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Ioannou P, Kofteridis DP. Special Issue: Recent Research on Hospital-Acquired Bloodstream Infections. Pathogens 2023; 12:906. [PMID: 37513753 PMCID: PMC10384916 DOI: 10.3390/pathogens12070906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Hospital-acquired infections (HAIs) are infections that occur in patients 48 h after admission to hospital [...].
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Affiliation(s)
- Petros Ioannou
- School of Medicine, University of Crete, 71003 Heraklion, Greece
- Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Diamantis P Kofteridis
- School of Medicine, University of Crete, 71003 Heraklion, Greece
- Internal Medicine Department, University Hospital of Heraklion, 71110 Heraklion, Greece
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Ioannou P, Astrinaki E, Vitsaxaki E, Bolikas E, Christofaki D, Salvaraki A, Lagoudaki E, Ioannidou E, Karakonstantis S, Saplamidou S, Cleovoulou C, Stamataki E, Ilia S, Messaritaki A, Avdi M, Chalkiadaki A, Papathanasaki S, Markopoulou C, Magouli E, Moustaki M, Kataxaki VA, Skevakis P, Spernovasilis N, Chamilos G, Kofteridis DP. A Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Public Acute Care Hospitals in Crete, Greece. Antibiotics (Basel) 2022; 11:antibiotics11091258. [PMID: 36140037 PMCID: PMC9495163 DOI: 10.3390/antibiotics11091258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Both healthcare-associated infections (HAIs) and antimicrobial resistance are associated with an increased length of stay and hospital costs, while they have also been linked to high morbidity and mortality rates. In 2016 and 2017, the latest point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals highlighted an HAI prevalence of 6.5%, while Greece had a higher HAI prevalence of 10%. The aim of this PPS was to record the prevalence of HAIs and antimicrobial use in all eight public acute care hospitals in Crete, Greece during the COVID-19 pandemic in order to highlight the types of infections and antimicrobial practices that need to be prioritized for infection control initiatives. Methods: The PPS was conducted between 30 March and 15 April 2022, according to the ECDC standardized relevant protocol (version 5.3). Statistics were extracted using the ECDC Helics.Win.Net application (software version 4.1.0). Results: A total of 1188 patients were included. The overall point prevalence of patients with at least one HAI was 10.6%. The most frequent types of infections were pneumonia (34.3%), bloodstream infections (10.5%), systemic infections and urinary tract infections (10.5% and 9.1%, respectively). In 14 (12.4%) cases, the pathogen responsible for HAI was SARS-CoV-2 following onsite spread, accounting for almost 10% of all HAIs. Microorganisms were identified in 60.1% of HAIs. Antimicrobials were administered in 711 (59.8%) patients, with 1.59 antimicrobials used per patient. Conclusion: The prevalence of HAI and antimicrobial use among hospitalized patients in Crete, Greece was similar to the national HAI prevalence in 2016 despite the enormous pressure on public hospitals due to the COVID-19 pandemic. Nevertheless, both HAI prevalence and antimicrobial use remain high, underlining the need to implement adequate infection control and antimicrobial stewardship interventions.
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Affiliation(s)
- Petros Ioannou
- Department of Internal Medicine, University Hospital of Heraklion, 71500 Heraklion, Greece
- Correspondence: (P.I.); (D.P.K.)
| | - Eirini Astrinaki
- Infection Control Committee, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Efsevia Vitsaxaki
- Infection Control Committee, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Emmanouil Bolikas
- Infection Control Committee, “Venizeleio-Pananeio” General Hospital of Heraklion, 71409 Heraklion, Greece
| | - Despoina Christofaki
- Infection Control Committee, Organic Unit of Agios Nikolaos, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72100 Agios Nikolaos, Greece
| | - Apostolia Salvaraki
- Infection Control Committee, General Hospital of Rethymno, 74132 Rethymno, Greece
| | - Eirini Lagoudaki
- Infection Control Committee, General Hospital of Chania “St. George”, 73300 Chania, Greece
| | - Eleni Ioannidou
- Infection Control Committee, General Hospital of Rethymno, 74132 Rethymno, Greece
| | | | - Stamatina Saplamidou
- Infection Control Committee, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Christos Cleovoulou
- Infection Control Committee, General Hospital of Chania “St. George”, 73300 Chania, Greece
| | - Eleni Stamataki
- Infection Control Committee, General Hospital of Chania “St. George”, 73300 Chania, Greece
| | - Stavroula Ilia
- Pediatric Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
- School of Medicine, University of Crete, 71500 Heraklion, Greece
| | - Argyri Messaritaki
- Office of Nursing Services, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Michaela Avdi
- Internal Medicine, General Hospital of Rethymno, 74132 Rethymno, Greece
| | - Anthoula Chalkiadaki
- Infection Control Committee, Organic Unit of Agios Nikolaos, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72100 Agios Nikolaos, Greece
| | - Styliani Papathanasaki
- Infection Control Committee, Decentralized Organic Unit of Sitia, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72300 Sitia, Greece
| | - Chrisanthi Markopoulou
- Infection Control Committee, Decentralized Organic Unit of Ierapetra, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72200 Ierapetra, Greece
| | - Evagelia Magouli
- Infection Control Committee, General Hospital-Health Care Center of Neapoli “Dialinakeio”, 72400 Neapoli, Greece
| | - Maria Moustaki
- Infection Control Committee, Decentralized Organic Unit of Sitia, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72300 Sitia, Greece
| | - Vasileia-Athina Kataxaki
- Infection Control Committee, Decentralized Organic Unit of Sitia, General Hospital of Lasithi/General Hospital-Health Center of Neapoli “Dialinakio”, 72300 Sitia, Greece
| | - Panagiotis Skevakis
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 15451 Athens, Greece
| | - Nikolaos Spernovasilis
- School of Medicine, University of Crete, 71500 Heraklion, Greece
- German Oncology Center, 4108 Limassol, Cyprus
| | - Georgios Chamilos
- Department of Clinical Microbiology, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Diamantis P. Kofteridis
- Department of Internal Medicine, University Hospital of Heraklion, 71500 Heraklion, Greece
- Correspondence: (P.I.); (D.P.K.)
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Tsuchimoto D, Morioka H, Imaizumi T, Miyagawa S, Yamamoto M, Onishi K, Kuwabara Y, Takada K, Watamoto K. Current Status of Outpatient Oral Antimicrobial Prescription and the Influence of Antimicrobial Stewardship for Inpatients: A Repeated Cross-Sectional Study at a Japanese Community Hospital. Biol Pharm Bull 2022; 45:1340-1346. [DOI: 10.1248/bpb.b22-00309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Kazuto Takada
- Department of Respiratory Medicine, Komaki City Hospital
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Morioka H, Ohge H, Nagao M, Kato H, Kokado R, Yamada K, Yamada T, Shimono N, Nukui Y, Yoshihara S, Sakamaki I, Nosaka K, Kubo Y, Kawamura H, Fujikura Y, Kitaura T, Sunakawa M, Yagi T. Appropriateness of surgical antimicrobial prophylaxis in Japanese university hospitals. J Hosp Infect 2022; 129:189-197. [PMID: 35835283 DOI: 10.1016/j.jhin.2022.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to determine the adherence to the Japanese surgical antimicrobial prophylaxis (SAP) guidelines in Japanese university hospitals. DESIGN A retrospective cohort study. SETTING Fifteen general and one dental university hospitals. METHODS We evaluated up to three cases of 18 designated surgeries regarding adherence to Japanese SAP guidelines: selection of antibiotics, timing of administration, re-dosing intervals, and duration of SAP. When all items were appropriate, surgery was defined as 'appropriate.' RESULTS In total, 688 cases (22-45 cases per surgery) were included. The overall appropriateness was 46.8% (322/688), and the appropriateness of each surgery ranged from 8.0% (2/25, cardiac implantable electronic device implantation) to 92.1% (35/38, distal gastrectomy). The appropriateness of each item was as follows: pre/intraoperative selections, 78.5% (540/688); timing of administrations, 96.0% (630/656); re-dosing intervals, 91.8% (601/656); postoperative selection, 78.9% (543/688); and duration of SAP, 61.4% (423/688). The overall appropriateness of hospitals ranged from 17.6% (9/51) to 73.3% (33/45). The common reasons for inappropriateness were the longer duration (38.5%, 265/688) and choice of antibiotics with a non-optimal antimicrobial spectrum before/during, and after surgery (19.0%, 131/688 and 16.8%, 116/688, respectively), compared to the guideline. CONCLUSIONS Adherence to the guidelines differed greatly between the surgeries and hospitals. Large-scale multicentre surveillance of SAP in Japanese hospitals is necessary to identify inappropriate surgeries, factors related to the appropriateness, and incidences of surgical site infections.
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Affiliation(s)
- Hiroshi Morioka
- Nagoya University Hospital, Department of Infectious Diseases, Nagoya, Japan.
| | - Hiroki Ohge
- Hiroshima University, Project Research Center for Nosocomial Infectious Diseases, Hiroshima, Japan
| | - Miki Nagao
- Kyoto University Graduate School of Medicine, Department of Clinical Laboratory Medicine, Kyoto, Japan
| | - Hideaki Kato
- Yokohama City University Hospital, Infection Prevention and Control Department, Yokohama, Japan
| | - Ryohei Kokado
- Osaka University Hospital, Division of Infection Control and Prevention, Suita, Japan
| | - Koichi Yamada
- Osaka Metropolitan University, Graduate School of Medicine, Department of Infection Control Science, Osaka, Japan
| | - Takahiro Yamada
- Hamamatsu University School of Medicine, Department of Hospital Pharmacy, Hamamatsu, Japan
| | - Nobuyuki Shimono
- Kyushu University Hospital, Center for the Study of Global Infection, Fukuoka, Japan
| | - Yoko Nukui
- Tokyo Medical and Dental University Hospital, Department of Infection Control and Prevention, Bunkyo City, Japan; Kyoto Prefectural University of Medicine, Department of Infection Control and Laboratory Medicine
| | - Shingo Yoshihara
- Nara Medical University, Center for Infectious Diseases, Kashihara, Japan
| | - Ippei Sakamaki
- Toyama University Hospital, Department of Clinical Infectious Diseases, Toyama, Japan
| | - Kisato Nosaka
- Kumamoto University Hospital, Department of Hematology, Rheumatology and Infectious Disease, Kumamoto, Japan
| | - Yuko Kubo
- Hiroshima University Hospital, Department of Pharmaceutical Services, Hiroshima, Japan
| | - Hideki Kawamura
- Kagoshima University Hospital, Department of Infection Control and Prevention, Kagoshima, Japan
| | - Yuji Fujikura
- National Defense Medical College Hospital, Department of Medical Risk Management and Infection Control, Tokorozawa, Japan
| | - Tsuyoshi Kitaura
- Tottori University Hospital, Division of Infectious Diseases, Yonago, Japan
| | - Mitsuhiro Sunakawa
- Tokyo Medical and Dental University, Dental Hospital, Infection Control Team, Tokyo, Japan
| | - Tetsuya Yagi
- Nagoya University Hospital, Department of Infectious Diseases, Nagoya, Japan
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Inciong JFB, Chaudhary A, Hsu HS, Joshi R, Seo JM, Trung LV, Ungpinitpong W, Usman N, Pradelli L, Omaralsaleh AJ. Economic burden of hospital malnutrition: A cost-of-illness model. Clin Nutr ESPEN 2022; 48:342-350. [DOI: 10.1016/j.clnesp.2022.01.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023]
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Haseeb A, Faidah HS, Algethamy M, Alghamdi S, Alhazmi GA, Alshomrani AO, Alqethami BR, Alotibi HS, Almutiri MZ, Almuqati KS, Albishi AA, Elrggal ME, Mahrous AJ, Khogeer AA, Saleem Z, Iqbal MS, Sheikh A. Antimicrobial Usage and Resistance in Makkah Region Hospitals: A Regional Point Prevalence Survey of Public Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010254. [PMID: 35010512 PMCID: PMC8782433 DOI: 10.3390/ijerph19010254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2022]
Abstract
(1) Background: Inappropriate use of antimicrobials and subsequently rise of antimicrobial resistance (AMR) remains a major public health priority. Over-prescribing of broad-spectrum antibiotics is one of the main contributing factors for the emergence of AMR. We sought to describe antimicrobial prescribing trends among patients in public hospitals in Makkah hospitals. (2) Method: We undertook a point prevalence survey (PPS) in six hospitals in Makkah, Saudi Arabia, from January 2019 to July 2019. The survey included all the inpatients receiving antimicrobials on the day of PPS. Data was collected using the Global point prevalence survey (PPS) tool developed by the University of Antwerp, Belgium. (3) Results: Of 710 hospitalized patients, 447 patients (61.9%) were treated with one or more antimicrobials during the study period. The average bed occupancy among six hospitals was 74.4%. The majority of patients received antimicrobials parenterally (90.3%). Of the total prescribed antimicrobials, 415 (53.7%) antimicrobials were used in medical departments, 183 (23.7%) in surgical departments, and 175 (22.6%) in ICUs. Pneumonia (17.3%), skin and soft tissue infections (10.9%), and sepsis (6.6.%) were three common clinical indications. Ceftriaxones were the most commonly used antibiotics that were prescribed in 116 (15%) of patients, followed by piperacillin, with an enzyme inhibitor in 84 (10.9%). (4) Conclusion: There was a high prevalence of antibiotic use in the hospitals of Makkah, which could be a potential risk factor for the incidence of resistant strains, particularly MRSA infection. Public health decision-makers should take these findings into consideration to update national policies for antibiotic use in order to reduce the risks of further increases of AMR.
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Affiliation(s)
- Abdul Haseeb
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah 21955, Saudi Arabia; (M.E.E.); (A.J.M.)
- Correspondence: ; Tel.: +966-568560776
| | - Hani Saleh Faidah
- Department of Microbiology, Faculty of Medicine, Umm Al Qura University, Makkah 21955, Saudi Arabia;
| | - Manal Algethamy
- Department of Infection Prevention and Control Program, Alnoor Specialist Hospital Makkah, Makkah 24382, Saudi Arabia;
| | - Saleh Alghamdi
- Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Al Baha University, Al Baha 65779, Saudi Arabia;
| | - Ghaidaa Ali Alhazmi
- Departments of Pharmacy, King Abdullah Medical City, Ministry of Health, Makkah 21955, Saudi Arabia;
| | - Afnan Owedah Alshomrani
- King Abdul Aziz Medical City, WR, Jeddah, Ministry of National Guard, Jeddah 21423, Saudi Arabia;
| | | | - Hind Saeed Alotibi
- Prince Meshari Bin Saud- General Baljarshi Hospital, Al Baha 65779, Saudi Arabia;
| | | | - Khawlah Saad Almuqati
- King Faisal Specialist Hospital and Research Centre (Gen. Org.), Riyadh 11211, Saudi Arabia;
| | | | - Mahmoud Essam Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah 21955, Saudi Arabia; (M.E.E.); (A.J.M.)
| | - Ahmad Jamal Mahrous
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al Qura University, Makkah 21955, Saudi Arabia; (M.E.E.); (A.J.M.)
| | - Asim Abdulaziz Khogeer
- Plan and Research Department, General Directorate of Health Affairs of Makkah Region, Ministry of Health, Makkah 21955, Saudi Arabia;
- Medical Genetics Unit, Maternity and Children Hospital, Makkah Healthcare Cluster, Ministry of Health, Makkah 21955, Saudi Arabia
| | - Zikria Saleem
- Department of Pharmacy Practice, Faculty of Pharmacy, New Campus, The University of Lahore, Lahore 54000, Pakistan;
| | - Muhammad Shahid Iqbal
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia;
| | - Aziz Sheikh
- Usher Institute, Old Medical School, The University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK;
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Morioka H, Iguchi M, Tetsuka N, Kinoshita F, Tomita Y, Kato D, Hirabayashi A, Matsumoto A, Oka K, Kato H, Inagaki T, Kato Y, Kitagawa K, Ichikawa K, Kouyama Y, Kawamura N, Toyodome Y, Adachi N, Ito Y, Yagi T. Five-year point prevalence survey of healthcare-associated infections and antimicrobial use in a Japanese university hospital. Infect Prev Pract 2021; 3:100151. [PMID: 34647007 PMCID: PMC8498696 DOI: 10.1016/j.infpip.2021.100151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/28/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Periodic point prevalence surveys (PPSs) provide a method for assessing changes in healthcare-associated infections (HAIs) and antimicrobial use over time. Following the introduction of an antimicrobial stewardship programme at Nagoya University Hospital (Aichi, Japan) a five-year PPS study was performed to highlight any epidemiological changes. METHODS One-day PPSs were performed annually in July at Nagoya University Hospital. Data on patient characteristics, medical devices, active HAIs and antimicrobial use were collected using a standard data-collection form. RESULTS A total of 4339 patients were included. Over the five-year study period the median patient age was 62 years, median duration of hospital admission was nine days, 9% of patients had an HAI and 35.2% received at least one antimicrobial. Overall there were 406 HAIs (95% confidence interval, 369-447) with surgical site infection, pneumonia and febrile neutropenia occurring most frequently. Enterobacterales were the most common pathogens (N = 78, 28.6%) and 32.1% were third-generation cephalosporin-resistant. Meropenem was the most frequently prescribed antimicrobial for HAIs. Surgical antimicrobial prophylaxis changed drastically, with shorter durations and a marked reduction in oral cephalosporin use. However, antimicrobials for medical prophylaxis gradually increased. CONCLUSIONS This five-year PPS study shows consistent data for patient background, HAIs and causative pathogens and highlights changes in antimicrobial use during the era of the National Action Plan on Antimicrobial Resistance. To describe the epidemiology of Japanese hospitals by PPS, multicentre PPSs including in community hospitals should be performed annually.
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Affiliation(s)
- H. Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - M. Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - N. Tetsuka
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - F. Kinoshita
- Department of Advanced Medicine, Nagoya University Hospital, Aichi, Japan
| | - Y. Tomita
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
- Department of Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan
| | - D. Kato
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
- Department of Orthopedic Surgery, Okazaki City Hospital, Aichi, Japan
| | - A. Hirabayashi
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - A. Matsumoto
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - K. Oka
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
| | - H. Kato
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
- Department of Infectious Diseases, Toyota Memorial Hospital, Aichi, Japan
| | - T. Inagaki
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
| | - Y. Kato
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
| | - K. Kitagawa
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
| | - K. Ichikawa
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
- Department of Pharmacy, NHO Mie Chuo Medical Center, Mie, Japan
| | - Y. Kouyama
- Department of Hospital Pharmacy, Nagoya University Hospital, Aichi, Japan
- Department of Pharmacy, Fujita Health University Hospital, Aichi, Japan
| | - N. Kawamura
- Department of Nursing, Nagoya University Hospital, Aichi, Japan
| | - Y. Toyodome
- Department of Nursing, Nagoya University Hospital, Aichi, Japan
| | - N. Adachi
- Department of Nursing, Nagoya University Hospital, Aichi, Japan
| | - Y. Ito
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - T. Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Aichi, Japan
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Analysis of Continuous Prevalence Survey of Healthcare-Associated Infections Based on the Real-Time Monitoring System in 2018 in Shandong in China. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6693889. [PMID: 34222481 PMCID: PMC8213461 DOI: 10.1155/2021/6693889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
Background Healthcare-associated infection (HAI) is a serious threat to the safety of patients worldwide. The prevalence survey is widely used to explore and study the characteristics of HAI. However, the annual continuous prevalence survey of hospital-acquired infections has not been reported so far. Aim This study is aimed at examining the occurrence and development trend of HAIs dynamically and accurately. Methods An annual continuous HAI prevalence survey based on the real-time monitoring system was conducted in representative hospitals from different regions in Shandong in China. Findings. A total of 64 hospitals participated in the survey, and 2,741,433 patients were monitored in 2018. The highest prevalence of HAIs in Shandong was 3.83% (February 15), the lowest was 1.85% (February 28), and the average was 2.45%. The percentile distribution of prevalence of HAIs in this study was as follows: P10, 2.23%; P25, 2.31%; P50, 2.41%; P75, 2.55%; and P90, 2.73%. Conclusion This study dynamically and accurately showed the occurrence and development trend of HAIs in Shandong in 2018. The results of this study can be used as a reference for the HAI prevalence survey in various medical institutions in Shandong and provide the basis for the regional HAI prevention and control strategy.
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Šuljagić V, Bajčetić M, Mioljević V, Dragovac G, Mijović B, Janićijević I, Đorđević Z, Krtinić G, Rakić V, Ćirković I, Nikolić V, Marković-Denić L. A nationwide assessment of the burden of healthcare-associated infections and antimicrobial use among surgical patients: results from Serbian point prevalence survey, 2017. Antimicrob Resist Infect Control 2021; 10:47. [PMID: 33676578 PMCID: PMC7936242 DOI: 10.1186/s13756-021-00889-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/05/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND As the only non-European Union (EU) country, Serbia participated in a second point prevalence survey of healthcare-associated infections (HAIs) and antimicrobial use (AMU) organized by the European Centre for Disease Prevention and Control (ECDC) in the EU countries. Here, we aimed to estimate the prevalence of HAI and AMU in patients who had recently undergone a surgery and to compare risk profile, HAI rates, and AMU among surgical patients and non-surgical patients. METHODS A national PPS was performed in 65 Serbian acute-care hospitals, in November 2017. In this paper, the data of 61 hospitals for adult acute-care were analyzed. To ensure the comparability of study design we used the Serbian translation of ECDC case definitions and ECDC PPS protocol. The trained infection control staff, led by a hospital coordinator, reviewed medical records to identify HAI active at the time of the survey and AMU. Only inpatients admitted to the ward before 8 a.m. on the day if the survey were included. RESULTS A total of 12,478 patients from 61 hospitals for adult acute-care were eligible for inclusion in this study. Significantly higher proportions of surgical patients were female, belonged to the 60-to-79 age group, and were less severely ill. Also, extrinsic factors (invasive devices, hospitalization at the ICU, and prior antibiotics therapy) were more frequent in surgical patients. Prevalence of HAIs was higher among surgical patients (261/3626; 7.2%) than among non-surgical patients (258/8852; 2.9%) (p < 0.0001). The highest prevalence of all HAIs was noted in patients who had kidney transplantation (4/11; 36.4%), while SSIs were the most prevalent among patients who had peripheral vascular bypass surgery (3/15; 20.0%). Non-surgical patients received treatment for community-acquired infections in significantly higher proportion (2664/8852; 64.3) (p < 0.001). Surgical prophylaxis for more than 1 day was applied in 71.4% of surgical patients. CONCLUSION We have provided an insight into the burden of HAIs and AMU among Serbia acute-care hospitals, and highlighted several priority areas and targets for quality improvement.
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Affiliation(s)
- Vesna Šuljagić
- Faculty of Medicine of Military Medical Academy, University of Defence, Belgrade, Serbia.
| | - Milica Bajčetić
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Gorana Dragovac
- Institute of Public Health of Vojvodina, Novi Sad, Serbia.,Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Biljana Mijović
- Faculty of Medicine, University of East Sarajevo, Foča, Bosnia and Herzegovina.,General Hospital of Čačak, Čačak, Serbia
| | | | | | | | - Violeta Rakić
- Institute of Public Health of Serbia, Belgrade, Serbia
| | - Ivana Ćirković
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Infection prevention practices in the United States, the Netherlands, Switzerland, and Japan: Results from national surveys. Infect Control Hosp Epidemiol 2021; 42:1206-1214. [PMID: 33536105 DOI: 10.1017/ice.2020.1395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the extent to which evidence-based practices are regularly used in acute care hospitals in different countries. DESIGN Cross-sectional survey study. Participants and setting: Infection preventionists in acute care hospitals in the United States (US), the Netherlands, Switzerland, and Japan. METHODS Data collected from hospital surveys distributed between 2015 and 2017 were evaluated to determine the use of practices to prevent catheter-associated urinary tract infection (CAUTI), central-line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). Descriptive statistics were used to examine hospital characteristics and the percentage of hospitals reporting regular use of each infection prevention practice. RESULTS Survey response rates were 59% in the United States, 65% in the Netherlands, 77% in Switzerland, and 65% in Japan. Several recommended practices were used in the majority of hospitals: aseptic catheter insertion and maintenance (CAUTI), maximum sterile barrier precautions (CLABSI), semirecumbent patient positioning (VAP), and contact precautions and routine daily cleaning (CDI). Other prevention practices for CAUTI and VAP were used less frequently, particularly in Swiss and Japanese hospitals. Established surveillance systems were also lacking in Dutch, Swiss and Japanese hospitals. CONCLUSIONS Most hospitals in the United States, the Netherlands, Switzerland, and Japan have adopted certain infection prevention practices. Clear opportunities for reducing HAI risk in hospitals exist across all 4 countries surveyed.
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Saleem Z, Hassali MA, Godman B, Versporten A, Hashmi FK, Saeed H, Saleem F, Salman M, Rehman IU, Khan TM. Point prevalence surveys of antimicrobial use: a systematic review and the implications. Expert Rev Anti Infect Ther 2020; 18:897-910. [PMID: 32394754 DOI: 10.1080/14787210.2020.1767593] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: In view of increasing concerns with antimicrobial resistance (AMR), the World Health Organization (WHO) instituted a Global Action Plan (GAP) to address this. Area covered: One of the strategies to achieve the goals of GAP is to conduct regular surveillance of antimicrobial use through point prevalence surveys (PPS). In this review, PubMed, EBSCO, Proquest, Cinahl, and Scopus were searched for PPS of antimicrobial use published in English between January 2000 and December 2019. After systematic database screening of 2,893 articles, 60 PPS met the inclusion criteria and consequently were incorporated in this systematic review. Expert opinion: This review highlighted that most of the PPS were conducted in upper-middle and high-income countries. Prevalence of antimicrobial use was significantly higher in non-European hospitals compared with European hospitals. The domination of third-generation cephalosporin and fluoroquinolones use across all the regions suggests substantial use of broad-spectrum antimicrobials across countries. Among all identified regions around the world, India was the region where the highest use of antimicrobials was observed. Although PPS is a useful tool to assess the pattern of antimicrobial use and provides a robust baseline; however, a standardized surveillance method is needed. In order to optimize antimicrobial use, more efforts are required to improve antimicrobial use.
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Affiliation(s)
- Zikria Saleem
- School of Pharmaceutical Sciences, Universiti Sains Malaysia , George Town, Malaysia.,Faculty of Pharmacy, The University of Lahore , Lahore, Pakistan
| | - Mohamed Azmi Hassali
- School of Pharmaceutical Sciences, Universiti Sains Malaysia , George Town, Malaysia
| | - Brian Godman
- Health Economics Centre, University of Liverpool Management School , Liverpool, UK.,Department of Clinical Pharmacology, Karolinska Institute , Stockholm, Sweden.,Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University , Glasgow, UK
| | - Ann Versporten
- Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp , Antwerp, Belgium
| | | | - Hamid Saeed
- University College of Pharmacy, University of the Punjab , Lahore, Pakistan
| | - Fahad Saleem
- Faculty of Pharmacy and Health Sciences, University of Balochistan , Quetta, Pakistan
| | - Muhammad Salman
- Faculty of Pharmacy, The University of Lahore , Lahore, Pakistan
| | - Inayat Ur Rehman
- Department of Pharmacy, Abdul Wali Khan University Mardan , Mardan, Pakistan.,School of Pharmacy, Monash University Malaysia , Bandar Sunway, Malaysia
| | - Tahir Mehmood Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences , Lahore, Pakistan
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Komagamine J, Yabuki T, Hiraiwa T. A trend in prevalence of antimicrobial use and appropriateness of antimicrobial therapy in an acute care hospital from 2018 to 2019: repeated prevalence surveys in Japan. BMC Res Notes 2019; 12:811. [PMID: 31849341 PMCID: PMC6918669 DOI: 10.1186/s13104-019-4849-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 12/08/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The supply of cefazolin has been reduced dramatically since March 2019 in Japan. However, no studies have evaluated the effects of cefazolin shortage on the appropriateness of antimicrobial use. Therefore, we compared the appropriateness of inpatient antimicrobial drug use between the two surveys conducted in August 2018 and August 2019 in a Japanese hospital with no supply of cefazolin since the cefazolin shortage. RESULTS In the 2019 survey, a total of 275 patients were included, and 256 patients were included in the 2018 survey. The prevalence of antimicrobial drug use did not change from 2018 to 2019 (28.5% versus 28.7%; p = 0.96). The proportion of cefazolin in all antimicrobial drugs used on the survey date significantly decreased from 2018 to 2019 (24.1% versus 0.0%; p < 0.001). The proportion of appropriate antimicrobial use in all antimicrobial therapies tended to be lower in 2019 than in 2018 (41.2% versus 60.6%; p = 0.06), and the proportion of unnecessary use of a broader spectrum of antimicrobial drugs significantly increased from 2018 to 2019 (4.7% versus 37.3%; p = 0.002). The shortage of cefazolin might lead to inappropriate use of other antimicrobial drugs.
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Affiliation(s)
- Junpei Komagamine
- Department of Internal Medicine, National Hospital Organization Tochigi Medical Center, 1-10-37, Nakatomatsuri, Utsunomiya, Tochigi, Japan.
| | - Taku Yabuki
- Department of Internal Medicine, National Hospital Organization Tochigi Medical Center, 1-10-37, Nakatomatsuri, Utsunomiya, Tochigi, Japan
| | - Taku Hiraiwa
- Department of Internal Medicine, National Hospital Organization Tochigi Medical Center, 1-10-37, Nakatomatsuri, Utsunomiya, Tochigi, Japan
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Russo PL, Stewardson AJ, Cheng AC, Bucknall T, Mitchell BG. The prevalence of healthcare associated infections among adult inpatients at nineteen large Australian acute-care public hospitals: a point prevalence survey. Antimicrob Resist Infect Control 2019; 8:114. [PMID: 31338161 PMCID: PMC6628491 DOI: 10.1186/s13756-019-0570-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/04/2019] [Indexed: 01/09/2023] Open
Abstract
Background Australia does not have a national healthcare associated infection (HAI) surveillance program. Only one HAI point prevalence study has been undertaken in 1984. The objective of this study was to estimate the burden of healthcare associated infection (HAI) in acute adult inpatients in Australia. Methods A cross sectional point prevalence study (PPS) was conducted in a sample of large acute care hospitals. All data were collected by two trained Research Assistants. Surveillance methodology was based on the European Centre for Disease Prevention and Control (ECDC) PPS Protocol with variation in the sampling method in that only acute inpatients ≥ 18 years old were included. ECDC HAI definitions were applied. Results Data was collected between August and November 2018. A total of 2767 patients from 19 hospitals were included in the study. The median age of patients was 67, and 52.9% of the sample were male. Presence of a multi-drug resistant organism was documented for 10.3% of the patients. There were 363 HAIs present in 273 patients. The prevalence of patients with a HAI was 9.9% (95%CI: 8.8-11.0). Hospital prevalence rates ranged from 5.7% (95%CI:2.9-11.0) to 17.0% (95%CI:10.7-26.1). The most common HAIs were surgical site infection, pneumonia and urinary tract infection, comprising 64% of all HAIs identified. Conclusion This is the first HAI PPS to be conducted in Australia in 34 years. The prevalence rate is higher than the previous Australian study and that reported by the ECDC, however differences in methodology limit comparison. Regular, large scale HAI PPS should be undertaken to generate national HAI data to inform and drive national interventions.
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Affiliation(s)
- Philip L. Russo
- Department of Nursing Research, Cabrini Institute, Malvern, VIC Australia
- Department of Nursing and Midwifery, Monash University, Building E, Peninsula Campus, 47-49 Moorooduc Highway, Frankston, VIC 3199 Australia
- Centre for Quality and Patient Safety Research - Alfred Health Partnership, Deakin University, Melbourne, VIC Australia
| | | | - Allen C. Cheng
- School of Public Health and Preventive Medicine, Monash University, Prahran, VIC Australia
- Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, Melbourne, VIC Australia
| | - Tracey Bucknall
- Centre for Quality and Patient Safety Research - Alfred Health Partnership, Deakin University, Melbourne, VIC Australia
- School of Public Health and Preventive Medicine, Monash University, Prahran, VIC Australia
- School of Nursing and Midwifery, Deakin University, Geelong, VIC Australia
| | - Brett G. Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Cooranbong, NSW Australia
- School of Nursing and Midwifery, University of Newcastle, Callaghan, NSW Australia
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Komagamine J, Yabuki T, Kobayashi M, Okabe T. Prevalence of antimicrobial use and active healthcare-associated infections in acute care hospitals: a multicentre prevalence survey in Japan. BMJ Open 2019; 9:e027604. [PMID: 31256027 PMCID: PMC6609065 DOI: 10.1136/bmjopen-2018-027604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE To determine the prevalence of antimicrobial drug use and active healthcare-associated infections (HAIs) and to evaluate the appropriateness of antimicrobial therapy in acute care hospitals in Japan. DESIGN A prospective multicentre cross-sectional study. PARTICIPANTS All hospitalised patients on a survey day. MAIN OUTCOME MEASURES The primary outcome was the proportion of patients receiving any antimicrobial agents. The secondary outcome was the proportion of patients with active HAIs. The reasons for antimicrobial drug use and appropriateness of antibiotic therapy were also investigated. RESULTS Eight hundred twenty eligible patients were identified. The median patient age was 70 years (IQR 55-80); 380 (46.3%) were women, 150 (18.3%) had diabetes mellitus and 107 (13.1%) were immunosuppressive medication users. The proportion of patients receiving any antimicrobial drugs was 33.5% (95% CI 30.3% to 36.8%). The proportion of patients with active HAIs was 7.4% (95% CI 5.6% to 9.2%). A total of 327 antimicrobial drugs were used at the time of the survey. Of those, 163 (49.8%), 101 (30.9%) and 46 (14.1%) were used for infection treatment, surgical prophylaxis and medical prophylaxis, respectively. The most commonly used antimicrobial drugs for treatment were ceftriaxone (n=25, 15.3%), followed by piperacillin-tazobactam (n=22, 13.5%) and cefmetazole (n=13, 8.0%). In the 163 antimicrobial drugs used for infection treatment, 62 (38.0%) were judged to be inappropriately used. CONCLUSIONS The prevalence of antimicrobial use and active HAIs and the appropriateness of antimicrobial therapy in Japan were similar to those of other developed countries. A strategy to improve the appropriateness of antimicrobial therapy provided to hospitalised patients is needed. TRIAL REGISTRATION NUMBER UMIN000033568.
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Affiliation(s)
- Junpei Komagamine
- Internal Medicine, National Hospital Orginization Tochigi Medical Center, Utsunomiya, Japan
| | - Taku Yabuki
- Internal Medicine, National Hospital Orginization Tochigi Medical Center, Utsunomiya, Japan
| | - Masaki Kobayashi
- Geriatrics and Gerontology, National Hospital Organisation Tokyo Medical Center, Meguro-ku, Japan
| | - Taro Okabe
- Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
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Saleem Z, Godman B, Hassali MA, Hashmi FK, Azhar F, Rehman IU. Point prevalence surveys of health-care-associated infections: a systematic review. Pathog Glob Health 2019; 113:191-205. [PMID: 31215326 PMCID: PMC6758614 DOI: 10.1080/20477724.2019.1632070] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Health-care-associated infections (HAIs) are considered a serious public health issues that contribute substantially to the global burden of mortality and morbidity with respect to infectious diseases. The aim is to assess the burden of health-care-associated infections by collation of available data from published point prevalence surveys (PPS) on HAIs to give future guidance. Study protocol and methodology were designed according to preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Published research papers that conducted a point prevalence survey of HAIs in hospital settings by following the structured survey methodology employed by European Centre of Disease Prevention and Control (ECDC) were included. Of 1212 articles, 67 studies were included in the final analysis conducted across different countries. Overall, 35 studies were conducted in Europe, 21 in Asia, 9 in America, and 2 in Africa. The highest prevalence of HAIs was recorded in a study conducted in adult ICU settings of 75 regions of Europe (51.3%). The majority of the studies included HAI data on urinary tract infections, respiratory tract infections, and bloodstream infections. Klebsiella pneumonia, Pseudomonas aeruginosa and E. coli were the most frequent pathogens responsible for HAIs. PPS is an useful tool to quantify HAIs and provides a robust baseline data for policymakers. However, a standardize surveillance method is required. In order to minimize the burden of HAIs, infection prevention and control programs and antibiotic stewardship may be effective strategies to minimize the risk of HAIs.
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Affiliation(s)
- Zikria Saleem
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
- Rashid Latif College of Pharmacy, Lahore, Pakistan
| | - Brian Godman
- Department of Clinical Pharmacology, Karolinska Institute, Stockholm, Sweden
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK
- Health Economics Centre, University of Liverpool Management School, Liverpool, UK
| | - Mohamed Azmi Hassali
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, George Town, Malaysia
| | | | - Faiza Azhar
- University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Inayat Ur Rehman
- School of Pharmacy, Monash University Malaysia, Kuala Selangor, Malaysia
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, Pakistan
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Sakamoto F, Asano K, Sakihama T, Saint S, Greene MT, Patel P, Ratz D, Tokuda Y. Changes in health care-associated infection prevention practices in Japan: Results from 2 national surveys. Am J Infect Control 2019; 47:65-68. [PMID: 30172609 DOI: 10.1016/j.ajic.2018.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/21/2018] [Accepted: 06/22/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND A national survey conducted in 2012 revealed that the rates of regular use of many evidence-based practices to prevent device-associated infections were low in Japanese hospitals. We conducted a second survey 4 years later to evaluate changes in infection prevention practices. METHODS Between July 2016 and January 2017, the instrument used in a survey of Japanese hospitals in 2012 was sent to 1,456 Japanese hospitals. The survey assessed general hospital and infection prevention program characteristics and use of practices specific to preventing catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). Independent sample chi-square tests were used to compare prevention practice rates between the first and second surveys. RESULTS A total of 685/971 (71%) and 940/1,456 (65%) hospitals responded to the first and second surveys, respectively. For CAUTI, only use of bladder ultrasound scanners (11.1%-18.1%; P < .001) increased. For CLABSI, use of chlorhexidine gluconate for insertion site antisepsis (18.5%-41.1%; P < .001), antimicrobial dressing with chlorhexidine (3.4%-7.1%; P = .001), and central line insertion bundle (22.9%-33.0%; P < .001) increased. For VAP, use of semirecumbent positioning of patients (65.0%-72.3%; P = .002), sedation vacation (31.5%-41.6%; P < .001), oscillating/kinetic beds (4.7%-8.6%; P = .002), and a collective VAP prevention bundle (24.8%-34.8%; P < .001) increased. Fewer than 50% of Japanese hospitals reported conducting CAUTI and VAP surveillance. CONCLUSIONS Collaborative approaches and stronger incentives promoting infection prevention efforts may be warranted to further increase use of most evidence-based practices to reduce common health care-associated infections in Japan.
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Affiliation(s)
- Fumie Sakamoto
- Quality Improvement Center, St. Luke's International Hospital, Tokyo, Japan.
| | - Keiko Asano
- Quality Improvement Center, St. Luke's International Hospital, Tokyo, Japan
| | - Tomoko Sakihama
- Department of Nursing, International University of Health and Welfare Graduate School, Tokyo, Japan
| | - Sanjay Saint
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI; Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, MI; Center for Clinical Management Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - M Todd Greene
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI; Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, MI; Center for Clinical Management Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - Payal Patel
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI; Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, MI
| | - David Ratz
- Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, MI; Center for Clinical Management Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
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Russo PL, Stewardson A, Cheng AC, Bucknall T, Marimuthu K, Mitchell BG. Establishing the prevalence of healthcare-associated infections in Australian hospitals: protocol for the Comprehensive Healthcare Associated Infection National Surveillance (CHAINS) study. BMJ Open 2018; 8:e024924. [PMID: 30413520 PMCID: PMC6231587 DOI: 10.1136/bmjopen-2018-024924] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 09/25/2018] [Accepted: 10/04/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION A healthcare-associated infection (HAI) data point prevalence study (PPS) conducted in 1984 in Australian hospitals estimated the prevalence of HAI to be 6.3%. Since this time, there have been no further national estimates undertaken. In the absence of a coordinated national surveillance programme or regular PPS, there is a dearth of national HAI data to inform policy and practice priorities. METHODS AND ANALYSIS A national HAI PPS study will be undertaken based on the European Centres for Disease Control method. Nineteen public acute hospitals will participate. A standardised algorithm will be used to detect HAIs in a two-stage cluster design, random sample of adult inpatients in acute wards and all intensive care unit patients. Data from each hospital will be collected by two trained members of the research team. We will estimate the prevalence of HAIs, invasive device use, single room placement and deployment of transmission-based precautions. ETHICS AND DISSEMINATION Ethics approval was obtained from the Alfred Health Human Research Ethics Committee (HREC/17/Alfred/203) via the National Mutual Assessment. A separate approval was obtained from the Tasmanian Health and Medical Human Research Committee (H0016978) for participating Tasmanian hospitals. Findings will be disseminated in individualised participating hospital reports, peer-reviewed publications and conference presentations.
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Affiliation(s)
- Philip L Russo
- School of Nursing and Midwifery, Faculty of Health, Centre for Quality and Patient Safety Research-Alfred Health Partnership, Deakin University, Melbourne, Victoria, Australia
| | - Andrew Stewardson
- Department of Infectious Diseases, Alfred Health and Monash University, Melbourne, Victoria, Australia
| | - Allen C Cheng
- Infection Prevention and Healthcare Epidemiology Unit, The Alfred Hospital, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Faculty of Health, Centre for Quality and Patient Safety Research-Alfred Health Partnership, Deakin University, Melbourne, Victoria, Australia
| | - Kalisvar Marimuthu
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore
- National Centre for Infectious Diseases, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Brett G Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Wahroonga, New South Wales, Australia
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The Prevalence of Healthcare-Associated Infections in Mainland China: A Systematic Review and Meta-analysis. Infect Control Hosp Epidemiol 2018; 39:701-709. [DOI: 10.1017/ice.2018.60] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVETo assess the prevalence of healthcare-associated infections (HAIs) in mainland China.DESIGNSystematic review and meta-analysis.SETTINGAdults and children from secondary and tertiary acute-care hospitals in mainland China.METHODSWe searched PubMed, the China National Knowledge Infrastructure, and Wan Fang for multicenter point-prevalence surveys of acute-care hospitals in mainland China from January 2006 to August 2016. All reports related to HAI, using a point-prevalence methodology and published either in English or Chinese were eligible.RESULTSIn total, 3,021 publications were identified; 115 were eligible for quality assessment and data abstraction. The weighted HAI prevalence (95% confidence interval [CI]) overall, in general hospitals, children’s hospitals, maternal and child health hospitals, and oncology hospitals were 3.12% (95% CI, 2.94%–3.29%), 3.02% (95% CI, 2.79%–3.26%), 4.43% (95% CI, 3.39%–5.47%), 1.88% (95% CI, 1.47%–2.29%), and 3.96% (95% CI, 3.12%–4.79%), respectively. In general hospitals, prevalence was highest in adult intensive care units (26.07%; 95% CI, 23.03%–29.12%), followed by surgery (3.26%; 95% CI, 2.96%–3.57%), and internal medicine (3.06%; 95% CI, 2.67%–3.46%). Overall, lower respiratory tract infection was the most frequent HAI (24,185, 47.28%), followed by urinary tract infection (5,773, 11.29%) and upper respiratory tract infection (5,194, 10.15%). Gram-negative bacilli were the most frequently isolated pathogens, and Pseudomonas aeruginosa (3,395, 14.91%), and Escherichia coli (2,918, 12.82%) were the most common single microorganisms.CONCLUSIONSThis study is the largest systematic review on the prevalence of HAI in mainland China. These results provide a benchmark for future PPSs and a reference for infection prevention and control strategies in mainland China.Infect Control Hosp Epidemiol 2018;39:701–709
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Morioka H, Nagao M, Yoshihara S, Ohge H, Kasahara K, Shigemoto N, Kajihara T, Mori M, Iguchi M, Tomita Y, Ichiyama S, Yagi T. The first multi-centre point-prevalence survey in four Japanese university hospitals. J Hosp Infect 2018; 99:325-331. [PMID: 29549049 DOI: 10.1016/j.jhin.2018.03.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 03/05/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Japanese government adopted a national action plan on antimicrobial resistance, which aims to reduce drug-resistant pathogens and antimicrobial use. A point-prevalence survey (PPS) is a useful surveillance method to gain information about hospital epidemiology; however, no multi-centre PPS has previously been performed in Japan. AIM To investigate general information about hospital epidemiology, healthcare-associated infections (HCAIs), and antimicrobial use in multiple Japanese university hospitals. METHODS In July 2016, a multi-centre PPS was conducted using a standardized protocol at four university hospitals in Japan. FINDINGS A total of 3199 patients were included. Median age and duration of hospital stay were 64 years and 10 days, respectively. A total of 246 (7.7%; 95% confidence interval (CI): 6.8-8.7) patients had 256 active HCAIs, and 933 (29.2%; 95% CI: 27.6-30.8) patients received 1318 antimicrobials. Pneumonia and gastrointestinal system infection were the most common HCAIs (N = 42, 16.4%), and Enterobacteriaceae (N = 49, 30.8%) were the predominant causative organisms. Carbapenems (N = 52, 17.8%), anti-MRSA medications, and cephems with antipseudomonal activity were the most frequently prescribed antimicrobials for HCAIs. As surgical prophylaxis, 46 of 278 antimicrobials (16.5%) were administered orally. Proportions of HCAI and antimicrobial use in each hospital ranged from 4.8% to 9.5% and 19.3%-35.0%, respectively. CONCLUSION This multi-centre PPS recorded detailed HCAI data and distinct antimicrobial use in Japanese university hospitals. Further surveillance is necessary to reduce HCAIs and formulate feasible plans to achieve the national action plan on antimicrobial resistance.
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Affiliation(s)
- H Morioka
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - M Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan
| | - S Yoshihara
- Center for Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - H Ohge
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - K Kasahara
- Center for Infectious Diseases, Nara Medical University, Kashihara, Nara, Japan
| | - N Shigemoto
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - T Kajihara
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - M Mori
- Project Research Center for Nosocomial Infectious Diseases, Hiroshima University, Hiroshima, Japan
| | - M Iguchi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Y Tomita
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - S Ichiyama
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan
| | - T Yagi
- Department of Infectious Diseases, Nagoya University Hospital, Nagoya, Aichi, Japan.
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Cai Y, Venkatachalam I, Tee NW, Tan TY, Kurup A, Wong SY, Low CY, Wang Y, Lee W, Liew YX, Ang B, Lye DC, Chow A, Ling ML, Oh HM, Cuvin CA, Ooi ST, Pada SK, Lim CH, Tan JWC, Chew KL, Nguyen VH, Fisher DA, Goossens H, Kwa AL, Tambyah PA, Hsu LY, Marimuthu K. Prevalence of Healthcare-Associated Infections and Antimicrobial Use Among Adult Inpatients in Singapore Acute-Care Hospitals: Results From the First National Point Prevalence Survey. Clin Infect Dis 2018; 64:S61-S67. [PMID: 28475790 DOI: 10.1093/cid/cix103] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background We conducted a national point prevalence survey (PPS) to determine the prevalence of healthcare-associated infections (HAIs) and antimicrobial use (AMU) in Singapore acute-care hospitals. Methods Trained personnel collected HAI, AMU, and baseline hospital- and patient-level data of adult inpatients from 13 private and public acute-care hospitals between July 2015 and February 2016, using the PPS methodology developed by the European Centre for Disease Prevention and Control. Factors independently associated with HAIs were determined using multivariable regression. Results Of the 5415 patients surveyed, there were 646 patients (11.9%; 95% confidence interval [CI], 11.1%-12.8%) with 727 distinct HAIs, of which 331 (45.5%) were culture positive. The most common HAIs were unspecified clinical sepsis (25.5%) and pneumonia (24.8%). Staphylococcus aureus (12.9%) and Pseudomonas aeruginosa (11.5%) were the most common pathogens implicated in HAIs. Carbapenem nonsusceptibility rates were highest in Acinetobacter species (71.9%) and P. aeruginosa (23.6%). Male sex, increasing age, surgery during current hospitalization, and presence of central venous or urinary catheters were independently associated with HAIs. A total of 2762 (51.0%; 95% CI, 49.7%-52.3%) patients were on 3611 systemic antimicrobial agents; 462 (12.8%) were prescribed for surgical prophylaxis and 2997 (83.0%) were prescribed for treatment. Amoxicillin/clavulanate was the most frequently prescribed (24.6%) antimicrobial agent. Conclusions This survey suggested a high prevalence of HAIs and AMU in Singapore's acute-care hospitals. While further research is necessary to understand the causes and costs of HAIs and AMU in Singapore, repeated PPSs over the next decade will be useful to gauge progress at controlling HAIs and AMU.
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Affiliation(s)
- Yiying Cai
- Department of Pharmacy, Singapore General Hospital.,Department of Pharmacy, National University of Singapore
| | | | - Nancy W Tee
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital
| | - Thean Yen Tan
- Department of Laboratory Medicine, Changi General Hospital
| | - Asok Kurup
- Infectious Diseases Care, Mount Elizabeth (Orchard) Hospital
| | - Sin Yew Wong
- Infectious Disease Specialists, Gleneagles Hospital
| | - Chian Yong Low
- Novena Medical Specialists, Mount Elizabeth (Novena) Hospital
| | - Yang Wang
- Division of Nursing, Raffles Hospital, Departments of
| | - Winnie Lee
- Department of Pharmacy, Singapore General Hospital
| | - Yi Xin Liew
- Department of Pharmacy, Singapore General Hospital
| | | | | | - Angela Chow
- Clinical Epidemiology, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital.,Saw Swee Hock School of Public Health, National University of Singapore, 13Infection Control, Singapore General Hospital
| | | | - Helen M Oh
- Division of Infectious Diseases, Changi General Hospital
| | | | - Say Tat Ooi
- Department of General Medicine, Khoo Teck Puat Hospital
| | - Surinder K Pada
- Department of Infectious Diseases, Ng Teng Fong General Hospital
| | - Chong Hee Lim
- Department of Cardiothoracic Surgery, National Heart Center
| | | | - Kean Lee Chew
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - Van Hai Nguyen
- School of Pharmacy, Memorial University, St John's, NL, Canada
| | - Dale A Fisher
- Division of Infectious Disease, National University Hospital, and.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Herman Goossens
- Laboratory of Medical Microbiology, University of Antwerp, Belgium; and
| | - Andrea L Kwa
- Department of Pharmacy, Singapore General Hospital.,Department of Pharmacy, National University of Singapore.,Emerging Infectious Diseases, Duke-NUS Medical School, Singapore
| | - Paul A Tambyah
- Division of Infectious Disease, National University Hospital, and.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Li Yang Hsu
- Infectious Diseases and.,Saw Swee Hock School of Public Health, National University of Singapore, 13Infection Control, Singapore General Hospital
| | - Kalisvar Marimuthu
- Infectious Diseases and.,Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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