Nosocomial infections in the ICU: Pens and spectacles as fomites (original) (raw)
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W riting Pens - A Potential Source of Nosocom ial Infections
2011
Background : Nonmedical devices such as pens used by doctors and nurses can harbour various potential pathogens and can become an exogenous source of infections. Aim : The main objective was to study bacterial contamination of pens used by healthcare personnel in ICU and duration of bacterial survival on new pens. Material and Methods : Seventy five pens used by doctors and nurses working in ICU were studied for bacterial contamination. The isolates obtained were identified and their antibiotic susceptibility pattern was also studied. Three kinds of new pens were deliberately contaminated with different organisms to determine their survival. Results : Growth was obtained on 37(49.3%) pens. Coagulase negative staphylococci was found to be the most common isolate obtained from 8(10.6%) pens. Staphylococcus aureus, Bacillus spp, Micrococcus spp, Corynebacterium spp, Enterococcus spp and other Gram negative bacilli were obtained from 7(9.3%), 7(9.3%), 5(6.6%), 4(5.3%), 2(2.6%) and 4 (5....
Nosocomial Infections: Prevention, Control and Surveillance
IJSR, Vol (2), No (12), December 2023, 2023
Introduction: Nosocomial infections can have significant negative consequences, including extra hospitalization days, additional costs, and even deaths, depending on the site of infection. These consequences and associated costs can be substantial, and it is important to identify patients at highest risk for infection in order to prioritize prevention and control efforts. In this review, we aimed to include all preventive, control and surveillance strategies targeting nosocomial infections. Methods: A systematic review was conducted to examine the effects of modifications to hospital architecture on nosocomial infections in intensive care units (ICUs), surgical departments, isolation units, and hospitals in general. The review included experimental and nonexperimental studies published before 2022 in English. The search was conducted using a combination of keywords and abbreviated terms related to hospital architecture and nosocomial infections, and was carried out through seven medical databases, reference lists, and expert consultation. In addition, the Cochrane Controlled Trials Database and the internet were checked. The bibliographies of reviewed papers, reports, and textbooks were searched by hand and experts in the field of hospital hygiene were consulted. The principal outcome measure was the rate of nosocomial infections.
International Journal of Infection Control, 2015
Critically ill patients are at increased risk of developing nosocomial infection. Hospitals in developing countries are facing higher incidence of this problem. The aim of this study was to assess the epidemiology of infections in hospital. A retrospective study was conducted at CCU of a tertiary care teaching hospital in South India. All patients who stayed in ICU for more than 48 hours were included in the study. Relevant data on demographics, ICU length of stay, co-morbidities, pre-admission infections and number of devices were recorded from case records. The culture and sensitivity reports were accessed from the microbiology lab registers. Chi square, unpaired t-test and Fisher's exact test were used wherever applicable. Out of 315 patients included in the study, 93 patients (29.5%) developed 126 episodes of ICU acquired infections (Incidence density rate; 70.3/1000 ICU days), of which common nosocomial infections were pneumonias (15.5%), urinary tract infections (8.9%), blood stream infections (8.2%) and surgical site infections (7%). Patients who acquired infections in ICU had longer ICU stay and received mechanical ventilation for longer hours. The most common isolates were Pseudomonas aeruginosa (24.9%), Acinetobacter baumannii (23.1%). In logistic regression analysis, following risk factors were significantly associated with higher infection rates: medical category, emergency surgery, diabetes, presence of tracheostomy and total parenteral nutrition (TPN). In conclusion TPN, medical category, emergency surgery, diabetes mellitus and presence of tracheostomy were significant risk factors which lead to higher infection rate. These data will help reinforce the infection control measures.
Critical Care Medicine
To describe the epidemiology of nosocomial infections in medical intensive care units (ICUs) in the United States. Analysis of ICU surveillance data collected through the National Nosocomial Infections Surveillance (NNIS) System between 1992 and 1997. Medical ICUs in the United States. A total of 181,993 patients. Nosocomial infections were analyzed by infection site and pathogen distribution. Urinary tract infections were most frequent (31%), followed by pneumonia (27%) and primary bloodstream infections (19%). Eighty-seven percent of primary bloodstream infections were associated with central lines, 86% of nosocomial pneumonia was associated with mechanical ventilation, and 95% of urinary tract infections were associated with urinary catheters. Coagulase-negative staphylococci (36%) were the most common bloodstream infection isolates, followed by enterococci (16%) and Staphylococcus aureus (13%). Twelve percent of bloodstream isolates were fungi. The most frequent isolates from pneumonia were Gram-negative aerobic organisms (64%). Pseudomonas aeruginosa (21%) was the most frequently isolated of these. S. aureus (20%) was isolated with similar frequency. Candida albicans was the most common single pathogen isolated from urine and made up just over half of the fungal isolates. Fungal urinary infections were associated with asymptomatic funguria rather than symptomatic urinary tract infections (p < .0001). Certain pathogens were associated with device use: coagulase-negative staphylococci with central lines, P. aeruginosa and Acinetobacter species with ventilators, and fungal infections with urinary catheters. Patient nosocomial infection rates for the major sites correlated strongly with device use. Device exposure was controlled for by calculating device-associated infection rates for bloodstream infections, pneumonia, and urinary tract infections by dividing the number of device-associated infections by the number of days of device use. There was no association between these device-associated infection rates and number of hospital beds, number of ICU beds, or length of stay. There is a considerable variation within the distribution of each of these infection rates. The distribution of sites of infection in medical ICUs differed from that previously reported in NNIS ICU surveillance studies, largely as a result of anticipated low rates of surgical site infections. Primary bloodstream infections, pneumonia, and urinary tract infections associated with invasive devices made up the great majority of nosocomial infections. Coagulase-negative staphylococci were more frequently associated with primary bloodstream infections than reported from NNIS ICUs of all types in the 1980s, and enterococci were a more frequent isolate from bloodstream infections than S. aureus. Fungal urinary tract infections, often asymptomatic and associated with catheter use, were considerably more frequent than previously reported. Invasive device-associated infections were associated with specific pathogens. Although device-associated site-specific infection rates are currently our most useful rates for performing comparisons between ICUs, the considerable variation in these rates between ICUs indicates the need for further risk adjustment.
2015
Critically ill patients are at increased risk of developing nosocomial infection. Hospitals in developing countries are facing higher incidence of this problem. The aim of this study was to assess the epidemiology of infections in hospital. A retrospective study was conducted at CCU of a tertiary care teaching hospital in South India. All patients who stayed in ICU for more than 48 hours were included in the study. Relevant data on demographics, ICU length of stay, co-morbidities, pre-admission infections and number of devices were recorded from case records. The culture and sensitivity reports were accessed from the microbiology lab registers. Chi square, unpaired t-test and Fisher's exact test were used wherever applicable. Out of 315 patients included in the study, 93 patients (29.5%) developed 126 episodes of ICU acquired infections (Incidence density rate; 70.3/1000 ICU days), of which common nosocomial infections were pneumonias (15.5%), urinary tract infections (8.9%), blood stream infections (8.2%) and surgical site infections (7%). Patients who acquired infections in ICU had longer ICU stay and received mechanical ventilation for longer hours. The most common isolates were Pseudomonas aeruginosa (24.9%), Acinetobacter baumannii (23.1%). In logistic regression analysis, following risk factors were significantly associated with higher infection rates: medical category, emergency surgery, diabetes, presence of tracheostomy and total parenteral nutrition (TPN). In conclusion TPN, medical category, emergency surgery, diabetes mellitus and presence of tracheostomy were significant risk factors which lead to higher infection rate. These data will help reinforce the infection control measures.
To describe the epidemiology of nosocomial infections in medical intensive care units (ICUs) in the United States. Analysis of ICU surveillance data collected through the National Nosocomial Infections Surveillance (NNIS) System between 1992 and 1997. Medical ICUs in the United States. A total of 181,993 patients. Nosocomial infections were analyzed by infection site and pathogen distribution. Urinary tract infections were most frequent (31%), followed by pneumonia (27%) and primary bloodstream infections (19%). Eighty-seven percent of primary bloodstream infections were associated with central lines, 86% of nosocomial pneumonia was associated with mechanical ventilation, and 95% of urinary tract infections were associated with urinary catheters. Coagulase-negative staphylococci (36%) were the most common bloodstream infection isolates, followed by enterococci (16%) and Staphylococcus aureus (13%). Twelve percent of bloodstream isolates were fungi. The most frequent isolates from pneumonia were Gram-negative aerobic organisms (64%). Pseudomonas aeruginosa (21%) was the most frequently isolated of these. S. aureus (20%) was isolated with similar frequency. Candida albicans was the most common single pathogen isolated from urine and made up just over half of the fungal isolates. Fungal urinary infections were associated with asymptomatic funguria rather than symptomatic urinary tract infections (p < .0001). Certain pathogens were associated with device use: coagulase-negative staphylococci with central lines, P. aeruginosa and Acinetobacter species with ventilators, and fungal infections with urinary catheters. Patient nosocomial infection rates for the major sites correlated strongly with device use. Device exposure was controlled for by calculating device-associated infection rates for bloodstream infections, pneumonia, and urinary tract infections by dividing the number of device-associated infections by the number of days of device use. There was no association between these device-associated infection rates and number of hospital beds, number of ICU beds, or length of stay. There is a considerable variation within the distribution of each of these infection rates. The distribution of sites of infection in medical ICUs differed from that previously reported in NNIS ICU surveillance studies, largely as a result of anticipated low rates of surgical site infections. Primary bloodstream infections, pneumonia, and urinary tract infections associated with invasive devices made up the great majority of nosocomial infections. Coagulase-negative staphylococci were more frequently associated with primary bloodstream infections than reported from NNIS ICUs of all types in the 1980s, and enterococci were a more frequent isolate from bloodstream infections than S. aureus. Fungal urinary tract infections, often asymptomatic and associated with catheter use, were considerably more frequent than previously reported. Invasive device-associated infections were associated with specific pathogens. Although device-associated site-specific infection rates are currently our most useful rates for performing comparisons between ICUs, the considerable variation in these rates between ICUs indicates the need for further risk adjustment.
We studied the magnitude and determinants of device-related nosocomial infections in intensive care units (ICU) and identified the predominant microorganisms involved. Sputum, urine, blood cultures and chest X-ray were taken from each patient on admission and on appearance of any sign/symptom of infection. Out of 400 patients admitted to 3 units during the study, 45 (11.3%) developed nosocomial infections. The most important determinants of infection were previous admission to an ICU, whether in the same or another hospital, and duration of stay. Overall, 38 patients developed 43 device-related nosocomial infections (1.13 episodes per patient). The main infectied association with invasive procedures were ventilator-associated pneumonia followed by catheter-related urinary tract infection and bloodstream infections.
Nosocomial infections and risk factors in intensive care unit of a university hospital in Turkey
Central European Journal of Medicine, 2009
The aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be 68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit.
Nosocomial infections and infectious risks related to hospital environment
E3S Web of Conferences, 2021
Introduction: The fight against nosocomial infections, particularly those linked to environmental germs, is one of the priorities of health establishments. Microbiological control of the hospital environment is an essential element of the strategy for the fight against these infections. The aim of this study is to determine the microbial ecology of hospital surfaces and medical devices. Methods: This is a study, which was carried out in the El Idrissi hospital in Kénitra. For the microbiological control of surfaces, we opted for the swab technique: the search for specific germs on flat surfaces and in areas that are difficult to access and not flat. Results: Among the bacteria most frequently responsible for isolated nosocomial infections: Bacillus (28%) and coagulase-negative staphylococci (27%) were predominant, followed by Staphylococcus aureus (19%), Klebsiella pneumoniae (17%), Pseudomonas aeruginosa (5%), Enterobacter cloacae (3%) and Proteus vulgaris (1%).The overall distribu...