Posts filed under ‘Infecciones nosocomiales’

2019-11 Hospital-Acquired Infections in New York State, 2018 –  N York State Department of Health 24 Pags

Contents

Introduction ………………………………………………………………………………………………………… 3

Surgical Site Infections (SSIs)………………………………………………………………………………………………. 4

Catheter-Associated Infections ………………………………………………………………………………………………………… 5

Laboratory-identified (LabID) infections………………………………………………………………………………………. 6

Clostridioides difficile Infections (CDI)……………………………………………………………………………………………….. 7

Carbapenem-resistant Enterobacteriaceae (CRE) Infections………………………………………………………………………………………. 8

Methicillin-resistant Staphylococcus aureus (MRSA) Infections………………………………………………………………………………………. 9

Hospital Performance …………………………………………………………………………………………………………10

Role of the State Health Department…………………………………………………………………………………….23

What Patients Can do to Prevent Infections………………………………………………………………………………………..24

PDF

https://www.health.ny.gov/statistics/facilities/hospital/hospital_acquired_infections/2018/docs/hospital_acquired_infection_p1.pdf

November 20, 2019 at 7:11 am

Control and Elimination of Extensively Drug-Resistant Acinetobacter baumanii in an Intensive Care Unit

Emerging Infectious Diseases November 2019 V.25 N.10 P.1928-1931

We decreased antimicrobial drug consumption in an intensive care unit in Lebanon by changing to colistin monotherapy for extensively drug-resistant Acinetobacter baumanii infections.

We saw a 78% decrease of A. baumanii in sputum and near-elimination of blaoxa-23-carrying sequence type 2 clone over the 1-year study.

Non–A. baumanii multidrug-resistant infections remained stable.

FULL TEXT

https://wwwnc.cdc.gov/eid/article/25/10/18-1626_article

PDF (CLIC en PDF)

November 13, 2019 at 7:02 am

Real-world efficacy of bezlotoxumab for prevention of recurrent Clostridium difficile infection: a retrospective study of 46 patients in five university hospitals in Finland

European Journal of Clinical Microbiology & Infectious Diseases October 2019 V.38 N.10 P.1947–1952

Reports on real-world experience on efficacy of bezlotoxumab (BEZ) has been lacking thus far. We retrospectively studied the efficacy and safety of BEZ in preventing the recurrence of Clostridium difficile infection (CDI) in five university hospitals in Finland. Seventy-three percent of our 46 patients remained free of recurrence in the following 3 months and the performance remained as 71% effective also among immunocompromised patients. In severe CDI, BEZ prevented recurrence in 63% of cases. From our study patients, 78% had three or more known risk factors for recurrence of CDI. Eight of our patients were waiting for fecal microbiota transplantation but after stopping the antibiotics that were continued to prevent recurrence of CDI and after receiving BEZ, all remained free of recurrence and did not need the procedure. Success with BEZ as an adjunctive treatment in preventing recurrence of CDI in high-risk patients may be rated as high. Among a subgroup of our patients, those already evaluated to be in need of fecal microbiota transplantation, BEZ seems to be an alternative option.

FULL TEXT

https://link.springer.com/article/10.1007/s10096-019-03630-y?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_10096_38_10

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-019-03630-y.pdf

November 12, 2019 at 3:45 pm

Risk factors for acquisition of carbapenem-resistance during treatment with carbapenem in the intensive care unit: a prospective study

European Journal of Clinical Microbiology & Infectious Diseases V.38 N.11 P.2077–2085

François Labaste, Julia Grossac, Fanny Vardon Bounes, Jean-Marie Conil, Stéphanie Ruiz, Thierry Seguin, Marion Grare, Olivier Fourcade, Vincent Minville & Bernard Georges

The emergence of carbapenemases in gram-negative aerobes is worrying.

The aim of this prospective study was to estimate the incidence of acquisition of carbapenem-resistance during treatment in ICU and to identify the risk factors. This was a prospective, observational, cohort study.

This study was conducted at intensive care unit, academic medical center, Toulouse Rangueil University Hospital. Patients were included if they received antibiotic treatment with carbapenem for more than 48 h.

Biological samples were taken in accordance with current practice in the unit. The main endpoint was the occurrence of bacterial resistance to carbapenems occurring between the onset of treatment and the patient’s exit from the ICU. Uni- and multi-variate analyses were carried out.

Of the 364 patients admitted to the unit between May and November 2014, 78 were included in our study and 16 (20.51%) developed resistance.

The two main risk factors were a length of stay in ICU of more than 29 days (HR = 3.61, p = 0.01) and the presence of Pseudomonas aeruginosa in the samples taken before the start of treatment (HR = 5.31, p = 0.002).

No resistance due to carbapenemase production was observed in this study. The prescription of carbapenems in the ICU setting must adhere to the expert guidelines.

In light of our results, special attention must be paid to patients whose stay in intensive care is prolonged, and those in whom Pseudomonas aeruginosa is isolated from bacteriological samples taken before the beginning of antibiotic therapy.

FULL TEXT

https://link.springer.com/article/10.1007/s10096-019-03644-6?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_10096_38_11

PDF

https://link.springer.com/content/pdf/10.1007%2Fs10096-019-03644-6.pdf

November 12, 2019 at 8:42 am

Diagnosis and Treatment of Adults with Community-acquired Pneumonia

Am J Respir Crit Care Med October 1, 2019 V.200 N.7 P.e45–e67

An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America

FULL TEXT

https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST

PDF

https://www.atsjournals.org/doi/pdf/10.1164/rccm.201908-1581ST

November 10, 2019 at 11:36 am

Effect of procalcitonin-guided antibiotic treatment on clinical outcomes in intensive care unit patients with infection and sepsis patients: a patient-level meta-analysis of randomized trials.

Crit Care. 2018;22:191. 

Wirz Y, Meier MA, Bouadma L, et al.

FULL TEXT 

https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2125-7

 

November 10, 2019 at 11:35 am

Surviving Sepsis Campaign: International guidelines for management of sepsis and septic shock: 2016.

Crit Care Med. 2017;45:486-552. 

Rhodes A, Evans LE, Alhazzani W, et al.

FULL TEXT

https://journals.lww.com/ccmjournal/fulltext/2017/03000/Surviving_Sepsis_Campaign__International.15.aspx

PDF (CLIC DOWNLOAD)

November 10, 2019 at 11:33 am

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