HCS/465 Homework Help

Camellia Little

University of Phoenix

HCS/465

Ann Impens

November 1, 2021

American Infection Rates Among ICU Patients

Chelazzi, C., Pettini, E., Villa, G., & De Gaudio, A. R. (2015). Epidemiology, associated factors and outcomes of ICU-acquired infections caused by Gram-negative bacteria in critically ill patients: an observational, retrospective study. BMC Anesthesiology, 15(1), 1–7. https://doi.org/10.1186/s12871-015-0106-9

This prospective study included every patient admitted to a mixed ICU unit in a higher-level referral hospital in the United States of America. . The study showed that medical-surgical ICU showed that 9.3% of patients acquired a new ICU-acquired bacterium within 48 hours of admission and that only medical admission and prophylactic antifungal therapy were significantly associated with ICU-acquired bacterium. Age, sex, body mass index, medical or surgical admission, cardiovascular comorbidities, chronic obstructive pulmonary disease, diabetes, end-stage renal failure, co-existing tumors, and prophylactic anti-fungal treatment were all compared between patients who did and did not get a Gram-negative infection. Prophylactic antifungal therapy and medical admissions were strongly associated with ICU-acquired Gram-negative infection in this study. Multiple patients with Gram-negative infections were typically observed in the ICU. Antifungal prophylaxis and medical admission were found to be associated with the ICU that received Grassroots funding. Only medical admission and anti-fungal prophylaxis were found to be independently associated with these infections; they had no effect on ICU mortality.

This study was carried out in a tertiary hospital intensive care unit in Brazil. Yearly, this ICU admits approximately 2,200 patients. In the United States, 150 million central venous catheters are placed in patients each year. A patient with a CVC and at least one positive blood culture obtained from a peripheral vein, as well as a positive semi-quantitative (>15 CFU) culture of a catheter segment from which the same organism was isolated, was defined as the standard method. A patient with a CVC and at least one positive blood culture obtained from a peripheral vein was defined as using the conservative method. The episodes in this study were classified as catheter-related bloodstream infections (CR-BSI) or catheter-associated bloodstream infections (CA-BSI) (CABSI). Only CR-BSI patients were included in the study. The overall purpose of this research study was to compare hospital-related deaths among patients with CR-BSI when the catheter was not removed. In-hospital deaths, the study observed no significant differences between the conservative and standard methods.

Roach, D. J., Burton, J. N., Lee, C., Stackhouse, B., Butler-Wu, S. M., Cookson, B. T., Shendure, J., & Salipante, S. J. (2015). A Year of Infection in the Intensive Care Unit: Prospective Whole Genome Sequencing of Bacterial Clinical Isolates Reveals Cryptic Transmissions and Novel Microbiota. PLoS Genetics, 11(7), 1–21. https://doi.org/10.1371/journal.pgen.1005413

The research was carried out at the University of Washington Medical Center in Seattle, Washington. This hospital is a higher-level care facility, and three of its intensive care units (ICUs) were included in the study. It housed the cardiac, surgical, and neonatal units. This paper aimed to perform whole genome sequencing and a prospective collection of all the different bacterial isolates obtained from the hospital's ICUs. The study included a total of 1,316 isolates obtained from approximately 421 hospital patients. The patients who took part in the study were all subjected to shotgun genome sequencing.

Furthermore, the selection of microbial genomes aided in the quantitative measurement of a range of infectious diseases bacteria features in patients. This study also discovered Novel Microbiota and Cryptic Transmissions infections among Intensive Care Unit patients. It also provided a broad and unbiased understanding of bacterial infections that impacted intensive care patients. The study also highlighted significant differences between the traditional microbiological process and genome sequencing. The authors also advocated for the use of microbial genome sequencing in all clinical practices.

References:

Chelazzi C, Pettini E, Villa G, & De Gaudio A.R. Epidemiology, associated factors and outcomes of ICU-acquired infections caused by Gram-negative bacteria in critically ill patients: an observational, retrospective study.BMC Anesthesiol. 2015; 15: 125