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REVIEW ARTICLE |
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Year : 2012 | Volume
: 53
| Issue : 2 | Page : 59-64 |
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Healthcare - associated infections: A public health problem
Angela Revelas
Department of Pathological, General Hospital of St.Nicolaos, Crete Greece
Date of Web Publication | 17-Nov-2012 |
Correspondence Address: Angela Revelas Idomeneos 1, St. Nicolaos Crete 72100, Greece
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0300-1652.103543
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 |
Introduction | |  |
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 | |  |
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 | |  |
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 | |  |
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 | |  |
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 | |  |
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 | |  |
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 | |  |
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 | |  |
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 | |  |
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.  |
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.  |
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.  |
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.  |
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)  |
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.  [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.  |
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.  [PUBMED] |
9. | Weinstein RA. Controlling antimicrobial resistance in hospitals: Infection control and use of antibiotics. Emergency Infect. Dis 2001;7:188-92.  [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.  |
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.  |
12. | Newman CD. Catheter-related bloodstream infections in the pediatric intensive care unit. Semin Pediatr Infect Dis 2006;17:20-4.  [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.  |
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.  |
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.  [PUBMED] |
16. | Tikhomirov E. WHO programme for the control of hospital infections. Chemioterapia 1987;6:148-51.  [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.  |
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.  |
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.  |
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].  |
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.  [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.  [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.  |
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.  |
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.  |
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.  |
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.  |
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.  [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.  [PUBMED] |
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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] | | 12 |
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] | | 13 |
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] | | 14 |
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] | | 15 |
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] | | 16 |
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] | | 17 |
Assessing the Risk of Spatial Spreading of Diseases in Hospitals |
|
| Dan Lu, Alberto Aleta, Yamir Moreno | | Frontiers in Physics. 2022; 10 | | [Pubmed] | [DOI] | | 18 |
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] | | 19 |
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] | | 20 |
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] | | 21 |
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] | | 22 |
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] | | 23 |
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] | | 24 |
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] | | 25 |
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] | | 26 |
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] | | 27 |
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] | | 28 |
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] | | 29 |
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] | | 30 |
Improving hand hygiene standards in the veterinary setting |
|
| Tina M S?rensen | | Veterinary Record. 2021; 189(1): 29 | | [Pubmed] | [DOI] | | 31 |
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] | | 32 |
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] | | 33 |
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] | | 34 |
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] | | 35 |
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] | | 36 |
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] | | 37 |
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] | | 38 |
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] | | 39 |
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] | | 40 |
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] | | 41 |
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] | | 42 |
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] | | 43 |
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] | | 44 |
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] | | 45 |
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] | | 46 |
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] | | 47 |
A Review of Nosocomial Infections: Source and Prevention |
|
| D.B. Phule,A.V. Manwar | | Mikrobiolohichnyi Zhurnal. 2021; 83(4): 98 | | [Pubmed] | [DOI] | | 48 |
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] | | 49 |
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] | | 50 |
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] | | 51 |
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] | | 52 |
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] | | 53 |
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] | | 54 |
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] | | 55 |
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] | | 56 |
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] | | 57 |
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] | | 58 |
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] | | 59 |
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] | | 60 |
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] | | 61 |
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] | | 62 |
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] | | 63 |
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] | | 64 |
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] | | 65 |
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] | | 66 |
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] | | 67 |
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] | | 68 |
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] | | 69 |
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] | | 70 |
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] | | 71 |
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] | | 72 |
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] | | 73 |
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] | | 74 |
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] | | 75 |
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] | | 76 |
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] | | 77 |
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] | | 78 |
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] | | 79 |
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] | | 80 |
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] | | 81 |
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] | | 82 |
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] | | 83 |
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] | | 84 |
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] | | 85 |
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] | | 86 |
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] | | 87 |
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] | | 88 |
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] | | 89 |
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] | | 90 |
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] | | 91 |
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] | | 92 |
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] | | 93 |
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] | | 94 |
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] | | 95 |
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] | | 96 |
Les enjeux des bactéries multi-résistantes à l’hôpital |
|
| Armelle Lorcy,Eve Dubé | | Anthropologie et Santé. 2018; (16) | | [Pubmed] | [DOI] | | 97 |
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] | | 98 |
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] | | 99 |
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] | | 100 |
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] | | 101 |
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] | | 102 |
Nosocomial herpes simplex encephalitis: A challenging diagnosis |
|
| Hussein Algahtani,Bader Shirah,Mohammed Hmoud,Ahmad Subahi | | Journal of Infection and Public Health. 2016; | | [Pubmed] | [DOI] | | 103 |
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] | | 104 |
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] | |
|
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