18 results on '"Almendral, Alexander"'
Search Results
2. An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008–2019)
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Arroyo-Garcia, Nares, Badia, Josep M., Vázquez, Ana, Pera, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Díez, Cecilia, Fraccalvieri, Domenico, López-Contreras, Joaquín, and Pujol, Miquel
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- 2022
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3. Comparison of two bundles for reducing surgical site infection in colorectal surgery: multicentre cohort study.
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Flores-Yelamos, Miriam, Gomila-Grange, Aina, Badia, Josep M, Almendral, Alexander, Vázquez, Ana, Parés, David, Pascual, Marta, Limón, Enric, Pujol, Miquel, Juvany, Montserrat, and Team, members of the VINCat Colorectal Surveillance
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SURGICAL site infections ,RECTAL surgery ,ELECTIVE surgery ,PROCTOLOGY ,INFECTION prevention ,ANTIBIOTIC prophylaxis - Abstract
Background There is controversy regarding the maximum number of elements that can be included in a surgical site infection prevention bundle. In addition, it is unclear whether a bundle of this type can be implemented at a multicentre level. Methods A pragmatic, multicentre cohort study was designed to analyse surgical site infection rates in elective colorectal surgery after the sequential implementation of two preventive bundle protocols. Secondary outcomes were to determine compliance with individual measures and to establish their effectiveness, duration of stay, microbiology and 30-day mortality rate. Results A total of 32 205 patients were included. A 50% reduction in surgical site infection was achieved after the implementation of two sequential sets of bundles: from 18.16% in the Baseline group to 10.03% with Bundle-1 and 8.19% with Bundle-2. Bundle-2 reduced superficial-surgical site infection (OR 0.74 (95% c.i. 0.58 to 0.95); P = 0.018) and deep-surgical site infection (OR 0.66 (95% c.i. 0.46 to 0.93); P = 0.018) but not organ/space-surgical site infection (OR 0.88 (95% c.i. 0.74 to 1.06); P = 0.172). Compliance increased after the addition of four measures to Bundle-2. In the multivariable analysis, for organ/space-surgical site infection, laparoscopy, oral antibiotic prophylaxis and mechanical bowel preparation were protective factors in colonic procedures, while no protective factors were found in rectal surgery. Duration of stay fell significantly over time, from 7 in the Baseline group to 6 and 5 days for Bundle-1 and Bundle-2 respectively (P < 0.001). The mortality rate fell from 1.4% in the Baseline group to 0.59% and 0.6% for Bundle-1 and Bundle-2 respectively (P < 0.001). There was an increase in Gram-positive bacteria and yeast isolation, and reduction in Gram-negative bacteria and anaerobes in organ/space-surgical site infection. Conclusions The addition of measures to create a final 10-measure protocol had a cumulative protective effect on reducing surgical site infection. However, organ/space-surgical site infection did not benefit from the addition. No protective measures were found for organ/space-surgical site infection in rectal surgery. Compliance with preventive measures increased from Bundle-1 to Bundle-2. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Response to the letter: Comment on “Care bundle for the prevention of peripheral venous catheter blood stream infections at a secondary care university hospital: Implementation and results”
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Lladó Maura, Yolanda, primary, Lucía Berga Figuerola, Magdalena, additional, Rodríguez Moreno, M José, additional, Lluch Garvi, Verónica, additional, E Soler Felsner, Elisabet, additional, Rodríguez-Rodríguez, Adrián, additional, Almendral, Alexander, additional, Limón, Enric, additional, and Fusté, Ester, additional
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- 2023
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5. Vigilància de les Infeccions relacionades amb l’atenció sanitària de Catalunya (VINCat) - 2022
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Badia, Josep M, Barrufet, Pilar, Calbo, Esther, Besoli, Anna, Casas, Irma, Diaz, Emili, Domènech-Bagué, Dolors, García, Pilar M, Gasch, Oriol, Giménez Hernández, Montserrat, Horcajada, Juan Pablo, Hornero, Ana, Jover-Saenz, Alfredo, López, Ana Felisa, Lopez-Contreras, Joaquin, Martinez Martinez, Jose Antonio, Melendo, Susana, Nuvials, Xavier, Padullés-Zamora, Ariadna, Pomar, Virginia, Smithson, Alex, Sopena, Nieves, Urrea Ayala, Mireia, Hernández Baeza, Sergi, Porrón, Rosario, Almendral, Alexander, Larrosa, María Nieves, Moreno, Esther, and Departament de Salut
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Catalonia ,infecciones bacterianas y micosis::infección::infección hospitalaria [ENFERMEDADES] ,Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires::Health Surveys::Health Status Indicators [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Infeccions nosocomials - Epidemiologia - Catalunya ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Cataluña ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios::encuestas de salud::indicadores de salud [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Indicadors de salut - Catalunya ,RA644.N66 P762 ,Bacterial Infections and Mycoses::Infection::Cross Infection [DISEASES] - Abstract
Infeccions nosocomials; Hospitals; Vigilància epidemiològica Infecciones nosocomiales; Hospitales; Vigilancia epidemiológica Nosocomial infections; Hospitals; Epidemiological surveillance VINCat és un programa que estableix un sistema de vigilància unificat de les infeccions nosocomials als hospitals de Catalunya. La seva missió és contribuir a reduir les taxes d'aquestes infeccions mitjançant la vigilància epidemiològica activa i continuada. El programa es fonamenta en la tasca que porten a terme els professionals dels equips multidisciplinaris de control d'infecció dels hospitals catalans. VINCat is a program of the Catalan Health Service that establishes a unified surveillance system for nosocomial infections in hospitals in Catalonia. Its mission is to help reduce the rates of these infections through active and ongoing epidemiological surveillance. The program is based on the work carried out by the multidisciplinary teams of infection control of Catalan hospitals. VINCat es un programa del Servicio Catalán de la Salud que establece un sistema de vigilancia unificado de las infecciones nosocomiales en los hospitales de Cataluña. Su misión es contribuir a reducir las tasas de estas infecciones mediante la vigilancia epidemiológica activa y continuada. El programa se fundamenta en la tarea que llevan a cabo los profesionales de los equipos multidisciplinares de control de infección de los hospitales catalanes.
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- 2023
6. Clostridioides difficile infection recurrence in the VINCat hospitals: a prospective observational cohort study
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Pujol, Miquel, primary, Limón, Enric, additional, Sopena, Nieves, additional, Lopez-Contreras, Joaquín, additional, Castellá, Laia, additional, Cuquet, Jordi, additional, López-Sánchez, Maria, additional, Pérez, Rafel, additional, Gudiol, Carlota, additional, Coloma, Ana, additional, Marimón, Mariló, additional, Espinach, Joan, additional, Andres, Marta, additional, Martos, Purificación, additional, Hernández, Sergi, additional, Almendral, Alexander, additional, Saliba, Patrick, additional, Rodrigues, Gonçalo Carvalho, additional, Calbo, Esther, additional, and Group, VINCat Program, additional
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- 2022
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7. An interventional nationwide surveillance program lowers postoperative infection rates in elective colorectal surgery. A cohort study (2008-2019)
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Arroyo-García, Nares, Badia, Josep M., Vázquez, Ana, Pera Roman, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Cecilia, Díez, Fraccalvieri, Domenico, López Contreras, Joaquín, Pujol, Miquel, Colorectal Surveillance Team, VINCat Program, Arroyo-García, Nares, Badia, Josep M., Vázquez, Ana, Pera Roman, Miguel, Parés, David, Limón, Enric, Almendral, Alexander, Piriz, Marta, Cecilia, Díez, Fraccalvieri, Domenico, López Contreras, Joaquín Pujol, Miquel, Colorectal Surveillance Team, VINCat Program, [Arroyo-Garcia N, Badia JM] Department of Surgery, Hospital General Granollers, Granollers, Spain. School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain. [Vázquez A] Servei d’Estadística Aplicada, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Pera M] Department of Surgery, Hospital del Mar, Barcelona, Spain. [Parés D] Department of Surgery, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. [Limón E] VINCat Program, Universitat de Barcelona, Barcelona, Spain, and Hospital General de Granollers
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Prevenció i control ,Infeccions quirúrgiques ,Cirurgia colorectal ,Surgical wound infection ,Estudios de cohortes ,Infection control ,Còlon - Cirurgia ,Cohort Studies ,Health Occupations::Medicine::Specialties, Surgical::Colorectal Surgery [DISCIPLINES AND OCCUPATIONS] ,Cirugía colorrectal ,Control d'infeccions ,Prevención y control ,Colorectal surgery ,Risk Factors ,Infección del sitio quirúrgico ,Humans ,Surgical Wound Infection ,Estudis de cohorts ,Epidemiologia ,Proporción de infección estandarizada ,Digestive System Surgical Procedures ,Standardized infection ratio ,Infecció del lloc quirúrgic ,Adverse effects ,Prevention & control ,Infeccions quirúrgiques - Estudi de casos ,Cirurgia colorrectal ,General Medicine ,Efectos adversos ,Infección de la herida quirúrgica ,Elective Surgical Procedures ,profesiones sanitarias::medicina::especialidades quirúrgicas::cirugía colorrectal [DISCIPLINAS Y OCUPACIONES] ,Ratio d'infecció estandarditzat ,Surgery ,Efectes adversos ,Colorectal Surgery ,Surgical site infection ,Infecció de ferides quirúrgiques - Abstract
Colorectal surgery; Postoperative infection; Cohort studies Cirugía colorrectal; Infección postoperatoria; Estudios de cohortes Cirurgia colorectal; Infecció postoperatòria; Estudis de cohorts Background: Colorectal surgery is associated with the highest rate of surgical site infection (SSI). This study analyses the effectiveness of an interventional surveillance program on SSI rates after elective colorectal surgery. Material and methods: Cohort study showing temporal trends of SSI rates and Standardized Infection Ratio (SIR) in elective colorectal surgery over a 12-year period. Prospectively collected data of a national SSI surveillance program was analysed and the effect of specific interventions was evaluated. Patient and procedure characteristics, as well as SIR and SSI rates were stratified by risk categories and type of SSI analysed using stepwise multivariate logistic regression models. Results: In a cohort of 42,330 operations, overall cumulative SSI incidence was 16.31%, and organ-space SSI (O/S-SSI) was 8.59%. There was a 61.63% relative decrease in SSI rates (rho = -0.95804). The intervention which achieved the greatest SSI reduction was a bundle of 6 measures. SSI in pre-bundle period was 19.73% vs. 11.10% in post-bundle period (OR 1.969; IC 95% 1.860-2.085; p < 0.0001). O/S-SSI were 9.08% vs. 6.06%, respectively (OR 1.547; IC 95% 1.433-1.670; p < 0.0001). Median length of stay was 7 days, with a significant decrease over the studied period (rho = -0.98414). Mortality of the series was 1.08%, ranging from 0.35% to 2.0%, but a highly significant decrease was observed (rho = -0.67133). Conclusions: Detailed analysis of risk factors and postoperative infection in colorectal surgery allows strategies for reducing SSI incidence to be designed. An interventional surveillance program has been effective in decreasing SIR and SSI rates.
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- 2021
8. Cross-Sectional Survey on the Current Role of Clinical Pharmacists among Antimicrobial Stewardship Programmes in Catalonia: Much Ado about Nothing.
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Echeverria-Esnal, Daniel, Hernández, Sergi, Murgadella-Sancho, Anna, García-Paricio, Ramón, Ortonobes, Sara, Barrantes-González, Melisa, Padullés, Ariadna, Almendral, Alexander, Tuset, Montse, Limón, Enric, and Grau, Santiago
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ANTIMICROBIAL stewardship ,PHARMACISTS ,INFORMATION technology ,CLINICAL competence ,INFECTION control - Abstract
Background. Antimicrobial resistance killed 1.27 million people in 2019, so urgent actions are desperately needed. Antimicrobial stewardship programmes (ASPs) are essential to optimize antimicrobial use. The objective was to acknowledge the current role of clinical pharmacists engaged in ASP activities in Catalonia. Methods. This was a cross-sectional survey shared through the Catalan Infection Control Programme (VINCat). The survey consisted of four sections and was sent by e-mail. Results. A total of 69.0% of the centres answered. Pharmacists dedicated a median of 5.0 h per week (2.1 h/week/100 acute care beds), representing 0.15 full time equivalents. The ASP lacked information technology (IT) support, as only 16.3% of centres automatically calculated defined daily doses and days of therapy. Those with less than 15% of their time available for ASPs conducted fewer clinical activities, especially prospective audits and feedback. Those without official infectious diseases training also performed fewer clinical activities, but training was less determinant than IT support or time. Pharmacists performed interventions mostly through annotation in the medical records. Conclusions. Clinical pharmacists from Catalonia dedicated to ASPs present an important lack of time and IT support to perform clinical activities. Pharmacists should also improve their clinical skills and try to conduct clinical advice to prescribers, either by phone or face-to-face. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Informe VINCat
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Barrufet, Pilar, Campins Martí, Magda, Casas-García, Irma, Cots, Josep M, Díaz, Emili, Domènech-Bagué, Dolors, Duran, Julio, Grau-Cerrato, Santiago, Hornero, Ana, Larrosa Escartin, María Nieves, Martinez, Jose Antonio, Melendo Perez, Susana, Monistrol-Ruano, Olga, Nuvials Casals, Xavier, Olona-Cabases, Montserrat, Padullés, Ariadna, Porrón, Rosario, Rodrigo Pendás, Jose Angel, Smithson, Alex, Urrea Ayala, Mireia, Hernández Baeza, Sergi, Badia, Josep M, Gasch, Oriol, Horcajada, Juan Pablo, Lopez-Contreras, Joaquin, Pomar, Virginia, Almendral, Alexander, Moreno, Esther, and Departament de Salut
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infecciones bacterianas y micosis::infección::infección hospitalaria [ENFERMEDADES] ,Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires::Health Surveys::Health Status Indicators [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Infeccions nosocomials - Epidemiologia - Catalunya ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios::encuestas de salud::indicadores de salud [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Indicadors de salut - Catalunya ,RA644.N66 P762 ,Bacterial Infections and Mycoses::Infection::Cross Infection [DISEASES] - Abstract
Infeccions nosocomials; Hospitals; Vigilància epidemiològica Infecciones nosocomiales; Hospitales; Vigilancia epidemiológica Nosocomial infections; Hospitals; Epidemiological surveillance VINCat és un programa que estableix un sistema de vigilància unificat de les infeccions nosocomials als hospitals de Catalunya. La seva missió és contribuir a reduir les taxes d’aquestes infeccions mitjançant la vigilància epidemiològica activa i continuada. El programa es fonamenta en la tasca que porten a terme els professionals dels equips multidisciplinaris de control d’infecció dels hospitals catalans.
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- 2022
10. Antimicrobial consumption among 66 acute care hospitals in Catalonia: impact of the COVID-19 pandemic
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Grau, Santiago, Hernandez, Sergi, Echeverría-Esnal, Daniel, Almendral, Alexander, Ferrer, Ricard, Limón, Enrique, Horcajada Gallego, Juan Pablo, Antimicrobial Stewardship Program, Institut Català de la Salut, [Echeverria-Esnal D] Department of Pharmacy, Hospital del Mar, Barcelona, Spain. Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain. Departament de Farmacologia, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Hernández S, Almendral A, Limón E] VINCat Program Surveillance of Healthcare Related Infections in Catalonia, Barcelona, Spain. [Echeverría-Esnal D] Department of Pharmacy, Hospital del Mar, Barcelona, Spain. Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain. [Ferrer R] Servei de Medicina Intensiva, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
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0301 basic medicine ,Azithromycin ,Biochemistry ,antibiotics ,chemistry.chemical_compound ,0302 clinical medicine ,Antibiotics ,Amphotericin B ,virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES] ,Pharmacology (medical) ,030212 general & internal medicine ,Other subheadings::/therapeutic use [Other subheadings] ,General Pharmacology, Toxicology and Pharmaceutics ,Fungicides ,Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES] ,acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos [COMPUESTOS QUÍMICOS Y DROGAS] ,defined daily doses ,Hospitals ,Infectious Diseases ,Ceftriaxone ,Vancomycin ,antifungals ,medicine.drug ,Microbiology (medical) ,medicine.medical_specialty ,Catalonia ,Cefepime ,Medicaments antiinfecciosos - Ús terapèutic ,030106 microbiology ,Antibiòtics ,RM1-950 ,Microbiology ,Article ,03 medical and health sciences ,Internal medicine ,medicine ,COVID-19 (Malaltia) - Catalunya ,Voriconazole ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents [CHEMICALS AND DRUGS] ,business.industry ,Otros calificadores::/uso terapéutico [Otros calificadores] ,COVID-19 ,Catalunya ,equipment and supplies ,chemistry ,Linezolid ,Therapeutics. Pharmacology ,Caspofungin ,antimicrobial consumption ,business - Abstract
COVID-19; Consumo de antimicrobianos; Dosis diarias definidas COVID-19; Consum d'antimicrobians; Dosis diàries definides COVID-19; Antimicrobial consumption; Defined daily doses Background: Antimicrobials have been widely used during the COVID-19 pandemic. This study aimed to analyze the impact of the COVID-19 pandemic on the antimicrobial consumption of 66 hospitals in Catalonia. Methods: Adult antibacterial and antimycotic consumption was calculated as defined daily doses (DDD)/100 bed-days and DDD/100 discharges. Firstly, overall and ICU consumption in 2019 and 2020 were compared. Secondly, observed ICU 2020 consumptions were compared with non-COVID-19 2020 estimated consumptions (based on the trend from 2008–2019). Results: Overall, antibacterial consumption increased by 2.31% and 4.15% DDD/100 bed-days and DDD/100 discharges, respectively. Azithromycin (105.4% and 109.08% DDD/100 bed-days and DDD/100 discharges, respectively) and ceftriaxone (25.72% and 27.97% DDD/100 bed-days and DDD/100 discharges, respectively) mainly accounted for this finding. Likewise, antifungal consumption increased by 10.25% DDD/100 bed-days and 12.22% DDD/100 discharges, mainly due to echinocandins or amphotericin B. ICU antibacterial and antimycotic consumption decreased by 1.28% and 4.35% DDD/100 bed-days, respectively. On the contrary, antibacterial and antifungal use, expressed in DDD/100 discharges, increased by 23.42% and 19.58%. Azithromycin (275.09%), ceftriaxone (55.11%), cefepime (106.35%), vancomycin (29.81%), linezolid (31.28%), amphotericin B (87.98%), and voriconazole (96.17%) use changed the most. Observed consumption of amphotericin B, azithromycin, caspofungin, ceftriaxone, vancomycin, and voriconazole were higher than estimated values. Conclusions: The consumption indicators for most antimicrobials deviated from the expected trend pattern. A worrisome increase in antibacterial and antifungal consumption was observed in ICUs in Catalonia. The present study was carried out as part of our routine work. The VINCat program is supported by public funding from the Catalan Health Service, Department of Health, Generalitat de Catalunya.
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- 2021
11. Impact of Generic Entry on Hospital Antimicrobial Use: A Retrospective Quasi-Experimental Interrupted Time Series Analysis
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Espona, Mercè, primary, Echeverria-Esnal, Daniel, additional, Hernandez, Sergi, additional, Almendral, Alexander, additional, Gómez-Zorrilla, Silvia Inés, additional, Limon, Enric, additional, Ferrandez, Olivia, additional, and Grau, Santiago, additional
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- 2021
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12. Informe VINCat
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Barrufet, Pilar, Campins Martí, Magda, Casas García, Irma, Cots, Josep M., Díaz, Emili, Domènech-Bagué, Dolors, Duran, Julio, Grau-Cerrato, Santiago, Hornero, Ana, Larrosa Escartin, María Nieves, Martinez, Jose Antonio, Melendo Perez, Susana, Monistrol-Ruano, Olga, Nuvials Casals, Xavier, Olona-Cabases, Montserrat, Padullés, Ariadna, Porrón, Rosario, Rodrigo Pendás, Jose Angel, Smithson, Alex, Urrea Ayala, Mireia, Hernández Baeza, Sergi, Badia, Josep M, Gasch, Oriol, Horcajada, Juan Pablo, Lopez-Contreras, Joaquin, Pomar, Virginia, Almendral, Alexander, Moreno, Esther, and Departament de Salut
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infecciones bacterianas y micosis::infección::infección hospitalaria [ENFERMEDADES] ,Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires::Health Surveys::Health Status Indicators [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Infeccions nosocomials - Epidemiologia - Catalunya ,Other subheadings::Other subheadings::/epidemiology [Other subheadings] ,Otros calificadores::Otros calificadores::/epidemiología [Otros calificadores] ,técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios::encuestas de salud::indicadores de salud [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,Indicadors de salut - Catalunya ,RA644.N66 P762 ,Bacterial Infections and Mycoses::Infection::Cross Infection [DISEASES] - Abstract
Infeccions nosocomials; Hospitals; Vigilància epidemiològica Infecciones nosocomiales; Hospitales; Vigilancia epidemiológica Nosocomial infections; Hospitals; Epidemiological surveillance VINCat és un programa que estableix un sistema de vigilància unificat de les infeccions nosocomials als hospitals de Catalunya. La seva missió és contribuir a reduir les taxes d’aquestes infeccions mitjançant la vigilància epidemiològica activa i continuada. El programa es fonamenta en la tasca que porten a terme els professionals dels equips multidisciplinaris de control d’infecció dels hospitals catalans. VINCat is a program that establishes a unified surveillance system for nosocomial infections in hospitals in Catalonia. Its mission is to help reduce the rates of these infections through active and ongoing epidemiological surveillance. The program is based on the work carried out by the multidisciplinary teams of infection control of Catalan hospitals. VINCat es un programa que establece un sistema de vigilancia unificado de las infecciones nosocomiales en los hospitales de Cataluña. Su misión es contribuir a reducir las tasas de estas infecciones mediante la vigilancia epidemiológica activa y continuada. El programa se fundamenta en la tarea que llevan a cabo los profesionales de los equipos multidisciplinares de control de infección de los hospitales catalanes.
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- 2021
13. Clostridioides difficileinfection recurrence in the VINCat hospitals: a prospective observational cohort study
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Pujol, Miquel, Limón, Enric, Sopena, Nieves, Lopez-Contreras, Joaquín, Castellá, Laia, Cuquet, Jordi, López-Sánchez, Maria, Pérez, Rafel, Gudiol, Carlota, Coloma, Ana, Marimón, Mariló, Espinach, Joan, Andres, Marta, Martos, Purificación, Hernández, Sergi, Almendral, Alexander, Saliba, Patrick, Rodrigues, Gonçalo Carvalho, Calbo, Esther, and Group, VINCat Program
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Background:The 2016 cumulative incidence of Clostridioides difficileinfection (CDI) in Spain was reported by the European Center for Disease Control to be above the mean of other European countries. The aim of this multicenter prospective observational cohort study was to examine the risk factors that determine 90-day CDI recurrence in Catalonia, Spain. Methods:The study included 558 consecutive adults admitted to hospital who had a symptomatic, first positive CDI diagnosis. Sociodemographic, clinical and epidemiological variables were recorded. The primary outcome was 90-day CDI recurrence. Results:In this Catalan population, having received more than one course of antibiotics in the 30 days prior to CDI diagnosis (odds ratio: 2.459; 95% CI: 1.195–5.060; p = 0.015) and active chemotherapy (odds ratio: 4.859; 95% CI: 1.495–15.792; p = 0.009) are significant predictors of 90-day CDI recurrence. Conclusion:The identification of independent risk factors of 90-day CDI recurrence will enable the optimization of preventive measures in at-risk populations.
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- 2022
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14. Surveillance of surgical site infections among caesarean section in VINCat hospitals: Results from 2008 to 2022
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Barrufet, Mª Pilar, Almendral, Alexander, Flores, Àngels Garcia, del Rio Perez, Oscar, Hanacsek, Carme Agusti, Garcia, Leonor Invernon, Lletget, David Coroleu, Limón, Enric, Pujol, Miquel, Fernandez, Vicens Diaz-Brito, Prat, MªTeresa Ros, Hidalgo, María Ramirez, González, Elisa Montiu, Cabases, Montserrat Olona, Pino, Antonia Garcia, Altabella, David Blancas, Rubio, Esther Moreno, Barres, Roger Malo, Moron, Marilo Marimon, Fernández, Francisco José Vargas-Machuca, Ramírez, Mª de Gracia García, Oña, Ricardo Gabriel Zules, Quer, Alba Guitard, Codina, Anna Besolí, Iftimie, Simona, Butille, M. Rosa Prieto, Savall, Maria de la Roca Toda, Beltran, Mª Luisa Monje, Fidalgo, Arantzazu Mera, Canosa, Josep Cucurull, Balibrea, Carme Burgas, Rodriguez-Pardo, Dolors, Royo, Elisa Navarro, de la Cruz, Pilar, Sanz, Marta Milián, Moise, Alexandra Lucia, Castillo, Yolanda Meije, Redondo, José Carlos de la Fuente, Ávila, Montserrat Nolla, Gil, Eva Palau, Fernandez, Yurisel Ramos, Chippirraz, Elisabet Lerma, López, Demelza Maldonado, Carreras, Josep Farguell, Nadal, Mireia Saballs, Soriano, Ludivina Ibáñez, Ariño, Mª Angeles Ariño, Flores, Angels Garciae, Aguilera, Roser Ferrer i, Ros, Núria Bosch, Mone, Sandra Insa, Galan, Aroa Sancho, Carrascosa, Montserrat Carrascosa, Forcadell, Teresa Domenech, Gonzalez, Laura Linares, Esteve, María Cuscó, Villaverde, Nerea Roch, Gonzalez, Joaquín López-Contreras, Vidal, Rafel Perez, Valencia, Elena Gomez, Rubio, Dolors Mas, Galindo, Nieves Sopena, Perez, Montserrat Gimenez, Valencia, Elvira Carballas, and Diez, Elena Vidal
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The VINCat programme focuses on monitoring surgical site infections (SSI) in caesarean sections (CS) performed across affiliated hospitals.
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- 2024
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15. Prevalence of healthcare-associated urinary tract infections in catalonia
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Smithson, Alex, Villaverde, Nerea Roch, Salas, Raúl López, Shaw, Evelyn, Almendral, Alexander, Porrón, Rosario, Limon, Enric, and Pujol, Miquel
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Introduction: Healthcare-associated urinary tract infections (HCA-UTIs) account for an important number of infections in acute care hospitals (ACH) and long-term care facilities (LTCF). Our objective was to evaluate the prevalence of HCA-UTIs in Catalonia.
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- 2024
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16. Long-term impact of COVID-19 pandemic on antibiotic use in primary care: lessons to optimize antimicrobial use.
- Author
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de Pando T, Grau S, Almendral A, Echeverría-Esnal D, Hernández S, Limon E, and Pontes C
- Abstract
Background: Lockdowns due to the COVID-19 pandemic was associated with changes in the pattern of use of antimicrobials, but persistence of changes after lockdowns has not been described. The objective was to describe the number of patients with dispensed antibiotic treatment and consumption of antibiotics in outpatients from primary care in Catalonia 18 months after the end of the emergency period., Research Design and Methods: Data for the COVID-19 pandemic period was obtained from March 2020 to December 2021. Four high transmission rate (Rt > 100) periods were established. To compare data, a simple Bayesian structural time series model was used., Results: The observed number of patients with dispensed antibiotics decreased respect to the estimated, especially during the four high transmission rate periods: April-May 2020 (lockdown period) (-42.57% and -42.68%); December 2020-February 2021 (-41.65%, -49.97% and -43.64%); October 2021 (-16.23%), and December 2021 (-20.16%). Overall antibiotic consumption was reduced by 23.37% ( p = 0.002). These differences were mainly observed in those ≤ 15 years., Conclusions: We describe the reduction in the number of patients with dispensed antibiotics and antibiotic consumption after the COVID-19 lockdown persisted in a period of recovery of healthcare accessibility. This information may help to improve antimicrobial use at the primary care level.
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- 2024
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17. Leveraging a nationwide infection surveillance program to implement a colorectal surgical site infection reduction bundle: a pragmatic, prospective, and multicenter cohort study.
- Author
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Badia JM, Arroyo-Garcia N, Vázquez A, Almendral A, Gomila-Grange A, Fraccalvieri D, Parés D, Abad-Torrent A, Pascual M, Solís-Peña A, Puig-Asensio M, Pera M, Gudiol F, Limón E, and Pujol M
- Subjects
- Humans, Cohort Studies, Prospective Studies, Surgical Wound Infection epidemiology, Surgical Wound Infection prevention & control, Colorectal Neoplasms surgery
- Abstract
Background: Bundled interventions usually reduce surgical site infection (SSI) when implemented at single hospitals, but the feasibility of their implementation at the nationwide level and their clinical results are not well established., Materials and Methods: Pragmatic interventional study to analyze the implementation and outcomes of a colorectal surgery care bundle within a nationwide quality improvement program. The bundle consisted of antibiotic prophylaxis, oral antibiotic prophylaxis (OAP), mechanical bowel preparation, laparoscopy, normothermia, and a wound retractor. Control group (CG) and Intervention group (IG) were compared. Overall SSI, superficial (S-SSI), deep (D-SSI), and organ/space (O/S-SSI) rates were analyzed. Secondary endpoints included microbiology, 30-day mortality, and length of hospital stay., Results: A total of 37 849 procedures were included, 19 655 in the CG and 18 194 in the IG. In all, 5462 SSIs (14.43%) were detected: 1767 S-SSI (4.67%), 847 D-SSI (2.24%), and 2838 O/S-SSI (7.5%). Overall SSI fell from 18.38% (CG) to 10.17% (IG), odds ratio (OR) of 0.503 [0.473-0.524]. O/S-SSI rates were 9.15% (CG) and 5.72% (IG), OR of 0.602 [0.556-0.652]. The overall SSI rate was 16.71% when no measure was applied and 6.23% when all six were used. Bundle implementation reduced the probability of overall SSI (OR: 0.331; CI 95 : 0.242-0.453), and also O/S-SSI rate (OR: 0.643; CI 95 : 0.416-0.919). In the univariate analysis, all measures except normothermia were associated with a reduction in overall SSI, while only laparoscopy, OAP, and mechanical bowel preparation were related to a decrease in O/S-SSI. Laparoscopy, wound retractor, and OAP decreased overall SSI and O/S-SSI in the multivariate analysis., Conclusions: In this cohort study, the application of a specific care bundle within a nationwide nosocomial infection surveillance system proved feasible and resulted in a significant reduction in overall and O/S-SSI rates in the elective colon and rectal surgery. The OR for SSI fell between 1.5 and 3 times after the implementation of the bundle., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2023
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18. Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic.
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Grau S, Hernández S, Echeverría-Esnal D, Almendral A, Ferrer R, Limón E, and Horcajada JP
- Abstract
Background: Antimicrobials have been widely used during the COVID-19 pandemic. This study aimed to analyze the impact of the COVID-19 pandemic on the antimicrobial consumption of 66 hospitals in Catalonia., Methods: Adult antibacterial and antimycotic consumption was calculated as defined daily doses (DDD)/100 bed-days and DDD/100 discharges. Firstly, overall and ICU consumption in 2019 and 2020 were compared. Secondly, observed ICU 2020 consumptions were compared with non-COVID-19 2020 estimated consumptions (based on the trend from 2008-2019)., Results: Overall, antibacterial consumption increased by 2.31% and 4.15% DDD/100 bed-days and DDD/100 discharges, respectively. Azithromycin (105.4% and 109.08% DDD/100 bed-days and DDD/100 discharges, respectively) and ceftriaxone (25.72% and 27.97% DDD/100 bed-days and DDD/100 discharges, respectively) mainly accounted for this finding. Likewise, antifungal consumption increased by 10.25% DDD/100 bed-days and 12.22% DDD/100 discharges, mainly due to echinocandins or amphotericin B. ICU antibacterial and antimycotic consumption decreased by 1.28% and 4.35% DDD/100 bed-days, respectively. On the contrary, antibacterial and antifungal use, expressed in DDD/100 discharges, increased by 23.42% and 19.58%. Azithromycin (275.09%), ceftriaxone (55.11%), cefepime (106.35%), vancomycin (29.81%), linezolid (31.28%), amphotericin B (87.98%), and voriconazole (96.17%) use changed the most. Observed consumption of amphotericin B, azithromycin, caspofungin, ceftriaxone, vancomycin, and voriconazole were higher than estimated values., Conclusions: The consumption indicators for most antimicrobials deviated from the expected trend pattern. A worrisome increase in antibacterial and antifungal consumption was observed in ICUs in Catalonia.
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- 2021
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