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1.
Qatar Med J ; 2023(1): 11, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37521091

RESUMO

BACKGROUND: Healthcare-associated infections (HAI) in critical patients affect the quality and safety of patient care as they impact morbidity and mortality. During the COVID-19 pandemic, an increase in the incidence rate was reported worldwide. We aim to describe the incidence of HAI in the intensive care unit (ICU) during a 10-year follow-up period and compare the incidence during the pre-COVID-19 and COVID-19 periods. METHODS: A retrospective observational study of HAI in the medical-surgical ICU at The Cuban Hospital was conducted. The data collected include the annual incidence of HAI, its etiology, and antimicrobial resistance, using the Centers for Disease Control and Prevention definitions, except for other respiratory tract infections (RTIs). RESULTS: A total of 155 patients had HAI, of which 130 (85.5%) were identified during COVID-19. The frequency of device-associated infections (DAI) and non-DAI was higher during COVID-19, except for Clostridium difficile infections. Etiology was frequently related to species of Enterobacter, Klebsiella, and Pseudomonas in both periods, and a higher frequency of Acinetobacter, Enterococcus, Candida, Escherichia coli, Serratia marcescens, and Stenotrophomonas maltophilia was noted during the COVID-19 period. Device utilization ratio increased by 10.7% for central lines and 12.9% for ventilators, while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19, with a 2.79 higher risk of infection (95% CI: 0.93-11.21; p < 0.0050), 15.31 (2.53-625.48), and 3.25 (0.68-31.08) for CLABSI, VAP, and CAUTI, respectively. CONCLUSION: The incidence of DAI increased during the pandemic period as compared to the pre-pandemic period, and limited evidence of the impact on antimicrobial resistance was observed. The infection control program should evaluate strategies to minimize the impact of pandemics on HAI.

2.
Qatar Med J ; 2023(1): 14, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37521093

RESUMO

INTRODUCTION: Catheter-associated urinary tract infection (CAUTI) is a frequently reported healthcare-associated infection in critical and non-critical patients. Limited data are available about CAUTI incidence in non-critical patients. We aim to describe the incidence of CAUTI over 9 years and evaluate the impact of the pandemic on the incidence in non-critical acute care patients. METHODS: A retrospective observational study of CAUTI in medical-surgical and maternity wards was carried out at a public hospital in the west of the State of Qatar. Data collected included the annual CAUTI incidence (per 1,000 device days), urinary catheter utilization ratio (UC-UR), etiology, and antimicrobial resistance. RESULTS: 115,238 patient days and 6,681 urinary catheters (UC) days were recorded over the study period, and 9 and 4 CAUTI were confirmed in medical-surgical and maternity wards, respectively. The infection rate was 1.9 per 1,000 UC days, and the UC-UR was 0.06. The CAUTI rate was higher in medical-surgical wards over the COVID-19 period (2.4 × 1,000 UC days) in comparison with the non-COVID-19 period (1.7 × 1,000 UC days) (RR 1.46; 1.12-1.80). However, in the maternity ward, the result was 0 and 2.5 × 1,000 UC days during these periods, respectively. No differences were observed in the infection rate among periods for all patients (RR 1.06; 0.81-1.31). Multidrug-resistant organisms were identified in 7 patients, and non-multidrug-resistant in 6 cases. CONCLUSION: The study findings describe a lower CAUTI risk over 9 years in non-critical acute care patients. The impact of COVID-19 on the CAUTI risk is mainly related to medical patients who had previously been admitted to critical care. The infection control program should consider these data as a benchmark for quality improvement.

3.
Qatar Med J ; 2014(1): 50-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25320693

RESUMO

UNLABELLED: Public health surveillance systems should be evaluated periodically, and should involve an assessment of system attributes. OBJECTIVE: Evaluate hospital-based surveillance of communicable diseases using the elements of timeliness and data quality. METHOD: Descriptive study was conducted of communicable diseases reported at The Cuban Hospital, Qatar during January 2012 to December 2013. The completeness of notifications were assessed for contact number, address, place of work, and date of symptom onset. Time between the symptoms onset and physician notification, time between physician and Supreme Council of Health notification and time between physician notification and lab confirmation were calculated for each case. ANALYSIS: Percentage of cases with documented essential information and 95% confidence interval (CI) were determined. Mean and standard deviation (SD) of time were calculated. RESULTS: 1065 patients were reported, 75% were male, 80% non-qataries and 91.5% were group 1 (high priority) diseases. Symptom onset date was documented in 91.5% (95% CI, 89.8; 93.2) of cases; contact number in 84.7% (82.5;86.8), with lower frequencies for address (68.1%, 65.3;70.9) and place of work (60.5%, 57.5;63.4). Diagnostic time for tuberculosis was 61.7 days (SD 93.0), acute hepatitis 18.5 days (SD 17.6), typhoid fever 17.0 days (SD 11.6 days), other diseases of sexual transmission 300.2 days, chronic hepatitis 165 days and AIDS 154.5 days. The time of notification to the Supreme Council of Health for group 1 diseases was 1.2 days (SD 1.4). CONCLUSION: Our results show that the quality of essential data and timeliness is not sufficient to meet the needs of the health system. Additional studies should focus on the evaluation of time delay for diagnosis of high priority diseases.

4.
East Mediterr Health J ; 25(11): 813-819, 2019 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-31782518

RESUMO

BACKGROUND: Hospital-based surveillance has proved useful in determining the incidence of infectious diseases. AIMS: This study aimed to describe the epidemiological characteristics of reported cases and specific performance indicators of the surveillance system. METHODS: A descriptive study of reported communicable diseases was carried out in The Cuban Hospital (Qatar) during January 2012 to December 2013. A multidimensional communicable diseases surveillance approach was used. Information of epidemiological variables, laboratory confirmation and notification date were collected. We calculated the proportion of cases with laboratory confirmation and time between the report by the physician and notification to the Supreme Council of Health. RESULTS: A total of 1065 patients were reported; 802 (75.3%) male with a mean age of 33.2 (standard deviation 15.4) years. There was a predominance of cases from Southeast Asia (41.5%) and Eastern Mediterranean Region (16.7%). There were 539 cases of influenza-like illness, 186 of skin infectious diseases, 66 of scabies, 48 with multidrug-resistant organisms, and 39 cases of diarrhoea of presumed infectious etiology. A steady increase in laboratory confirmation was observed (mean 59.3%). Timing for notification to the Supreme Council of Health was 1.88 (2.9) days. CONCLUSION: The implemented hospital-based surveillance system was feasible and delivered important insights into the epidemiological characteristic of communicable diseases in a western community in Qatar.


Assuntos
Doenças Transmissíveis/epidemiologia , Administração Hospitalar , Vigilância da População/métodos , Adulto , Notificação de Doenças/métodos , Feminino , Humanos , Incidência , Capacitação em Serviço , Masculino , Pessoa de Meia-Idade , Catar/epidemiologia
5.
Oman Med J ; 33(1): 76-79, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29468005

RESUMO

OBJECTIVES: To validate hand hygiene (HH) observers following training and determine the concordance between the observers and the Kappa index. METHODS: This study was conducted during June 2017. HH observers from 15 hospital units received eight-hours training including a two-hour workshop conducted by the infection control practitioner and hospital epidemiologist. After its completion, parallel observations were conducted by trained nurses from each respective unit for a maximum of 20 minutes per session at any time or day. RESULTS: A total of 789 parallel observations were performed. In observed HH actions, the percentage of agreement between trained and experienced observers was 75.4%, with a Kappa index of agreement of 0.61 (95% confidence interval (CI): 0.57-0.66). For the observed HH moments, the agreement among observers was 83.8% with a Kappa index of 0.71 (95% CI: 0.66-0.75). CONCLUSIONS: HH observers were validated after a dedicated training in correspondence with the recommendation to improve HH monitoring. Additional studies should focus on evaluating the sustainability of the agreement, the requirement of retraining, and other alternatives for observers' validation.

6.
Oman Med J ; 32(1): 31-35, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28042400

RESUMO

OBJECTIVES: Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks. METHODS: We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected. RESULTS: Of a total 603 patients, 22 (3.6%) cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds (6.6%). About 65% of isolates from the surgical site were multidrug-resistant organisms (Escherichia coli and Klebsiella spp.). CONCLUSIONS: This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis.

7.
Oman Med J ; 31(5): 352-6, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27602189

RESUMO

OBJECTIVES: We sought to evaluate the trend of antibiotic consumption in patients admitted to a community hospital in Qatar with an antimicrobial stewardship program. METHODS: This observational study was carried out in a 75-bed facility in Western Qatar over a 4-year period (2012-2015). The monitoring of antimicrobial consumption from inpatient wards was performed from the pharmacy records and presented as defined daily dose (DDD) divided by the patient days and expressed as 100 bed-days (DBD). RESULTS: The consumption of antimicrobials in 2012 was 171.3 DBD, and increased to 252.7 DBD in 2013, 229.1 DBD in 2014, and 184.7 DBD in 2015. Cephalosporins use reduced from 98.2 DBD in 2013 to 51.5 DBD in 2015 while the consumption of penicillins increased during the beginning of 2014 with a slight decrease in 2015. Carbapenems consumption during 2014-2015 was lower than previous years, and vice-versa for aminoglycosides. Fluoroquinolones had a sustained increase with 37.1% increased consumption in 2015 compared to the two previous years. There was an increase in the use of intravenous (IV) (108.5%) and oral azithromycin (55.1%) and the use of oral (152.8%) and IV moxifloxacin (22.9%). CONCLUSIONS: We observed a decrease in antibiotic use in patients admitted to a community hospital with an antimicrobial stewardship program, but the increase in fluoroquinolones consumption is a concern that requires focused strategies.

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