- Email: [email protected]
Extra Length of Stay of Nosocomial Infections in Pediatric ICUs of Colombia and Mexico. Findings of the International Nosocomial Infection Control Consortium (INICC)
June 2006
E133
CONCLUSIONS: Diagnosis, cut time and ASA were found to be significant in this study. The identification of SSIs after 366 days (2 to 5 years) postoperatively is becoming an increasing concern requiring surveillance for infection to continue for several years to determine the actual SSI rate for this population of patients.
Publication Number 18-161
Extra Mortality of Nosocomial Infections in Adult ICUs of 9 Hospitals of Argentina. Findings of the International Nosocomial Infection Control Consortium (INICC) VD Rosenthal1 D Sztokhamer2 M Viegas3 LC Soroka4 S Forciniti5 1
Infection Infection 3 Infection 4 Infection 5 Infection 2
Control, Control, Control, Control, Control,
Medical College, Buenos Aires, Argentina Estrada Medical Center, Buenos Aires, Argentina Peron Hospital, Buenos Aires, Argentina Evita Hospital, Buenos Aires, Argentina Fiorito Hospital, Buenos Aires, Argentina
BACKGROUND/OBJECTIVES: Our goal was to determine the extra mortality (EM) of the health care associated infections (HAI) at intensive care units (ICU) of hospital members of the INICC in Argentina. METHODS: We conducted a case control analysis nested in a prospective cohort study in 11 Adult ICUs at 9 hospitals members of the INICC, between 2002 and 2005 (4 years) to analyze the extra mortality of patients with central vascular catheter associated blood stream infection (CVC-BSI), mechanical ventilator associated pneumonia (VAP), and catheter associated urinary tract infection (CA-UTI). All patients were assessed for mortality. Adult patients who died were called cases, while those who did not die, were called controls. RESULTS: The CVC-BSI rate was 10.7 per 1000 CVC days, the VAP rate was 30.1 per 1000 device days, and CA-UTI rate was 12.8 per catheter days. 1,613 out of 8,006 (20.1%) patients without HAI died; 29 out of 65 patients (44.6%) with CVC-BSI died, the extra mortality of CVC-BSI was 24.5%, (RR, 2.21; 95% CI, 1.53-3.20; P, 0.0000); 100 out of 157 patients (63.7%) with VAP died, the extra mortality of VAP was 43.5%, (RR, 3.16; 95% CI, 2.58-3.87; P, 0.0000); 98 out of 226 patients (43.4%) with CA-UTI died, the extra mortality of CA-UTI was 23.2%, (RR, 2.15; 95% CI, 1.76-2.64; P, 0.0000). CONCLUSIONS: This study has identified that CVC-BSI, VAP and CA-UTI are significantly associated with higher mortality.
Publication Number 18-162
Extra Length of Stay of Nosocomial Infections in Pediatric ICUs of Colombia and Mexico. Findings of the International Nosocomial Infection Control Consortium (INICC) A Armas Ruiz1 W Villamil Gomez2 VD Rosenthal3 C Alvarez Moreno4 C Rojas5
E134 1
Vol. 34 No. 5
Infection Infection 3 Infection 4 Infection 5 Infection 2
Control, Control, Control, Control, Control,
La Raza Hospital, Mexico, Mexico Santa Maria Medical Center, Sucre, Colombia Medical College, Buenos Aires, Argentina San Ignacio University Hospital - Javeriana Catholic University, Bogota, Colombia del Olaya Medical Center, Bogota, Colombia
BACKGROUND/OBJECTIVES: Our goal was to determine the extra length of stay (LOS) of the health care associated infections (HAI) at Pediatric intensive care units (ICU) of hospital members of the INICC in Colombia, and Mexico. METHODS: We conducted a case control analysis nested in a prospective cohort study in 4 Pediatric ICUs at 4 hospitals members of the INICC, to analyze the extra LOS of patients with central vascular catheter associated blood stream infection (CVC-BSI), mechanical ventilator associated pneumonia (VAP), and catheter associated urinary tract infection (CA-UTI). All patients were assessed for LOS. Patients with HAI were called cases, while those without HAI were called controls. HAIs were identified using the CDC-NNIS definitions. We calculated E-LOS subtracting nosocomial average length of stay (ALOS) of patients with and without HAI. RESULTS: From 2003 to 2005, we enrolled 379 patients, representing 2,543 bed days. The overall HAI rate was 10.0 per 100 patients and 14.9 per 1000 bed days. The CVC-BSI rate was 14.9 per 1000 CVC days, the VAP rate was 2.8 per 1000 device days, and CA-UTI rate was 3.4 per catheter days. LOS of patients without HAI was 5.5 days; LOS of patients with CVC-BSI was 15.0 days (RR, 2.73; 95% CI, 2.45-3.04; P, 0.0000), representing 9.5 extra days; LOS of patients with VAP was 8.7 days (RR, 1.58; 95% CI, 1.07-2.33; P, 0.0193), representing 3.2 extra days; and LOS of patients with CA-UTI was 23.6 days (RR, 4.30 ; 95% CI, 3.57-5.19; P, 0.0000), representing 18.1 extra days. CONCLUSIONS: This study has identified that CVC-BSI, VAP, and CA-UTI increase from 3.2 to 18.1 days the length of stay of patients at ICUs.
Publication Number 18-163
Integrating Oral Care into a Process for Prevention of Pneumonia in Patients with Artificial Airways K Bryant, BA Ed, RN, CIC1 S Powell, RN1 L Camp, RN1 J Horton, RN1 1
Infection Control, Medical Pulmonary and Surgical Trauma Intensive Care Units, Spartanburg Regional Healthcare System, Spartanburg, SC, USA ISSUE: In intensive care settings, effective oral care may be a lower priority due to the demand for more critical nursing skills. However, the impact for infections involving the respiratory tract, particularly for patients with artificial airways, can be significant. Bacterial colonization and the risk of introducing pathogens along the conduit of an endotracheal tube are significant risk factors for ventilator associated pneumonia. PROJECT: In May 2004, a task force consisting of Infection Control, Medical Pulmonary Intensive Care (MICU) and Surgical Trauma Intensive Care (STICU) nurses was charged with developing a process for effective oral care. Concurrently, the Infection Control department monitored ventilator associated pneumonia (VAP) rates. A product based on interval oral care was selected. A six-month trial was mandated by the hospital Value Analysis Committee. The task force designed a program with 4 components: hand hygiene, oral care, mobility and elevation of head of bed. The initiative was called ‘‘Our Goal is HOME,’’ an acronym from the components. Educational storyboards, data collection tools, written policy and procedure were developed, implemented and feedback provided.
E133
CONCLUSIONS: Diagnosis, cut time and ASA were found to be significant in this study. The identification of SSIs after 366 days (2 to 5 years) postoperatively is becoming an increasing concern requiring surveillance for infection to continue for several years to determine the actual SSI rate for this population of patients.
Publication Number 18-161
Extra Mortality of Nosocomial Infections in Adult ICUs of 9 Hospitals of Argentina. Findings of the International Nosocomial Infection Control Consortium (INICC) VD Rosenthal1 D Sztokhamer2 M Viegas3 LC Soroka4 S Forciniti5 1
Infection Infection 3 Infection 4 Infection 5 Infection 2
Control, Control, Control, Control, Control,
Medical College, Buenos Aires, Argentina Estrada Medical Center, Buenos Aires, Argentina Peron Hospital, Buenos Aires, Argentina Evita Hospital, Buenos Aires, Argentina Fiorito Hospital, Buenos Aires, Argentina
BACKGROUND/OBJECTIVES: Our goal was to determine the extra mortality (EM) of the health care associated infections (HAI) at intensive care units (ICU) of hospital members of the INICC in Argentina. METHODS: We conducted a case control analysis nested in a prospective cohort study in 11 Adult ICUs at 9 hospitals members of the INICC, between 2002 and 2005 (4 years) to analyze the extra mortality of patients with central vascular catheter associated blood stream infection (CVC-BSI), mechanical ventilator associated pneumonia (VAP), and catheter associated urinary tract infection (CA-UTI). All patients were assessed for mortality. Adult patients who died were called cases, while those who did not die, were called controls. RESULTS: The CVC-BSI rate was 10.7 per 1000 CVC days, the VAP rate was 30.1 per 1000 device days, and CA-UTI rate was 12.8 per catheter days. 1,613 out of 8,006 (20.1%) patients without HAI died; 29 out of 65 patients (44.6%) with CVC-BSI died, the extra mortality of CVC-BSI was 24.5%, (RR, 2.21; 95% CI, 1.53-3.20; P, 0.0000); 100 out of 157 patients (63.7%) with VAP died, the extra mortality of VAP was 43.5%, (RR, 3.16; 95% CI, 2.58-3.87; P, 0.0000); 98 out of 226 patients (43.4%) with CA-UTI died, the extra mortality of CA-UTI was 23.2%, (RR, 2.15; 95% CI, 1.76-2.64; P, 0.0000). CONCLUSIONS: This study has identified that CVC-BSI, VAP and CA-UTI are significantly associated with higher mortality.
Publication Number 18-162
Extra Length of Stay of Nosocomial Infections in Pediatric ICUs of Colombia and Mexico. Findings of the International Nosocomial Infection Control Consortium (INICC) A Armas Ruiz1 W Villamil Gomez2 VD Rosenthal3 C Alvarez Moreno4 C Rojas5
E134 1
Vol. 34 No. 5
Infection Infection 3 Infection 4 Infection 5 Infection 2
Control, Control, Control, Control, Control,
La Raza Hospital, Mexico, Mexico Santa Maria Medical Center, Sucre, Colombia Medical College, Buenos Aires, Argentina San Ignacio University Hospital - Javeriana Catholic University, Bogota, Colombia del Olaya Medical Center, Bogota, Colombia
BACKGROUND/OBJECTIVES: Our goal was to determine the extra length of stay (LOS) of the health care associated infections (HAI) at Pediatric intensive care units (ICU) of hospital members of the INICC in Colombia, and Mexico. METHODS: We conducted a case control analysis nested in a prospective cohort study in 4 Pediatric ICUs at 4 hospitals members of the INICC, to analyze the extra LOS of patients with central vascular catheter associated blood stream infection (CVC-BSI), mechanical ventilator associated pneumonia (VAP), and catheter associated urinary tract infection (CA-UTI). All patients were assessed for LOS. Patients with HAI were called cases, while those without HAI were called controls. HAIs were identified using the CDC-NNIS definitions. We calculated E-LOS subtracting nosocomial average length of stay (ALOS) of patients with and without HAI. RESULTS: From 2003 to 2005, we enrolled 379 patients, representing 2,543 bed days. The overall HAI rate was 10.0 per 100 patients and 14.9 per 1000 bed days. The CVC-BSI rate was 14.9 per 1000 CVC days, the VAP rate was 2.8 per 1000 device days, and CA-UTI rate was 3.4 per catheter days. LOS of patients without HAI was 5.5 days; LOS of patients with CVC-BSI was 15.0 days (RR, 2.73; 95% CI, 2.45-3.04; P, 0.0000), representing 9.5 extra days; LOS of patients with VAP was 8.7 days (RR, 1.58; 95% CI, 1.07-2.33; P, 0.0193), representing 3.2 extra days; and LOS of patients with CA-UTI was 23.6 days (RR, 4.30 ; 95% CI, 3.57-5.19; P, 0.0000), representing 18.1 extra days. CONCLUSIONS: This study has identified that CVC-BSI, VAP, and CA-UTI increase from 3.2 to 18.1 days the length of stay of patients at ICUs.
Publication Number 18-163
Integrating Oral Care into a Process for Prevention of Pneumonia in Patients with Artificial Airways K Bryant, BA Ed, RN, CIC1 S Powell, RN1 L Camp, RN1 J Horton, RN1 1
Infection Control, Medical Pulmonary and Surgical Trauma Intensive Care Units, Spartanburg Regional Healthcare System, Spartanburg, SC, USA ISSUE: In intensive care settings, effective oral care may be a lower priority due to the demand for more critical nursing skills. However, the impact for infections involving the respiratory tract, particularly for patients with artificial airways, can be significant. Bacterial colonization and the risk of introducing pathogens along the conduit of an endotracheal tube are significant risk factors for ventilator associated pneumonia. PROJECT: In May 2004, a task force consisting of Infection Control, Medical Pulmonary Intensive Care (MICU) and Surgical Trauma Intensive Care (STICU) nurses was charged with developing a process for effective oral care. Concurrently, the Infection Control department monitored ventilator associated pneumonia (VAP) rates. A product based on interval oral care was selected. A six-month trial was mandated by the hospital Value Analysis Committee. The task force designed a program with 4 components: hand hygiene, oral care, mobility and elevation of head of bed. The initiative was called ‘‘Our Goal is HOME,’’ an acronym from the components. Educational storyboards, data collection tools, written policy and procedure were developed, implemented and feedback provided.