Impact of an infection control service in a university psychiatric hospital: significantly lowering healthcare-associated infections during 18 years of surveillance.
Adult
Catheter-Related Infections
/ prevention & control
Cross Infection
/ epidemiology
Delivery of Health Care
/ methods
Epidemiological Monitoring
Female
Hospitals, Psychiatric
Hospitals, University
Humans
Incidence
Infection Control
/ methods
Male
Middle Aged
Prevalence
Switzerland
/ epidemiology
Healthcare-associated infections
Infection control service
Psychiatric hospital
Surveillance
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
30
04
2020
accepted:
15
07
2020
pubmed:
25
7
2020
medline:
16
6
2021
entrez:
25
7
2020
Statut:
ppublish
Résumé
Healthcare-associated infections (HAIs) lead to high morbidity and mortality. Data for HAIs in psychiatric hospitals are scarce, and are not derived from long-term surveillance. To assess the impact of an infection control service on the prevalence of HAIs in a psychiatric hospital over an 18-year period. In 1999, a professional infection control service was initiated at the University Psychiatric Hospital in Basel, Switzerland, with a part-time infection control nurse, a hospital epidemiologist, and administrative support. In addition to monitoring rates of multi-drug-resistant pathogens, eight prevalence studies using definitions outlined by the Centers for Disease Control and Prevention (CDC) were conducted between 2001 and 2018. For the primary outcome, a Poisson regression model was fitted to confirm cases of HAIs, standardized for patients at risk as a model offset. Overall, the predicted prevalence of nosocomial infections decreased from 3.7% (95% confidence interval (CI) 2.2-5.3%) in 2001 to 1.0% (95% CI 0.2-1.8%) in 2018 after introduction of an infection control service (incidence ratio rate (IRR) for yearly decrease of 0.93, 95% CI 0.87-0.98, P=0.007). Implementation of an infection control service may lead to a significant long-term decrease in HAIs, even in an institution caring for patients with low risk for HAIs, such as in psychiatric hospitals. In addition, epidemics and clusters were rapidly contained. Infection control services from acute-care hospitals should be expanded to psychiatric institutions, in order to decrease the incidence of HAIs and meet new challenges in times of emergence of multi-drug-resistant pathogens.
Sections du résumé
BACKGROUND
BACKGROUND
Healthcare-associated infections (HAIs) lead to high morbidity and mortality. Data for HAIs in psychiatric hospitals are scarce, and are not derived from long-term surveillance.
AIM
OBJECTIVE
To assess the impact of an infection control service on the prevalence of HAIs in a psychiatric hospital over an 18-year period.
METHODS
METHODS
In 1999, a professional infection control service was initiated at the University Psychiatric Hospital in Basel, Switzerland, with a part-time infection control nurse, a hospital epidemiologist, and administrative support. In addition to monitoring rates of multi-drug-resistant pathogens, eight prevalence studies using definitions outlined by the Centers for Disease Control and Prevention (CDC) were conducted between 2001 and 2018. For the primary outcome, a Poisson regression model was fitted to confirm cases of HAIs, standardized for patients at risk as a model offset.
FINDINGS
RESULTS
Overall, the predicted prevalence of nosocomial infections decreased from 3.7% (95% confidence interval (CI) 2.2-5.3%) in 2001 to 1.0% (95% CI 0.2-1.8%) in 2018 after introduction of an infection control service (incidence ratio rate (IRR) for yearly decrease of 0.93, 95% CI 0.87-0.98, P=0.007).
CONCLUSIONS
CONCLUSIONS
Implementation of an infection control service may lead to a significant long-term decrease in HAIs, even in an institution caring for patients with low risk for HAIs, such as in psychiatric hospitals. In addition, epidemics and clusters were rapidly contained. Infection control services from acute-care hospitals should be expanded to psychiatric institutions, in order to decrease the incidence of HAIs and meet new challenges in times of emergence of multi-drug-resistant pathogens.
Identifiants
pubmed: 32707193
pii: S0195-6701(20)30349-2
doi: 10.1016/j.jhin.2020.07.018
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
343-347Informations de copyright
Copyright © 2020. Published by Elsevier Ltd.