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Song JE, Kwak YG, Oh GB, Choi YH, Kim SR, Han SH, Yoo SY, Yoo HM, Choi JY, Shin MJ. External and internal validation of healthcare-associated infection data collected by the Korean National healthcare-associated Infections Surveillance System (KONIS). Am J Infect Control 2024; 52:214-219. [PMID: 37406965 DOI: 10.1016/j.ajic.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND This study analyzed the validity of healthcare-associated infection (HAI) data of the Korean National healthcare-associated Infections Surveillance System. METHODS The validation process consisted of external (EV) and internal (IV) validation phases. Of the 193 hospitals that participated from July 2016 through June 2017, EV was performed for 10 hospitals that were selected based on the HAI rate percentile. The EV team reviewed 295 medical records for 60 HAIs and 235 non-HAI control patients. IV was performed for both the 10 EV hospitals and 11 other participating hospitals that did not report any HAIs. RESULTS In the EV, the diagnosis of urinary tract infections had a sensitivity of 72.0% and a specificity of 99.3%. The respective sensitivities of bloodstream infection and pneumonia were 63.2% and 70.6%; the respective specificities were 98.8% and 99.6%. The agreement (ĸ) between the EV and IV for 10 hospitals was 0.754 for urinary tract infections and 0.674 for bloodstream infections (P < .001, respectively). Additionally, IV found additional cases among 11 zero-report hospitals. DISCUSSION This study demonstrates the need for ongoing validation and continuous training to maintain the accuracy of nationwide surveillance data. CONCLUSIONS IV should be considered a validation method to supplement EV.
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Affiliation(s)
- Je Eun Song
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Yee Gyung Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
| | - Gang-Bok Oh
- Infection Control Office, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Young Hwa Choi
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sung Ran Kim
- Infection Control Office, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Su Ha Han
- Department of Nursing, Soonchunhyang University of Medicine, Cheonan, Republic of Korea
| | - So-Yeon Yoo
- Department of Nursing, The Catholic University of Korea College of Nursing, Seoul, Republic of Korea
| | - Hyeon Mi Yoo
- Infection Control Office, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Ji-Youn Choi
- Infection Control Team, Chungang University Hospital, Seoul, Republic of Korea
| | - Myoung Jin Shin
- Infection Control Office, Seoul National University Bundang Hospital, Sungnam, Republic of Korea
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Hoskins A, Worth LJ, Malloy MJ, Walker K, Bull A, Bennett N. Hepatitis B immune status of staff in smaller acute healthcare facilities. AUST HEALTH REV 2023; 47:254-257. [PMID: 36877980 DOI: 10.1071/ah22219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/09/2023] [Indexed: 03/08/2023]
Abstract
ObjectiveTo determine the proportion of staff employed in smaller Victorian public acute healthcare facilities with evidence of immunity to hepatitis B.MethodsFor optimal long-term immunity, a completed hepatitis B vaccination course and post vaccination hepatitis B surface antibody (anti-HBs) level ≥10 mIU/mL is desirable for all high-risk staff employed in healthcare facilities. For the financial years 2016/17-2019/20, a standardised surveillance module developed by the Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre was completed by the smaller Victorian public acute healthcare facilities (individual hospitals with <100 acute care beds or their multi-site health service). Staff were assessed as having evidence or no evidence of optimal immunity to hepatitis B. Those without optimal evidence were sub-classified as 'incomplete vaccination course', 'no serology', 'contraindicated', 'non-responder', 'declined' or 'unknown'. Data were analysed to determine trends over time for healthcare facilities that participated more than once.ResultsA total of 88 healthcare facilities reported hepatitis B immunity status of high-risk (Category A) staff (n = 29 920) at least once over 5 years; 55 healthcare facilities reported more than once. The aggregate proportion with evidence of optimal immunity was 66.3%. Healthcare facilities with 100-199 Category A staff employed reported the lowest evidence of optimal immunity (59.6%). Of all Category A staff with no evidence of optimal immunity, the majority had 'unknown' status (19.8%), with only 0.6% overall who declined vaccination.ConclusionsOur study found evidence of optimal staff hepatitis B immunity in only two-thirds of Category A staff working in surveyed healthcare facilities.
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Affiliation(s)
- Alex Hoskins
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia
| | - Leon James Worth
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia; and Department of Medicine, University of Melbourne, Melbourne, Vic. 3065, Australia
| | - Michael James Malloy
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia
| | - Katherine Walker
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia
| | - Ann Bull
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia
| | - Noleen Bennett
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia; and Department of Nursing, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Vic. 3065, Australia
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Bennett N, Malloy MJ, Atkins SE, Gonelli S, Worth LJ. The same but different: a comparison of Staphylococcus aureus bloodstream infections in metropolitan and non-metropolitan hospitals (2010-2020). Intern Med J 2023; 53:89-94. [PMID: 34549859 DOI: 10.1111/imj.15538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Variation of infection rates between hospitals must be identified; differences may highlight opportunities for quality improvement in healthcare delivery to specific hospitals groups. AIMS To analyse burden, time trends and risks of healthcare-associated (HA) Staphylococcus aureus bloodstream infections (SABSI) in patients admitted to Victorian metropolitan and non-metropolitan public acute care hospitals. METHODS SABSI surveillance data submitted between 1 July 2010 and 30 June 2020 by all 118 Victorian public acute care hospitals were analysed. Aligned with the Australian Statistical Geography Standard Remoteness Structure, these hospitals were classified as metropolitan (major cities) or non-metropolitan (inner regional, outer regional, remote or very remote). RESULTS Most SABSI were community associated: 66.9% and 75.0% of metropolitan (n = 9441) and non-metropolitan (n = 2756) hospital SABSI respectively. The overall HA-SABSI rate was statistically higher in metropolitan hospitals (1.13 per 10 000 occupied bed days (OBD)) compared with non-metropolitan hospitals (0.82 per 10 000 OBD; P < 0.001). In metropolitan and non-metropolitan hospitals, there was a statistically significant decline in the overall HA-SABSI rate (incidence rate ratio = 0.96; 95% confidence interval: 0.95-0.97; P < 0.001; and incidence rate ratio = 0.98; 95% confidence interval: 0.97-1.00; P = 0.044, respectively). In metropolitan and non-metropolitan hospitals, HA-SABSI were frequently associated with central venous (52.8%) and peripheral intravenous (62.2%) catheter use respectively. CONCLUSION To reduce risks for SABSI and improve patient outcomes, hospital infection prevention and control programmes should be tailored according to local epidemiology. In common geographic locations, networking of hospitals should be considered as a means of strengthening delivery of these programmes.
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Affiliation(s)
- Noleen Bennett
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, Victoria, Australia.,National Centre for Antimicrobial Stewardship, Department of Medicine and Radiology, The University of Melbourne, Melbourne, Victoria, Australia.,The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michael J Malloy
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, Victoria, Australia.,The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sue E Atkins
- Rural and Regional Health, Commissioning and System Improvement Division, Department of Health, Ballarat, Victoria, Australia
| | - Susan Gonelli
- Infection Prevention and Control Unit, Peninsula Health, Melbourne, Victoria, Australia
| | - Leon J Worth
- Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, Victoria, Australia.,The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.,National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
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Méndez L, Castro P, Ferreira J, Caneiras C. Epidemiological Characterization and the Impact of Healthcare-Associated Pneumonia in Patients Admitted in a Northern Portuguese Hospital. J Clin Med 2021; 10:jcm10235593. [PMID: 34884292 PMCID: PMC8658659 DOI: 10.3390/jcm10235593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 12/01/2022] Open
Abstract
Pneumonia is one of the main causes of hospitalization and mortality. It’s the fourth leading cause of death worldwide. Healthcare-associated infections are the most frequent complication of healthcare and affect hundreds of millions of patients around the world, although the actual number of patients affected is unknown due to the difficulty of reliable data. The main goal of this manuscript is to describe the epidemiological characteristics of patients admitted with pneumonia and the impact of healthcare-associated pneumonia (HCAP) in those patients. It is a quantitative descriptive study with retrospective analysis of the clinical processes of 2436 individuals for 1 year (2018) with the diagnosis of pneumonia. The individuals with ≤5 years old represented 10.4% (n = 253) and ≥65 were 72.6% (n = 1769). 369 cases resulted in death, which gives a sample lethality rate of 15.2%. The severity and mortality index were not sensitive to the death event. We found 30.2% (n = 735) individuals with HCAP and 0.41% (n = 59) with ventilator-associated pneumonia (VAP). In only 59 individuals (2.4%) the agent causing pneumonia was isolated. The high fatality rate obtained shows that pneumonia is a major cause of death in vulnerable populations. Moreover, HCAP is one of the main causes of hospital admissions from pneumonia and death and the most pneumonias are treated empirically. Knowledge of the epidemiology characterization of pneumonia, especially associated with healthcare, is essential to increase the skills of health professionals for the prevention and efficient treatment of pneumonia.
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Affiliation(s)
- Lucía Méndez
- Pneumology Department, Centro Hospitalar de Entre Douro e Vouga, 4520-221 Santa Maria da Feira, Portugal;
- EnviHealthMicro Lab, Microbiology Research Laboratory on Environmental Health, Institute of Environmental Health (ISAMB), Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Correspondence:
| | - Pedro Castro
- Intensive Care Unit, Centro Hospitalar de Entre Douro e Vouga, 4520-221 Santa Maria da Feira, Portugal;
| | - Jorge Ferreira
- Pneumology Department, Centro Hospitalar de Entre Douro e Vouga, 4520-221 Santa Maria da Feira, Portugal;
| | - Cátia Caneiras
- EnviHealthMicro Lab, Microbiology Research Laboratory on Environmental Health, Institute of Environmental Health (ISAMB), Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal;
- Institute of Preventive Medicine and Public Health, Faculty of Medicine, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Microbiology and Immunology Department, Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisboa, Portugal
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Sartelli M, Coccolini F, Carrieri A, Labricciosa FM, Cicuttin E, Catena F. The "Torment" of Surgical Antibiotic Prophylaxis among Surgeons. Antibiotics (Basel) 2021; 10:antibiotics10111357. [PMID: 34827295 PMCID: PMC8614853 DOI: 10.3390/antibiotics10111357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/28/2021] [Accepted: 11/05/2021] [Indexed: 12/14/2022] Open
Abstract
Surgical antibiotic prophylaxis (SAP) is one of the peri-operative measures for preventing surgical site infections (SSIs). Its goal is to counteract the proliferation of bacteria in the surgical site during intervention in order to reduce the risk of SSIs. SAP should be administered for surgical interventions where the benefit expected (prevention of SSIs) is higher compared to the risk (serious side effects, such as acute kidney injury, Clostridioides difficile infection, and the spread of antimicrobial resistance). In prescribing SAP, surgeons should have both the awareness necessary “to handle antibiotics with care”, and the knowledge required to use them appropriately.
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Affiliation(s)
- Massimo Sartelli
- Department of Surgery, Macerata Hospital, 62100 Macerata, Italy;
- Correspondence:
| | - Federico Coccolini
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, 56100 Pisa, Italy; (F.C.); (E.C.)
| | | | | | - Enrico Cicuttin
- Department of General, Emergency and Trauma Surgery, Pisa University Hospital, 56100 Pisa, Italy; (F.C.); (E.C.)
| | - Fausto Catena
- General and Emergency Surgery Department, Bufalini Hospital, 47521 Cesena, Italy;
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Wang S, Cai C, Shen Y, Sun C, Shi Q, Wu N, Zheng S, Qian J, Zhang R, Zhou H. In vitro Activity of Contezolid Against Methicillin-Resistant Staphylococcus aureus, Vancomycin-Resistant Enterococcus, and Strains With Linezolid Resistance Genes From China. Front Microbiol 2021; 12:729900. [PMID: 34489919 PMCID: PMC8417360 DOI: 10.3389/fmicb.2021.729900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/30/2021] [Indexed: 12/13/2022] Open
Abstract
Contezolid is a novel oxazolidinone, which exhibits potent activity against gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and penicillin-resistant Streptococcus pneumoniae (PRSP). In this study, the in vitro activity of contezolid was compared with linezolid (LZD), tigecycline (TGC), teicoplanin (TEC), vancomycin (VA), daptomycin (DAP), and florfenicol (FFC) against MRSA and VRE strains isolated from China. Contezolid revealed considerable activity against MRSA and VRE isolates with MIC90 values of 0.5 and 1.0 μg/mL, respectively. For VRE strains with different resistance genotypes, including vanA- and vanM-type strains, contezolid did not exhibit significantly differential antibacterial activity. Furthermore, the antimicrobial activity of contezolid is similar to or slightly better than that of linezolid against MRSA and VRE strains. Subsequently, the activity of contezolid was tested against strains carrying linezolid resistance genes, including Staphylococcus capitis carrying cfr gene and Enterococcus faecalis carrying optrA gene. The results showed that contezolid exhibited similar antimicrobial efficacy to linezolid against strains with linezolid resistance genes. In general, contezolid may have potential benefits to treat the infections caused by MRSA and VRE pathogens.
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Affiliation(s)
- Siheng Wang
- Clinical Microbiology Laboratory, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Chang Cai
- China Australia Joint Laboratory for Animal Health Big Data Analytics, College of Animal Science and Technology, Zhejiang Agricultural and Forestry University, Hangzhou, China
| | - Yingbo Shen
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Chengtao Sun
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Qingxin Shi
- Clinical Laboratory Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Ningjun Wu
- Clinical Laboratory, Lishui People's Hospital, Lishui, China
| | - Shufang Zheng
- Department of Laboratory Medicine, Jinhua People's Hospital, Jinhua, China
| | - Jiao Qian
- Clinical Laboratory Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China
| | - Rong Zhang
- Clinical Microbiology Laboratory, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Hongwei Zhou
- Clinical Microbiology Laboratory, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
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