血清C反应蛋白的动态变化%Dynamic change of serum C -reactive protein in premature infants with nosocomial infection

    Institute of Scientific and Technical Information of China (English)

    温碧艳

    2011-01-01

    Objective: To observe the dynamic change of serum C - reactive protein (CRP) in premature infants with nosocomial infection. Methods; 130 premature infants were divided into non - nosocomial infection group (105 premature infants) and nosocomial infection group (25 premature infants) according to combining with nosocomial infection or not, heel blood samples were obtained from the premature infants at 1, 3, 5, 7, and 9 days after birth, double antibody sandwich method wag used to detect the dynamic changes of serum CRP levels at different time points in the two groups. Results; The premature infants in nosocomial infection group with different causes of infection had different peaks of serum CRP levels, the premature infants with skin infection had the lowest peak level, the premature infants with sepsis had the highest peak level, showing a decreasing trend: skin infection 0. 05) . On the first day after birth, the serum CRP level in nosocomial infection group was significantly higher than that in non - nosocomial infection group ( P 0. 05 ) . Conclusion; Monitoring serum CRP level dynamically has a good clinical value for clinical prevention and treatment of premature infants with nosocomial infection.%目的:观察伴院内感染早产儿血清C反应蛋白(CRP)水平的动态变化.方法:根据是否伴有院内感染将130例早产儿分为无院内感染的对照组105例和伴院内感染组25例,分别于出生后第1、3、5、7、9天采集早产儿足跟血,采用双抗体夹心法检测两组早产儿不同时间点的血清CRP水平动态变化.结果:伴院内感染组早产儿不同感染原因其血清CRP水平峰值相异,以皮肤感染最低,败血症最高,表现为皮肤感染<尿路感染<呼吸道感染<败血症.对照组早产儿血清CRP水平在监测期间未发生显著变化(P>0.05).伴院内感染组早产儿出生后第1天血清CRP水平明显高于对照组(P<0.05),第3天升高达峰值,治疗后从出生后第5

  17. Health care-associated Clostridium difficile infection in adults admitted to acute care hospitals in Canada: a Canadian Nosocomial Infection Surveillance Program Study.

    Science.gov (United States)

    Gravel, Denise; Miller, Mark; Simor, Andrew; Taylor, Geoffrey; Gardam, Michael; McGeer, Allison; Hutchinson, James; Moore, Dorothy; Kelly, Sharon; Boyd, David; Mulvey, Michael

    2009-03-01

    Clostridium difficile infection (CDI) is the most frequent cause of health care-associated infectious diarrhea in industrialized countries. The only previous report describing the incidence of health care-associated CDI (HA CDI) in Canada was conducted in 1997 by the Canadian Nosocomial Infection Surveillance Program. We re-examined the incidence of HA CDI with an emphasis on patient outcomes. A prospective surveillance was conducted from 1 November 2004 through 30 April 2005. Basic demographic data were collected, including age, sex, type of patient ward where the patient was hospitalized on the day HA CDI was identified, and patient comorbidities. Data regarding severe outcome were collected 30 days after the diagnosis of HA CDI; severe outcome was defined as an admission to the intensive care unit because of complications of CDI, colectomy due to CDI, and/or death attributable to CDI. A total of 1430 adults with HA CDI were identified in 29 hospitals during the 6-month surveillance period. The overall incidence rate of HA CDI for adult patients admitted to these hospitals was 4.6 cases per 1000 patient admissions and 65 per 100,000 patient-days. At 30 days after onset of HA CDI, 233 patients (16.3%) had died from all causes; 31 deaths (2.2%) were a direct result of CDI, and 51 deaths (3.6%) were indirectly related to CDI, for a total attributable mortality rate of 5.7%. The rates are remarkably similar to those found in our previous study; although we found wide variations in HA CDI among the participating hospitals. However, the attributable mortality increased almost 4-fold (5.7% vs. 1.5%; P<.001).

  18. Risk factors of nosocomial MRSA infection%医院MRSA感染危险因素分析

    Institute of Scientific and Technical Information of China (English)

    黎映静; 廖九中; 曾茹; 毕翠梅

    2012-01-01

    目的 分析医院耐甲氧西林金黄色葡萄球菌(MRSA)感染危险的因素,以便采取有效措施降低感染率.方法 对各科室送检标本实施MRSA菌株分离,然后采用1∶1成组病例对照选取非医院MRSA感染患者60例,并与60例医院MRSA感染患者料进行单因素分析、多因素研究分析.结果 单因素分析结果显示高龄、住院时间长、抗生素使用超过2种、广谱抗菌药使用时间超过7 d、侵入性操作超过2项等因素与医院MRSA感染有关.多因素分析结果显示医院MRSA感染的危险因素主要有住院时间长、侵入性操作超过2项、广谱抗菌药使用时间超过7 d和抗生素使用超过2种.结论 侵入性操作、长时间住院、光谱抗菌药长时间使用和抗菌药的不合理应用是医院MRSA感染的危险因素.%Objective To analyze the risk factors of nosocomial meticillin - resistant Staphylococcus aureus ( MRSA ) infections, so as to take effective measures to reduce nosocomial MRSA infection rates. Methods MRSA isolates were isolated from specimens collected from departments of the hospital. The data of the patients including 60 cases of MRSA infection from the hospital and 60 cases of MRSA infection from outside the hospital were analyzed by single factor analysis and multiple factors analysis. Results According to the single factor analysis, old age, long stay in hospital, more than 2 kinds of antibiotics used, broad - spectrum antibiotics used more than 7 days, and more than 2 invasive procedures performed were related to nosocomial MRSA infection. Multiple factors analysis showed that the risk factors of nosocomial MRSA infection were long stay in hospital, more than 2 kinds of antibiotics used, broad - spectrum antibiotics used more than 7 days, and more than 2 invasive procedures performed. Conclusion The risk factors of nosocomial MRSA infection involve invasive procedures, long stay in hospital, long time use of broad - spectrum antibiotics

  19. Antimicrobial resistance patterns among Gram-negative bacilli isolated from patients with nosocomial infections: Disk diffusion versus E-test

    Directory of Open Access Journals (Sweden)

    Hadadi A

    2007-08-01

    Full Text Available Background: The object of this study was to investigate the antimicrobial resistance pattern among common nosocomial Gram-negative bacilli isolated from patients with nosocomial infections. Methods: From June 2004 to December 2005, 380 isolates of common Gram-negative bacilli (Klebsiella, Pseudomonas, Acinetobacter and E. coli from 270 patients with nosocomial infections in Sina and Imam Hospitals, Tehran, Iran, were evaluated for susceptibility to Imipenem, Cefepime, Ciprofloxacine, Ceftriaxone and Ceftazidime by Disc diffusion and E-test methods. Results: The most frequent pathogens isolated were Klebsiella spp. (40%, followed by Pseudomonas (28%, Acinetobacter spp. (20% and E. coli (12%. The most active antibiotic was imipenem (84%. 26% of all isolates were sensitive to Cefepime, 26% to Ciprofloxacin, 20% to Ceftazidime and 10% to Ceftrixone. The susceptibility rates of Klebsiella to Imipenem, cefepime, ciprofloxacin, Ceftazidime and Ceftriaxone were 91, 25, 21, 13 and 7 percent, respectively and 91, 19, 17, 21 and 21 percent, respectively, for E. coli. Among Acineto- bacter spp., the susceptibility rate was 77% for Imipenem and 21% for Ciprofloxacin. Among Pseudomonas spp., 75% of isolates were susceptible to Imipenem and 39% to Ciprofloxacin. The comparison of the resistance status of microorganisms by both Disc diffusion and E-test methods showed a clinically noticeable agreement between these two tests. Conclusions: Since antibiotic resistance among Gram-negative bacilli has increased, enforcement of policy regarding proper antibiotic use is urgently needed in order to delay the development of resistance. Although it is widely accepted that E-test is more accurate in determining the resistance of microorganisms, our study showed that the Disc diffusion test will give the same results in most occasions and is therefore still considered useful in clinical practice.

  20. Proactive infection control measures to prevent nosocomial transmission of carbapenem-resistant Enterobacteriaceae in a non-endemic area

    Institute of Scientific and Technical Information of China (English)

    CHENG Vincent Chi-Chung; CHAN Jasper Fuk-Woo; WONG Sally Cheuk-Ying; CHEN Jonathan Hon-Kwan; TAI Josepha Wai-Ming; YAN Mei-Kum; KWAN Grace See-Wai

    2013-01-01

    Background Identification of hospitalized carbapenem-resistant Enterobacteriaceae (CRE)-positive patient is important in preventing nosocomial transmission.The objective of this study was to illustrate the implementation of proactive infection control measures in preventing nosocomial transmission of CRE in a healthcare region of over 3200 beds in Hong Kong between October 1,2010 and December 31,2011.Methods The program included active surveillance culture in patients with history of medical tourism with hospitalization and surgical operation outside Hong Kong within 12 months before admission,and "added test" as an opportunistic CRE screening in all fecal specimens submitted to the laboratory.Outbreak investigation and contact tracing were conducted for CRE-positive patients.Serial quantitative culture was performed on CRE-positive patients and the duration of fecal carriage of CRE was analyzed.Results During the study period,a total of 6533 patients were screened for CRE,of which 76 patients were positive (10 from active surveillance culture,65 from "added test",and 1 secondary case from contact tracing of 223 patients with no nosocomial outbreak),resulting in an overall rate of CRE fecal carriage of 1.2%.The median time of fecal carriage of CRE was 43 days (range,13-119 days).Beta-lactam-beta-lactamase-inhibitors,cephalosporins,and fluoroquinolones were associated significantly with high fecal bacterial load when used 90 days before CRE detection,while use of cephalosporins,carbapenems,and fiuoroquinolones after CRE detection are significantly associated with longer duration of carriage.The duration of fecal carriage of CRE also correlates significantly with the initial fecal bacterial load (Pearson correlation:0.53; P=0.02).Conclusion Proactive infection control measures by enhanced surveillance program identify CRE-positive patients and data obtained are useful for the planning of and resource allocation for CRE control.

  1. 加强护工培训与管理控制医院感染%Nosocomial infection control by strengthening education and management of nursing workers

    Institute of Scientific and Technical Information of China (English)

    张丽; 李天蓉

    2012-01-01

    目的 通过加强对护工医院感染的管理与预防控制,提高医疗护理服务质量.方法 对医院感染相关因素进行分析,加强医院感染知识培训,重点环节管理,规范流程并检查反馈结果.结果 通过对护工工作流程、工作用具等有关医院感染知识的强化培训,可从自身工作有效地阻断传染源,控制医院感染,创造一个安全的就医环境.结论 护工严格执行安全操作规程与规范化管理,是降低及控制医院感染的重要措施.%OBJECTIVE To strengthen the control and prevention of nosocomial infections in nursing staff so as to improve the quality of medical service. METHODS Risk factors for nosocomial infections were analyzed, education of the nosocomial infection knowledge and management of key links were strengthened, process was standardized, and feedback of the results was checked. RESULTS Through intensive education of nosocomial infection like workflow and tools in nursing workers, nosocomial infections could be effectively prevented and controlled, and the safe environment for medical treatment could be ensured. CONCLUSION Strict implementation of the safe operation procedures by nursing staff and the standardized management are important measures to reduce and control nosocomial infections.

  2. Antibacterial activity of Thymus maroccanus and Thymus broussonetii essential oils against nosocomial infection - bacteria and their synergistic potential with antibiotics.

    Science.gov (United States)

    Fadli, Mariam; Saad, Asmaa; Sayadi, Sami; Chevalier, Jacqueline; Mezrioui, Nour-Eddine; Pagès, Jean-Marie; Hassani, Lahcen

    2012-03-15

    The aim of this study was to evaluate the antibacterial effect of the association between conventional antibiotics and essential oils (EOs) of endemic Moroccan thyme species, Thymus maroccanus and T. broussonetii, on antibiotic-resistant bacteria involved in nosocomial infections. Synergistic interactions between antibiotics (ciprofloxacin, gentamicin, pristinamycin, and cefixime) and EOs, and between T. maroccanus and T. Broussonetii EOs were determined by the checkerboard test. Serial dilutions of two antimicrobial agents were mixed together so that each row (and column) contained a fixed amount of the first agent and increasing amounts of the second one. The results indicate that the oils had a high inhibitory activity against tested bacteria, except for Pseudomonas aeruginosa. In parallel with the increase of cellular killing, the release of 260nm-absorbing materials from bacterial cells, treated with EOs, increased in response to oil concentration. Out of 80 combinations tested between EOs and antibiotics, 71% showed total synergism, 20% had partial synergistic interaction and 9% showed no effect. Combination with carvacrol, the major constituent of T. maroccanus and T. broussonetii, showed also an interesting synergistic effect in combination with ciprofloxacin. The effect on Gram-positive bacteria was more important than on Gram-negative bacteria. These findings are very promising since the use of these combinations for nosocomial infections treatment is likely to reduce the minimum effective dose of the antibiotics, thus minimizing their possible toxic side effects and treatment cost. However, further investigations are needed to assess the potential for therapeutic application.

  3. Phytochemistry of the essential oil of Melissa officinalis L. growing wild in Morocco: preventive approach against nosocomial infections

    Institute of Scientific and Technical Information of China (English)

    Zineb; Jalal; Yassine; El; Atki; Badiaa; Lyoussi; Abdelfattah; Abdellaoui

    2015-01-01

    Objective: To determine the phytochemical characterization and antibacterial activity of Melissa oi cinalis essential oil against bacteria responsible for nosocomial infections.Methods: The phytochemical characterization of essential oil was evaluated using gas chromatography-flame ionization detector and gas chromatography-mass spectrometer analysis. Antibacterial activity of the oil was tested against four bacterial strains responsible for nosocomial infections: Pseudomonas aeruginosa, Klebsiella pneumonia, Staphylococcus aureus and Citrobacter koseri using disc dif usion method.Results: Thirty three components were identified representing 89.30% of the total oil composition. The yield of essential oil was 0.4% and the predominant components were citronellal(14.40%), isogeraniol(6.40%), geraniol acetate(10.20%), nerol acetate(5.10%), caryophyllene(8.10%) and β-caryophyllene oxide(11.00%). Antibacterial activity of the oil showed the higher activity against all bacterial strains tested.Conclusions: The essential oil extracted from lemon balm can be used to clean the environment of reanimation polyvalent and anesthesia service.

  4. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module.

    Science.gov (United States)

    Rosenthal, Víctor Daniel; Maki, Dennis George; Mehta, Yatin; Leblebicioglu, Hakan; Memish, Ziad Ahmed; Al-Mousa, Haifaa Hassan; Balkhy, Hanan; Hu, Bijie; Alvarez-Moreno, Carlos; Medeiros, Eduardo Alexandrino; Apisarnthanarak, Anucha; Raka, Lul; Cuellar, Luis E; Ahmed, Altaf; Navoa-Ng, Josephine Anne; El-Kholy, Amani Ali; Kanj, Souha Sami; Bat-Erdene, Ider; Duszynska, Wieslawa; Van Truong, Nguyen; Pazmino, Leonardo N; See-Lum, Lucy Chai; Fernández-Hidalgo, Rosalia; Di-Silvestre, Gabriela; Zand, Farid; Hlinkova, Sona; Belskiy, Vladislav; Al-Rahma, Hussain; Luque-Torres, Marco Tulio; Bayraktar, Nesil; Mitrev, Zan; Gurskis, Vaidotas; Fisher, Dale; Abu-Khader, Ilham Bulos; Berechid, Kamal; Rodríguez-Sánchez, Arnaldo; Horhat, Florin George; Requejo-Pino, Osiel; Hadjieva, Nassya; Ben-Jaballah, Nejla; García-Mayorca, Elías; Kushner-Dávalos, Luis; Pasic, Srdjan; Pedrozo-Ortiz, Luis E; Apostolopoulou, Eleni; Mejía, Nepomuceno; Gamar-Elanbya, May Osman; Jayatilleke, Kushlani; de Lourdes-Dueñas, Miriam; Aguirre-Avalos, Guadalupe

    2014-09-01

    We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.

  5. Are red blood cell transfusions associated with nosocomial infections in critically ill children?

    Science.gov (United States)

    Naveda Romero, Omar E; Naveda Meléndez, Andrea F

    2016-08-01

    Aunque la transfusión de hemoderivados es una práctica común, los efectos sobre el sistema inmune no han sido bien estudiados. Para determinar la asociación entre transfusión de glóbulos rojos (TGR) e infecciones nosocomiales, se realizó un estudio de cohorte prospectivo con niños críticamente enfermos, seguidos hasta su fallecimiento, transferencia o egreso. Las infecciones nosocomiales se consideraron postransfusionales si ocurrieron dentro de los 14 días después de la TGR. Se incluyeron 162 niños, 35 adquirieron infección nosocomial (21,6%) y 49 recibieron TGR (30,2%). Los niños con infección nosocomial recibieron más frecuentemente TGR (48,5% vs. 14,9%; OR 5,4; IC 95%: 2,4-12,6; p 〈 0,0001) y presentaron mayor mortalidad (45,7% vs. 10,2%; OR 7,4; IC 95%: 3,1-18,2; p 〈 0,0001). En la regresión logística binaria, la TGR se mantuvo asociada independientemente a infección nosocomial (OR 4,2; IC 95%: 2,1-20,2; p = 0,049). Conclusión: La TGR se asoció a un incremento del riesgo de adquirir infecciones nosocomiales.

  6. Targeted surveillance of nosocomial infections in general ICU%综合性 ICU 医院感染目标性监测结果分析

    Institute of Scientific and Technical Information of China (English)

    王娇; 陈梦燕; 黄静

    2015-01-01

    OBJECTIVE To understand the prevalence of nosocomial infections in ICU patients and take targeted in‐terventions so as to control the nosocomial infections .METHODS According to the Standards for targeted surveil‐lance of nosocomial infections ,the incidence of nosocomial infections ,daily infection rate ,incidence of three types of catheter‐related infections ,nosocomial infection sites ,and distribution of pathogens in the ICU patients who were hospitalized from Feb 2012 to Feb 2013 were monitored .RESULTS The nosocomial infections occurred in 78 (72 case‐times) of 655 patients with the incidence of nosocomial infections of 11 .90% and the case‐time infection rate of 12 .52% ;the daily infection rate was 13 .84‰ ,and the case‐time daily infection rate was 14 .55‰ ;the inci‐dence of central venous catheter‐related bloodstream infections was 0 .56‰ ,the incidence of urinary catheter‐relat‐ed urinary tract infections was 1 .15‰ ,and the incidence of ventilator‐associated pneumonia was 78 .43‰ .The in‐cidence of lower respiratory tract infections was 80 .25% ,the incidence of bloodstream infections was 7 .41% ,the incidence of urinary tract infections was 3 .70% .The K lebsiella pneumoniae was dominant among the isolated pathogens ,accounting for 42 .74% .CONCLUSION The incidence of nosocomial infections is high in the ICU ,and the catheter‐related infections are the high risk factors .It is necessary to take targeted rectification measures of the ward management so as to reduce the incidence of nosocomial infections .%目的:了解医院IC U患者发生医院感染的情况,以采取针对性的干预措施控制医院感染的发生。方法根据《医院感染目标性监测规范》,监测2012年2月-2013年2月入住IC U患者的医院感染率、日感染率、3种导管相关感染率、医院感染部位及感染病原菌分布。结果监测的655例患者中发生医院感染78例、82例次,医院感染率11

  7. 革兰阴性菌与NSICU医院感染的关系%Relationship between gram-negative bacteria and nosocomial infections in neurological intensive care unit

    Institute of Scientific and Technical Information of China (English)

    于垚; 元艺; 元小冬; 许亚茹; 王淑娟; 刘顺莉; 王小玲; 郑秀芬; 徐应军

    2012-01-01

    目的 研究革兰阴性菌在NSICU环境中的分布及其所致医院感染的特征,为其防治提供理论依据.方法 选取2010年10月-2011年9月某医院NSICU发生医院感染患者进行病原学检查及药敏试验,同时监测NSICU空气和病床单位的细菌学分布特征.结果 209例患者中有61例发生医院感染,感染率为29.2%;其中42例进行了病原学检测,检出革兰阴性菌占77.9%,其中肺炎克雷伯菌和铜绿假单胞菌分别占25.9%和23.3%,均对左氧氟沙星敏感;在病房环境中检出的病原菌以革兰阴性杆菌为主,主要为鲍氏不动杆菌.结论 革兰阴性杆菌是引发NSICU医院感染最重要的病原菌之一,下呼吸道是最易发生医院感染的部位,其病原菌主要为肺炎克雷伯菌和铜绿假单胞菌;NSICU环境是除肺炎克雷伯菌以外的其他革兰阴性杆菌感染的主要传播途径,肺炎克雷伯菌对大多数抗菌药物敏感,而其他革兰阴性杆菌对于多数抗菌药物具有不同程度的耐药性.%OBJECTIVE To analyze the distribution of the gram-negative in neurological intensive care unit environment and the clinical characteristics of nosocomial infection patients in neurological intensive care unit,so as to institute prevention strategy for nosocomial infection caused by G~ bacteria. METHODS All inpatients admitted to neurological intensive care unit of the hospital from Dec. 2010 to Sep. 2011were collected as monitoring objectives. The results of pathogen identification and drug susceptibility test were recorded. The microbiological characteristics of indoor environment (air-environment and the bed-unit) of the ward were also monitored. RESULTS During the study period, there were 61 patients got nosocomial infection among all 209 monitoring objectives,the incidence was 29. 2%. 42 patients received the pathogenic examination, and G~ bacteria accounted for 77. 9%. Among the gram-negative bacilli,K. Pneumoniae and P. Aeruginosa

  8. 发挥省级医院感染管理质控中心的作用提高全省医院感染管理水平%Giving play to the role of provincial nosocomial infection management and quality control center, improving nosocomial infection management level of the whole province

    Institute of Scientific and Technical Information of China (English)

    姜亦虹

    2015-01-01

    江苏省医院感染管理质控中心成立后,开展了一系列质控工作,加强医院感染管理专业人才队伍建设;建章立制,细化医院感染防控工作规范;围绕工作规范开展检查与调研;规范医院感染目标性监测;开展多种形式的专业技术培训,对全省医院感染管理工作起到积极的推进作用。同时,对医院感染管理质控标准、专家团队的组建、组织关系及经费拨付、多学科合作及省际间专业交流、开展医院感染管理科学研究等进行了有益地探讨。%Since its establishment, the Nosocomial Infection Management and Quality Control Center of Jiangsu Province has carried out a series of quality control activities, enhanced the construction of talent team specialized in nosocomial infection management, set up new systems to reifne the work speciifcation for the prevention and control of nosocomial infection, and conducted examination and survey based on the work speciifcation. It has also normalized objective monitoring of nosocomial infection, carried out professional technical training in multiple forms, and played a positive role in promoting the nosocomial infection management of the whole province. Meanwhile, beneifcial discussions have also been made on the standards for nosocomial infection management and quality control, the building, organization relationship, and fund appropriation of expert team, interdisciplinary cooperation, and inter-province professional exchanges, as well as the scientiifc research on nosocomial infection management.

  9. 上海市某医院感染死亡患者相关因素分析%Related risk factors for deaths of patients with nosocomial infections in a hospital of Shanghai

    Institute of Scientific and Technical Information of China (English)

    朱帅; 张群; 徐莉春; 陆燕; 殷瑾

    2014-01-01

    OBJECTIVE To explore the related risk factors for deaths of the patients with nosocomial infections in a three A general hospital of Shanghai ,observe the cost-effect ,strengthen the dynamic monitoring of the related risk factors for nosocomial infections ,and take corresponding prevention measures so as to make more scientific and reasonable strategies for control of the nosocomial infections .METHODS From 2012 to 2013 ,the related data were obtained from the death cases of nosocomial infections through the nosocomial infection surveillance system and doctors'working station ,and the data were processed and analyzed by using the Excel2013 and SPSS18 .0 . RESULTS The nosocomial infections occurred in 1506 patients in the two years ,among whom 63 cases died with the mortality rate of 4 .2% .The age distribution of the patients with nosocomial infections was (65 .4 ± 16 .6) years old ,the elderly patients aged more than 60 years occupied the highest proportion of the death cases ;the hospitalization duration was(2-2164)days ,with the median value of 28 days .Among the death cases of nosocomial infections ,the patients with respiratory tract infections accounted for 54 .0% ;the patients from the emergency department accounted for 20 .6% .The gram-negative bacteria causing the infections accounted for 62 .1% ;the median hospitalization cost of the death cases of nosocomial infections was 168 174 .4 yuan .CONCLUSION The mortality rate of the patients with nosocomial infections is high in the hospital of Shanghai ,the total medical cost of the death cases of nosocomial infections is increased due to the extended hospitalization duration .The lower respiratory tract is the major infection site ,and the gram-negative bacteria are the predominant pathogens .The old age and severe underlying diseases are the risk factors for the nosocomial infections .%目的:了解上海某三级综合性医院的医院感染死亡患者相关危险因素及其成本效益,加强医

  10. ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF ORGANISMS CAUSING SURGICAL SITE INFECTIONS (SSI

    Directory of Open Access Journals (Sweden)

    Rohini Murlidhar Gajbhiye

    2017-02-01

    Full Text Available BACKGROUND CDC defines surgical site infection as ‘Infections related to operative procedure that occurs at or near surgical incision within 30 days of operative procedure or within one year if the implant is left in situ’. Surgical site infection (SSI is 3 rd most frequently reported nosocomial infection (12%-16% as per National Nosocomial Infection Surveillance (NNIS. The aim of this study was to investigate the antimicrobial susceptibility pattern of organisms causing SSI. MATERIALS AND METHODS During a two year study period in a tertiary care hospital, 19,127 patients underwent surgeries in various surgical departments. Of these 517 (2.7% developed surgical site infection. The surgical wounds were classified by CDC & NNIS criteria into 4 classes. Two wound swabs were taken and processed by standard microbiological techniques. Antimicrobial susceptibility along with testing of ESBLs, MBLs, AmpCβ lactamases was done for all isolates causing SSI. RESULTS Among 19,127 patients, 517 (2.7% developed SSI. It was highest in patients of perforation peritonitis (11.99%.Among 517 specimens, 340 (65.76% showed growth and 177 (34.23% were culture negative. E.coli (23.33% was the commonest organism isolated followed by Acinetobacter spp. (16%, Klebsiella spp. (15.66%, Pseudomonas spp. (15.33%, S. aureus (10.33%, S. epidermidis(7.3%, Proteus spp. (6.00% and Citrobacter spp. (2.66%.Staphylococcus spp. were 100 % sensitive to Vancomycin & Linezolid. (27.5% S. aureus were MRSA and (17.5% were Inducible Clindamycin resistant (ICR. Enterobacteriaceae isolates showed maximum sensitivity towards Imipenem, Piperacillin-Tazobactam and Amikacin. Klebsiella spp. (40.62%, E.coli (35.89%, Citrobacter spp. (33.33%, Proteus spp. (26.08% were ESBL producers. Klebsiella spp. (17.18%, E.coli (10.25%, Proteus spp. (11.11% and Citrobacter spp. (8.69% were AmpC producers. Acinetobacter spp. (28.57% was commonest MBL producer followed by Klebsiella spp. (20

  11. Pulmonary Infection Caused by Achromobacter xylosoxidans in a Patient with Carcinoma of Epiglottis: A Rare Case.

    Science.gov (United States)

    Roy, Priyamvada

    2014-05-01

    Achromobacter xylosoxidans is an aerobic, motile, oxidase and catalase positive, non-fermenting, gram negative bacillus. It is an opportunistic pathogen which is responsible for various nosocomial and community-acquired infections. However, there are only very few reports of pulmonary infections caused by this bacterium in cancer patients. We are presenting a case of a patient with carcinoma of epiglottis, who developed pulmonary infection caused by Achromobacter xylosoxidans. According to the available literature, this is the first case of pulmonary infection caused by Achromobacter xylosoxidans, which was detected in a cancer patient in India. Since Achromobacter xylosoxidans demonstrates resistance to many classes of antimicrobials, vigilant and efficient microbiological work-ups and surveillances are needed, to diagnose infections caused by this rare pathogen in clinical settings.

  12. Clinical analysis of nosocomial infection in patients with Parkinson disease%帕金森病患者医院感染临床分析

    Institute of Scientific and Technical Information of China (English)

    费益君

    2011-01-01

    OBJECTIVE To investigate the nosocomial infection circumstance in parkinson disease and explore the risk factors of nosocomial infection, so that can obtain the methods of controlling the infection. METHODS A retrospective analysis of nosocomial infection circumstance had been accomplished among 165 Parkinson disease cases from our department ward from Jan 1,2008 to Oct 31,2010. RESULTS It showed cases with nosocomial infection were found among 165 cases. The nosocomial infection rate was 10. 30% and case-time rate was 15. 15% among inpatients of Parkinson disease. Nosocomial infection mostly took place within the first 2 weeks after patients hospitalized. Among inpatients with nosocomial infection, the respiratory tract infection was the highest (55. 43%) ,the second one was the urinary tract (24. 00%). Pathogenic bacteria were mostly the conditional ones. Nosocomial infection was closely related to such factors as age, diseases history, invasive operation, antibiotic prophylaxis,hospitalization days, plasma total protein. CONCLUSION Nosocomial infection is still a high factors frequent complication in parkinson disease and those related factors should be paid attention to. It is most important step for the rehabilitation of Parkinson disease and the effective control of nosocomial infection.%目的 分析帕金森病患者的医院感染情况,探讨其相关因素,以采取有效的控制措施.方法 对2008年1月1日-2010年12月31日神经内科出院的165例帕金森病患者的医院感染情况进行回顾性调查分析.结果 医院感染17例25例次,感染率为10.30%,例次感染率为15.15%;多发生在住院2周内;呼吸道感染最多,占55.43%,其次为泌尿道,占24.00%;共分离出33株病原菌,居首位的为肺炎克雷伯菌,占42.42%;年龄、病程、侵入性操作、抗菌药物预防性应用、住院天数、血浆白蛋白与医院感染的发生相关.结论 帕金森病患者的医院感染发生率高,应重视

  13. Analysis of nosocomial infections in patients with rheumatic immunologic diseases%风湿免疫性疾病患者医院感染分析

    Institute of Scientific and Technical Information of China (English)

    李建设; 高秀兰; 韩静

    2015-01-01

    tion ,accounting for 12 .0% and12 .0% respectively ;diabetes ,drainage pipe ,cirrhosis of the liver had the smaller proportion of risk factors ,which were only 8 .0 % ,4 .0% and 4 .0% .CONCLUSION The hospitals should deeply analyze the risk factors causing nosocomial infections in hospitalized patients with rheumatological disease ,and take effective measures to reduce the incidence of infections to a minimum .

  14. Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Manoj Kumar Sahu

    2016-01-01

    Full Text Available Background: Nosocomial infections (NIs in the postoperative period not only increase morbidity and mortality, but also impose a significant economic burden on the health care infrastructure. This retrospective study was undertaken to (a evaluate the incidence, characteristics, risk factors and outcomes of NIs and (b identify common microorganisms responsible for infection and their antibiotic resistance profile in our Cardiac Surgical Intensive Care Unit (CSICU. Patients and Methods: After ethics committee approval, the CSICU records of all patients who underwent cardiovascular surgery between January 2013 and December 2014 were reviewed retrospectively. The incidence of NI, distribution of NI sites, types of microorganisms and their antibiotic resistance, length of CSICU stay, and patient-outcome were determined. Results: Three hundred and nineteen of 6864 patients (4.6% developed NI after cardiac surgery. Lower respiratory tract infections (LRTIs accounted for most of the infections (44.2% followed by surgical-site infection (SSI, 11.6%, bloodstream infection (BSI, 7.5%, urinary tract infection (UTI, 6.9% and infections from combined sources (29.8%. Acinetobacter, Klebsiella, Escherichia coli, and Staphylococcus were the most frequent pathogens isolated in patients with LRTI, BSI, UTI, and SSI, respectively. The Gram-negative bacteria isolated from different sources were found to be highly resistant to commonly used antibiotics. Conclusion: The incidence of NI and sepsis-related mortality, in our CSICU, was 4.6% and 1.9%, respectively. Lower respiratory tract was the most common site of infection and Gram-negative bacilli, the most common pathogens after cardiac surgery. Antibiotic resistance was maximum with Acinetobacter spp.

  15. Incidence, microbiological profile of nosocomial infections, and their antibiotic resistance patterns in a high volume Cardiac Surgical Intensive Care Unit.

    Science.gov (United States)

    Sahu, Manoj Kumar; Siddharth, Bharat; Choudhury, Arin; Vishnubhatla, Sreenivas; Singh, Sarvesh Pal; Menon, Ramesh; Kapoor, Poonam Malhotra; Talwar, Sachin; Choudhary, Shiv; Airan, Balram

    2016-01-01

    Nosocomial infections (NIs) in the postoperative period not only increase morbidity and mortality, but also impose a significant economic burden on the health care infrastructure. This retrospective study was undertaken to (a) evaluate the incidence, characteristics, risk factors and outcomes of NIs and (b) identify common microorganisms responsible for infection and their antibiotic resistance profile in our Cardiac Surgical Intensive Care Unit (CSICU). After ethics committee approval, the CSICU records of all patients who underwent cardiovascular surgery between January 2013 and December 2014 were reviewed retrospectively. The incidence of NI, distribution of NI sites, types of microorganisms and their antibiotic resistance, length of CSICU stay, and patient-outcome were determined. Three hundred and nineteen of 6864 patients (4.6%) developed NI after cardiac surgery. Lower respiratory tract infections (LRTIs) accounted for most of the infections (44.2%) followed by surgical-site infection (SSI, 11.6%), bloodstream infection (BSI, 7.5%), urinary tract infection (UTI, 6.9%) and infections from combined sources (29.8%). Acinetobacter, Klebsiella, Escherichia coli, and Staphylococcus were the most frequent pathogens isolated in patients with LRTI, BSI, UTI, and SSI, respectively. The Gram-negative bacteria isolated from different sources were found to be highly resistant to commonly used antibiotics. The incidence of NI and sepsis-related mortality, in our CSICU, was 4.6% and 1.9%, respectively. Lower respiratory tract was the most common site of infection and Gram-negative bacilli, the most common pathogens after cardiac surgery. Antibiotic resistance was maximum with Acinetobacter spp.

  16. Nosocomial keratitis caused by methicillin-resistant Staphylococcus aureus: case report and preventative measures

    Directory of Open Access Journals (Sweden)

    Puneet S. Braich

    2015-10-01

    Full Text Available A 47-year-old African-American woman was admitted to the intensive care unit of our community hospital for respiratory failure secondary to severe decompensated heart failure, requiring intubation. In the ensuing days, she developed a methicillin-resistant Staphylococcus aureus (MRSA infection of the cornea, despite no growth of MRSA in multiple blood, sputum, and urine cultures. This unexpected corneal infection complicated her hospital stay, and increased morbidity and disease-related cost. Risk factors, warning signs, and preventative measures for MRSA keratitis secondary to lagophthalmos (inability to completely close one's eyelids are outlined in this case report. Implementing simple precautions such as taping eyelids shut or using artificial lubrication may reduce patient morbidity and disease-related costs. These recommendations are directed to non-ophthalmic clinicians who provide care to patients in settings where MRSA colonization is widespread.

  17. 烧伤整形外科医院感染的病原菌分布及耐药性%Nosocomial infections in department of burn and plastic surgery:distribution and antimicrobiai resistance

    Institute of Scientific and Technical Information of China (English)

    彭友林

    2012-01-01

    OBJECTIVE To investigate the status of nosocomial infections and drug resistance of pathogens in department of burn and plastic surgery and provide the reference for the prevention and control of nosocomial infections in department of surgery. METHODS Retrospective review was performed for data, from medical record of patients with nosocomial infections. The primary diseases, operation category and resistance rate were analyzed statistically. RESULTS The pathogenic bacteria causing nosocomial infections in department of burn and plastic surgery mainly comprised Staphylococcus aureus (28. 1 % ), coagulase-negative Staphylococcus (18. 0%), Pseud-omonas aeruginosa (17. 2%) , and Klebsiellar pneumonia (13. 3%) , etc. The above strains all showed high drug resistance. Among 59 strains of Staphylococci, 28 strains of methicillin-resistant Staphylococcus aureus (MRS) were detected with the detection rate of 47. 5%. CONCLUSION Effective interventions should be adopted to prevent and control the nosocomial infections in department of burn and plastic surgery.%目的 探讨烧伤整形外科医院感染现状及病原菌耐药性,为预防与控制外科医院感染提供参考依据.方法 同顾性医院感染患者的病案资科,统计医院感染的原发疾病及手术种类、病原菌耐药率.结果 烧伤整形外科医院感染主要病原菌是:金黄色葡萄球菌、凝固酶阴性葡萄球菌、铜绿假单胞菌、肺炎克雷伯菌,分别占28.1%、18.0%、17.2%、13.3%;以上病原菌均显示出较高的耐药性;59株葡萄球菌属中,检出耐甲氧西林葡萄球菌(MRS)28株,检出率为47.5%.结论 务必采取有效的干预措施,预防与控制烧伤整形外科医院感染.

  18. Nosocomial fungal infections in 18 severely burn patients: an retrospective clinical analysis%18例危重烧伤患者医院感染真菌回顾性分析

    Institute of Scientific and Technical Information of China (English)

    吴祖煌; 宋斌; 卓燕舞; 陈国养

    2011-01-01

    目的 分析烧伤后真菌性感染的相关因素,进一步探讨真菌性医院感染的防治措施.方法 回顾性分析2004年1月-2008年12月18例危重烧伤(烧伤面积≥30%体表总面积)后真菌性感染的病例资料.结果 白色假丝酵母菌是危重烧伤真菌性医院感染的主要病原菌,占75.8%;长期使用广谱抗菌药物是最常见的诱因,烧伤程度重、住院时间长、低白蛋白血症、侵入性操作、高龄、大剂量激素的应用等也是该病重要的危险因素;临床表现无特异性,临床症状不典型.结论积极控制感染相关危险因素,合理使用抗菌药物,减少侵入性操作,提高患者机体免疫力和尽早切削痂治疗等是预防真菌性医院感染的主要措施.%OBJECTIVE To analyze the predisposing factors and investigate the preventive measures for nosocomial fungal infection. METHODS The clinical features, therapy and outcome of 18 patients with in nosocomial fungal infection burn patients which happened from Jan 2004 to Dec 2008 were retrospectively reviewed. RESULTS Candida albican was the main pathogens causing nosocomial fungal infection. The rate of nosocomial fungal infection was higher in burn patients with long-term use of broad-spectrum antibiotic> severity of burn, long bed-days, hypoalbuminemia, invasive operation, long aging, abuse application of hormone. CONCLUSIONS We must take some measures to control the risk factors, reasonably use antibiotics, reduce the invasive procedure, improve physical immunity of the patients and perform crust treatment in early stage, which are key to prevention of nosocomial fungal infection.

  19. Epidemiology of CTX-M-type extended-spectrum beta-lactamase (ESBL)-producing nosocomial -Escherichia coli infection in China.

    Science.gov (United States)

    Shi, Huiqing; Sun, Fengjun; Chen, Jianhong; Ou, Qianyi; Feng, Wei; Yong, Xiaolan; Xia, Peiyuan

    2015-01-16

    Escherichia coli is one of the most common clinical pathogens causing nosocomial infection. The widespread cefotaxime-beta lactamases (CTX) has increased the multidrug resistance (MDR) of E. coli and has brought great trouble to the doctor treating the infection. ESBL-positive E. coli isolates were collected from different hospitals in different areas and the minimal inhibitory concentration (MIC) was analyzed by the agar dilution method. The resistance gene types were detected using polymerase chain reaction (PCR) and the sequence types were determined by multilocus sequence typing (MLST). We found that the blaCTX-M-1 group and the blaCTX-M-9 group were the main CTX-M gene types, with many kinds of MLST gene types. Except for TEM with high isolate, SHV, OXA and VEB were relatively rare, while no PER and GES was detected. Most strains may have other resistance mechanisms, and the ESBL positive strains have high resistance not only to cephalosporins but also to other kinds of antibiotics. The study provides wide epidemiological data and enables more effective infection control and treatment plans.

  20. Survey on Prevalence rate of Nosocomial Infection in 435 Inpatients%435例住院患者医院感染现患率调查

    Institute of Scientific and Technical Information of China (English)

    刘万清; 陈玲

    2013-01-01

    Objective To investigate the status of nosocomial infection, the use of antibacterials and the detectable rate of pathogenic germs so as to discover the potential problems of nosocomial infection and provide a scientific basis for controlling nosocomial infection effectively and improving the management of nosocomial infection. Methods With the method of cross - sectional survey, the inpatients were visited, the medical records were looked up in the specified period and unified questionnaires were completed. At last the statistical analysis of survey results was made. Results Four hundred and thirty- five medical records were planned and checked, the check rate was 100% . Among those 435 cases, the prevalence rate of nosocomial infection was 2.8%. The respiratory tract infection rate was top among all nosocomial infection cases, which included lower respiratory tract infection (83.3%), superficial incisional infection (8.3%) and organ lacunar infection (8.3%). The utilization rate of antibacterial drugs was 39.1 % , and the pathogenic detection rate in medication was 53.8% . Conclusions The prevalence survey can truthfully reflect the risk factors and the existing problems in nosocomial infection. It is conducive to constantly improving prevention and control measures, promoting the control quality of nosocomial infection and reducing the incidence rate of nosocomial infection.%目的 了解医院感染发生的基本情况、抗菌药物的使用及病原菌的送检情况,发现存在医院感染的隐患,为有效控制医院感染,提高医院感染管理水平提供科学依据.方法 采用横断面调查的方法,在指定的时间段内查阅在架病历,床旁访视患者,填写统一调查表,对调查结果进行统计分析.结果 应查病历435份,实查病历435份,实查率为100%,医院感染现患率为2.8%,医院感染部位以呼吸道感染居首位,其中下呼吸道感染为83.3%,表浅切口感染为8.3%,器官腔隙感染为8.3

  1. Cockroaches (Periplaneta americana and Blattella germanica) as potential vectors of the pathogenic bacteria found in nosocomial infections.

    Science.gov (United States)

    Fakoorziba, M R; Eghbal, F; Hassanzadeh, J; Moemenbellah-Fard, M D

    2010-09-01

    Although it has been difficult to prove the direct involvement of cockroaches (i.e. insects of the order Blattaria) in the transmission of pathogenic agents to humans, such insects often carry microorganisms that are important in nosocomial infections, and their medical importance in the spread of bacteria cannot be ruled out. In houses and institutions with poor standards of hygiene, heavy infestations with cockroaches, such as the peridomestic American cockroach (Periplaneta americana L.) and the domestic German cockroach (Blattella germanica L.), can occur. In the present study, cockroaches (126 B. germanica and 69 P. americana) were collected from four buildings (three public training hospitals and one house) in central Tehran, Iran. Each insect was processed, under sterile conditions, so that the bacteria on its external surfaces and in its alimentary tract and faecal pellets could be isolated and identified. The oldest and largest of the three hospitals sampled (a 1400-bed unit built 80 years ago) appeared to be the one most heavily infested with cockroaches, and cockroaches from this hospital accounted for most (65.4%) of the isolates of medically important bacteria made during the study. No significant difference was found between the percentages of P. americana and B. germanica carrying medically important bacteria (96.8% v. 93.6%; P>0.05). At least 25 different species of medically important bacteria were isolated and identified, and at least 22 were Gramnegative. The genus of enteric bacteria most frequently isolated from both cockroach species, at all four collection sites, was Klebsiella. The cockroaches from each hospital were much more likely to be found contaminated with medically important bacteria than those from the house. The hospital cockroaches were also more likely to be carrying medically important bacteria internally than externally (84.3% v. 64.1%; Pcockroaches and nosocomial infections, are discussed.

  2. Risk factors for nosocomial infection and mortality in burn patients: 10 years of experience at a university hospital.

    Science.gov (United States)

    Alp, Emine; Coruh, Atilla; Gunay, Galip K; Yontar, Yalcin; Doganay, Mehmet

    2012-01-01

    To evaluate the risk factors for nosocomial infection (NI) and mortality in a university hospital, 10-year data of burn patients were assessed retrospectively. The study was conducted at Erciyes University's Burn Center during 2000 and 2009. The records of 1190 patients were obtained. Overall, 131 (11%) patients had 206 NIs with an incidence density of 14.7 infections/1000 patient days. Burn wound infection (n = 109, 53%) was the most common NI. High (%TBSA burned) and late excision were found to be the most significant risk factors for the development of NI. Pseudomonas aeruginosa was the most frequent causative microorganism. However, the prevalence of multidrug-resistant Acinetobacter baumannii has increased in recent years with a prevalence of 47% in 2009. The carbapenem resistance of P. aeruginosa has decreased in recent years, whereas that of A. baumannii increased and it had a prevalence of 94% in the last year. Conversely, the most important risk factors for mortality were advanced age, high %TBSA and having an underlying disease. Prevention of NI is an important issue in burn units to reduce mortality rates. Early excision and wound closure are important therapeutic approaches for the prevention of burn wound infection.

  3. 一起缅甸输入霍乱疫情的调查处置%Progress in research of nosocomial infection of methicillin-resistant Staphylococcus aureus

    Institute of Scientific and Technical Information of China (English)

    李琼芬; 余建兴; 杨建斌

    2012-01-01

    2010年12月14日,云南省德宏州中缅边境的潞西市轩岗乡户弄村发生1起缅甸输入O1群稻叶型霍乱疫情,患者经云南省德宏州人民医院规范治疗7d,症状消失,两次采样,实验室检测结果为阴性,痊愈出院,病例未出现重症及死亡.%The wide use of antibiotics and development of new broad-spectrum antibiotics have resulted in serious drug resistance of bacteria, which is one of the important public health problems in the globe. Nosocomial infection of methicillin-resistant Staphylococcus aureus (MRSA) is common and duo to its multi drug resistance and proneness to spread f the treatment of MRSA infection is difficult. Not only the nosocomial infection of MRSA infection is seriuos, but also the community acquired infection of MRSA is in increase. Vancomycin-resistant Staphylococcus aureus (VRSA) has emerged in foreign countries, which is called super-bacteria (Superbug) or silent killer- This paper summerizes the progress in the research of the nosocomial infection of MRSA and in the prevetnion and treatment of MRSA infection.

  4. Guidelines for prevention of nosocomial pneumonia. Centers for Disease Control and Prevention.

    Science.gov (United States)

    1997-01-03

    This document updates and replaces CDC's previously published "Guideline for Prevention of Nosocomial Pneumonia" (Infect Control 1982;3:327-33, Respir Care 1983;28:221-32, and Am J Infect Control 1983;11:230-44). This revised guideline is designed to reduce the incidence of nosocomial pneumonia and is intended for use by personnel who are responsible for surveillance and control of infections in acute-care hospitals; the information may not be applicable in long-term-care facilities because of the unique characteristics of such settings. This revised guideline addresses common problems encountered by infection-control practitioners regarding the prevention and control of nosocomial pneumonia in U.S. hospitals. Sections on the prevention of bacterial pneumonia in mechanically ventilated and/or critically ill patients, care of respiratory-therapy devices, prevention of cross-contamination, and prevention of viral lower respiratory tract infections (e.g., respiratory syncytial virus [RSV] and influenza infections) have been expanded and updated. New sections on Legionnaires disease and pneumonia caused by Aspergillus sp. have been included. Lower respiratory tract infection caused by Mycobacterium tuberculosis is not addressed in this document. Part I, "An Overview of the Prevention of Nosocomial Pneumonia, 1994, provides the background information for the consensus recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC) in Part II, Recommendations for Prevention of Nosocomial Pneumonia." Pneumonia is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. Most patients who have nosocomial pneumonia are infants, young children, and persons > 65 years of age; persons who have severe underlying disease, immunosuppression, depressed sensorium, and/or cardiopulmonary disease and persons who have had thoracoabdominal surgery. Although patients receiving mechanically

  5. Clinical analysis of nosocomial infections in hospitalized patients with lung cancer%肺癌住院患者医院感染的临床分析

    Institute of Scientific and Technical Information of China (English)

    涂英华; 练祖平; 白广德

    2015-01-01

    目的:探讨肺癌住院患者感染病原菌分布、动态变化以及感染相关因素,为临床制定感染预防措施提供参考。方法对2009年1月-2014年1月入院的357例肺癌患者感染资料进行回顾性分析,收集患者的痰液、咽拭子、尿液、胸腔积液、粪便、局部病灶分泌物等标本进行病原菌的分离、培养及鉴定,采用 SPSS统计软件进行数据处理。结果357例肺癌患者发生感染71例,感染率为19.9%,小细胞肺癌较非小细胞肺癌更容易发生感染;感染发生部位以呼吸道和肺部为主,占43.7%;共检出病原菌168株,其中革兰阳性菌51