Antibiotic consumption trends among acute care hospitals in Catalonia (2008-2016): impact of different adjustments on the results.

Objectives: Hospital antibiotic consumption is measured using defined-daily-doses (DDD) divided by bed days. However,other denominators as discharges could provide a more accurate interpretation of consumption. The main objective was to analyze trends of antibiotic consumption among hospitals in Catalonia during the period 2008-2016, using both DDD/100 bed days and DDD/100 discharges.

Impact of pre-hospital antibiotic therapy on mortality in invasive meningococcal disease: a propensity score study.

The role of pre-hospital antibiotic therapy in invasive meningococcal diseases remains unclear with contradictory data. The aim was to determine this role in the outcome of invasive meningococcal disease. Observational cohort study of patients with/without pre-hospital antibiotic therapy in invasive meningococcal disease attended at the Hospital Universitari de Bellvitge (Barcelona) during the period 1977-2013.

Invasive Meningococcal Disease: What We Should Know, Before It Comes Back.

Background: Invasive meningococcal disease (IMD), sepsis and/or meningitis continues to be a public health problem, with mortality rates ranging from 5% to 16%. The aim of our study was to further knowledge about IMD with a large series of cases occurring over a long period of time, in a cohort with a high percentage of adult patients.

Methods: Observational cohort study of patients with IMD between 1977 hand 2013 at our hospital, comparing patients with only sepsis and those with meningitis and several degrees of sepsis.

Widespread increase of empirical carbapenem use in acute care hospitals in Catalonia, Spain.

Introduction: The overall increase in the use of carbapenems could lead to the selection of carbapenem-resistant bacteria. The objectives of this study were to analyze carbapenem use from 2008 to 2015 and their prescription profile in 58 hospitals affiliated to the VINCat Programme (nosocomial infection vigilance system).

Methods: Retrospective, longitudinal and descriptive study of carbapenem use.

Invasive meningococcal disease: Impact of short course therapy. A DOOR/RADAR study.

Background: Invasive meningococcal disease is a severe infection. The appropriate duration of antibiotic therapy is not well established.

Methods: Two hundred and sixty-three consecutive patients with invasive meningococcal disease treated with 4 days' antibiotic therapy were compared with 264 consecutive patients treated previously at the same center with 7 days' antibiotic therapy.

Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery.

Background: Organ-space surgical site infections (SSI) are the most serious and costly infections after colorectal surgery. Most previous studies of risk factors for SSI have analysed colon and rectal procedures together. The aim of the study was to determine whether colon and rectal procedures have different risk factors and outcomes for organ-space SSI.

Current outcomes and predictors of treatment failure in patients with surgical site infection after elective colorectal surgery. A multicentre prospective cohort study.

Objective: To determine current outcomes and predictors of treatment failure among patients with surgical site infection (SSI) after colorectal surgery.

Methods: A multicentre observational prospective cohort study of adults undergoing elective colorectal surgery in 10 Spanish hospitals (2011-2014). Treatment failure was defined as persistence of signs/symptoms of SSI or death at 30 days post-surgery.

Consumption of systemic antifungal agents among acute care hospitals in Catalonia (Spain), 2008-2013.

Objective To know the patterns and consumption trends (2008-2013) of antifungal agents for systemic use in 52 acute care hospitals affiliated to VINCat Program in Catalonia (Spain). Methods Consumption was calculated in defined daily doses (DDD)/100 patient-days and analyzed according to hospital size and complexity and clinical departments. Results Antifungal consumption was higher in intensive care units (ICU) (14.

Diagnosis and treatment of bacteremia and endocarditis due to Staphylococcus aureus. A clinical guideline from the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC).

Both bacteremia and infective endocarditis caused by Staphylococcus aureus are common and severe diseases. The prognosis may darken not infrequently, especially in the presence of intracardiac devices or methicillin-resistance. Indeed, the optimization of the antimicrobial therapy is a key step in the outcome of these infections.

Executive summary of the diagnosis and treatment of bacteremia and endocarditis due to Staphylococcus aureus. A clinical guideline from the Spanish Society of Clinical Microbiology and Infectious Diseases (SEIMC).

Bacteremia and infective endocarditis caused by Staphylococcus aureus are common and severe diseases. Optimization of treatment is fundamental in the prognosis of these infections. The high rates of treatment failure and the increasing interest in the influence of vancomycin susceptibility in the outcome of infections caused by both methicillin-susceptible and -resistant isolates have led to research on novel therapeutic schemes.

Relationship between consumption of MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia, Spain.

Objectives: To analyse the possible relationship between consumption of old and new MRSA-active antibiotics and burden of MRSA in acute care hospitals in Catalonia during the period 2007-12.

Methods: Fifty-four hospitals participating in the VINCat Programme were included. Proportion of MRSA (resistant isolates of Staphylococcus aureus per 100 isolates of S.

[Validation of the structure and resources of nosocomial infection control team in hospitals ascribed to VINCat program in Catalonia, Spain].

The main objective of this study was to validate the structure of the infection control team (ICT) in the hospitals adhered to VINCat program and secondary objective was to establish the consistency of resources of each center with the requirements established by the program. Qualitative research consisting of an ethnographic study using participant observation during the years 2008-2010. The centers were stratified in three groups by complexity and beds.

['Third day intervention': an analysis of the factors associated with following the recommendations on the prescribing of antibiotics].

Introduction: Stewardship programs on the use of antibiotics usually include interventions based on non-compulsory recommendations for the prescribers. Factors related to the adherence to expert recommendations, and the implementation of these programmes in daily practice, are of interest.

Methods: A randomized, controlled, multicentre intervention study was performed in 32 hospitalization units.

Rainfall is a risk factor for sporadic cases of Legionella pneumophila pneumonia.

It is not known whether rainfall increases the risk of sporadic cases of Legionella pneumonia. We sought to test this hypothesis in a prospective observational cohort study of non-immunosuppressed adults hospitalized for community-acquired pneumonia (1995-2011). Cases with Legionella pneumonia were compared with those with non-Legionella pneumonia.

Prognostic value of serum albumin levels in hospitalized adults with community-acquired pneumonia.

Objective: To investigate whether serum albumin levels within 24 h of admission correlate with outcomes in community-acquired pneumonia (CAP).

Methods: Observational analysis of a prospective cohort of adults with CAP requiring hospitalization from 1995 through 2011. Serum albumin level was the independent variable.

Community-acquired Legionella pneumophila pneumonia: a single-center experience with 214 hospitalized sporadic cases over 15 years.

Legionella pneumophila has been increasingly recognized as a cause of community-acquired pneumonia (CAP) and an important public health problem worldwide. We conducted the present study to assess trends in epidemiology, diagnosis, clinical features, treatment, and outcomes of sporadic community-acquired L. pneumophila pneumonia requiring hospitalization at a university hospital over a 15-year period (1995-2010).

Antibiotic consumption at 46 VINCat hospitals from 2007 to 2009, stratified by hospital size and clinical services.

The aim of the study was to assess the evolution of antibiotic consumption in acute care hospitals in Catalonia (population 7.5 million), according to hospital size and department, during the period 2007-2009. The methodology used for monitoring antibiotic consumption was the ATC/DDD system, and the unit of measurement was DDD/100 occupied bed-days (DDD/100 OBD).

Surveillance of surgical site infections in elective colorectal surgery. Results of the VINCat Program (2007-2010).

The VINCat Program is a standardized surveillance program of healthcare infections in Catalonia, Spain. This program includes monitoring of surgical site infections (SSI) of elective colorectal surgery. The aim of this study was to define SSI rates in colorectal surgery among VINCat hospitals over a period of 4 years.

Prevalence of nosocomial infections in acute care hospitals in Catalonia (VINCat Program).

The first objective of the Catalonian Nosocomial Infection Surveillance Program (VINCat) is to monitor the prevalence (%) of patients with nosocomial infections (NI), patients undergoing urinary catheterization with closed circuit drainage (%) and patients undergoing antibiotic treatment (%). We present the results for the period 2008-2010. Comprehensive and point annual prevalence surveys were conducted that included conventionally hospitalized patients in acute care hospitals belonging to the VINCat Program.

The development and successful implementation of the VINCat Program.

In 2006 the VINCat Program was established in order to develop and support a standardized surveillance system of hospital-acquired infections (HAI). All acute care hospitals included in the public health system network of Catalonia (Spain) were invited to participate. The aim was to provide risk-adjusted, procedure-specific rates for most relevant infections.

Risk stratification and prognosis of acute cardiac events in hospitalized adults with community-acquired pneumonia.

Objective: To determine the risk factors and the prognosis of acute cardiac events in patients with community-acquired pneumonia (CAP).

Methods: Observational analysis of a prospective cohort of hospitalized adults with CAP (1995-2010). A logistic regression analysis was performed to identify predictors for acute cardiac events and mortality.

Effect of a 3-step critical pathway to reduce duration of intravenous antibiotic therapy and length of stay in community-acquired pneumonia: a randomized controlled trial.

Background: The length of hospital stay (LOS) for community-acquired pneumonia (CAP) varies considerably, even though this factor has a major impact on the cost of care. We aimed to determine whether the use of a 3-step critical pathway is safe and effective in reducing duration of intravenous antibiotic therapy and length of stay in hospitalized patients with CAP.

Methods: We randomly assigned 401 adults who required hospitalization for CAP to follow a 3-step critical pathway including early mobilization and use of objective criteria for switching to oral antibiotic therapy and for deciding on hospital discharge or usual care.

Pneumonia complicating pandemic (H1N1) 2009: risk factors, clinical features, and outcomes.

We performed an observational analysis of a prospective cohort of adults hospitalized for pandemic (H1N1) 2009 at 13 Spanish hospitals, from June to November 2009, to determine the risk factors, clinical features, and outcomes of pneumonia. Of 585 patients requiring hospitalization, chest radiography was obtained in 542. A total of 234 (43.