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Zhong X, Wang DL, Xiao LH, Liu Y, Yang SW, Mo LF, Wu QF, Lin M, He LF, Luo XF. Investigation of multiple nosocomial infections using a semi-Markov multi-state model. Antimicrob Resist Infect Control 2024; 13:58. [PMID: 38845037 PMCID: PMC11157730 DOI: 10.1186/s13756-024-01421-5] [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: 12/20/2023] [Accepted: 06/04/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS). METHOD This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI). RESULTS The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06-8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03-18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be. CONCLUSION The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.
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Affiliation(s)
- Xiao Zhong
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China.
| | - Dong-Li Wang
- Testing Centre, Guangming District Centre for Disease Control and Prevention, Shenzhen, Guangdong, China
| | - Li-Hua Xiao
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
| | - Yan Liu
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
| | - Shan-Wen Yang
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
| | - Lan-Fang Mo
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
| | - Qin-Fei Wu
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
| | - Mei Lin
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
| | - Lan-Fang He
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
| | - Xiao-Feng Luo
- Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, 518106, China
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Takahashi N, Imaeda T, Oami T, Abe T, Shime N, Komiya K, Kawamura H, Yamao Y, Fushimi K, Nakada TA. Incidence and mortality of community-acquired and nosocomial infections in Japan: a nationwide medical claims database study. BMC Infect Dis 2024; 24:518. [PMID: 38783190 PMCID: PMC11112762 DOI: 10.1186/s12879-024-09353-6] [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: 12/20/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND It is important to determine the prevalence and prognosis of community-acquired infection (CAI) and nosocomial infection (NI) to develop treatment strategies and appropriate medical policies in aging society. METHODS Patients hospitalized between January 2010 and December 2019, for whom culture tests were performed and antibiotics were administered, were selected using a national claims-based database. The annual trends in incidence and in-hospital mortality were calculated and evaluated by dividing the patients into four age groups. RESULTS Of the 73,962,409 inpatients registered in the database, 9.7% and 4.7% had CAI and NI, respectively. These incidences tended to increase across the years in both the groups. Among the patients hospitalized with infectious diseases, there was a significant increase in patients aged ≥ 85 years (CAI: + 1.04%/year and NI: + 0.94%/year, P < 0.001), while there was a significant decrease in hospitalization of patients aged ≤ 64 years (CAI: -1.63%/year and NI: -0.94%/year, P < 0.001). In-hospital mortality was significantly higher in the NI than in the CAI group (CAI: 8.3%; NI: 14.5%, adjusted mean difference 4.7%). The NI group had higher organ support, medical cost per patient, and longer duration of hospital stay. A decreasing trend in mortality was observed in both the groups (CAI: -0.53%/year and NI: -0.72%/year, P < 0.001). CONCLUSION The present analysis of a large Japanese claims database showed that NI is a significant burden on hospitalized patients in aging societies, emphasizing the need to address particularly on NI.
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Affiliation(s)
- Nozomi Takahashi
- Centre for Heart Lung Innovation, St. Paul's Hospital, The University of British Columbia, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Taro Imaeda
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takehiko Oami
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Toshikazu Abe
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Department of Emergency and Critical Care Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Ad Hoc Committee On Clinical Research Using DPC, The Japanese Association for Infectious Diseases, Tokyo, Japan
| | - Kosaku Komiya
- Ad Hoc Committee On Clinical Research Using DPC, The Japanese Association for Infectious Diseases, Tokyo, Japan
- Respiratory Medicine and Infectious Diseases, Faculty of Medicine, Oita University, Oita, Japan
| | - Hideki Kawamura
- Ad Hoc Committee On Clinical Research Using DPC, The Japanese Association for Infectious Diseases, Tokyo, Japan
- Department of Infection Control and Prevention, Kagoshima University Hospital, Kagoshima, Japan
| | - Yasuo Yamao
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Taka-Aki Nakada
- Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
- Ad Hoc Committee On Clinical Research Using DPC, The Japanese Association for Infectious Diseases, Tokyo, Japan
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Kim D, Canovas-Segura B, Jimeno-Almazán A, Campos M, Juarez JM. Spatial-temporal simulation for hospital infection spread and outbreaks of Clostridioides difficile. Sci Rep 2023; 13:20022. [PMID: 37974000 PMCID: PMC10654661 DOI: 10.1038/s41598-023-47296-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023] Open
Abstract
Validated and curated datasets are essential for studying the spread and control of infectious diseases in hospital settings, requiring clinical information on patients' evolution and their location. The literature shows that approaches based on Artificial Intelligence (AI) in the development of clinical-support systems have benefits that are increasingly recognized. However, there is a lack of available high-volume data, necessary for trusting such AI models. One effective method in this situation involves the simulation of realistic data. Existing simulators primarily focus on implementing compartmental epidemiological models and contact networks to validate epidemiological hypotheses. Nevertheless, other practical aspects such as the hospital building distribution, shifts or safety policies on infections has received minimal attention. In this paper, we propose a novel approach for a simulator of nosocomial infection spread, combining agent-based patient description, spatial-temporal constraints of the hospital settings, and microorganism behavior driven by epidemiological models. The predictive validity of the model was analyzed considering micro and macro-face validation, parameter calibration based on literature review, model alignment, and sensitive analysis with an expert. This simulation model is useful in monitoring infections and in the decision-making process in a hospital, by helping to detect spatial-temporal patterns and predict statistical data about the disease.
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Affiliation(s)
- Denisse Kim
- Med AI Lab, University of Murcia, Campus Espinardo, 30100, Murcia, Spain.
| | | | - Amaya Jimeno-Almazán
- Internal Medicine Service, Infectious Diseases Section, Hospital Universitario Santa Lucía, Cartagena, Spain
| | - Manuel Campos
- Med AI Lab, University of Murcia, Campus Espinardo, 30100, Murcia, Spain
- Murcian Bio-Health Institute (IMIB-Arrixaca), El Palmar, 30120, Murcia, Spain
| | - Jose M Juarez
- Med AI Lab, University of Murcia, Campus Espinardo, 30100, Murcia, Spain
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Salu S, Okyere J, Charles-Unadike VO, Ananga MK. Nurses' knowledge on nosocomial infections preventive measures and its associated factors in Ghana: a cross-sectional study. BMC Health Serv Res 2023; 23:941. [PMID: 37658361 PMCID: PMC10474753 DOI: 10.1186/s12913-023-09942-2] [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: 05/26/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Nosocomial infections (NCIs) have been associated with several adverse outcomes including extended hospitalization, persistent disability, heightened antimicrobial resistance, amplified socio-economic disruption, and elevated mortality rates. The adoption of infection prevention strategies has the greatest tendency to significantly reduce the risk and occurrence of NCIs among the population, particularly in resource constrained health systems. This study assessed nurses' knowledge on NCI preventive measures and its associated factors in Ghana. METHODS A cross-sectional study was conducted from July to August 2021. A sample of 237 healthcare workers in the Hohoe Municipality was selected to participate in the study. Data was collected with a questionnaire designed in Google Forms and analyzed using Stata version 16.0. RESULTS Overall, most of the participants (69.2%) were not knowledgeable about the preventive measures of NCIs. Nurses who were within the age group of 20-40 years [aOR = 0.25 (95% CI = 0.09-0.69), p = 0.007] and 41-60 years [aOR = 0.05 (95% CI = 0.01-0.29), p = 0.001] were significantly less likely to be knowledgeable about the preventive measures of NCIs compared to those who those aged less than 20 years. Nurses who attended in-service training or workshop were approximately 10 times more likely to be knowledgeable about preventive measures of nosocomial infection compared to those who had never attended in-service training or workshop [aOR = 9.55 (95% CI = 1.23-74.36), p = 0.031]. CONCLUSION The study concludes that age and participation in-service training or workshop are significant factors that influence the knowledge of healthcare workers in preventive measures for nosocomial infections. These results highlight the importance of providing ongoing training and professional development opportunities to nurses to enhance their knowledge and improve their ability to prevent and control nosocomial infections. Additionally, the study emphasizes the need for targeted training programs that consider the age of nurses, to ensure that training is tailored to their specific needs.
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Affiliation(s)
- Samuel Salu
- Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana.
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- School of Nursing & Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Mark Kwame Ananga
- Department of Population and Behavioral Sciences, University of Health and Allied Sciences, Ho, Ghana
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Raoofi S, Pashazadeh Kan F, Rafiei S, Hosseinipalangi Z, Noorani Mejareh Z, Khani S, Abdollahi B, Seyghalani Talab F, Sanaei M, Zarabi F, Dolati Y, Ahmadi N, Raoofi N, Sarhadi Y, Masoumi M, sadat Hosseini B, Vali N, Gholamali N, Asadi S, Ahmadi S, Ahmadi B, Beiramy Chomalu Z, Asadollahi E, Rajabi M, Gharagozloo D, Nejatifar Z, Soheylirad R, Jalali S, Aghajani F, Navidriahy M, Deylami S, Nasiri M, Zareei M, Golmohammadi Z, Shabani H, Torabi F, Shabaninejad H, Nemati A, Amerzadeh M, Aryankhesal A, Ghashghaee A. Global prevalence of nosocomial infection: A systematic review and meta-analysis. PLoS One 2023; 18:e0274248. [PMID: 36706112 PMCID: PMC9882897 DOI: 10.1371/journal.pone.0274248] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/24/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Hospital-acquired infections (HAIs) are significant problems as public health issues which need attention. Such infections are significant problems for society and healthcare organizations. This study aimed to carry out a systematic review and a meta-analysis to analyze the prevalence of HAIs globally. METHODS We conducted a comprehensive search of electronic databases including EMBASE, Scopus, PubMed and Web of Science between 2000 and June 2021. We found 7031 articles. After removing the duplicates, 5430 studies were screened based on the titles/ abstracts. Then, we systematically evaluated the full texts of the 1909 remaining studies and selected 400 records with 29,159,630 participants for meta-analysis. Random-effects model was used for the analysis, and heterogeneity analysis and publication bias test were conducted. RESULTS The rate of universal HAIs was 0.14 percent. The rate of HAIs is increasing by 0.06 percent annually. The highest rate of HAIs was in the AFR, while the lowest prevalence were in AMR and WPR. Besides, AFR prevalence in central Africa is higher than in other parts of the world by 0.27 (95% CI, 0.22-0.34). Besides, E. coli infected patients more than other micro-organisms such as Coagulase-negative staphylococci, Staphylococcus spp. and Pseudomonas aeruginosa. In hospital wards, Transplant, and Neonatal wards and ICU had the highest rates. The prevalence of HAIs was higher in men than in women. CONCLUSION We identified several essential details about the rate of HAIs in various parts of the world. The HAIs rate and the most common micro-organism were different in various contexts. However, several essential gaps were also identified. The study findings can help hospital managers and health policy makers identify the reason for HAIs and apply effective control programs to implement different plans to reduce the HAIs rate and the financial costs of such infections and save resources.
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Affiliation(s)
- Samira Raoofi
- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashazadeh Kan
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Rafiei
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahra Hosseinipalangi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Noorani Mejareh
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saghar Khani
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Bahare Abdollahi
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Seyghalani Talab
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mohaddeseh Sanaei
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Farnaz Zarabi
- Department of Anesthesia, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Yasamin Dolati
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Niloofar Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Neda Raoofi
- Cardiovascular Research Center Kermanshah, Kermanshah, Iran
| | - Yasamin Sarhadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Masoumi
- Clinical Research and Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Batool sadat Hosseini
- Department of Anesthesia, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Negin Vali
- Shahid AkbarAbadi Clinical Research Development unit (SHACRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Negin Gholamali
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Saba Asadi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Saba Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Behrooz Ahmadi
- Clinical Research Development Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Zahra Beiramy Chomalu
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Elnaz Asadollahi
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mona Rajabi
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Dorsa Gharagozloo
- Department of Molecular and Cellular Sciences, Faculty of Advanced Sciences and Technology, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Zahra Nejatifar
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Rana Soheylirad
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Shabnam Jalali
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farnaz Aghajani
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mobina Navidriahy
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sama Deylami
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Nasiri
- Researcher at Toward Evidence (http://towardevidence.co.uk/), Glasgow, United Kingdom
| | - Mahsa Zareei
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Golmohammadi
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamideh Shabani
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Torabi
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Shabaninejad
- Population Health Sciences Institute (PHSI), Newcastle University, Newcastle, United Kingdom
| | - Ali Nemati
- Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amerzadeh
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Aidin Aryankhesal
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ghashghaee
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
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Antibacterial Screening of Isoespintanol, an Aromatic Monoterpene Isolated from Oxandra xylopioides Diels. Molecules 2022; 27:molecules27228004. [PMID: 36432105 PMCID: PMC9692887 DOI: 10.3390/molecules27228004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
The incidence of nosocomial infections, as well as the high mortality and drug resistance expressed by nosocomial pathogens, especially in immunocompromised patients, poses significant medical challenges. Currently, the efficacy of plant compounds with antimicrobial potential has been reported as a promising alternative therapy to traditional methods. Isoespintanol (ISO) is a monoterpene with high biological activity. Using the broth microdilution method, the antibacterial activity of ISO was examined in 90 clinical isolates, which included 14 different species: (Escherichia coli (38), Pseudomonas aeruginosa (12), Klebsiella pneumoniae (13), Acinetobacter baumannii (3), Proteus mirabilis (7), Staphylococcus epidermidis (3), Staphylococcus aureus (5), Enterococcus faecium (1), Enterococcus faecalis (1), Stenotrophomonas maltophilia (2), Citrobacter koseri (2), Serratia marcescens (1), Aeromonas hydrophila (1), and Providencia rettgeri (1). MIC90 minimum inhibitory concentration values ranged from 694.3 to 916.5 µg/mL and MIC50 values from 154.2 to 457.3 µg/mL. The eradication of mature biofilms in P. aeruginosa after 1 h of exposure to ISO was between 6.6 and 77.4%, being higher in all cases than the percentage of biofilm eradication in cells treated with ciprofloxacin, which was between 4.3 and 67.5%. ISO has antibacterial and antibiofilm potential against nosocomial bacteria and could serve as an adjuvant in the control of these pathogens.
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