Osong Public Health and Research Perspectives

Review Article

Management of Hospital Infection Control in Iran: A Need for Implementation of Multidisciplinary Approach: Setareh Mamishi, Babak Pourakbari, Mostafa Teymuri, Abdolreza Babamahmoodi, Shima Mahmoudi; Osong Public Health Res Perspect. 2014;5(4):179-186. Published online August 31, 2014; DOI: https://doi.org/10.1016/j.phrp.2014.06.001

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Nosocomial, or hospital-acquired, infections are considered the most common complications affecting hospitalized patients. According to results obtained from studies conducted in the Children Medical Center Hospital, a teaching children's hospital and a tertiary care referral unit in Tehran, Iran, improvements in infection control practices in our hospital seem necessary. The aim of this study was to identify risk management and review potential hospital hazards that may pose a threat to the health as well as safety and welfare of patients in an Iranian referral hospital. Barriers to compliance and poor design of facilities, impractical guidelines and policies, lack of a framework for risk management, failure to apply behavioral-change theory, and insufficient obligation and enforcement by infection control personnel highlight the need of management systems in infection control in our hospital. In addition, surveillance and early reporting of infections, evaluation of risk-based interventions, and production of evidence-based guidelines in our country are recommended.

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Article

Early Detection of Nosocomial Outbreaks Caused by Rare Pathogens: A Case Study Employing Score Prediction Interval: Hiroshi Nishiura; Osong Public Health Res Perspect. 2012;3(3):121-127. Published online June 30, 2012; DOI: https://doi.org/10.1016/j.phrp.2012.07.010

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Abstract PDF

Objectives
Nosocomial outbreaks involve only a small number of cases and limited baseline data. The present study proposes a method to detect the nosocomial outbreaks caused by rare pathogens, exploiting score prediction interval of a Poisson distribution.
Methods
The proposed method was applied to three empirical datasets of nosocomial outbreaks in Japan: outbreaks of (1) multidrug-resistant Acinetobacter baumannii (n = 46) from 2009 to 2010, (2) multidrug-resistant Pseudomonas aerginosa (n = 18) from 2009 to 2010, and (3) Serratia marcescens (n = 226) from 1999 to 2000.
Results
The proposed method successfully detected all three outbreaks during the first 2 months. Both the model-based and empirically derived threshold values indicated that the nosocomial outbreak of rare infectious disease may be declared upon diagnosis of index case(s), although the sensitivity and specificity were highly variable.
Conclusion
The findings support the practical notion that, upon diagnosis of index patient(s), one should immediately start the outbreak investigation of nosocomial outbreak caused by a rare pathogen. The proposed score prediction interval can permit easy computation of outbreak threshold in hospital settings among healthcare experts.

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