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]
…show more content…
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):
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
Rello, J., Kollef, M., Diaz, E. and Rodriguez, A. (2010). Infectious Diseases in Critical Care. 2nd ed. Boston: Springer US.
In this day and age, the general population assumes that when someone is hospitalized the risk for getting a new infection while in the hospital is minimal. However, in the United States the risk for gaining a hospital-associated infection has become a serious concern and a costly one at that. The Center for Disease Control and Prevention has reported that hospital-associated infections have cost an estimate of 35.7 to 45 billion dollars to United States hospital when 20% of these infections could have been preventable with the correct interventions. One of the most common hospital-associated infections has become hospital-acquired pneumonia. (Scott II, 2009) This type of pneumonia is easily preventable if healthcare workers would comply with a few simple interventions that should already be in place in their facility. While these interventions have been proven effective, full compliance is still lacking and in the end it is being left to up the health care staff to become aware of the results.
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
Neonatal intensive care units are normally thought as a safe place for a neonatal to be, but there are instances where the neonatal develops an infection in their fragile bodies. This paper examines the ways that they could develop infections that harm them. The ANA states, “individuals who become nurses are expected to adhere to the ideals and morals norms of the profession and also to embrace them as a part of what it means to be a nurse.” (Code of Ethics, n.d.). German NICUs participated in a study of very low birth weight infants (VLBW) from 2006-2011 and found that an outbreak of severe neonatal infection occurred within a period of time in the same center in four different patients (Schwab, 2014).
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)
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...
Healthcare-associated infections (HAIs) have been a persistent problem in the United States for decades. Yang et al. (2013) stated that “Nosocomial infections or healthcare-associated infections are defined as a localized or systemic condition resulting from an adverse reaction to the presence of an infectious agent or its toxin. There must be no evidence that the infection was present or incubating at the time of admission to the acute care setting” Also if infections occur within 48 hours of being discharged from the hospital or a healthcare setting, then it is considered as a healthcare-associated infection (Daud-Gallotti et al., 2012). Healthcare-associated infections can be easily prevented, however they are held accountable for hundreds of thousands of deaths for the past few decades. They have been known to increase rates of drawn-out hospital stays, cost, morbidity, mortality, and readmission to the hospital (Montoya & Mody, 2011). When antibiotic-resistant organisms (AROs) are involved with these types of infections, the rates are expanded even further and usually cause many more fatalities (Srigley, Lightfoot, Fernie, Gardam & Muller, 2013).
...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.
MRSA is a major source of healthcare associated diseases, increased hospital mortality, and leading surgical site infection (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). With the implementation of active surveillance screening and contact isolations program, an overall decrease in hospital associated MRSA infections has been observed (Jennings, Bennett, Fisher, & Cook, 2014, p. 83). The author of this paper will identify a theory that can be used to support the proposed intervention i.e., reduce the transmission of MRSA by active screening in patients at high-risk for MRSA on admission. This paper will then describe the selected theory, and rational for the selection, and how this theory will support the proposed solution and how to incorporate this theory in this project.
The correct definition of this term has created an immense controversy among the scholar whereby some say that it is the cluster of microorganisms bundled together in the material that contains proteins, DNA, and polysaccharides that establish the mechanical scaffold around such living organisms (Fein, 2006). Biofilm forms very fast within the duration of intubation. Positive pressure and suction from the mechanical ventilation leads to detachment of bacteria from the ETT and moves to the interior section of the lower respiratory tract. Some of the pathogens that lead to VAP include; Enterobacteriaceae, Acinetobacter baumannii, Pseudomonas aeruginosa, Candida albicans, and Enterococci. Some pathogens can be identified by culture from secretions, the trachea, and the ETT. Acinetobacter baumannii, Pseudomonas aeruginosa are highly infectious bacteria that are directly related to the increased rates of mortality among the intubated patients. Treatment and early discovery of VAP can diminish the length of hospital stay, patient mortality, and morbidity (Yunen & Frendl,
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?