Infection control in Polish medical wards--data from the PROHIBIT project.

INTRODUCTION: Nosocomial infections and the problem of their surveillance concern all patients, including patients treated in medical wards. The objective of the study was to ewaluate selected infection control practices in Polish medical wards in comparison with wards of European hospitals. MATERIAL AND METHODS: The study was conducted by means of a standardized questionnaire fullfiled by a total of 506 wards, including 10 Polish, in 24 European countries, as a part of the PROHIBIT project. RESULTS: The median number of beds in Polish wards (PW) was 35 vs. 30 in European ones (EW), while the proportion of beds in single rooms in Poland were almost ten times lower than in Europe. The number of nurses employed in PW was similar to EW. In all PW alcohol-based handrub solutions were available in more than 76% points of care and it was better situation than in EW. Similar situation in PW and EW was observed in case of existence of written procedure of UTI and CDI prevention. Differences between PW and EW were observed in the manner of usage of close drainage system in catheterized patients and in consumption of alcohol-based handrubs. CONCLUSIONS: In Poland, selected component of infection control is a challenge for the future and its implementation and realization require increasing the awareness of both medical staff and the management of hospitals.

Perineal wound infections: an audit.

An audit was completed by an NHS trust to determine the rate of perineal trauma amongst vaginal births and to assess the rate of perineal wound infections. The audit results confirmed a higher than average rate of perineal wound infections amongst women who had an instrumental birth. The trust decided to separate the contents of the delivery packs into two separate packs--one pack for birth and one pack for suturing--and developed a back-to-basics update session that was delivered to staff working within the maternity setting. A re-audit the following year confirmed that these measures had worked and the overall perineal wound infection rate reduced within the trust.

Changing trends of in vitro antimicrobial resistance patterns in blood isolates in a tertiary care hospital over a period of 4 years.

CONTEXT: Multidrug-resistant organisms continue to be a problem for clinicians worldwide. AIMS: To analyze the changing trend of antimicrobial susceptibility patterns in the blood isolates over a period of 4 years in our hospital. SETTINGS AND DESIGN: This is a retrospective study done in tertiary care cardiac institute over a period of 4 years. MATERIALS AND METHODS: We retrospectively analyzed blood culture positive isolates and studied the antimicrobial susceptibility patterns of microorganisms during the period starting from January 2007 to December 2010. STATISTICAL ANALYSIS USED: Statistical analysis was conducted using SPSS for windows version 13.0. Fisher exact test or chi-square test was applied for comparison of categorical variables. P values less than .05 were considered as statistically significant. RESULTS: The rate of blood culture positivity was 3.72%. Gram-negative bacteria were more common than Gram-positive bacteria. There was a gradual increase in Gram-negative bacteria especially Klebsiella pneumoniae and Acinetobacter species. Klebsiella pneumoniae showed a significant increase of resistance to cefoperazone sulbactam (P = .023), piperacillin tazobactam (P < 0.001), imipenem (P < 0.001), and meropenem (P < 0.001) between the first (2007-2008) and second period (2009-2010) of study. The carbapenems resistance is on rise in Gram-negative bacteria including Enterobacteriaceae and non-fermenters. CONCLUSIONS: Our findings suggest that there is a definite increase in the multidrug resistant organisms. The data on the changing trends in antibiotic resistance, we believe is an important pillar in our efforts at improving infection control practices.

[Staphylococcal infections as an important problem in intensive therapy--own clinical observations]. / Zakazenia gronkowcowe jako istotny problem w intensywnej terapii - doswiadczenia wlasne.

The microbiological monitoring in the Intensive Care Units, in the last few years, revealed a significant increase of infections caused by Gram+ bacteria. Authors of multi-center studies focus upon the problems related to the treatment of the infections caused by the methicilline-resistant staphylococci (MRS) as well as to its spreading. The Staphylococcal infections were 26.6 % of all bacterial infections in the Intensive Care Unit of the Department of Anesthesiology and Intensive Care of the Medical Academy in Bialystok, during one year observation. MRS rods counted 21.4% among all pathogens isolated from the specimens collected from the patients, undergoing the treatment in the ICU, and were responsible for 83.6% of all Staphylococcal infections. The analysis revealed the significant percentage MRS rods resistant to commonly used empirical antibiotic therapy. Our experience shows that vancomycin or linezolid should be used, as an empirical antibiotic therapy, in suspected MRS-caused severe infections along with the simultaneous monitoring of changes in G+ bacteria drug resistance and strict infection-control regime.

Hospital infection control in Italy.

In 1998, the National Health Plan identified the reduction of hospital infection (HI) incidence as a priority. This article reviews the main activities set up in Italy on infection control in the hospital setting. In 1983, the first national prevalence survey reported 6.8% and 7.6% prevalence rates of patients with HI and of HIs, respectively. The high point prevalence found in the intensive care units (ICU) (12.5%), prompted a national incidence study in 1985. This study found an incidence of 29.5 HIs per 100 patients in the ICUs: lower respiratory tract infections (LRTI) were the most common HIs (47.8%), followed by urinary tract infections (UTI) (19.9%) and blood stream infections (BSI) (4.8%). A 1999 survey showed that in 463 Italian hospitals only 40.5% had protocols on the use of disinfectants, 32.3% on sterilization, 30.8% on occupational risk management, 18.3% on isolation measures, 17.7% on hand-washing, 14.3% on antibiotic prophylaxis in surgery, 9.4% on the prevention of surgical site infections and 8.5% on the management of CVC. A national forum to consider surveillance systems using standardized definitions and methodologies is urgently needed.