1887

Abstract

The purpose of this study is to describe the epidemiological surveillance of microbiological sentinel events (SEs) carried out between 2012 and 2014 at the Neurological Hospital Carlo Besta, Milano, Italy. The setting is inpatient care with multidrug-resistant infections. The aim of the procedure is to formalize the management mode, reporting and transmission of SEs. Categorical variables were described by counts and percentages, as mean and or median and interquartile range. The incidence rates of SE were calculated per 1000 patient-days and for 100 admissions using Poisson distribution. The incidence rate of isolation for 1000 patient-days varies from a minimum of 0.52 (95 % confidence interval, 0.23–1.15) for the second quarter of 2014 to a maximum value of 4.16 (95 % confidence interval, 3.20–5.40) for the first quarter of 2013. A decrease followed from the third quarter of 2013 that remained constant in 2014, reaching values similar to those of 2012. Preventive actions and their effectiveness on , the primary cause in our division of multidrug-resistant infections in 2012, have ensured a reduction of the incidence of the same; preventive actions and their effectiveness allowed us to intercept microbiological SE and trigger appropriate precautionary behaviour and isolation. Surveillance of healthcare-associated infections is fundamental in understanding the sources that are contributing to the growing reservoir within hospital communities.

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2016-12-16
2024-03-28
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References

  1. Barlow G., Nathwani D. 2005; Is antibiotic resistance a problem? A practical guide for hospital clinicians. Postgrad Med J 81:680692 [View Article][PubMed]
    [Google Scholar]
  2. Chen L. F., Freeman J. T., Nicholson B., Keiger A., Lancaster S., Joyce M., Woods C. W., Cook E., Adcock L. et al. 2014; Widespread dissemination of Ctx-M-15 genotype extended-spectrum-β-lactamase-producing Enterobacteriaceae among patients presenting to community hospitals in the southeastern United States. Antimicrob Agents Chemother 58:12001202 [View Article][PubMed]
    [Google Scholar]
  3. Chong Y., Shimoda S., Yakushiji H., Ito Y., Miyamoto T., Kamimura T., Shimono N., Akashi K. 2013; Community spread of extended-spectrum β-lactamase- producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis: a long-term study in Japan. J MedMicrobiol 62:10381043
    [Google Scholar]
  4. Christoff J., Tolentino J., Mawdsley E., Matushek S., Pitrak D., Weber S. G. 2010; Optimizing empirical antimicrobial therapy for infection due to Gram-negative pathogens in the intensive care unit: utility of a combination antibiogram. Infect Control Hosp Epidemiol 31:256261 [View Article][PubMed]
    [Google Scholar]
  5. Cope M., Cevallos M. E., Cadle R. M., Darouiche R. O., Musher D. M., Trautner B. W. 2009; Inappropriate treatment of catheter-associated asymptomatic bacteriuria in a tertiary care hospital. Clin Infect Dis 48:11821188 [View Article][PubMed]
    [Google Scholar]
  6. Custovic A., Smajlovic J., Hadzic S., Ahmetagic S., Tihic N., Hadzagic H. 2014; Epidemiological surveillance of bacterial nosocomial infections in the surgical intensive care unit. Mater Sociomed 26:711 [View Article][PubMed]
    [Google Scholar]
  7. Dellinger P. R., Levy M. M., Rhodes A. 2013; Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med 41:580637
    [Google Scholar]
  8. Dent L. L., Marshall D. R., Pratap S., Hulette R. B. 2010; Multidrug resistant Acinetobacter baumannii: a descriptive study in a city hospital. BMC Infect Dis 10:196 [View Article][PubMed]
    [Google Scholar]
  9. Emori T. G., Gaynes R. P. 1993; An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 6:428442 [View Article]
    [Google Scholar]
  10. Gaibani P., Ambretti S., Berlingeri A., Gelsomino F., Bielli A., Landini M. P., Sambri V. 2011; Rapid increase of carbapenemase-producing Klebsiella pneumoniae strains in a large Italian hospital: surveillance period 1 March-30 September 2010. Euro Surveill 16:19800[PubMed]
    [Google Scholar]
  11. Han J., Lautenbach E., Bilker W. B., Tolomeo P., Santana E., Maslow J. 2012; Colonization with extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella species in long-term care facility residents. Infect Control Hosp Epidemiol 33:302304 [View Article][PubMed]
    [Google Scholar]
  12. Hauck K., Zhao X. 2011; How dangerous is a day in hospital? A model of adverse events and length of stay for medical inpatients. Med Care 49:10681075 [View Article][PubMed]
    [Google Scholar]
  13. Jarvis W. R. 1996; The epidemiology of colonization. Infect Control Hosp Epidemiol 17:4752 [View Article][PubMed]
    [Google Scholar]
  14. Johnson J. R., Roberts P. L., Olsen R. J., Moyer K. A., Stamm W. E. 1990; Prevention of catheter-associated urinary tract infection with a silver oxide-coated urinary catheter: clinical and microbiologic correlates. J Infect Dis 162:11451150 [View Article][PubMed]
    [Google Scholar]
  15. Johnson L., Sabel A., Burman W. J., Everhart R. M., Rome M., MacKenzie T. D., Rozwadowski J., Mehler P. S., Price C. S. 2008; Emergence of fluoroquinolone resistance in outpatient urinary Escherichia coli isolates. Am J Med 121:876884 [View Article]
    [Google Scholar]
  16. Kluytmans–VandenBergh M. F. Q., Kluytmans J. A. J. W., Voss A. 2005; Dutch guideline for preventing nosocomial transmission of highly resistant microorganisms (HRMO). Infection 33:309313 [View Article]
    [Google Scholar]
  17. Li J., Nation R. L., Milne R. W., Turnidge J. D., Coulthard K. 2005; Evaluation of colistin as an agent against multi-resistant Gram-negative bacteria. Int J Antimicrob Agents 25:1125 [View Article][PubMed]
    [Google Scholar]
  18. Lo E., Nicolle L. E., Coffin S. E., Gould C., Maragakis L. L., Meddings J., Pegues D. A., Pettis A. M., Saint S., Yokoe D. S. 2014; Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 35:464479 [View Article][PubMed]
    [Google Scholar]
  19. Mandell G. L., Bennett J. E., Dolin R., Douglas M. 2010 Bennett’s Principles and Practice of Infectious Diseases, 7th edn.. Oxford, United Kingdom: Elsevier/Churchill Livingstone;
    [Google Scholar]
  20. Monnet D. L. 2000; Toward multinational antimicrobial resistance surveillance systems in Europe. Int J Antimicrob Agents 15:91101 [View Article][PubMed]
    [Google Scholar]
  21. O'Brien T. F., Stelling J. 2011; Integrated multilevel surveillance of the world's infecting microbes and their resistance to antimicrobial agents. Clin Microbiol Rev 24:281295 Review [View Article][PubMed]
    [Google Scholar]
  22. Pfeifer Y., Cullik A., Witte W. 2010; Resistance to cephalosporins and carbapenems in Gram-negative bacterial pathogens. Int J Med Microbiol 300:371379 [View Article][PubMed]
    [Google Scholar]
  23. Ronzani F., Scarin M., Brusaferro A., Intenti A., Marchetto R., Boldrin M., Pierotti S., Marcolongo A. 2013; Surveillance of healthcare acquired infections in hospital and community: a retrospective study in local healthcare organization of Rovigo. EBPH 1:87478748
    [Google Scholar]
  24. Thaden J. T., Fowler V. G., Sexton D. J., Anderson D. J. 2015; Increasing incidence of extended-spectrum β-lactamase-producing Escherichia coli in community hospitals throughout the Southeastern United States. Infect. Control Hosp Epidemiol 13:16
    [Google Scholar]
  25. van de Sande-Bruinsma N., Grundmann H., Verloo D., Tiemersma E., Monen J., Goossens H., Ferech M. European Antimicrobial Resistance Surveillance System Group European Surveillance of Antimicrobial Consumption Project Group 2008; Antimicrobial drug use and resistance in Europe. Emerg Infect Dis 14:17221730 [View Article][PubMed]
    [Google Scholar]
  26. Vasudevan A., Mukhopadhyay A., Li J., Yuen E. G., Tambyah P. A. 2014; A prediction tool for nosocomial multi-drug resistant Gram-negative bacilli infections in critically ill patients – prospective observational study. BMC Infect Dis 14:615 [View Article][PubMed]
    [Google Scholar]
  27. Vincent J. L., Bihari D. J., Suter P. M., Bruining H. A., White J., Nicolas-Chanoin M. H., Wolff M., Spencer R. C., Hemmer M. 1995; The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) study. JAMA 274:639644
    [Google Scholar]
  28. World Health Organization 2002 Prevention of Hospital-Acquired Infections. a Practical Guide, 2nd edn.. Geneva: WHO/CDS/CSR/EPH;
    [Google Scholar]
  29. Vincent J. L. 2003; Nosocomial infections in adult intensive-care units. Lancet 361:20682077 [View Article][PubMed]
    [Google Scholar]
  30. Wisplinghoff H., Bischoff T., Tallent S. M., Seifert H., Wenzel R. P., Edmond M. B. 2004; Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 39:309317 [View Article][PubMed]
    [Google Scholar]
  31. Zeng D., Chen H., Castillo-Chavez C., Thurmond M. 2011; Clinical laboratory data for biosurveillance. In Infectious Disease Informatics and Biosurveillance pp. 6787 Edited by Zeng D., Chen H., Castillo-Chavez C., Lober W. B., Thurmond M. New York: Springer;
    [Google Scholar]
  32. Zhao F., Bai J., Wu J., Liu J., Zhou M., Xia S., Wang S., Yao X., Yi H. et al. 2010; Sequencing and genetic variation of multidrug resistance plasmids in Klebsiella pneumoniae . PLoS One 5:e10141 [View Article][PubMed]
    [Google Scholar]
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