Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 20693

 

Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Advertise Contacts Login 
     

  Table of Contents  
REVIEW ARTICLE
Year : 2012  |  Volume : 53  |  Issue : 2  |  Page : 59-64  

Healthcare - associated infections: A public health problem


Department of Pathological, General Hospital of St.Nicolaos, Crete Greece

Date of Web Publication17-Nov-2012

Correspondence Address:
Angela Revelas
Idomeneos 1, St. Nicolaos Crete 72100, Greece

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0300-1652.103543

Rights and Permissions
   Abstract 

Disinfection and sterilization in hospitals, is of increasing concern. Nosocomial infections can be defined as those occurring within 48 hours of hospital admission, 3 days of discharge or 30 days of an operation. They affect 1 in 10 patients admitted to hospital. Nosocomial infections are associated with a great deal of morbidity, mortality, and increased financial burden

Keywords: Infections, health problem, morbility, hospitals


How to cite this article:
Revelas A. Healthcare - associated infections: A public health problem. Niger Med J 2012;53:59-64

How to cite this URL:
Revelas A. Healthcare - associated infections: A public health problem. Niger Med J [serial online] 2012 [cited 2024 Mar 29];53:59-64. Available from: https://www.nigeriamedj.com/text.asp?2012/53/2/59/103543


   Introduction Top


Nosocomial infections, otherwise known as hospital-acquired infections, are those infections acquired in hospital or healthcare service unit that first appear 48 h or more after hospital admission [1] or within 30 days after discharge following in patient care. They are unrelated to the original illness that brings patients to the hospital and neither present nor incubating as at the time of admission. They are several reasons why nosocomial infections are even more alarming in the 21 st century. These include hospitals housing large number of people who are sick and whose immune system are often in a weak end state, increased of outpatient treatment meaning that people who are in hospital are sicker on average, many medical procedures that bypass the body's natural protective barriers, medical staff move from patient to patient thus providing a way for pathogens to spread, inadequate sanitation protocols regarding uniforms equipment sterilization, washing and other preventive measures that may either be unheeded by hospital personnel or too lax to sufficiently isolate patients from infectious agents, and the routine use of anti-microbial agents in hospitals creates selection pressure for the emergence of the resistant strains of microorganisms.

Healthcare-associated infections occur in both adult and pediatric patients. Bloodstream infections, followed by pneumonia and urinary tract infections are the most infections in children, urinary tract infections are the most common healthcare -associated infections in adults. Among pediatric patients, children younger than 1 year, babies with extremely low birth weight <1000g and children in either the PICU or NICU have higher rates of healthcare -associated infections. [2],[3] The most effective method of containment is disinfection - of instruments and especially hospital staff and visitors. The surgeons disinfection procedure- hand rubbing 3 min or hand scrubbing 5 min has to be repeated many times a day, with a number of negative side effects arising from the mechanical irritation, chemical and, possibly allergic stress for the skin, quite apart from the time required. For the hospital staff, the issue of the hand disinfection is equally daunting. Plasma sterilization of equipment is a well-established technology in medicine. It works at the atomic molecular level and therefore is able to reach all surfaces, including the interior of hollow needle injections and other regions not accessible to fluid disinfectants.

In addition to the presence of systemic signs and symptoms of infection (e.g. fever, tachycardia, tachypnea, skin rash, general malaise), the source of healthcare-associated infections may be suggested by the instrumentation used in various procedures. For example, an endotracheal tube may be associated with sinusitis, tracheitis, and pneumonia; an intravascular catheter may be the source of phlebitis or line infection; and a Foley catheter may be associated with a urinary tract infection.

Patients with pneumonia may have fever, cough, purulent sputum and abnormal chest auscultatory findings such as decreased breath sounds, crackles or wheezes.

Patients with urinary tract infection may present with or without fever. Patients with cystitis can have suprapubic tenderness while those with pyelonephritis can have costovertebral tenderness. Upon inspection, their urine can be cloudy and foul-smelling.

Neonates on the other hand usually do not present with any of the above findings and may have very subtle and nonspecific signs of infection. Fever may or may not be present. Signs of infection can include temperature and/or blood pressure instability, apnea, bradycardia, lethargy, fussiness, and feeding intolerance.

Laboratory investigations should be guided by the results of a detailed physical examination and review of systems.

Caution should be taken when interpreting laboratory results because not all bacterial or fungal growth on a culture are pathogenic. Growth on cultures may reflect simple microbial colonization. Consider the following:

  • Clinical presentation of the patient
  • Reason for obtaining the test
  • The process by which the specimen was obtained (e.g. a urine culture obtained through a newly placed Foley catheter is less likely to be contaminated by microbial colonization)
  • The presence of other supporting evidence of infection (e.g. the significance of bacterial growth on tracheal aspirate culture is strengthened by the presence of radiographic changes and clinical signs compatible with pneumonia)


Among the different methods used to establish the catheter as the source of bloodstream infections (catheter-associated bloodstream infection), the differential time to positivity of paired blood cultures is the simplest. [4] The catheter is confirmed as the source of bloodstream infection if the blood culture from the catheter showed microbial growth 2 h or more earlier than a peripheral blood culture obtained at the same time. The other methods include quantitative cultures of blood obtained from the catheter and peripheral vein and also, quantitative culture of catheter segment. Unfortunately, quantitative culture is not readily available in most laboratories and culture of the catheter requires pulling out the device.

Multiple blood cultures over 24 h and appropriate volume of blood sample may increase the yield in cases of intermittent or low-inoculum bacteremia. Fungal cultures should be obtained if fungal infection is suspected. The laboratory should incubate cultures longer for fungus detection than for other pathogens.

Imaging studies such as echocardiography should be considered if thrombosis or vegetations is a concern. Candidate patients include those who have prolonged or persistent bacteremia or fungemia despite antimicrobial therapy or in patients with a new-onset murmur.

In immunocompromised patients, special studies are occasionally requested, such as cultures for nocardia and atypical mycobacteria, cytomegalovirus, and cytomegalovirus antigenemia detection Special imaging techniques (e.g. ultrasonography, CT scan, MRI) may be helpful in evaluating obscure-site infections.


   Pathophysiology Top


We have witnessed a cyclical parade of pathogens in hospitals. In Semmelweis's era, Group A streptococci created most nosocomial problems. For the next 50 to 60 years, grampositive cocci, particularly streptococci and Staphylococcus aureus, were the hospital pathogens of major concern. These problems culminated in the pandemic of 1940 to 1950, when S. aureus phage type 94/96 caused major nosocomial problems. In the 1970s, gram-negative bacilli, particularly Pseudomonas aeruginosa and Enterobacteriaceae, became synonymous with nosocomial infection. By the late 1980s and early 1990s, several different classes of antimicrobial drugs effective against gram-negative bacilli provided a brief respite. During this time, methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) emerged, signaling the return of the "blue bugs." In 1990 to1996, the three most common gram-positive pathogens-S. aureus, coagulase-negative staphylococci, and enterococci-accounted for 34% of nosocomial infections, and the four most common gram-negative pathogens-Escherichia coli, P. aeruginosa, Enterobacter spp., and Klebsiella pneumoniae-accounted for 32%/ [5] However, tracking nosocomial infections by site has become difficult in the last few years because of shorter inpatient stays. For example, the average postoperative stay of approximately 5 days now is usually shorter than the 5- to 7-day incubation period for S. aureus surgical wound infections. Acquired antimicrobial resistance is the major anticipated problem in hospitals. VRE and MRSA are the major gram-positive pathogens of concern [6],[7] P. aeruginosa, Klebsiella, and Enterobacter that harbour chromosomal or plasmid-mediated beta-lactamase enzymes are the major resistant gram-negative pathogens. Devices have more bloodstream infections due to coagulase-negative staphylococci. In fact, most cases of occult bacteremia in ICU patients are probably due to vascular access-related infections. Fungal urinary tract infections have also increased in ICU patients, presumably because of extensive exposure to broad-spectrum antibiotics. In the National nosocomial infections Surveillance system, Candida spp. are the main cause of nosocomial urinary infections in ICUs [8]


   Antibiotics Top


Appropriate use of antibiotics is important. Up to 30 of ventilator associated pneumonias are treated inadequately. There is increasing evidence to suggest that the use of appropriate and early antibiotics improves morbidity and mortality. Antibiotics should be administered at the right dose and for the appropriate duration. [9] Daily ICU ward rounds with the microbiologist can lead to rational use of antibiotics tailored to benefit individual patients. Antibiotic-resistant bacteria prolong hospitalization, increase the risk of death, and require treatment with toxic and expensive antibiotics. Empirical use of antibiotic is often necessary as laboratory results are often not available for 48 h after the samples are sent to the laboratory for culture. Appropriate specimens include blood, urine, sputum, bronchoalveolar lavage, pus and wound swabs. Blood cultures are only positive for pathogen in a third of cases. Once the antibiotic profile is available, a narrow-spectrum antibiotic can be commenced. Indicators of response to treatment include temperature, leucocytes count and C- reactive protein CRP levels. Procalcitonin is secreted by macrophages in response to septic shock and is an early and a more specific marker of bacterial infection than CRP.


   De-Escalation Top


De-escalation involves early initiation of broad-spectrum antibiotic therapy in patients with suspected sepsis without the availability of microbiology results. The increase in antibiotic resistant pathogens such as MRSA has led some investigators to suggest broader antibiotic coverage by adding a glycopeptide to carbapenem as the initial empirical therapy. This aggressive empirical regimen is continued for 24-48 h by which time laboratory tests have confirmed the causative organisms and sensitivities. This allows for de-escalation of antibiotic therapy.

This regimen should be reserved for selected patients on ICU who are seriously ill, with an extended antibiotic history and evidence of colonization by multi-resistant organisms. Unnecessary continuation of this regime will increase the risk of colonization with resistant bacteria.


   Rotational Antibiotic Therapy Top


Rotational antibiotic therapy is a strategy to reduce antibiotic resistance by withdrawing an antibiotic, or class of antibiotics, from ICU for a short period, to allow resistance rates to decrease or remain stable. The persistent use of one class of antibiotics leads to the emergence of resistant strains of bacteria; this is known as selective pressure. Rotational regimens are thought to reduce this selective pressure. There is growing support for this regimen. Kollef and colleagues [10] demonstrated a statistical decrease in nosocomial pneumonia in a large ICU after the introduction of an antibiotic rotation policy.

Restrictive antibiotic policies are less flexible and, to a certain extent binding, with respect to prescribing. They require the prescriber to give written justification for any deviation from the policy. Automatic stop orders restrict prolonged antibiotic administration. In the general hospital setting, these measures have had some success with significant reductions in antibiotic resistance. However, the overall survival in ICU was unchanged.

The concept that commensals within the bowel may provide a protective role against more virulent organisms is called colonization resistance. Translocation of Gram-negative bacteria across the intestinal wall is thought to be a major cause of nosocomial infections. SDD aims to eliminate Gram-negative aerobic bacteria by decontamination of the oral cavity and intestinal tract. There are several variations of the SDD regimen. One such regimen is non-absorbable polymyxin E, tobramycin, and amphotericin B for gastrointestinal decontamination and cefotaxime for systemic prophylaxis. Cephalosporins are usually given as prophylaxis as they act on commensal respiratory flora such as Streptococcus pneumoniae, Hemophilus influenza and S. aureus. Meta-analysis has demonstrated that SDD regimens decrease the incidence of nosocomial pneumonia but overall survival or duration of intensive care treatment is unchanged. The cost effectiveness of SDD has not been evaluated.


   Epidemiology Top


Healthcare-associated infections are most commonly caused by viral, bacterial, and fungal pathogens. These pathogens should be investigated in all febrile patients who are admitted for a noufebrile illness or those who develop clinical deterioration unexplained by the initial diagnosis. Most patients who have healthcare-associated infections caused by bacterial and fungal pathogens have a predisposition to infection caused by invasive supportive measures such as endotracheal intubation and the placement of intravascular lines and urinary catheters. Ninety-one of bloodstream infections were in patients with central intravenous lines CVL, 95 of pneumonia cases were in patients undergoing mechanical ventilation and 77 of urinary tract infections were in patients with urinary tract catheters.

Risk factors for the development of catheter-associated bloodstream infections in neonates include catheter hub colonization, exist site colonization, catheter insertion after the first week of life, duration of parenteral nutrition, and extremely low birth weight (< 1000g) at the time of catheter insertion. [11] In patients in the PICU risks, for catheter-associated bloodstream infections increase with neutropenia, prolonged catheter dwell time 7d, use of percutaneously placed CVL higher than tunneled or implanted devices, and frequent manipulation of lines. [12]

Candida spp are increasingly important pathogens in the NICU. Risk factors for the development of candidemia in neonates include gestational age less than 32 weeks, 5 min Apgar scores of less than 5, shock disseminated intravascular coagulopathy, prior use of intralipids, parenteral nutrition administration, CVL use, H2 Blocker administration, intubation, or length of stay longer than 7 days. [13] Risk factors for the development of ventilator-associated pneumonia (VAP) in pediatric patients include reintubation, genetic syndromes, immunodeficiency, and immunosuppression. [14] In neonates, a prior episode of blood steam infection is a risk factor for the development of VAP. [15]

Risk factors for the development of healthcare associated urinary tract infection in pediatric patients include bladder catheterization, prior antibiotic therapy, and cerebral palsy.

Both developed and resource-poor countries are faced with the burden of healthcare-associated infections. In a world health organization (WHO) cooperative study (55 hospitals in 14 countries from four WHO regions), about 8.7% of hospitalized patients had nosocomial infections. [16]

A six year surveillance study from 2002-2007 involving intensive care units (ICUs) in Latin America, Asia, Africa, and Europe, using CDC's NNIS definitions, revealed higher rates of central-line associated blood stream infections (BSI), ventilator associated pneumonias (VAP), and catheter-associated urinary tract infections than those of comparable United States ICUs. [17] The survey also reported higher frequencies of methicillin-resistant Staphylococcus aureus (MRSA), Enterobacter species resistance to ceftriaxone, and Pseudomonas aeruginosa resistance to fluoroquinolones.

With increasing recognition of burden from healthcare-associated infections, national surveillance systems have been developed in various countries; these have shown that nationwide healthcare-associated infection surveillance systems are effective in reducing healthcare-associated infections. [18]

Healthcare-associated infections result in excess length of stay, mortality and healthcare costs. In 2002, an estimated 1.7 million healthcare-associated infections occurred in the United States, resulting in 99,000 deaths. [19] In March 2009, the CDC released a report estimating overall annual direct medical costs of healthcare-associated infections that ranged from $28-45 billion. [20]

A report from the CDC showed that among the intensive care units in the United States, the year 2009 had 25,000 fewer central line-associated bloodstream infections (CLABSI) than in 2001, representing a 58% reduction. Between 2001 and 2009, an estimated 27,000 lives were saved and potential $1.8 billion cumulative excess health-care costs were prevented. Coordinated efforts from state and federal agencies, professional societies, and healthcare personnel in implementing best practices for insertion of central lines were thought to play a role in this achievement. [21]

Healthcare-associated infections do not have a discernible sex predilection.

Healthcare-associated infections occur in both adult and pediatric patients. Bloodstream infections, followed by pneumonia and urinary tract infections are the most common healthcare-associated infections in children; urinary tract infections are the most common healthcare-associated infections in adults. [22] Among pediatric patients, children younger than 1 year, babies with extremely low birth weight (≤1000 g) and children in either the PICU or NICU have higher rates of healthcare-associated infections. [22],[23],[24],[25]


   Prevention Top


The European prevalence of infection in intensive care study identified several factors predisposing a patient to nosocomial infections. Poor hand hygiene is responsible for 40% of infections [26] transmitted in hospitals. Surveys have shown that the improvement in compliance with hand washing reduces nosocomial infection.

Accessibility of the hand washing stations and the use of alcohol gels improves compliance with hand washing. Alcohol gel dries quickly, and is bactericidal, fungicidal and virucidal. Numerous studies have shown that doctors wash their hands less frequently than nurses and backs of hands, tips of fingers, web spaces and thumb are commonly missed areas.

Infection control can be very cost-effective. Approximately one third of nosocomial infections are preventable. To meet and exceed this level of prevention, we need to pursue several strategies simultaneously [27]

First, we need to continue to improve national surveillance of nosocomial infections so that we have more representative data. We must assess the sensitivity and specificity of our surveillance and of our case definitions, particularly for difficult-to-diagnose infections like ventilator-associated pneumonia. We also need to develop systems for surveillance of "nosocomial" infections that occur out of the hospital, where much health care is now given.

Second, we need to ensure that surveillance uses are valid. The Joint Commission on Accreditation of Healthcare Organization's ORYX initiative for monitoring health-care processes and outcomes will lead to core indicators and sentinel event monitoring. This initiative will be followed by increased outpatient surveillance, which ultimately may lead to systemwide realtime surveillance and reporting. Because, we want to use nosocomial infection rates as a core indicator of quality of care, we need to improve our ability to "risk adjust" infection rates so that we know our inter-provider and hospital comparisons are valid. Risk stratification will ultimately depend on organic-based computer systems that will mimic biologic events.

Third, many of our successes in controlling nosocomial infections have come from improving the design of invasive devices. This is particularly important given the marked increase in frequency of vascular access-associated bloodstream infections, particularly in ICU patients. Given the choice of changing human behavior (e.g. improving aseptic technique) or designing a better device, the device will always be more successful. Of particular importance is the development of noninvasive monitoring devices and minimally invasive surgical techniques that avoid the high risk associated with bypassing normal host defence barriers (e.g. the skin and mucous membranes).

Fourth, forestalling the post-antibiotic era will require aggressive antibiotic control programs; [28] these may become mandated for hospitals that receive federal reimbursements, as happened in the past with infection control programs. Risks for antibiotic-resistant strains also may be reduced in the future by controlling colonization through use of immunization or competing flora.

Fifth, antimicrobial resistance problems and the advent of xenotransplantation emphasize the importance of newer microbiologic methods. For investigation of outbreaks of multidrug-resistant pathogens, pulsed-field gel electrophoresis has become a routine epidemiologic tool. [29] Molecular epidemiologic analysis also may help us better understand the factors that lead to the emergence of resistant strains. For diagnosis of syndromes caused by unusual pathogens, representational difference analysis and speciation by use of the pathogen's phylogenetic r-RNA "clock" may become routine.

Sixth, control of tuberculosis (TB) in hospitals is an excellent example of the successful collaboration of the infection control community, CDC, and regulatory agencies. But, we can anticipate that the Occupational Safety and Health Administration may have many new employee health issues-beyond TB and bloodborne pathogens- to evaluate in hospitals, such as health problems related to exposure to magnetic fields, to new polymers, and to medications that contaminate the environment. Problems of mental stress due to unrelenting exposure to pagers, faxes, e-mail, holograms, and telephonic implanted communicators will require special attention.


   Infection Control in Developing Countries with Particular Emphasis of South Africa Top


Healthcare-associated infections HAIs area cause of significant morbidity and mortality in patients receiving healthcare, and the costs direct and indirect of these infections deplete the already limited financial resources allocated to healthcare delivery.

Approximately one in seven patients entering South African hospitals are at risk of acquiring an HAI.

Lower respiratory tract infections, urinary tract infections, bloodstream infections and post-surgical infections account for the majority of HAIs.

Indiscriminate and inappropriate use of antibiotics leads to the selection of antimicrobial-resistant organisms.

Bi-directional flow of resistance from hospitals into communities and vice versa makes it difficult to distinguish community-acquired multidrug-resistant pathogens from those that are nosocomial.

To counter the emergence and spread of multidrug-resistant pathogens the only feasible strategy is the implementation of an effective and integrated program that involves antimicrobial resistance surveillance, a rational antimicrobial-use program, and infection control.

Infection control activities on their own are primarily centered around the goal of decreasing or preventing the transmission of nosocomial healthcare -associated pathogens to patients and staff, irrespective of whether these organisms are multidrug-resistant or not.

To further reduce and control the emergence of antimicrobial resistance it is therefore essential that infection control activities be coupled with an optimized, effective and highly restrictive antimicrobial-use program.

Most importantly, such a program must be realistic, adaptable, and take cognizance of the severe limitation of resources characteristic of many developing countries.


   Conclusion Top


Intensive care is a risk factor for the emergence of antibiotic resistant bacteria. Gram-positive bacteria have overtaken Gram-negative organisms as the predominant cause of nosocomial infections. Inadequate antibiotic therapy is associated with poor outcome and particularly with bacterial resistance. Infection control measures are important for the effective control, prevention and treatment of infection. Shorter duration of treatment and correct dosage of antibiotic therapy is recommended to reduce the selection pressure for resistant isolakes. Hand washing is the single most important measure to prevent nosocomial infections. Gloves must not be used as a substitute for hand washing; they must be washed on glove removal.

 
   References Top

1.Horan TC, Gaynes RP. Surveillance of nosocomial infections. In: Mayhall CG, editor. Hospital epidemiology and infection control. Philadelphia: Lippincott Williams and Wilkins; 2004. p. 1659-702.  Back to cited text no. 1
    
2.Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, Sohn AH, Levine GL, Siegel JD, et al. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr 2002;140:432-8.  Back to cited text no. 2
    
3.Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr 2001;139:821-7.  Back to cited text no. 3
    
4.Zaoutis TE, Coffin SE. Clinical Syndromes of Device-Associated Infections. In: Long SS, Pickering LK, Prober CG, editors. Principles and Practice of Pediatric Infectious Diseases. 3rd ed. Philadelphia (US): Churchill Livingstone; 2008. p. 102.  Back to cited text no. 4
    
5.N Prabhu, M Sangeetha, P Chinnaswamy, PI Joseph. A rapid method of evaluating microbial load in health care industry and application of alcohol to reduce nosocomial infection.Journal of the Academy of Hospital Administration.Vol. 18, No1 (2006-01-2006-12)  Back to cited text no. 5
    
6.Slaughter S, Hayden MK, Nathan C, Hu TC, Rice T, Van Voorhis J, et al. A comparison of the effect of universal use of gloves and gowns with that of glove use alone on acquisition of vancomycin-resistant enterococci in a medical intensive care unit. Ann Intern Med 1996;125:448-56.  Back to cited text no. 6
[PUBMED]    
7.Bonten MJ, Hayden MK, Nathan C, Van Voorhis J, Matushek M, Slaughter S, et al. Epidemiology of colonisation of patients and environment with vancomycinresistant enterococci. Lancet 1996;348:1615-9.  Back to cited text no. 7
    
8.Fridkin SK, Welbel SF, Weinstein RA. Magnitude and prevention of nosocomial infections in the intensive care unit. Infect Dis Clin North Am 1997;11:479-96.  Back to cited text no. 8
[PUBMED]    
9.Weinstein RA. Controlling antimicrobial resistance in hospitals: Infection control and use of antibiotics. Emergency Infect. Dis 2001;7:188-92.  Back to cited text no. 9
[PUBMED]    
10.Kollef MH, Ward S, Sherman G, Prentice D, Schaiff R, Huey W, et al. Inadequate treatment of nosocomial infections is associated with certain empiric antibiotic choices. Crit Care Med 2000;28:3456-64.  Back to cited text no. 10
    
11.Mathieu LM, De Muynck AO, Leven MM, De Dvoy JJ, Goossens HJ, Van Reempts PJ. Risk factors for central vascular catheter-associated bloodstream infections among patients in a neonatal intensive care unit. J Hosp Infect 2001;48:108-16.  Back to cited text no. 11
    
12.Newman CD. Catheter-related bloodstream infections in the pediatric intensive care unit. Semin Pediatr Infect Dis 2006;17:20-4.  Back to cited text no. 12
[PUBMED]    
13.Saiman L, Ludington E, Pfaller M, Rangel-Frausto S, Wiblin RT, Dawson J, et al. Risk factors for candidemia in Neonatal Intensive Care Unit patients. The National Epidemiology of Mycosis Survey study group. Pediatr Infect Dis J 2000;19:319-24.  Back to cited text no. 13
    
14.Edward AM, Warren DK, Fraser VJ. Ventilator-associated pneumonia in pediatric intensive care unit patients: Risk factors and outcomes. Pediatrics 2002;109:758-64.  Back to cited text no. 14
    
15.Apisarnthanarak A, Holzmann-Pazgal G, Hamvas A, Olsen MA, Fraser VJ. Ventilator-associated pneumonia in extremely preterm neonates in a neonatal intensive care unit: Characteristics, risk factors, and outcomes. Pediatrics 2003;112:1283-9.  Back to cited text no. 15
[PUBMED]    
16.Tikhomirov E. WHO programme for the control of hospital infections. Chemioterapia 1987;6:148-51.  Back to cited text no. 16
[PUBMED]    
17.Rosenthal VD, Maki DG, Mehta A, Alvarez-Moreno C, Leblebicioglu H, Higuera F. International Nosocomial Infection Control Consortium report, data summary for 2002-2007, issued January 2008. Am J Infect Control 2008;36:627-37.  Back to cited text no. 17
    
18.Gastmeier P, Geffers C, Brandt C, Zuschneid I, Sohr D, Schwab F. Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect 2006;64:16-22.  Back to cited text no. 18
    
19.Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP, Pollock DA, et al. Estimating healthcare-associated infections in US hospitals, 2002. Public Health Rep 2007;122:160-6.  Back to cited text no. 19
    
20.Scott RD. The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention, 2008. CDC. Available from: http://www.cdc.gov/ncidod/dhqp/pdf/Scott_CostPaper.pdf. [Accessed 2009 Jan 7].  Back to cited text no. 20
    
21.Liang SY, Marschall J. Vital signs: Central line-associated blood stream infections-United States, 2001, 2008, and 2009. MMWR Morb Mortal Wkly Rep 2011;60:243-8.  Back to cited text no. 21
[PUBMED]    
22.Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial infections in pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System. Pediatrics 1999;103:e39.  Back to cited text no. 22
[PUBMED]    
23.Coffin SE, Zaoutis TE. Healthcare-Associated Infections. In: Long SS, Pickering LK, Prober CG, editors. Principles and Practice of Pediatric Infectious Diseases. 3 rd ed. Chapter 101. Philadelphia: Churchill Livingstone; 2008.  Back to cited text no. 23
    
24.Grohskopf LA, Sinkowitz-Cochran RL, Garrett DO, Sohn AH, Levine GL, Siegel JD, et al. A national point-prevalence survey of pediatric intensive care unit-acquired infections in the United States. J Pediatr 2002;140:432-8.  Back to cited text no. 24
    
25.Sohn AH, Garrett DO, Sinkowitz-Cochran RL, Grohskopf LA, Levine GL, Stover BH. Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey. J Pediatr 2001;139:821-7.  Back to cited text no. 25
    
26.Horan TC, Andrus M, Dureck MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309-32.  Back to cited text no. 26
    
27.Scheckler WE, Brimhall D, Buck AS, Farr BM, Friedman C, Garibaldi RA, et al. Requirements for infrastructure and essential activities of infection control and epidemiology in hospitals: A consensus panel report. Infect Control Hosp Epidemiol 1998;19:114-24.  Back to cited text no. 27
    
28.Goldmann DA, Weinstein RA, Wenzel RP, Tablan OC, Duma RJ, Gaynes RP, et al. Strategies to prevent and control the emergence and spread of antimicrobialresistant microorganisms in hospitals. A challenge to hospital leadership. JAMA 1996;275:234-40.  Back to cited text no. 28
[PUBMED]    
29.Tenover FC, Arbeit RD, Goering RV. How to select and interpret molecular strain typing methods for epidemiological studies of bacterial infections: A review for healthcare epidemiologists. Infect Control Hosp Epidemiol 1997;18:426-39.  Back to cited text no. 29
[PUBMED]    



This article has been cited by
1 Antibacterial activity of mixed metal oxide derived from Zn-Al layered double hydroxide precursors, effect of calcination temperature
Fethi Ghribi, Tayeb Bouarroudj, Youcef Messai, Ilyas Belkhattab, Abdelmounaim Chetoui, Amira Bourouba, Amina Bourouba, Houneida Benbouzid, Okba Louafi, Abdelghani Djahoudi, Zoubir Benmaamar, Khaldoune Bachari
Biologia. 2024;
[Pubmed] | [DOI]
2 Synthesis and antibacterial properties of unmodified polydopamine coatings to prevent infections
Sahra Fonseca, Nicolas Fontaine, Marie-Pierre Cayer, Jonathan Robidoux, Denis Boudreau, Danny Brouard
Next Materials. 2024; 3: 100161
[Pubmed] | [DOI]
3 Trends and predictors of antimicrobial resistance among patients with urinary tract infections at a tertiary hospital facility in Alexandria, Egypt: a retrospective record-based classification and regression tree analysis
Marian Shaker, Adel Zaki, Sara Lofty Asser, Iman El Sayed
BMC Infectious Diseases. 2024; 24(1)
[Pubmed] | [DOI]
4 Chitosan-Caffeic Acid Antibacterial Coating for PDMS Surfaces: A Sustained Moxifloxacin Release and Prolonged Coating Adhesion
Felipe Veloso, Pascale Chevallier, Helton José Wiggers, Francesco Copes, Bernard Drouin, Diego Mantovani
Coatings. 2024; 14(3): 291
[Pubmed] | [DOI]
5 Susceptibility Patterns in Staphylococcus and Klebsiella Causing Nosocomial Infections upon Treatment with E-Anethole-Rich Essential Oil from Clausena anisata
François Nguimatsia, Evariste Josué Momo, Paul Keilah Lunga, Virginia Lum Tamanji, Boniface Pone Kamdem, Pierre Michel Jazet Dongmo
Drugs and Drug Candidates. 2024; 3(1): 244
[Pubmed] | [DOI]
6 Availability of basic infection control items and personal protection equipment in 7948 health facilities in eight low- and middle-income countries: Evidence from national health system surveys
Shariful Hakim, Muhammad Abdul Baker Chowdhury, Md Jamal Uddin, Hannah H Leslie
Journal of Global Health. 2024; 14
[Pubmed] | [DOI]
7 The role of decontamination in reducing healthcare-associated infections
Shirley Kirnon
Nursing Standard. 2024;
[Pubmed] | [DOI]
8 Outbreak of colistin resistant, carbapenemase (blaNDM, blaOXA-232) producing Klebsiella pneumoniae causing blood stream infection among neonates at a tertiary care hospital in India
Ashutosh Pathak, Nidhi Tejan, Akanksha Dubey, Radha Chauhan, Nida Fatima, Jyoti, Sushma Singh, Sahil Bhayana, Chinmoy Sahu
Frontiers in Cellular and Infection Microbiology. 2023; 13
[Pubmed] | [DOI]
9 Incidence and determinants of nosocomial infection among hospital admitted adult chronic disease patients in University of Gondar Comprehensive Specialized Hospital, North–West Ethiopia, 2016–2020
Zewdu Wasie Taye, Yaregal Animut Abebil, Temesgen Yihunie Akalu, Getahun Mengistu Tessema, Eden Bishaw Taye
Frontiers in Public Health. 2023; 11
[Pubmed] | [DOI]
10 Knowledge, Attitude, Practice, and Perceived Barriers for the Compliance of Standard Precautions among Medical and Nursing Students in Central India
Megha Sharma, Rishika Bachani
International Journal of Environmental Research and Public Health. 2023; 20(8): 5487
[Pubmed] | [DOI]
11 Trends in antimicrobial susceptibility patterns of bacterial isolates in Lahore, Pakistan
Nauman Khalid, Zunaira Akbar, Nosheen Mustafa, Jamshaid Akbar, Shanawar Saeed, Zikria Saleem
Frontiers in Antibiotics. 2023; 2
[Pubmed] | [DOI]
12 Efficacy of Closed and Open Endotracheal Suction on Prevention of Ventilator-Associated Pneumonia on Patients Admitted to Critical Care Unit at Tertiary Care Hospital
Ruksar Jainuddin Mulla, Vaishali Rajsinh Mohite
Journal of Datta Meghe Institute of Medical Sciences University. 2023; 18(2): 192
[Pubmed] | [DOI]
13 Antibiotic Consumption in Primary Care in Costa Rica and Italy: A Retrospective Cross-Country Analysis
Esteban Zavaleta, Francesco Ferrara, Andrea Zovi, José Pablo Díaz-Madriz, Abigail Fallas-Mora, Bruno Serrano-Arias, Filomena Valentino, Sebastián Arguedas-Chacón, Roberto Langella, Ugo Trama, Eduardo Nava
Cureus. 2023;
[Pubmed] | [DOI]
14 A Descriptive Study on Infection Control
Bindu
International Journal Of Health Care And Nursing. 2023; 2(1): 13
[Pubmed] | [DOI]
15 Enhancing Antibacterial Performance: Structure, Phase Composition, and Microroughness of Selective Plated Copper Coatings on Medical-Grade Stainless Steel 1.4021 and Nickel Alloy Ni200
Deyan Veselinov, Hristo Skulev, Radostina Yankova, Stoyan Ivanov, Thomas Fintan Moriarty, Boyko Gueorguiev
Applied Sciences. 2023; 13(17): 9840
[Pubmed] | [DOI]
16 Spatial association between socio-economic health service factors and sepsis mortality in Thailand
Juree Sansuk, Wongsa Laohasiriwong, Kittipong Sornlorm
Geospatial Health. 2023; 18(2)
[Pubmed] | [DOI]
17 Evaluating Healthcare-Associated Infections in Public Hospitals: A Cross-Sectional Study
Daniela Iancu, Iuliu Moldovan, Brîndu?a ?ilea, Septimiu Voidazan
Antibiotics. 2023; 12(12): 1693
[Pubmed] | [DOI]
18 A comprehensive status update on modification of foley catheter to combat catheter-associated urinary tract infections and microbial biofilms
Jatin Chadha, Navdisha Thakur, Sanjay Chhibber, Kusum Harjai
Critical Reviews in Microbiology. 2023; : 1
[Pubmed] | [DOI]
19 Health care associated infections, antimicrobial resistance and outcomes in patients admitted to intensive care unit, India: A five-Year retrospective cohort study
Santenna Chenchula, Balakrishnan Sadasivam, Ajay Shukla, Saman Pathan, Saurabh saigal
Journal of Infection Prevention. 2023; : 1757177423
[Pubmed] | [DOI]
20 Nurse Staffing Level, Length of Work Experience, and Risk of Health Care–associated Infections Among Hospital Patients
Laura Peutere, Kirsi Terho, Jaana Pentti, Annina Ropponen, Mika Kivimäki, Mikko Härmä, Oxana Krutova, Jenni Ervasti, Aki Koskinen, Marianna Virtanen
Medical Care. 2023; Publish Ah
[Pubmed] | [DOI]
21 The microbiome of an outpatient rehabilitation clinic and predictors of contamination: A pilot study
Gabriella Brigando, Casey Sutton, Olivia Uebelhor, Nicholas Pitsoulakis, Matthew Pytynia, Thomas Dillon, Teresa Elliott-Burke, Nathaniel Hubert, Kristina Martinez-Guryn, Charlotte Bolch, Mae J. Ciancio, Christian C. Evans, Tze Shien Lo
PLOS ONE. 2023; 18(5): e0281299
[Pubmed] | [DOI]
22 PREVALENCE AND ANTIMICROBIAL RESISTANCE IN ENTEROCOCCUS SPECIES
SANIYA OHRI, KANWARDEEP SINGH, SHAILPREET KAUR SIDHU, LOVEENA OBEROI
Asian Journal of Pharmaceutical and Clinical Research. 2023; : 36
[Pubmed] | [DOI]
23 Nosocomial infections in the surgical intensive care unit: an observational retrospective study from a large tertiary hospital in Palestine
Banan M. Aiesh, Raghad Qashou, Genevieve Shemmessian, Mamoun W. Swaileh, Shatha A. Abutaha, Ali Sabateen, Abdel-Karim Barqawi, Adham AbuTaha, Sa’ed H. Zyoud
BMC Infectious Diseases. 2023; 23(1)
[Pubmed] | [DOI]
24 Does human movement-induced airflow elevate infection risk in burn patient’s isolation ward? A validated dynamics numerical simulation approach
Huiyi Tan, Keng Yinn Wong, Mohd Hafiz Dzarfan Othman, Bemgba Bevan Nyakuma, Desmond Daniel Chin Vui Sheng, Hong Yee Kek, Wai Shin Ho, Haslenda Hashim, Meng Choung Chiong, Muhammad Afiq Zubir, Nur Haliza Abdul Wahab, Syie Luing Wong, Roswanira Abdul Wahab, Ihab Hasan Hatif
Energy and Buildings. 2023; : 112810
[Pubmed] | [DOI]
25 A method to determine two antibiotics prescribed to treat nosocomial infections in plasma and urine by micellar liquid chromatography
J. Peris-Vicente, Jaume Albiol-Chiva, Devasish Bose, Abhilasha Durgbanshi, Samuel Carda-Broch
Journal of Chromatography B. 2023; : 123777
[Pubmed] | [DOI]
26 Liquid Metal Coated Textiles with Autonomous Electrical Healing and Antibacterial Properties
Jiayi Yang, Praneshnandan Nithyanandam, Shreyas Kanetkar, Ki Yoon Kwon, Jinwoo Ma, Sooik Im, Ji-Hyun Oh, Mohammad Shamsi, Mike Wilkins, Michael Daniele, Tae-il Kim, Huu Ngoc Nguyen, Vi Khanh Truong, Michael D. Dickey
Advanced Materials Technologies. 2023;
[Pubmed] | [DOI]
27 Patient Safety in Anesthesia: Hand Hygiene and Perioperative Infection Control
Colby G. Simmons, Andrew W. Hennigan, Jacob M. Loyd, Randy W. Loftus, Archit Sharma
Current Anesthesiology Reports. 2022;
[Pubmed] | [DOI]
28 Health Care Workers' Adherence to Hand Hygiene Guidelines in Emergency Surgical Room of a Tertiary Care Hospital
Suchin Sudhakar Dhamnaskar, Gautami Milind Chaudhari, Mandar Sharadchandra Koranne
The Surgery Journal. 2022; 08(02): e136
[Pubmed] | [DOI]
29 Genetic diversity and virulence factors of Gram-negative bacilli isolated at the CHU-Z in Abomey-Calavi/So-Ava (Benin)
Akim Socohou, Tomabu Adjobimey, Chimène Nanoukon, Haziz Sina, Mirabelle Kakossou, Wassiyath Moussé, Adolphe Adjanohoun, Lamine Baba-Moussa
Scientific African. 2022; : e01426
[Pubmed] | [DOI]
30 Hospital-acquired infections in a tertiary hospital in Iran before and during the COVID-19 pandemic
Abdolreza Mohammadi, Fatemeh Khatami, Zohreh Azimbeik, Alireza Khajavi, Mehdi Aloosh, Seyed Mohammad Kazem Aghamir
Wiener Medizinische Wochenschrift. 2022;
[Pubmed] | [DOI]
31 Alantolactone modulates the production of quorum sensing mediated virulence factors and biofilm formation in Pseudomonas aeruginosa
V T Anju, Siddhardha Busi, Sandeep Kumar, Kitlangki Suchiang, Ranjith Kumavath, Sampathkumar Ranganathan, Dinakara Rao Ampasala, Madhu Dyavaiah
Biofouling. 2022; : 1
[Pubmed] | [DOI]
32 Microbiological analysis of oral biofilms in patients admitted to intensive care unit: Pilot study
Raphael Florentino Souza Barbalho De Medeiros, Régia Carla Medeiros da Silva, Liliane Cristina Nogueira Marinho, Davi Neto de Araújo Silva, Isabelle Lisiany de Lima Tavares, Camila Alfrida Cabral Nascimento Rocha Antunes de Lima, Maria Celeste Nunes de Melo, Roberta Correia Sales, Domingos Sávio Barbalho de Medeiros, Beatriz Bezerra, Ericka Janine Dantas da Silveira, Ana Rafaela Luz de Aquino Martins
Oral Diseases. 2022;
[Pubmed] | [DOI]
33 Antibiotic utilization study in a teaching hospital in Nigeria
Kehinde F Sekoni, Ibrahim A Oreagba, Farouk A Oladoja
JAC-Antimicrobial Resistance. 2022; 4(5)
[Pubmed] | [DOI]
34 Interventions to improve knowledge or compliance to hand hygiene in nursing students: A scoping review
Charbell Ungido Meza Sierra, Giovanny Andres Perez Jaimes, Leidy Johanna Rueda Díaz
Journal of Infection Prevention. 2022; : 1757177422
[Pubmed] | [DOI]
35 Evaluate the Effectiveness of Outpatient Parenteral Antimicrobial Therapy (OPAT) Program in Saudi Arabia: A Retrospective Study
Haneen J. Al Shareef, Adnan Al Harbi, Yasser Alatawi, Ahmed Aljabri, Mohammed A. Al-Ghanmi, Mohammed S. Alzahrani, Majed Ahmed Algarni, Attiah Khobrani, Abdul Haseeb, Faisal AlSenani, Mahmoud E. Elrggal
Antibiotics. 2022; 11(4): 441
[Pubmed] | [DOI]
36 Assessing the Risk of Spatial Spreading of Diseases in Hospitals
Dan Lu, Alberto Aleta, Yamir Moreno
Frontiers in Physics. 2022; 10
[Pubmed] | [DOI]
37 An Overview of Healthcare Associated Infections and Their Detection Methods Caused by Pathogen Bacteria in Romania and Europe
Sándor Szabó, Bogdan Feier, Denisa Capatina, Mihaela Tertis, Cecilia Cristea, Adina Popa
Journal of Clinical Medicine. 2022; 11(11): 3204
[Pubmed] | [DOI]
38 New ways to prevent nosocomial infection (literature review)
A. M. Morozov, E. M. Askerov, S. V. Zhukov, M. I. , Konstantinova, M. A. Belyak, K. I. Horak
Sanitarnyj vrac (Sanitary Doctor). 2022; (7): 466
[Pubmed] | [DOI]
39 Bacterial profile and antibiotic susceptibility pattern of uropathogens causing urinary tract infection in the eastern part of Northern India
Kanika Bhargava, Gopal Nath, Amit Bhargava, Ritu Kumari, G. K. Aseri, Neelam Jain
Frontiers in Microbiology. 2022; 13
[Pubmed] | [DOI]
40 Reducing the Effectiveness of Ward Particulate Matter, Bacteria and Influenza Virus by Combining Two Complementary Air Purifiers
Bingliang Zhou, Tiantian Liu, Siqi Yi, Yuanyuan Huang, Yubing Guo, Si Huang, Chengxing Zhou, Rong Zhou, Hong Cao
International Journal of Environmental Research and Public Health. 2022; 19(16): 10446
[Pubmed] | [DOI]
41 A NLP Pipeline for the Automatic Extraction of a Complete Microorganism’s Picture from Microbiological Notes
Sara Mora, Jacopo Attene, Roberta Gazzarata, Daniele Roberto Giacobbe, Bernd Blobel, Giustino Parruti, Mauro Giacomini
Journal of Personalized Medicine. 2022; 12(9): 1424
[Pubmed] | [DOI]
42 Epidemiological surveillance of intravascular catheter-related infections in the multidisciplinary healthcare setting: problems and solution ways
A.V. Berezhna
Medicine Today and Tomorrow. 2022; 91(1)
[Pubmed] | [DOI]
43 Ultra Violet (UV) Light Irradiation Device for Hospital Disinfection
Ugochukwu Okwudili Matthew, Andrew Chinonso Nwanakwaugwu, Jazuli S. Kazaure, Ubochi Chibueze Nwamouh, Khalid Haruna, Nwamaka U. Okafor, Oluwafemi Olalere Olawoyin
International Journal of Information Communication Technologies and Human Development. 2022; 14(1): 1
[Pubmed] | [DOI]
44 Healthcare-Associated Infections (HAIs): Challenges and Measures Taken by the Radiology Department to Control Infection Transmission
Ali Alamer, Fawaz Alharbi, Asim Aldhilan, Ziyad Almushayti, Khalefa Alghofaily, Ayman Elbehiry, Adil Abalkhail
Vaccines. 2022; 10(12): 2060
[Pubmed] | [DOI]
45 The Development of Technology to Prevent, Diagnose, and Manage Antimicrobial Resistance in Healthcare-Associated Infections
Ayman Elbehiry, Eman Marzouk, Adil Abalkhail, Yasmine El-Garawany, Sulaiman Anagreyyah, Yaser Alnafea, Abdulaziz M. Almuzaini, Waleed Alwarhi, Mohammed Rawway, Abdelmaged Draz
Vaccines. 2022; 10(12): 2100
[Pubmed] | [DOI]
46 Epidemiology of Healthcare-Associated Infections and Adherence to the HAI Prevention Strategies
Saleh A. Alrebish, Hasan S. Yusufoglu, Reem F. Alotibi, Nawal S. Abdulkhalik, Nehad J. Ahmed, Amer H. Khan
Healthcare. 2022; 11(1): 63
[Pubmed] | [DOI]
47 Predictors of Self-Reported Hand Hygiene Performance among Nurses at Tertiary Care Hospitals in East Coast Malaysia
Mohamad Hazni Abd Rahim,Mohd Ismail Ibrahim,Siti Suraiya Md Noor,Norhana Mohamed Fadzil
International Journal of Environmental Research and Public Health. 2021; 18(2): 409
[Pubmed] | [DOI]
48 Early Prediction of Seven-Day Mortality in Intensive Care Unit Using a Machine Learning Model: Results from the SPIN-UTI Project
Martina Barchitta,Andrea Maugeri,Giuliana Favara,Paolo Riela,Giovanni Gallo,Ida Mura,Antonella Agodi
Journal of Clinical Medicine. 2021; 10(5): 992
[Pubmed] | [DOI]
49 Antibacterial Treatment of Selected High-Touch Objects and Surfaces within Provision of Nursing Care in Terms of Prevention of Healthcare-Associated Infections
Martin Krause,František Dolák
Healthcare. 2021; 9(6): 675
[Pubmed] | [DOI]
50 Occurrence of NDM-1 and VIM-2 Co-Producing Escherichia coli and OprD Alteration in Pseudomonas aeruginosa Isolated from Hospital Environment Samples in Northwestern Tunisia
Raouaa Maaroufi,Olfa Dziri,Linda Hadjadj,Seydina M. Diene,Jean-Marc Rolain,Chedly Chouchani
Diagnostics. 2021; 11(9): 1617
[Pubmed] | [DOI]
51 Fighting Antibiotic Resistance in Hospital-Acquired Infections: Current State and Emerging Technologies in Disease Prevention, Diagnostics and Therapy
Ekaterina Avershina,Valeria Shapovalova,German Shipulin
Frontiers in Microbiology. 2021; 12
[Pubmed] | [DOI]
52 Antimicrobial Susceptibility Trends and Risk Factors for Antimicrobial Resistance in Pseudomonas aeruginosa Bacteremia: 12-Year Experience in a Tertiary Hospital in Korea
Jin Suk Kang,Chisook Moon,Seok Jun Mun,Jeong Eun Lee,Soon Ok Lee,Shinwon Lee,Sun Hee Lee
Journal of Korean Medical Science. 2021; 36(43)
[Pubmed] | [DOI]
53 Prevention of hospital-acquired infections: A construct during Covid-19 pandemic
Manasij Mitra,Amrita Ghosh,Ranabir Pal,Maitraye Basu
Journal of Family Medicine and Primary Care. 2021; 10(9): 3348
[Pubmed] | [DOI]
54 Nosocomial Infections in a Tertiary Healthcare Center in Lebanon: Optimization of Safety Protocols
Pamela Abdallah, Clara Chaiban, Raymond El-Hajj, Claude Afif, Elias Chalhoub
European Journal of Medical and Health Sciences. 2021; 3(1): 201
[Pubmed] | [DOI]
55 Hepatitis B virus infection and its determinants among HIV positive pregnant women: Multicenter unmatched case-control study
Zelalem Alamrew Anteneh,Estifanose Wondaye,Endalkachew Worku Mengesha,Claudia Marotta
PLOS ONE. 2021; 16(4): e0251084
[Pubmed] | [DOI]
56 Antibiotic-Resistant Profiles of Bacteria Isolated from Cesarean and Surgical Patients from Kasese District Hospitals Western Uganda
Abraham Bwalhuma Muhindo,Adamu Almustapha Aliero,Martin Odoki,Ibrahim Ntulume,Emmanuel Eilu,Joe Mutebi,Yap Boum II,Richard Onyuthi Apecu
Borneo Journal of Pharmacy. 2021; 4(2): 145
[Pubmed] | [DOI]
57 Profile of gyrA gene mutation in clinical isolate of levofloxacin resistant Escherichia coli
Alifia Risma Fahmi,Alifia Risma Suharjono,Alifia Risma Kuntaman
Journal of Basic and Clinical Physiology and Pharmacology. 2021; 32(4): 751
[Pubmed] | [DOI]
58 Enterococcal contamination of hospital environments in KwaZulu-Natal, South Africa
Christiana O. Shobo,Sabiha Y. Essack,Linda A. Bester
Journal of Applied Microbiology. 2021;
[Pubmed] | [DOI]
59 A Review of Nosocomial Infections: Source and Prevention
D.B. Phule,A.V. Manwar
Mikrobiolohichnyi Zhurnal. 2021; 83(4): 98
[Pubmed] | [DOI]
60 Occurrence, Antibiotic Resistance, Virulence Factors, and Genetic Diversity of Bacillus spp. from Public Hospital Environments in South Africa
Zamile N. Mbhele,Christiana O. Shobo,Daniel G. Amoako,Oliver T. Zishiri,Linda A. Bester
Microbial Drug Resistance. 2021;
[Pubmed] | [DOI]
61 Knowledge And Judgments About Standard Precautions For Nosocomial Infection: Comparative Analysis Of Medical Vs. Non-Medical Students
Elmira Kultanova,Milton Severo,Anar Turmukhambetova
Russian Open Medical Journal. 2021; 10(3)
[Pubmed] | [DOI]
62 Performance of TDR-300B and VITEK®2 for the identification of Pseudomonas aeruginosa in comparison with VITEK®-MS
Lucky Hartati Moehario, Enty Tjoa, Hans Putranata, Shikha Joon, Daniel Edbert, Thomas Robertus
Journal of International Medical Research. 2021; 49(2): 0300060521
[Pubmed] | [DOI]
63 Lesson learned from the pandemic: Isolation and hygiene measures for COVID-19 could reduce the nosocomial infection rates in oncology wards
Deniz C Guven, Imdat Eroglu, Rashad Ismayilov, Ege Ulusoydan, Oktay H Aktepe, Gulcin Telli Dizman, Zafer Arik, Omer Dizdar, Serhat Unal, Gokhan Metan, Neyran Kertmen
Journal of Oncology Pharmacy Practice. 2021; : 1078155221
[Pubmed] | [DOI]
64 Genotypic and Phenotypic Characterizations of Methicillin-Resistant Staphylococcus aureus (MRSA) on Frequently Touched Sites from Public Hospitals in South Africa
Siyethaba Mkhize, Daniel G. Amoako, Christiana O. Shobo, Oliver T. Zishiri, Linda A. Bester, Joseph Falkinham
International Journal of Microbiology. 2021; 2021: 1
[Pubmed] | [DOI]
65 Trends of Healthcare-associated Infections in a Tuinisian University Hospital and Impact of COVID-19 Pandemic
Hela Ghali, Asma Ben Cheikh, Sana Bhiri, Selwa Khefacha, Houyem Said Latiri, Mohamed Ben Rejeb
INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2021; 58: 0046958021
[Pubmed] | [DOI]
66 Prognostic factors for surgical site infection following intramedullary nailing of diaphyseal fractures of the femur and tibia in adult patients at a tertiary hospital in Lusaka, Zambia
Webster Musonda, Derek Freitas, Kaunda Yamba, William Jim Harrison, James Munthali
Tropical Doctor. 2021; : 0049475521
[Pubmed] | [DOI]
67 The factors contributing to missed care and non-compliance in infection prevention and control practices of nurses: A scoping review
Lauren McCauley,Marcia Kirwan,Anne Matthews
International Journal of Nursing Studies Advances. 2021; 3: 100039
[Pubmed] | [DOI]
68 Health Care–Acquired Infections in Low- and Middle-Income Countries and the Role of Infection Prevention and Control
Gina Maki,Marcus Zervos
Infectious Disease Clinics of North America. 2021; 35(3): 827
[Pubmed] | [DOI]
69 Incidence of Healthcare-Associated Infections (HAIs) and the Adherence to the HAIs’ Prevention Strategies in a Military Hospital in Alkharj
Nehad J. Ahmed,Abdul Haseeb,Emad M. Elazab,Hamed M. Kheir,Azmi A. Hassali,Amer H. Khan
Saudi Pharmaceutical Journal. 2021;
[Pubmed] | [DOI]
70 Do closed waste containers lead to less air contamination than opened? A clinical case study at Jena University Hospital, Germany
Franziskus Büchner,Marc Hoffman,Ute-Helke Dobermann,Birgit Edel,Thomas Lehmann,Frank Kipp
Waste Management. 2021; 136: 11
[Pubmed] | [DOI]
71 Control Release Coating for Urinary Catheters with Enhanced Released Profile for Sustained Antimicrobial Protection
Esther Marie JieRong Lin, Chee Leng Lay, Gomathy Sandhya Subramanian, Wui Siew Tan, Susanna Su Jan Leong, Lionel Chuan Hui Moh, Kaiyang Lim
ACS Applied Materials & Interfaces. 2021;
[Pubmed] | [DOI]
72 Plasma-initiated graft polymerization of carbon nanoparticles as nano-based drug delivery systems
Tianchi Liu, Christopher Stradford, Ashwin Ambi, Daniel Centeno, Jasmine Roca, Thomas Cattabiani, Thomas J. Drwiega, Clive Li, Christian Traba
Biofouling. 2021; : 1
[Pubmed] | [DOI]
73 Improving hand hygiene standards in the veterinary setting
Tina M S?rensen
Veterinary Record. 2021; 189(1): 29
[Pubmed] | [DOI]
74 Barriers and facilitators on hand hygiene and hydro-alcoholic solutions’ use: representations of health professionals and prevention perspectives
Nicolas Calcagni,Anne-Gaëlle Venier,Raymond Nasso,Guillaume Broc,Eva Ardichen,Bruno Jarrige,Pierre Parneix,Bruno Quintard
Infection Prevention in Practice. 2021; : 100169
[Pubmed] | [DOI]
75 The utility of frailty indices in predicting the risk of healthcare associated infections: a systematic review
C.B. Cosentino,B.G. Mitchell,D.J. Brewster,P.L. Russo
American Journal of Infection Control. 2020;
[Pubmed] | [DOI]
76 A report of antibiotic restriction policy in Ghaem university hospital, Mashhad, Northea
Sepideh Hasanzadeh,Ali Mehri,Mahya Manouchehri,Sara Ganjloo,Mahin Sadat Shahabifar,Kiarash Ghazvini
Clinical Epidemiology and Global Health. 2020;
[Pubmed] | [DOI]
77 Bacterial diversity and functional profile of microbial populations on surfaces in public hospital environments in South Africa: A high throughput metagenomic analysis
Christiana Omowunmi Shobo,Arghavan Alisoltani,Akebe Luther King Abia,Philip Senzo Mtshali,Arshad Ismail,Oliver Zishiri,Juliana Deidre Horn,Petra Brysiewicz,Sabiha Yusuf Essack,Linda Antoinette Bester
Science of The Total Environment. 2020; 719: 137360
[Pubmed] | [DOI]
78 Staphylococcus aureus nasal carriage among healthcare workers, inpatients and caretakers in the Tamale Teaching Hospital, Ghana.
Williams Walana,Bernard Posotoso Bobzah,Eugene Dogkotengne Kuugbe,Samuel Acquah,Vicar Kofi Ezekiel,Iddrisu Baba Yabasin,Alhassan Abdul-Mumin,Juventus Benogle Ziem
Scientific African. 2020; : e00325
[Pubmed] | [DOI]
79 Infectious causes of acute meningitis among Thai adults in a university hospital
Kittipat Aimbudlop,Jackrapong Bruminhent,Sasisopin Kiertiburanakul
Journal of Infection and Chemotherapy. 2020;
[Pubmed] | [DOI]
80 The potential impact of enhanced hygienic measures during the COVID-19 outbreak on hospital-acquired infections: A pragmatic study in neurological units
Emanuele Cerulli Irelli,Biagio Orlando,Enrico Cocchi,Alessandra Morano,Francesco Fattapposta,Vittorio Di Piero,Danilo Toni,Maria R. Ciardi,Anna T. Giallonardo,Giovanni Fabbrini,Alfredo Berardelli,Carlo Di Bonaventura
Journal of the Neurological Sciences. 2020; 418: 117111
[Pubmed] | [DOI]
81 Broad spectrum antimicrobial activity of dispirooxindolopyrrolidine fused acenaphthenone heterocyclic hybrid against healthcare associated microbial pathogens (HAMPs)
Abdulrahman I. Almansour,Natarajan Arumugam,Raju Suresh Kumar,Rajesh Raju,Karuppiah Ponmurugan,Naif Abdullah Al-Dhabi,Dhanaraj Premnath
Journal of Infection and Public Health. 2020;
[Pubmed] | [DOI]
82 Prevalence of infections and antimicrobial use in the acute-care hospital setting in the Middle East: Results from the first point-prevalence survey in the region
Adel Alothman,Abdulhakeem Al Thaqafi,Adel Al Ansary,Ahmed Zikri,Akram Fayed,Faryal Khamis,Jameela Al Salman,Laila Al Dabal,Natasha Khalife,Tariq AlMusawi,Wadha Alfouzan,Said El Zein,Ramy Kotb,Yasser Ghoneim,Souha S. Kanj
International Journal of Infectious Diseases. 2020; 101: 249
[Pubmed] | [DOI]
83 Systematic review of antibacterial activity of eravacycline
Susan Khanjani,Hadi Sedigh Ebrahim-Saraie,Yalda Malekzadegan,Mehrdad Halaji,Ali Mojtahedi
Reviews in Medical Microbiology. 2020; 31(1): 11
[Pubmed] | [DOI]
84 Multi-drug resistance of blood stream, urinary tract and surgical site nosocomial infections of Acinetobacter baumannii and Pseudomonas aeruginosa among patients hospitalized at Felegehiwot referral hospital, Northwest Ethiopia: a cross-sectional study
Hilina Motbainor,Fetlework Bereded,Wondemagegn Mulu
BMC Infectious Diseases. 2020; 20(1)
[Pubmed] | [DOI]
85

Pharmaceutical Quality of Selected Metronidazole and Ciprofloxacin Infusions Marketed in South Eastern Nigeria

Angus Nnamdi Oli,MaryRose Ukamaka Ibeabuchi,Ifeoma Bessie Enweani,Stephen Chijioke Emencheta
Drug, Healthcare and Patient Safety. 2020; Volume 12: 103
[Pubmed] | [DOI]
86

Prevalence of Common Nosocomial Infections and Evaluation of Antibiotic Resistance Patterns in Patients with Secondary Infections in Hamadan, Iran

Fatemeh Nouri,Pezhman Karami,Omid Zarei,Faezeh Kosari,Mohammad Yousef Alikhani,Eghbal Zandkarimi,Ebrahim Rezazadeh Zarandi,Mohammad Taheri
Infection and Drug Resistance. 2020; Volume 13: 2365
[Pubmed] | [DOI]
87 Antibiotic resistance and sensitivity pattern of Metallo-ß-Lactamase Producing Gram-Negative Bacilli in ventilator-associated pneumonia in the intensive care unit of a public medical school hospital in Bangladesh
Tanzina Nusrat,Nasima Akter,Nor Azlina A Rahman,Brian Godman,Diana Thecla D. Rozario,Mainul Haque
Hospital Practice. 2020; : 1
[Pubmed] | [DOI]
88 The student knowledge of infectious diseases related to the immune system
C P Maghfirah,C P Saefudin,D Priyandoko
Journal of Physics: Conference Series. 2020; 1521: 042018
[Pubmed] | [DOI]
89 Pathogenic spectrum of blood stream infections and resistance pattern in Gram-negative bacteria from Aljouf region of Saudi Arabia
Altaf Bandy,Abdulrahman Hamdan Almaeen,Grzegorz Wozniakowski
PLOS ONE. 2020; 15(6): e0233704
[Pubmed] | [DOI]
90 The bactericidal potential of LLDPE with TiO2/ZnO nanocomposites against multidrug resistant pathogens associated with hospital acquired infections
Nor Hazliana Harun,Rabiatul Basria S. M. N Mydin,Srimala Sreekantan,Khairul Arifah Saharudin,Norfatehah Basiron,Azman Seeni
Journal of Biomaterials Science, Polymer Edition. 2020; : 1
[Pubmed] | [DOI]
91 Healthcare workers’ perspectives on healthcare-associated infections and infection control practices: a video-reflexive ethnography study in the Asir region of Saudi Arabia
Esther Paul,Ibrahim A. Alzaydani Asiri,Ahmed Al-Hakami,Harish C. Chandramoorthy,Sarah Alshehri,C. M. Beynon,Abdullah M. Alkahtani,Ali H. Asiri
Antimicrobial Resistance & Infection Control. 2020; 9(1)
[Pubmed] | [DOI]
92 Impact of COVID-19 on cancer patients: A review
Iago Dillion Lima Cavalcanti,José Cleberson Santos Soares
Asia-Pacific Journal of Clinical Oncology. 2020;
[Pubmed] | [DOI]
93

Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview

Mainul Haque,Judy McKimm,Massimo Sartelli,Sameer Dhingra,Francesco M Labricciosa,Salequl Islam,Dilshad Jahan,Tanzina Nusrat,Tajkera Sultana Chowdhury,Federico Coccolini,Katia Iskandar,Fausto Catena,Jaykaran Charan
Risk Management and Healthcare Policy. 2020; Volume 13: 1765
[Pubmed] | [DOI]
94 Candida spp. infective endocarditis: Characteristics and outcomes of twenty patients with a focus on injection drug use as a predisposing risk factor
Morgan K. Morelli,Michael P. Veve,William Lorson,Mahmoud A. Shorman
Mycoses. 2020;
[Pubmed] | [DOI]
95 Reduction of Health Care-Associated Infections (HAIs) with Antimicrobial Inorganic Nanoparticles Incorporated in Medical Textiles: An Economic Assessment
Finbarr Murphy,Anat Tchetchik,Irini Furxhi
Nanomaterials. 2020; 10(5): 999
[Pubmed] | [DOI]
96 Medicolegal implications from litigations involving necrotizing fasciitis
Min Ji Kim,Su Hwan Shin,Ji Yong Park
Annals of Surgical Treatment and Research. 2020; 99(3): 131
[Pubmed] | [DOI]
97 Antimicrobial Applications of Clay Nanotube-Based Composites
Anna Stavitskaya,Svetlana Batasheva,Vladimir Vinokurov,Gölnur Fakhrullina,Vadim Sangarov,Yuri Lvov,Rawil Fakhrullin
Nanomaterials. 2019; 9(5): 708
[Pubmed] | [DOI]
98 In vitro activities of colistin, imipenem and ceftazidime against drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii isolates in the south of Iran
Yalda Malekzadegan,Ali Abdi,Hamid Heidari,Melika Moradi,Elham Rastegar,Hadi Sedigh Ebrahim-Saraie
BMC Research Notes. 2019; 12(1)
[Pubmed] | [DOI]
99 Childhood nosocomial viral acute respiratory tract infections in teaching hospital Anuradhapura, Sri Lanka
Jayaweera Arachchige Asela Sampath Jayaweera,Mohammed Reyes
BMC Research Notes. 2019; 12(1)
[Pubmed] | [DOI]
100 Green synthesized CeO2 quantum dots: a study of its antimicrobial potential
Vaishali Pisal,Pratik Wakchaure,Niranjan Patil,Sunita Bhagwat
Materials Research Express. 2019; 6(11): 115409
[Pubmed] | [DOI]
101 Üniversite hastanesinde hasta bakici ve temizlik personellerine yönelik hastane enfeksiyonu, el hijyeni ve tibbi atik egitimlerinin degerlendirilmesi
Yasemin Durduran,Bahar Kandemir,Elif Nur Yildirim,Özlem Pakna,Lütfi Saltuk Demir
Ortadogu Tip Dergisi. 2019; : 89
[Pubmed] | [DOI]
102 The Occurrence of Nosocomial Pathogens on Cell Phones of Healthcare Workers in an Iranian Tertiary Care Hospital
Reza Khashei,Hadi Sedigh Ebrahim-Saraie,Mahtab Hadadi,Maysa Ghayem,Hadi Raeisi Shahraki
Infectious Disorders - Drug Targets. 2019; 19(3): 327
[Pubmed] | [DOI]
103 Vitamin E for prevention of biofilm-caused Healthcare-associated infections
Franca Vergalito,Laura Pietrangelo,Giulio Petronio Petronio,Federica Colitto,Marco Alfio Cutuli,Irene Magnifico,Noemi Venditti,Germano Guerra,Roberto Di Marco
Open Medicine. 2019; 15(1): 14
[Pubmed] | [DOI]
104 Keep hospitals dry as much as much as possible in order to prevent infections
Ali Mehrabi Tavana
Journal of Medicine and Life. 2019; 12(1): 90
[Pubmed] | [DOI]
105 Microbiological colonization of healthcare workers’ mobile phones in a tertiary-level Italian intensive care unit
Alessandro Galazzi,Mauro Panigada,Elena Broggi,Anna Grancini,Ileana Adamini,Filippo Binda,Tommaso Mauri,Antonio Pesenti,Dario Laquintana,Giacomo Grasselli
Intensive and Critical Care Nursing. 2019;
[Pubmed] | [DOI]
106 Nosocomial infections among patients with intracranial hemorrhage: a retrospective data analysis of predictors and outcomes
Roaæa Waleed Jaradat,Amro Lahlouh,Osama Y. Alshogran,Belal Aldabbour,Abedallah Balusha
Clinical Neurology and Neurosurgery. 2019;
[Pubmed] | [DOI]
107 Virulence genes profile and biofilm formation ability of Acinetobacter baumannii strains isolated from inpatients of a tertiary care hospital in southwest of Iran
Samira Jahangiri,Yalda Malekzadegan,Mohammad Motamedifar,Nahal Hadi
Gene Reports. 2019; : 100481
[Pubmed] | [DOI]
108 One-day point prevalence of healthcare-associated infections and antimicrobial use in four countries in Latin America
R. Huerta-Gutiérrez,L. Braga,A. Camacho-Ortiz,Humberto Díaz-Ponce,L. García-Mollinedo,M. Guzmán-Blanco,S. Valderrama-Beltrán,E. Landaeta-Nezer,S. Moreno-Espinosa,Rayo Morfín-Otero,P. Rodríguez-Zulueta,A. Rosado-Buzzo,Fernando Rosso-Suárez,W. Trindade-Clemente,Denusa Wiltgen
International Journal of Infectious Diseases. 2019; 86: 157
[Pubmed] | [DOI]
109 Antibiofilm effect of green engineered silver nanoparticles fabricated from Artemisia scoporia extract on the expression of icaA and icaR genes against multidrug-resistant Staphylococcus aureus
Pooria Moulavi,Hassan Noorbazargan,Aghigh Dolatabadi,Fatemeh Foroohimanjili,Zahra Tavakoli,Sana Mirzazadeh,Mojgan  Hashemi,Fatemeh Ashrafi
Journal of Basic Microbiology. 2019;
[Pubmed] | [DOI]
110 Prevalence and risk factors of health care–associated infections in a limited resources country: A cross-sectional study
Houda Ben Ayed,Sourour Yaich,Maroua Trigui,Maissa Ben Jemaa,Mariem Ben Hmida,Raouf Karray,Mondher Kassis,Yosra Mejdoub,Habib Feki,Jihène Jedidi,Jamel Damak
American Journal of Infection Control. 2019;
[Pubmed] | [DOI]
111 Incidence and costs of ventilator-associated pneumonia in the adult intensive care unit of a tertiary referral hospital in Mexico
Oscar Sosa-Hernández,Bernadine Matías-Téllez,Abril Estrada-Hernández,Monica Alethia Cureño-Díaz,Juan Manuel Bello-López
American Journal of Infection Control. 2019;
[Pubmed] | [DOI]
112 You get back what you give: Decreased hospital infections with improvement in CHG bathing, a mathematical modeling and cost analysis
Kelly A. Reagan,David M. Chan,Ginger Vanhoozer,Michael P. Stevens,Michelle Doll,Emily J. Godbout,Kaila Cooper,Rachel J. Pryor,Robin R. Hemphill,Gonzalo Bearman
American Journal of Infection Control. 2019;
[Pubmed] | [DOI]
113 Antibacterial and antibiofilm activity of nanochelating based silver nanoparticles against several nosocomial pathogens
Seyedeh Mahsan Hoseini-Alfatemi,Abdollah Karimi,Shahnaz Armin,Saideh Fakharzadeh,Fatemeh Fallah,Somayeh Kalanaky
Applied Organometallic Chemistry. 2018; : e4327
[Pubmed] | [DOI]
114 Predicting the severity of dengue fever in children on admission based on clinical features and laboratory indicators: application of classification tree analysis
Khansoudaphone Phakhounthong,Pimwadee Chaovalit,Podjanee Jittamala,Stuart D. Blacksell,Michael J. Carter,Paul Turner,Kheng Chheng,Soeung Sona,Varun Kumar,Nicholas P. J. Day,Lisa J. White,Wirichada Pan-ngum
BMC Pediatrics. 2018; 18(1)
[Pubmed] | [DOI]
115 Les enjeux des bactéries multi-résistantes à l’hôpital
Armelle Lorcy,Eve Dubé
Anthropologie et Santé. 2018; (16)
[Pubmed] | [DOI]
116 Detection of methicillin resistant Staphylococcus areus isolated from nasal carriage of health care workers by polymerase chain reaction
Seham O. Alsulami, Huda A. Al Doghaither
Journal of Experimental Biology and Agricultural Sciences. 2017; 5(3): 288
[Pubmed] | [DOI]
117 Epidemiology of Blood Stream Infections in Neonatal Intensive Care Unit at a Tertiary Care Centre
Monika Rajani,Yash Javeri
Journal of Pure and Applied Microbiology. 2017; 11(4): 1999
[Pubmed] | [DOI]
118 Nosocomial herpes simplex encephalitis: A challenging diagnosis
Hussein Algahtani,Bader Shirah,Mohammed Hmoud,Ahmad Subahi
Journal of Infection and Public Health. 2016;
[Pubmed] | [DOI]
119 Detection of bla SPM-1, bla KPC, bla TEM and bla CTX-M genes in isolates of Pseudomonas aeruginosa, Acinetobacter spp. and Klebsiella spp. from cancer patients with healthcare-associated infections
Paula Regina Luna de Araújo Jácome,Agenor Tavares Jácome-Júnior,Lílian Rodrigues Alves,Maria Jesuíta Bezerra da Silva,Jailton Lobo da Costa Lima,Ana Catarina S. Lopes,Paulo Sérgio Ramos Araújo,Maria Amélia Vieira Maciel
Journal of Medical Microbiology. 2016; 65(7): 658
[Pubmed] | [DOI]
120 Diverse Genetic Background of Multidrug-Resistant Pseudomonas aeruginosa from Mainland China and Emergence of an Extensively Drug-Resistant ST292 Clone in Kunming
Xin Fan, Yue Wu, Meng Xiao, Zhi-Peng Xu, Timothy Kudinha, Alda Bazaj, Fanrong Kong, Ying-Chun Xu
Scientific Reports. 2016; 6(1)
[Pubmed] | [DOI]
121 Ethanol Locks in the Prevention and Treatment of Catheter-Related Bloodstream Infections
Marisela Tan,Jackie Lau,B. Joseph Guglielmo
Annals of Pharmacotherapy. 2014; 48(5): 607
[Pubmed] | [DOI]



 

Top
  
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
   Pathophysiology
   Antibiotics
   De-Escalation
    Rotational Antib...
   Epidemiology
   Prevention
    Infection Contro...
   Conclusion
    References

 Article Access Statistics
    Viewed17837    
    Printed486    
    Emailed1    
    PDF Downloaded269    
    Comments [Add]    
    Cited by others 121    

Recommend this journal