Vigilancia epidemiológica de la infección nosocomial realizada por un equipo de control de infecciones multidisciplinar / Epidemiological surveillance of nosocomial infection by a multidisciplinary infection control team

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A protracted outbreak of Staphylococcus epidermidis infections among patients undergoing valve replacement.

OBJECTIVE: To investigate a Staphylococcus epidermidis outbreak among patients undergoing cardiac surgery. DESIGN: Retrospective cohort study. SETTING: A 260-bed community referral center. PATIENTS: Case-patients were patients with S. epidermidis mediastinitis, endocarditis, or both after valve implantation at Hospital de La Ribera from January to June 2002. The study population included patients undergoing valve surgery at Hospital de La Ribera from January 2000 to June 2002. RESULTS: From January to June 2002, 8 cases of mediastinitis, endocarditis, or both occurred among 53 patients undergoing cardiac surgery. In the same months of 2000, there had been no cases among 22 patients, and in 2001, only 1 case among 47 patients (P = .095 and P = .034, respectively). In 2002, there were 4 cases of mediastinitis and endocarditis, 3 cases of mediastinitis, and 1 case of endocarditis, all following aortic valve replacement. The epidemic curve suggested a protracted outbreak. Patients with chronic obstructive lung disease were six-fold more likely to be case-patients (95% confidence interval, 1.6-23.8). The mean duration of surgery tended to be longer in non-case-patients (161.4 +/- 57.9 minutes) than in case-patients (123.7 +/- 23.7 minutes) (P = .06). CONCLUSION: The cause of this protracted outbreak was likely multifactorial. Reemphasis of existing policies was associated with resolution of the outbreak.

[Two first years' bacteremia incidence and impact in a new hospital]. / Incidencia e impacto de las bacteriemias durante los dos primeros años de apertura de un nuevo hospital.

BACKGROUND AND OBJECTIVE: We pursued here to determine the incidence of blood-stream infections. PATIENTS AND METHOD: Longitudinal descriptive study. All patients admitted to hospital from January 1999 to December 2000 were included. Blood-stream infection episodes were defined according to CDC criteria. Blood-stream infection prevalence and incidence density (ID), nosocomial primary blood-stream infection attributable to intravascular devices intravascular devices and population attributable fraction were estimated. RESULTS: Overall blood-stream infection ID was 1.3 por 1,000 patient-years. Nosocomial blood-stream infection represented 1.1 per 1,000 patient-days. Nosocomial primary blood-stream infection attributable risk was 54.3%, population attributable risk was 49.8% and population attributable fraction was 86.6%. CONCLUSIONS: The incidence of blood-stream infection was similar to that reported by other centers. The impact of intravascular devices on nosocomial blood-stream infections in our hospital was high

Incidencia e impacto de las bacteriemias durante los dos primeros años de apertura de un nuevo hospital / Two first years' bacteremia incidence and impact in a new hospital

FUNDAMENTO Y OBJETIVO: Estudiar la incidencia de la bacteriemia durante los dos primeros años desde la apertura de un nuevo hospital. PACIENTES Y MÉTODO: Estudio descriptivo longitudinal. Se estudió a todos los pacientes que acudieron al hospital durante 19992000. Se definió bacteriemia según criterios de los Centers for Disease Control (CDC). Fueron calculadas la prevalencia y densidad de incidencia (DI) de bacteriemia, incidencia de bacteriemia primaria nosocomial atribuible a catéter intravascular (CIV) y fracción atribuible poblacional. RESULTADOS: La DI de bacteriemia global fue 1,3 por 1.000 pacientes-años. La bacteriemia nosocomial representó 1,1 por 1.000 pacientes-días. La incidencia de bacteriemia primaria nosocomial atribuible a CIV fue del 54,3 por ciento, y la fracción atribuible poblacional, del 86,6 por ciento. CONCLUSIONES: La incidencia de bacteriemia es equivalente a la observada en otros hospitales. En nuestro centro, el impacto del CIV en la bacteriemia nosocomial es elevado. (AU)