Letter to the editor: enhancing healthcare-associated infection reporting in Canada.

BackgroundAn estimated 3.2 million patients annually develop healthcare-associated infections (HCAIs) in Europe alone amid the major challenge of increasing antimicrobial resistance. Critically ill children warrant specific evaluation because of differences in epidemiology, causative organisms and infection sites.ObjectivesTo examine the prevalence and antimicrobial susceptibility patterns of three types of HCAI in critically ill children and determine the effect on their disease course.Materials and methodsRetrospective cohort review of critically ill children admitted to a general paediatric ICU (PICU) at a regional academic tertiary referral centre over a 3 year period.ResultsThere were 1930 admissions with a median age of 38 months. Children with HCAIs had a higher incidence of comorbidities (74% versus 24%) and a longer median length of stay (8 days versus 3 days). We identified 26 positive isolates (blood, lower respiratory and urine) taken 48 h or more after admission. The combined incidence was 1.34%. Hospital-acquired pneumonia accounted for 58% of HCAIs, urinary tract infections for 31% and bloodstream infections for 11%. The majority (61.5%) of HCAIs were caused by Gram-negative organisms. Seven isolates were resistant to antimicrobials used to treat HCAI. All of these were Gram-negative organisms (Pseudomonas aeruginosa, Klebsiella oxytoca and Escherichia coli).ConclusionsThese data revealed a low incidence of HCAIs, 27% of which were resistant Gram-negative organisms. Critically ill children with HCAIs were more likely to have comorbidities and an increased length of stay. These factors may increasingly impact on PICU bed availability, an already limited resource.

Bloodstream Infections in a Geriatric Cohort: A Population-Based Study

Healthcare Infections Associated with Care and Treatment of Humans and Animals

Objective: To estimate the registration quality of neonatal healthcare-associated infections (HAI) and intrauterine infections in separate maternity hospitals in Moscow. Material and methods: We carried out a retrospective epidemiological analysis neonates HAIs and intrauterine infections. In this study was conducted patients from Moscow during 2008–2017 and three maternity hospitals in Moscow during 2009–2017. These case study maternity hospitals would be known as MH № X01, № X02 and № X03. Also in this study we assessed postpartum woman’s HAIs morbidity in MH during 2009–2017. From these patients we selected cases where not only newborn suffered the disease but mother got sick neither. Then we analyzed on which day after day birth the child got the diagnosis HAIs or intrauterine infections. In addition, the quality of registration was established on the basis on Rospotrebnadzor order № 29 dated on 16.03.2018 «About an order of case registration of infectious and parasitic diseases in the city of Moscow». The data selection was from Statistical Reporting Form № 2 in Moscow. Also, were used data from infectious and parasitic diseases accounting and registration department of The Hygiene and Epidemiology Center in Moscow. The morbidity rate of HAIs and intrauterine infections of newborns was counted on 1,000 births newborns. The morbidity rate of HAIs of postpartum women was counted on 1000 births. For this purpose «Microsoft Office Excel 2010» software packages were used. The calculation of the increase/decrease rate was made by the method of least squares. Results: On basis of conducted analysis it was determined that morbidity HAIs newborn has tended to be on the decline, especially compared with a sharp and considerable increase in the intrauterine infections morbidity. This trend can be observed both in Moscow and in the three described MH. The incidence of HAIs of postpartum woman is represented by a single registration. It had been identified a minimal number of cases, when the disease was being recorded in both the mother and the baby. Analyzing the timing of intrauterine infections and HAIs diagnosis from the moment of birth, it was found that about a quarter of all cases of intrauterine infections should have been registered as nosocomial infections. According to the Order № 29 on the basis on the nosology list (diseases which can only be registered as HAIs) it was established that about 10% of cases of intrauterine infections was misdiagnosed. Thus, the analysis indicators once again do not refute, but only proves the poor-quality registration of moving the newborn HAIs and cases of intrauterine infections from one category to another. The identified problem is extremely relevant and requires action to solve it. Conclusion: Multi-criteria analysis, revealing the quality of newborns HAIs and intrauterine infections registration, such as an incidence rate, the ratio intrauterine infections and HAIs newborns, the number of the disease in mother and baby’s cases registration, compliance with normative documents, showed that official statistics are unreliable. The register system for the described infections is in needed of be reformed. First of all, it is necessary to standardize the diagnostic process, that mean the development of a standard case definition for each nosology among the HAIs and intrauterine infections.

Background‘Organisational governance’—the systems, processes, behaviours and cultures by which an organisation leads and controls its functions to achieve its objectives—is seen as an important influence on patient safety. The features...

Reduction of Healthcare-Associated Infections (HAIs) by 83% in a long-term acute care setting (LTAC)

Background and objective: Healthcare-associated infections (HAIs) are a serious threat to patient safety. They cause substantial morbidity and mortality across various healthcare settings, including neonatal intensive care units (NICUs). This study was undertaken to determine the incidence of HA bloodstream infection (HA-BSI) in the NICU of a tertiary care hospital. Methodology: Data were collected in a systematic manner based on the Centers for Disease Control and Prevention (CDC) guidelines for the surveillance of HAI for a period of 1 year (Jan–Dec, 2022). The HAI rate was calculated using the following formula: No. of cases/No. of patient days × 1,000. Result: Among the 1,085 admitted neonates, the incidence of HA-BSI was 15.80/1,000 patient days. HAI was seen in neonates having mean birth weight 1,722.5 ± 113.906 g, mean gestational age 29.6 ± 1.38, and mean duration of hospital stay 13.8 ± 4.081 days. Among the 80 cases of HA-BSI, recognized pathogens were 22 (27.5%) Klebsiella pneumoniae, 16 (20%) non-albicans Candida, 13 (16.25%) methicillin-sensitive Staphylococcus aureus, 10 (12.5%) Candida albicans, 10 (12.5%) Acinetobacter baumannii, 4 coagulase-negative staphylococci, 3 (3.75%) methicillin-resistant Staphylococcus aureus, 1 (1.25%) Escherichia coli, and 1 (1.25%) Enterococcus. The mortality rate was 56.78%. Conclusion: The predominance of K. pneumoniae and A. baumannii as causative pathogens suggests the need of stringent infection control measures and targeted antimicrobial strategies to reduce the burden of HAI and improve patient outcomes.

Knowledge and attitude of healthcare workers and patients on healthcare associated infections in a regional hospital in Ghana

International Nosocomial Infection Control Consortium (INICC) resources: INICC multidimensional approach and INICC surveillance online system

Background and aim: The incidence of Healthcare Associated Infections (HAI) is an important indicator of the quality of care. The behaviors associated with the prevention of infections are not only supported by rational knowledge or motivation, but are mediated by social, emotional and often stereotyped behaviors. The awarness of the good practices related to HAI, may be a factor. Other studies, identify how the perception of the problem in healthcare professionals is often influenced by a tendency towards an external Locus of Control: the patient, the family, the other wards, other care settings. The aim of this study is to investigate the perception of healthcare professionals. In particular they have been measured their awarness of the good practices , perceptions of the potential contamination level of some commonly used objects, knowledge about the management of invasive devices, Locus of Control. Method: A cross-sectional correlational design was utilized. An ad hoc questionnaire was interviewed by 222 health professionals nurses and physicians in a northern hospital of Italy. Results: The percentage of professionals who have attended training courses over the last 5 years was quite high, both for upgrades on HAI (78.7%) and Vascular Catheters (78.8%), while the percentage of professionals who updated on bladder catheterization (59.46%) was lower. The mean score of good practice awareness towards HAI (5.06), is high. The perception of the potential level of contamination of some devices had a mean ranging from 4.62 (for the drip) to 5.26 (for the door handle). The average value of the Locus of Control (43.54) indicates that participants demonstrated a value that is midway between External and Internal. The correlation test analysis revealed no significant relationships among professionals’age, knowledge about HAI, or infection related venus catheter. Also, results revealed that there were statistically significant positive relationships between professionals’ Good Practices awareness about HAI, Knowledge, and Locus of Control. Conclusion: The study findings demonstrated that good practice awareness towards HAI among nurse and physician was good but not completely optimal. Findings revealed that knowledge toward HAI prevention and HAI related device prevention were not completely adequate. The educational courses, according to our correlational findings, should definitely take into account the psycho-social aspects of this phenomenon.

Repeated prevalence surveys of healthcare-associated infections in Finnish neonatal intensive care units

Health Care–Associated Infections after Subarachnoid Hemorrhage

Background: Healthcare associated Infections (HAIs) is considered being the most serious patient safety issue in health care settings and nurses in Emergency Department (ED) face greater risk of exposure to infectious pathogens.
 Objective: The objectives of this study were to examine knowledge, attitude and behavior towards HAIs of Indonesian nurses working in ED and to examine the relationship among the above three variables.
 Method: A cross-sectional study with self-reported survey was conducted at four hospitals in Bandung, Indonesia. The Healthcare Associated Infections Survey consisting of four domains: demographic characteristics, knowledge, attitude and behavior related to HAIs was used. The participants of this study covered 115 nurses.
 Results: The mean of overall performance on the knowledge was good 21.23 ±5.173 (range 9-30) and 92.2% of them believed that guideline for HAIs control practice can reduced the risk of infections. The mean score for behavior when practicing infection control was 37.7±5.570 (26-50). Marital status and working hours per week, influenced nurses’ knowledge of HAIs (rs = 0.185, p = 0.048). Work experienced have negative correlation with attitude towards HAIs (rs = -0.196, p = 0.035). Furthermore, type of hospital and working hours per week have been associated with nurses’ behavior towards HAIs (r = 0.191, p = 0.04). There was no significant relationship between knowledge, attitude and behavior towards HAIs.
 Conclusion: Even though the majority of ED nurses in Indonesia believe that precautionary guidelines can reduce the risk of HAIs, this study has indicated that nurses’ behavior toward HAIs is still insufficient.

Excess length of stay due to hospital-associated infections in Thailand: 8 years retrospective data

Background The burden of healthcare-associated infections (HAIs) in European acute care hospitals is estimated through periodic Point Prevalence Studies (PPS) coordinated by European Centre for Disease Prevention and Control (ECDC). In 2016, Greece had the highest HAI prevalence among European countries (10%). The current PPS aimed to estimate the prevalence of HAIs among inpatients, especially in the context of COVID-19 pandemic. Methods A cross-sectional study was conducted between April and December 2022, according to ECDC PPS protocol v.6.1, in a representative sample of 50 Greek hospitals across all country regions. Patients admitted in wards before 8.00 am of the study day were screened for inclusion. Infection control teams collected hospital characteristics (e.g., total beds, infection control markers), wards (specialty, bed occupancy) and active HAIs (type, origin, microbiological results). Active HAIs included present HAIs or past HAIs that are still being treated. ECDC HelicsWin.Net software v.4.4.0, was used for data entry and analysis. Results Overall, 12.1% inpatients (1,175 of a total 9,707) had at least one active HAI. Among the 1,408 HAIs, the most commonly observed were lower respiratory tract infections (28.9%), bloodstream infections (20%), among which 4.6% were catheter-related, and urinary tract infections (13.1%), as shown in table 1. HAI prevalence was higher in patients of intensive care units (45.7%), compared to medical (13.5%) and surgical ones (8.2%). Laboratory data were available for 58.9% of HAIs and 1,259 microorganisms were identified. Klebsiella species (20.5%), Acinetobacter species (12.8%), P. aeruginosa (10.2%), Candida species (7.9%) and S. aureus (6.3%) were frequent isolates. Antimicrobial susceptibility patterns varied depending on the pathogen (table 2). Conclusion This study shows the increased burden of HAIs among inpatients and the emergence of difficult-to-treat pathogens in Greek hospitals. Subsequent prevalence studies will provide additional evidence regarding the trend in HAI prevalence among inpatients and support the identification of modifiable practices. The invigoration of infection control and antimicrobial stewardship programs in these settings is essential. Disclosures All Authors: No reported disclosures