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The Patient Survival Guide: 8 Simple Solutions to Prevent Hospital and Healthcare Associated Infections

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  • MMI International , Ardmore, PA
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The Patient Survival Guide: 8 Simple Solutions to Prevent Hospital and Healthcare Associated Infections

... Ein neuer Ansatz im Kontext der Gesundheitskompetenz ist nun, dass Patienten in den Prozess der Händehygiene mit einbezogen werden, um die Raten der Infektionen zu senken. Hier findet sich also ein klassisches Bespiel für die Integration der Patienten in extrem bedeutsame Kernprozesse, welche den Outcome von Behandlung, Therapie und Pflege massiv beeinflussen [5]. Ein innovativer Ansatz ist, Patienten und ihre Angehörigen dabei zu unterstützen, aktiv am Prozess zu partizipieren und zu überprüfen ob die Händehygiene korrekt und zu den richtigen Zeitpunkten von den Health Professionals durchgeführt wird. ...
... Sie müssen auch wissen, wie sie diese Informationen einsetzen können und müssen das Gefühl haben, dass ihre Intervention auch von der Organisation und dem Gesundheitspersonal gewünscht ist und für sie keine Nachteile mit Blick auf die Behandlung entstehen. Sehr entscheidend ist, wie in multiprofessionellen Teams mit der Einbeziehung der Patienten umgegangen wird [5]. Eine Beobachtungsstudie zeigt den Einfluss von zwei wesentlichen Faktoren auf das Händedesinfektionsverhalten in Teams: Das Desinfektionsverhalten des ranghöchsten Mitarbeiters sowie die Händedesinfektion derjenigen Person, die als erste das Patientenzimmer betritt. ...
Article
Zusammenfassung Im Kontext der Forschung findet die Fragestellung, wie Patienten in den Prozess der Händedesinfektion durch Gesundheitspersonal einbezogen werden können, bisher wenig Beachtung. In entsprechenden Kampagnen stellt lediglich das Gesundheitspersonal eine Zielgruppe dar. Der Beitrag zeigt die Public Health Relevanz des Themas sowie Möglichkeiten durch Gesundheitskompetenz mit Patienten, Organisation und Gesundheitspersonal Infektionsraten signifikant zu senken.
... Catheter-associated urinary tract infection (CAUTI) is an important cause of morbidity and mortality in Indian subjects, affecting all age groups [1]. Approximately 12%-16% of adult hospital inpatients will have an indwelling urinary catheter (IUC) at some time during their hospitalization, and each day the indwelling urinary catheter remains, a patient has a 3%-7% increased risk of acquiring a catheter-associated urinary tract infection (CAUTI) [2,3]. CAUTI can lead to such complications as prostatitis, epididymitis, and orchitis in males, and cystitis, pyelonephritis, gram-negative bacteremia, endocarditis, vertebral osteomyelitis, septic arthritis, endophthalmitis, and meningitis in patients. ...
Article
Background: Urinary tract infections (UTIs) attributed to the use of an indwelling catheter is one of the most common infections acquired by patients in health care facilities. This infection is associated with varied microbiological etiology. Catheter-associated urinary tract infection (CAUTI) is an important cause of morbidity and mortality in India. The objective of this study was to find the prevalence of CAUTI infection and to determine their antibiotic profile. Aims and Objectives: The aim of the study was to provide a baseline information in the context of culture positivity rate of urinary isolates and prevalence of catheter associated urinary tract infections (CAUTI), to identify the associated microbial, and to determine their susceptibility pattern to commonly used antimicrobial agents for prophylactic and empiric therapy. Materials and Methods: This prospective study was done on nonrepetitive urine samples from all age group patients of both inpatient and outpatient department. Semi quantitative bacterial culture was performed, and isolates were identified and antimicrobial sensitivity tests were carried out by Vitek-2 compact automated method. Results: Significant bacteriuria was observed among 257/1543 (16.65%) urine samples. Among bacterial isolates, Gram negative bacilli predominate. Escherichia coli 7/17 (44%) being the most common isolate followed by Klebsiella (35%). The incidence of CAUTI/1000 catheter days observed in our study was 2.77. Total 3 CAUTI were identified from July 2021 to June 2022, out of which 2 were Klebsiella pneumoniae and 1 isolate was Enterococcus faecium. Conclusions: Uropathogens from CAUTI patients exhibit significantly higher resistance to most antibiotics than non- CAUTI isolates. This is an important factor to take into consideration when choosing correct treatment options for patients with urinary tract infection. Klebsiella pneumoniae is one of the important notable pathogens causing nosocomial infections.............
... It is estimated that between 15% and 25% of hospitalized patients are being urinary catheterized (26,27), and, unfortunately, in many of these cases, the catheters are placed after an inappropriate indication (28,29). In addition, for every additional day a patient has an indwelling urinary catheter, there is a 3-7% increased risk of developing a caUTI (1,30,31). ...
Article
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THE IMPACT OF ESBL-PRODUCING ENTEROBACTERALES: AN OLD STORY WITH NEW PERSPECTIVES (Abstract): Antibiotic resistance represents a global crisis, one of the biggest challenges that humanity is facing. In addition to the SARS-Cov-2 pandemic, we are currently witnessing another, more devastating pandemic of multidrug-resistant microorganisms, not only in hospitals but also in the community. Material and methods: we aimed to analyze the incidence and implications of urinary isolated, extended-spectrum β-lactamase-producing (ESBL+) Enterobacterales, from patients admitted between 01/01/2018 and 31/12/2018. Results: the main identified pathogen was Escherichia coli, accounting for 67.3% of all cases; the ESBL-production rate was 26.5%, with E. coli and Klebsiella pneumoniae emerging as leading etiologies. Mean age was significantly higher for patients with ESBL+ isolates (57.6 vs. 65.1 years, p<0.0001), while urinary catheterization was more frequently associated with ESBL+ strains (21.8% ESBL+ vs. 6.2% ESBL-, p<0.0001). As anticipated, antibiotic susceptibility was significantly influenced both by ESBL production and urinary catheterization, except for nitrofurantoin and fosfomycin. Conclusions: comprehensive approach of the local antibiotic susceptibility profile can facilitate the choice of proper therapeutic management, based on the regional particularities of an East European country.
... Approximately 12-16% of adult hospital inpatients will have an indwelling urinary catheter at some time during their hospitalization, and each day the indwelling urinary catheter remains, a patient has a 3% to 7% increased risk of acquiring a CAUTI [3,4]. CAUTI accounts for over 1 million cases in the United States alone and almost 80% of the nosocomial infections worldwide [5,6]. ...
Article
Full-text available
New, contextualized modern solutions must be found to solve the dilemma of catheter-associated urinary infection (CAUTI) in long-term care settings. In this paper, we describe the etiology, risk factors, and complications of CAUTI, explore different preventive strategies proposed in literature from the past to the present, and offer new insights on therapeutic opportunities. A care bundle to prevent CAUTI mainly consists of multiple interventions to improve clinical indications, identifying a timeline for catheter removal, or whether any alternatives may be offered in elderly and frail patients suffering from chronic urinary retention and/or untreatable urinary incontinence. Among the various approaches used to prevent CAUTI, specific urinary catheter coatings according to their antifouling and/or biocidal properties have been widely investigated. Nonetheless, an ideal catheter offering holistic antimicrobial effectiveness is still far from being available. After pioneering research in favor of bladder irrigations or endovesical instillations was initially published more than 50 years ago, only recently has it been made clear that evidence supporting their use to treat symptomatic CAUTI and prevent complications is needed.
... 90% of all UTIs in ambulatory individuals and 50% of nosocomial UTIs are caused by E. coli [9]. Other uropathogens include: Pseudomonas, Proteus, and Klebsiella species amongst others [9][10][11]. ...
Article
Full-text available
Background: Gbogbonise Epa Ijebu is a commercially sold native concoction in SouthWest , Nigeria, with the potential of curing many ailments as claimed by the manufacturer and vendors. This study investigated the antimicrobial quality and efficacy of Gbogbonise Epa Ijebu. Materials and Methods: A total of 20 samples of the herbal remedy were purchased from local vendors in Ilishan-Remo Community of Ogun State, Nigeria and were assessed for their microbiological quality using standard microbiological methods. Also, the efficacy of the herbal remedy was tested against some selected uropathogens using the Punch-hole agar diffusion method. Data generated were analyzed using the Instant GraphPad software package and P value <0.05 was considered statistically significant. Results: The outcome of the study shows that half (50%) of the herbal remedy samples examined were sterile, while the other half (50%) were contaminated with a microbial count of <10 CFU/mL. The microbial isolates recovered from the herbal remedy include: Staphylococcus aureus (8.3%), Coagulase negative Staphylococcus (75%) and Microsporium spp (16.7%). Assessment of the antimicrobial potential of the herbal remedy show that the test herbal remedy had strong inhibitory activity against Staphylococcus aureus (17±0.6 mm), Escherichia coli (16.3±0.3 mm), Pseudomonas aeruginosa (16.3±0.3 mm), Klebsiella pneumoniae (15±0.6 mm) and Proteus mirabilis (14±0.8 mm), except Candida albican, at a concentration of 200 mg/mL. The combined herbal solution and standard drug gave higher zone diameter of inhibition: Klebsiella pneumoniae (25±0.6 mm), Pseudomonas aeruginosa (24±0.6 mm), Staphylococcus aureus (23.7±0.3 mm), Escherichia coli (23.3±0.3 mm) and Candida albican (15±0.6mm), except Proteus mirabilis. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal/Fungicidal Concentration (MBC/MFC) of the herbal remedy for all the test isolates (except Candida albican) was 100mg/mL and 200mg/mL, respectively. The result of the phytochemical screening showed the presence of alkaloids, anthraquinones, cardiac glycosides, flavonoids, saponins and tannins, while steroids and resins were absent. Conclusion: The outcome of this study further strengthens the claim of efficacy made by the manufacturer and vendors of the herbal remedy. However, more attention should be given to quality preparations, packaging and storage in view of the general safety of the consumers.
... Virtually all healthcareassociated UTIs are caused by instrumentation of the urinary tract. Approximately (12%-16%) of adult hospital inpatients will have an indwelling urinary catheter at some time during their hospitalization, and each day the indwelling urinary catheter remains, a patient has a (3%-7%) increased risk of acquiring a catheter-associated urinary tract infection (CAUTI) , [11,12]. ...
Article
Full-text available
Objective: Indwelling urinary catheters (IUCs) are commonly used in hospitalized patients. Catheter-associated urinary tract infections (CAUTIs) are a major source of nosocomial infections in the worldwide. The present study was conducted to the etiological Bacterial pathogens of the UTI and to determine the antibiotic sensitivity pattern of pathogens isolated. Methods: This study was carried out in AL-Imam Hussein Medical in holly Karbala city from (1st March, 2017) to (30st June, 2017).Total (300) urine samples were tested bacteriologically and for antibiotic susceptibility using standard procedures. Results: A total (300) patients,(111) by(37%) were female and (189) by (63%) were male with indwelling urinary catheters were studied divided into four groups according to hospital ward. The highest percentage of age group was seen in (36-45) years group. Uropathogens were isolated from (244) patients sample only. The bacterial isolates included E. coli (53), Pseudomonas aeruginosa (99), Klebseillapneumonia (22), Staphylococcus aureus (20), Coagulase negative Staphylococcus (16), Candida albicans (14), Enterococcus faecalis (8), B hemolytic Streptococci (6) and Serratiamarcesens (6). All isolated bacteria display variation in sensitivity and resistance pattern. Conclusions: This study observed that Pseudomonas aeruginosais the main organism which isolated from Catheterized patients caused UTI. In addition, the study showed that E. coli isolates were the predominant pathogens and showed increasing resistance pattern to the commonly drugs which used in present study.
... [5][6][7] The HA-UTI is frequently related to bladder catheterization, 3,4 and the risk of catheter-associated urinary tract infection (CA-UTI) is reported to increase by 3% to 7% within each day of the indwelling urinary catheter remains. 8,9 Most epidemiological data including the distribution of the etiologic agents and the resistance patterns of the microorganisms causing HA-UTI is mainly based on adult reports, and there are limited studies concerning the isolated HA-UTI in children. 4,10 In addition, most of the studies about nosocomial UTIs are mostly related to CA-UTI. ...
Article
Full-text available
Background: Healthcare–associated infections results increased healthcare costs and mortality. There are limited studies concerning the distribution of the etiologic agents and the resistance patterns of the microorganisms causing healthcare–associated urinary tract infections (HA-UTI) in pediatric settings. Objectives: The aim of this study was to evaluate the distribution and antibiotic susceptibility patterns of pathogens causing HA-UTI in children. Material and Methods: Isolates from 138 children with UTI who were hospitalized in pediatric, neonatal and pediatric surgery intensive care units were reviewed. Results: Most common isolated organism was Kleibsella pneumoniae (34.1%) and Escherichia coli (26.8%). Among the Pseudomonas aeruginosa, Meropenem and imipenem resistance rates were 46.2% and 38.5%. Extended spectrum beta-lactamase (ESBL) production was present in 48 Klebsiella species (82.75%). Among ESBL positive Klebsiella species, the rate of meropenem and imipenem resistance was 18.8% and ertapenem resistance was 45.9%. Extended spectrum beta-lactamase production was present in 27 (72.9%) Escherichia coli species. Among ESBL positive E.coli, the rate of meropenem and imipenem resistance was 7.4% and ertapenem resistance was 14.8% Conclusions: Emerging meropenem resistance in P. aeruginosa, higher rates of ertapenem resistance in ESBL positive ones in E.coli and Klebsiella species in pediatric nosocomial UTI are important notifying signs for superbug infections.
Article
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Background Enhanced recovery after surgery (ERAS) pathways have been shown to considerably reduce complications, length of stay and costs after most of surgical procedures by standardised application of best evidence-based perioperative care. The aim was to elaborate dedicated recommendations for cytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC) in a two-part series of guidelines based on expert consensus. The present part II of the guidelines highlights postoperative management and special considerations. Methods The core group assembled a multidisciplinary panel of 24 experts involved in peritoneal surface malignancy surgery representing the fields of general surgery (n=12), gynaecological surgery (n=6), and anaesthesia (n=6). Experts systematically reviewed and summarized the available evidence on 72 identified perioperative care items, following the GRADE (grading of recommendations, assessment, development, evaluation) system. Final consensus (defined as ≥50%, or ≥70% of weak/strong recommendations combined) was reached by a standardised 2-round Delphi process, regarding the strength of recommendations. Results Response rates were 100% for both Delphi rounds. Quality of evidence was evaluated high, moderate low and very low, for 15 (21%), 26 (36%), 29 (40%) and 2 items, respectively. Consensus was reached for 71/72(98.6%) items. Strong recommendations were defined for 37 items. No consensus could be reached regarding the preemptive use of fresh frozen plasma. Conclusion The present ERAS recommendations for CRS±HIPEC are based on a standardised expert consensus process providing clinicians with valuable guidance. There is an urgent need to produce high quality studies for CRS±HIPEC and to prospectively evaluate recommendations in clinical practice.
Chapter
Hospital-acquired infections can have a critical impact on our patients. Furthermore, together they make up a heavily weighted portion of most hospitals’ quality metrics. Though intensive care physicians are comfortable with making clinical diagnoses of various hospital-acquired infections, they are often not as comfortable with the complicated definitions that are used for surveillance and reporting purposed. Understanding these definitions and applying them consistently are critical when engaging in performance improvement. This chapter seeks to provide an overview of the surveillance definitions of hospital-acquired infections and of the most recent evidence-based measures for preventing these infections.
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