ABSTRACT
BACKGROUND AND OBJECTIVES: To identify risk factors, and to estimate the crude effects attributable to hospital acquired Clostridium difficile infection (CDI). PATIENTS AND METHODS: Case-control study matched by age, gender, and admission date. Patient and healthcare risk factors were evaluated. Hospital stays and mortality were compared. RESULTS: Thirty-eight cases and 76 controls were included (mean age 73 years). Cases presented worse Charlson index (P .02), higher pre-infection stay (median 10 vs. 5.5 days) and had received antibiotic treatment more frequently (89.5 vs. 40.7%) than their control counterparts. Albuminemia < 3.5 gr/dL (OR 7.1; 1.4-37), having received cephalosporins (OR 10.1; 1.8-55.1), quinolones (OR 9.4; 1.1-41.1), or proton pump inhibitors (OR 6.6; 1.1-41.1) were associated with an independent higher risk of CDI. Total hospital stay (31 vs. 5.5 days), as well as crude mortality, was higher for cases than for control patients (31.6 vs. 6.6%). CONCLUSIONS: Receiving cephalosporins, quinolones and proton pump inhibitors, as well as hyponutrition, increase the risk of CDI. CDI is associated with relevant crude effects on mortality and excess of stay.
Subject(s)
Clostridioides difficile , Clostridium Infections/etiology , Cross Infection/etiology , Age Factors , Aged , Aged, 80 and over , Anti-Bacterial Agents/adverse effects , Case-Control Studies , Clostridioides difficile/genetics , Clostridioides difficile/isolation & purification , Clostridium Infections/mortality , Cross Infection/mortality , Female , Hospitalization , Humans , Length of Stay/statistics & numerical data , Logistic Models , Male , Malnutrition/complications , Middle Aged , Risk FactorsABSTRACT
INTRODUCTION: Control of Acinetobacter baumannii is a challenge. METHODS: A survey was conducted on the control measures introduced against A baumannii in 30 Spanish hospitals. RESULTS: We found significant differences in the application of contact precautions, active surveillance, hygiene of colonised patients, environmental cleaning, and educational activities. Hospitals with a written control program for A. baumannii had a lower incidence of colonisation/infection due to this organism. CONCLUSION: A multidisciplinary consensus document for the control of A. baumannii is needed in Spain.
Subject(s)
Acinetobacter Infections/prevention & control , Acinetobacter baumannii , Infection Control/methods , Hospitals , Humans , Spain , Surveys and QuestionnairesABSTRACT
Introduction Control of Acinetobacter baumannii is a challenge. Methods A survey was conducted on the control measures introduced against A baumannii in 30 Spanish hospitals. Results We found significant differences in the application of contact precautions, active surveillance, hygiene of colonised patients, environmental cleaning, and educational activities. Hospitals with a written control program for A. baumannii had a lower incidence of colonisation/infection due to this organism.ConclusionA multidisciplinary consensus document for the control of A. baumannii is needed in Spain (AU)
Introducción El control de Acinetobacter baumannii es complejo. Métodos Se realizó una encuesta sobre las medidas de control frente a A. baumannii en 30 hospitales españoles. Resultados Se encontraron diferencias en la aplicación de precauciones de contacto, cultivos de cribado, higiene de los pacientes colonizados, limpieza ambiental, y actividades formativas. Los hospitales con un programa escrito de control de A. baumannii tuvieron menor incidencia de este patógeno. Conclusión Es necesario elaborar un documento de consenso multidisciplinar para el control de A. baumannii en España (AU)
Subject(s)
Humans , Acinetobacter baumannii/isolation & purification , Acinetobacter Infections/epidemiology , Communicable Disease Control/methods , Mass Screening/policies , Cross Infection/prevention & controlABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen, both in-hospital and in the community. Although there are several guidelines with recommendations for the control of this microorganism, the measures proposed are not uniformly implemented in Spanish hospitals. The objective of this document is to provide evidence-based recommendations that are applicable to Spanish hospitals, with the aim of reducing transmission of MRSA in our health care centers. The recommendations are divided into the following groups: surveillance, active detection of colonization in patients and health care workers, control measures for colonized or infected patients, decolonization therapy, environmental cleaning and disinfection, antimicrobial consumption, measures for non-hospitalized patients, and others. The main measures recommended include appropriate surveillance, hand hygiene, and implementation of active surveillance, contact precautions, and environmental cleaning.
Subject(s)
Cross Infection/prevention & control , Methicillin Resistance , Population Surveillance , Staphylococcal Infections/prevention & control , Staphylococcus aureus/drug effects , Cross Infection/diagnosis , Cross Infection/epidemiology , Hospitals , Humans , Spain , Staphylococcal Infections/diagnosis , Staphylococcal Infections/epidemiologyABSTRACT
Staphylococcus aureus resistente a meticilina (SARM)es un patógeno de gran trascendencia. Aunque existen numerosas guías para el control de este microorganismo, la aplicación de las medidas de control es heterogénea en los hospitales españoles. Este documento pretende ofrecer recomendaciones basadas en la evidencia aplicables a nuestros centros, con el objetivo de reducir la transmisión de SARM en los centros sanitarios. Las recomendaciones se distribuyen en aspectos relacionados con la vigilancia, la detección activa de la colonización en pacientes y sanitarios, las medidas de control con los pacientes colonizados o infectados, el tratamiento de descolonización, la limpieza y desinfección ambiental, el consumo de antimicrobianos, las actuaciones en pacientes no hospitalizados y otros. Las medidas principales se refieren a una adecuada vigilancia, la higiene de manos, la detección activa de pacientes colonizados, el uso de precauciones de contacto y la limpieza ambiental (AU)
Methicillin-resistant Staphylococcus aureus (MRSA)is an important pathogen, both in-hospital and in the community. Although there are several guidelines with recommendations for the control of this microorganism, the measures proposed are not uniformly implemented in Spanish hospitals. The objective of this document is to provide evidence-based recommendations that are applicable to Spanish hospitals, with the aim of reducing transmission of MRSA in our health care centers. The recommendations are divided into the following groups: surveillance, active detection of colonization inpatients and health care workers, control measures for colonized or infected patients, decolonization therapy, environmental cleaning and disinfection, antimicrobial consumption, measures for non-hospitalized patients, and others. The main measures recommended include appropriate surveillance, hand hygiene, and implementation of active surveillance, contact precautions, and environmental cleaning (AU)
Subject(s)
Humans , Staphylococcal Infections/epidemiology , Methicillin Resistance , Cross Infection/epidemiology , Epidemiological Monitoring , Staphylococcus aureus/isolation & purification , Staphylococcus aureus/pathogenicity , Communicable Disease Control/methodsABSTRACT
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