Prevention and control of vessel catheter associated infections: a harsh and long way to go / 中国实用护理杂志

Vascular access devices are regarded as double-edged swords since being used as lifesaving accesses widely as well as causing vessel catheter associated infections and other complications.In severe cases, it may even endanger life. This paper expounded the importance and necessity of vessel catheter associated infections prevention and control from several aspects such as national policy promotion, medical insurance payment innovation and clinical management demand, analyzed the key links of vessel catheter associated infections prevention and control and the research status quo here and abroad based on the life cycle of the catheter, and pondered the future directions considering the current difficulties and blind spots.

Risk factors forvessel catheter associated infection in children with intestinal failure: a scoping review / 中国实用护理杂志

Objective:To scope review of studies on the risk factors for vessel catheter associated infection in children with intestinal failure was reviewed, so as to provide a reference for clinical medical staff to prevent and control infection.Methods:Based on the framework of scope review method, PubMed, Embase, CINAHL, APA PsycInfo, Web of Science, Scopus, Cochrane Library, China Biomedical Literature Database, China Knowledge Networkand Wanfang database are retrieved. The retrieval period was from the database construction to February 1, 2022. The included literatures were Summarized and analyzed.Results:A total of 28 articles were included, and the risk factors of vessel catheter associated infection in children with intestinal failure were found to include 7 aspects: basic information of children, catheter nursing measures, type of tube-sealing solution, catheter factors, residual intestinal condition of children, nursing level of caregivers, therapeutic factors.Conclusions:The risk factors of vessel catheter associated infection in children with intestinal failure were found to include 7 aspects, which are complex and diverse with distinctive disease characteristics. In the future, medical staff can optimize the pipeline nursing measures; construct the model of cross-specialty health education and improve the nursing level of caregivers to reduce the incidence of vessel catheter associated infection.

Effect of Central Line Bundle Compliance on Central Line-Associated Bloodstream Infections

PURPOSE: The present study aimed to evaluate the effect of central line (CL) bundle compliance on central line-associated bloodstream infections (CLABSIs) in different departments of the same hospital, including the intensive care unit (ICU) and other departments. MATERIALS AND METHODS: The four components of the CL bundle were hand hygiene, use of maximal sterile barrier precautions, chlorhexidine use, and selection of an appropriate site for venous access. Compliance of the CL bundle and CLABSIs were measured for every department [emergency room (ER), ICU, general ward (GW), and operating room (OR)]. A total of 1672 patients were included over 3 years (August 2013 through July 2016). RESULTS: A total of 29 CLABSI episodes (1.73%) were identified, and only 53.7% of the patients completed CL bundles. The performance rates of all components of the CL bundle were 22.3%, 28.5%, 36.5%, and 84.6% for the ER, ICU, GW, and OR, respectively. The highest CLABSI rate was observed in patients of the ICU, for whom all components were not performed perfectly. Conversely, the lowest CLABSI rate was observed for patients of GWs, for whom all components were performed. Among individual components, femoral insertion site [relative risk (RR), 2.26; 95% confidence interval (CI), 1.09–4.68], not using a full body drape (RR, 3.55; 95% CI, 1.44–8.71), and not performing all CL bundle components (RR, 2.79; 95% CI, 1.19–6.54) were significant variables associated with CLABSIs. CONCLUSION: This study provides direct evidence that completing all CL bundle components perfectly is essential for preventing CLABSIs. Customized education should be provided, according to specific weaknesses of bundle performance.

Consecutive 6-year targeted monitoring on healthcare-associated infection in intensive care units in 176 hospitals / 中国感染控制杂志

Objective To understand the occurrence of healthcare-associated infection(HAI) in intensive care units (ICUs) in secondary and above hospitals in a province, and provide basis for HAI management.Methods HAI management quality control center in a province performed targeted monitoring on HAI in ICUs in secondary and above hospitals in a province from July 1, 2010 to June 30, 2015.Results ICUs in 176 hospitals were monitored, the incidence of HAI in ICUs for 6 consecutive years was 7.23％, case incidence of HAI was 9.72％;incidence of HAI showed a decreased trend in 6 years(P0.05).A total of 36 223 strains of pathogens were isolated, the top 6 isolated pathogens were Acinetobacter baumannii(22.77％), Klebsiella pneumoniae (11.96％), Pseudomonas aeruginosa(11.94％), Staphylococcus aureus (8.08％), Candida albicans (5.63％), and Escherichia coli(5.55％).The isolation rates of carbapenem-resistant Klebsiella pneumoniae showed a increased tendency for 6 years(P<0.05).Conclusion Continuous targeted monitoring on HAI in ICUs, regular analysis on risk factors for HAI, and timely implementation of intervention measures can effectively decrease the incidence of HAI.

Targeted monitoring on catheter-associated infection in general intensive care unit / 中国感染控制杂志

Objective To monitor the incidence of catheter-associated infection (CAI)in patients in general inten-sive care unit (ICU),and provide basis for taking proper prevention and control measures.Methods Targeted monitoring method was conducted,incidence of healthcare-associated infection (HAI)among patients receiving urinary catheterization,intravascular catheterization,and tracheal intubation in the general ICU of a tertiary hospital between January 2012 and December 2013 were surveyed.Results A total of 299 ICU patients with catheterization were investigated,the overall hospitalization days were 2 700 days,41 patients developed 48 episodes of HAI, incidence of HAI was 13.71%,case incidence was 16.05%,incidence of HAI per 1 000 catheter days was 15.19‰,37 patients developed 44 episodes of CAI;the other types of HAI were blood stream infection(n=1),skin and soft tissue infection(n = 1 ),antibiotic-associated diarrhea(n = 1 ),and herpes zoster(n = 1 ).Incidence of catheter-associated urinary tract infection (CAUTI),catheter-related bloodstream infection (CRBSI),and ventilator-associated pneumonia (VAP ) per 1 000 catheter days were 2.94‰,2.12‰,and 15.72‰ respectively. Conclusion CAI is the main HAI type in ICU patients with catheterization,and the major is VAP.

Medical cost of intensive care unit patients with catheter-associated infec-tion before and after intervention / 中国感染控制杂志

Objective To compare whether there is a difference in medical cost of intensive care unit(ICU)pa-tients with catheter-associated infection (CAI)between before and after targeted intervention.Methods CAI in ICU patients in 2010(pre-intervention group)and 2013 (post-intervention group)were investigated by retrospective survey,hospitalization cost of two groups of patients before and after intervention was compared.Results The morbidity and mortality in patients with CAI both decreased significantly after intervention,morbidity of healthcare-associated infection(HAI)decreased from 13.47% in 2010 to 4.41 % in 2013,mortality decreased from 10.36% in 2010 to 2.2% in 2103.Total hospitalization cost,blood transfusion cost,and cost of special material before and af-ter the implementation of targeted intervention all significantly different (all P <0.05),the difference of procalcito-nin and antimicrobial agents cost were also significant(all P <0.05).Conclusion Medical cost in ICU patients with CAI decreased after intervention.

Evaluation on laboratory diagnosis of catheter-related bloodstream infec-tion due to Rhizobium radiobacter in pediatric patients / 中国感染控制杂志

Objective To evaluate diagnostic method and infection factors for catheter-related bloodstream infec-tion(CRBSI)due to Rhizobium radiobacter (R.radiobacter)in pediatric patients.Methods Clinical data of 1 014 pediatric patients with central venous catheter(CVC)-related treatment in a hospital from February 2012 to February 2014 were collected,semi-quantitative culturing of catheter,colony forming unit (CFU)ratio of catheter to venous blood,difference in culture time between venous blood and catheter were detected among patients with R.radiobact-er infection;factors for R.radiobacter infection were analyzed.Results Of 1 014 pediatric patients who used CVC, 32 were detected R.radiobacter from catheter blood,28 were detected from venous blood,27 were detected from both catheter and venous blood.Catheter semi-quantitative culture of 27 patients were ≥ 15 CFU,5 were5 days are risk factors for R.radiobacter bloodstream infection.