Title: An algorithm to estimate the importance of bacterial acquisition routes in hospital settings.
Introduction The significant increase in antibiotic resistance amongst pathogens is making it very difficult to successfully treat infections, especially in intensive care units (ICU’s). Prevention of the spread of infection among patients within the hospitals is fast becoming amongst the most important methods for controlling infections. This requires the identification of the different acquisition routes, that is, routes by which bacterial colonization occurs. In this article, the authors analyzed the relative importance of various bacterial acquisition routes that resulted in colonization of the bacteria using data from individual patients.[1]
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This algorithm uses individual patient data regarding the duration of their stay in the ICU and specific characteristics which builds on previously proposed algorithms that only consider the number of patients colonized. The authors state that the algorithm is “a promising tool for disentangling the contributions of various acquisition routes on the basis of longitudinal data without requiring labor intensive and costly genotyping procedures”,[1] which shows that they believe that the algorithm can give reliable results regarding the contribution of each route for a specific patients in a cost effective and efficient manner. Thus in this study the authors build on the Markov model developed by Pelupessy et al,[2] by incorporating more information specific to individual patients without any added assumptions, thereby making it more reliable, closer to reality and more …show more content…
It helps in identifying the different factors and parameters that we will need to incorporate next year while designing a model for analysis of pathogen transmission in hospitals. It talks about a number of useful techniques that can be used and helps us understand the different kinds of assumptions that need to be made and the limitations associated with these assumptions.
Related articles:
“Understanding the spread of antibiotic resistant pathogens in hospitals: mathematical models as tools for control.”
“How to assess the relative importance of different colonization routes of pathogens within hospital settings.”
“Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals. A challenge to hospital leadership”
References
1. Bootsma, M. C. J., M. J. M. Bonten, S. Nijssen, A. C. Fluit, and O Diekmann. "An Algorithm to Estimate the Importance of Bacterial Acquisition Routes in Hospital Settings." Am J Epidemiol 166 (2007):
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
Nosocomial or healthcare-associated infection (HAI) occurs when a patient receiving treatment in a health care setting develops an infection secondary to their original condition. These infections are serious and costly adverse outcomes of medical care that affect nearly two million people in the United States annually and lead to substantial morbidity and mortality. With increased days of hospitalization and direct medical costs, HAIs account for an estimated $20 billion per year in national health care expenditure every year. As such, they present one of the major threats to patient safety and remain a critical challenge to public health. On any given day, approximately [one in 25 patients] contracts at least one infection while receiving
Scott II, D. R. (2009). The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention. Retrieved from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
Late-onset is what I’m most interested in, occurs four to ninety days from a “caregiving” environment, which is where the NICU comes into play (Anderson-Berry, 2014). The neonate outside of the womb, the skin, respiratory tract, conjunctivae, GI, and umbilicus becomes colonized and invasive microorganism can make its way into the body (Ande...
CLABSIs are not confined to one unit of nursing care and there are many precipitating factors that may contribute to the development of a CLABSI. Often times these lines are placed in emergent situations in the emergency department (ED) and there may be a break in sterile technique. However a study conducted by Smith, Egger, Franklin, Harbrecht, and Richardson (2011) found a higher incidence of CLABSIs among intensive care unit (ICU) patients compared to those patients whose CLs were placed either in the ED or operating room (OR). This indicates further education for ICU s...
Bacterial resistance to antibiotics has presented many problems in our society, including an increased chance of fatality due to infections that could have otherwise been treated with success. Antibiotics are used to treat bacterial infections, but overexposure to these drugs give the bacteria more opportunities to mutate, forming resistant strains. Through natural selection, those few mutated bacteria are able to survive treatments of antibiotics and then pass on their genes to other bacterial cells through lateral gene transfer (Zhaxybayeva, 2011). Once resistance builds in one patient, it is possible for the strain to be transmitted to others through improper hygiene and failure to isolate patients in hospitals.
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...
Five weeks later, after the cured patient left, KPC was in the respiratory culture and they didn 't know how it was spreading or how to cure it. To prevent it from spreading even more around the hospital, the hospital put signs up to remind people to wash their hands, they had robots clean rooms, they moved all the KCP patients into an isolated ICU and they built a wall up to separate them even more. They finally figured out that the bacteria was being passed by silent carriers, people who don 't know they have the bacteria. This was figured out through DNA sequencing. Six months after patient one had arrived, the outbreak was finally over, but it had infected eighteen people in the process and left six
C. difficile infection (CDI) is a dangerous healthcare-associated infection as well as a growing burden, especially with the appearance of more potent strains in the early 2000s. Clostridium difficile was initially identified as possessing the ability to initiate pseudomembranous colitis in the late 1970s. Asymptomatic colonization in healthy adults has been detected in only 3% of individuals, whereas the pervasiveness of such colonization among patients in long-term-care facilities is approximately 50%. People colonized with C. difficile act as a reservoir of contamination by infecting the environment with C. difficile spores, consequently leading to an increase of the pathogen in the hands of healthcare professionals or by way of medical equipment (Noorani, Soni, Pitrak, Belinson, & Aronson, 2012).... ... middle of paper ... ...
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
Infection control is very important in the health care profession. Health care professionals, who do not practice proper infection control, allow themselves to become susceptible to a number of infections. Among the most dreaded of these infections are: hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). Another infection which has more recently increased in prevalence is methicillin-resistant Staphylococcus aureus (MRSA). These infections are all treated differently. Each infection has its own symptoms, classifications, and incubation periods. These infections are transmitted in very similar fashions, but they do not all target the same population.
The Infection Prevention and Control (IPC) Program is an essential force maximizing quality, patient centered care, and safety throughout the Veterans Affairs North Texas Health Care System (VANTHCS). The VANTHCS “... is a progressive health care provider in the heart of Texas ... we serve more than 117,000 Veterans and deliver 1.4 million outpatient episodes of care each year to Veterans in 38 Texas counties and two counties in southern Oklahoma” (“VA North Texas,” 2016, para. 1). The purpose of the IPC Program is to guide a facility-wide approach toward identifying, preventing, controlling, and eliminating healthcare-associated infections (HAIs). This approach is facilitated through infection control (IC) practitioner’s role-modeling behaviors of assessing, supporting, guiding, and/or directing healthcare providers (HCPs) in the application of evidence-based practices (EBPs) to prevent HAIs. According to the Centers for Disease Control and Prevention (CDC), HAIs are often preventable adverse events that pose a major threat to patient safety (“Centers for Disease,” 2016). As a result, IC practitioners recognize the importance of preparing nurse faculty to engage clinical staff in the application of EBPs to prevent infections.
The occurrence of infectious disease and epidemics has speckled the history of humanity since the first civilization established itself. Considering that a large population can help to foster infectious diseases, and humans share almost 300 communicable agents with animals, the outbreak of epidemics is inextricably intertwined with revol...
Avoiding infection or, at least, breaking the chain of transmission is vital in any setting, but more so in healthcare environments where infections and vulnerable hosts are moving under the same roof. What needs to be done, then?