Automated surveillance systems for healthcare-associated infections: results from a European survey and experiences from real-life utilization.

BACKGROUND: As most automated surveillance (AS) methods to detect healthcare-associated infections (HAIs) have been developed and implemented in research settings, information about the feasibility of large-scale implementation is scarce. AIM: To describe key aspects of the design of AS systems and implementation in European institutions and hospitals. METHODS: An online survey was distributed via e-mail in February/March 2019 among (i) PRAISE (Providing a Roadmap for Automated Infection Surveillance in Europe) network members; (ii) corresponding authors of peer-reviewed European publications on existing AS systems; and (iii) the mailing list of national infection prevention and control focal points of the European Centre for Disease Prevention and Control. Three AS systems from the survey were selected, based on quintessential features, for in-depth review focusing on implementation in practice. FINDINGS: Through the survey and the review of three selected AS systems, notable differences regarding the methods, algorithms, data sources, and targeted HAIs were identified. The majority of AS systems used a classification algorithm for semi-automated surveillance and targeted HAIs were mostly surgical site infections, urinary tract infections, sepsis, or other bloodstream infections. AS systems yielded a reduction of workload for hospital staff. Principal barriers of implementation were strict data security regulations as well as creating and maintaining an information technology infrastructure. CONCLUSION: AS in Europe is characterized by heterogeneity in methods and surveillance targets. To allow for comparisons and encourage homogenization, future publications on AS systems should provide detailed information on source data, methods, and the state of implementation.

Catheter placement for hemodialysis in a patient in the prone position by anatomic reference, a case report

The use of renal replacement therapies in patients with SARS-COV2 infection accounts for up to 20% of patients admitted to the intensive care unit. Therefore, for an adequate dialysis therapy, the placement of an adequate catheter is imperative. In patients who develop a severe SIRA, the American and European guidelines recommend the prone position to improve pulmonary ventilation, so the placement of an catheter, becomes a great challenge, the use of technology such as ultrasound, helps reduce complications, however, when it is not available, the importance of an anatomical knowledge is vital for success. A 62-year-old male, with non-productive cough, asthenia, adynamia, adding, increasing dyspnea, even meriting ventilator mechanical support, with high ventilatory parameters, Therefore, as an added therapeutic measure, the patient was pronated, presenting ventilatory improvement. After 6 days of stay in the intensive care unit, renal compromise is added with evolution of oliguric AKIN 3 acute kidney injury, requiring initiate renal replacement therapy so it is decided to place a temporary catheter to start therapy. Because the patient's requirement to remain in pronation position, it is decided to place a temporary double- lumen catheter in that position, after not having an ultrasound available, the use of anatomical reference is chosen. The challenges that doctors have faced over the last few months, due to the recent coronavirus, have required new protocols and procedures to which techniques and procedures have had to be adapted to obtain better results, and improve the health status of each of the patients. A review of this case was carried out to refer the importance of anatomical knowledge, that the nephrologist, in the interventional area, is of utmost importance for reducing complications and increasing the success rate in each of their procedures.