RESUMO
In this retrospective study, we compared automated surveillance with conventional surveillance to detect surgical site infection after primary total hip or knee arthroplasty. Automated surveillance demonstrated better efficacy than routine surveillance in SSI diagnosis, sensitivity, and predictive negative value in hip and knee arthroplasty. Infect Control Hosp Epidemiol 2016;37:991-993.
Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Automação , Vigilância da População/métodos , Complicações Pós-Operatórias/microbiologia , Infecção da Ferida Cirúrgica/diagnóstico , Brasil/epidemiologia , Infecção Hospitalar/diagnóstico , Feminino , Humanos , Masculino , Estudos RetrospectivosRESUMO
OBJECTIVES: The aim of this study was to evaluate the risk factors and attributable mortality associated with imipenem-resistant Pseudomonas aeruginosa (IRPA) infections in a medical-surgical intensive care unit (ICU). METHODS: A retrospective case-control study was carried out at a 16-bed medical-surgical ICU in a 780-bed, university-affiliated hospital. All patients admitted from January 1, 2003, to December 31, 2004, who had nosocomial infection caused by IRPA, were included in the study. RESULTS: Imipenem-resistant P. aeruginosa was recovered from 63 patients during the study period. One hundred eighty-two controls were matched with cases by period of admission, age, and time at risk. Urinary tract (34.9%) and respiratory tract (22.2%) were the main sources of IRPA isolation. In multivariate analysis, a previous stay in the ICU (odds ratio, 3.54; 95% confidence interval [CI], 1.29-9.73; P = .03) was the only independent risk factor for IRPA infection. The in-hospital mortality rate among case patients was 49% (31 of 63) compared with 33% (61 of 182) for control patients (odds ratio, 1.92; 95% CI, 1.07-3.44; P = .02). Thus, we had an attributable mortality of 16% (95% CI, 9.74%-22.3%; P = .03). CONCLUSIONS: Our study suggests that IRPA infections are strongly related to previous ICU stay, and that IRPA infections significantly increase mortality in those critical patients.
Assuntos
Anti-Infecciosos/farmacologia , Farmacorresistência Bacteriana , Imipenem/farmacologia , Infecções por Pseudomonas/mortalidade , Pseudomonas aeruginosa/efeitos dos fármacos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Mortalidade Hospitalar , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/microbiologia , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
We examined the impact of an antimicrobial formulary change, based on reduction in third-generation cephalosporin use, on resistant gram-negative pathogens in a tertiary hospital. No significant changes were demonstrated in their incidence per 1000 patient-days. Otherwise, there was a significant decrease in rate of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae (63.1% to 52.5%, P = .04) and third-generation cephalosporin-resistant Enterobacter species (31.4% to 25%, P = .04) between the 2 study periods. On the other hand, there was also a significant increase in rate of ampicillin-sulbactam-resistant Acinetobacter baumannii (8% to 47%, P = .01) after the implementation of the formulary intervention.
Assuntos
Antibacterianos/uso terapêutico , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana Múltipla , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/epidemiologia , Antibacterianos/farmacologia , Brasil/epidemiologia , Infecção Hospitalar/microbiologia , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/microbiologia , Hospitais , Humanos , IncidênciaRESUMO
Handwashing compliance was compared at two medical- surgical intensive care units (ICUs) of a teaching and a non-teaching hospital. The mean compliance was 22.2% and 42.6%, respectively. Respiratory therapists at the non-teaching hospital had the best handwashing compliance (52.6%). Nursing assistants at the teaching hospital had the worst compliance (11.5%). Nursing assistant was the only health-care worker category with a significant difference between the two ICUs (odds ratio = 6.0; 95% confidence interval = 3.83-9.43; p< 0.001).
Assuntos
Infecção Hospitalar/prevenção & controle , Fidelidade a Diretrizes/estatística & dados numéricos , Desinfecção das Mãos , Unidades de Terapia Intensiva/estatística & dados numéricos , Recursos Humanos em Hospital , Brasil , Hospitais de Ensino , HumanosRESUMO
Handwashing compliance was compared at two medical- surgical intensive care units (ICUs) of a teaching and a non-teaching hospital. The mean compliance was 22.2 percent and 42.6 percent, respectively. Respiratory therapists at the non-teaching hospital had the best handwashing compliance (52.6 percent). Nursing assistants at the teaching hospital had the worst compliance (11.5 percent). Nursing assistant was the only health-care worker category with a significant difference between the two ICUs (odds ratio = 6.0; 95 percent confidence interval = 3.83-9.43; p< 0.001).
