Microbiological sentinel events at a neurological hospital: a retrospective cohort study

Abstract

The purpose of this study is to describe the epidemiological surveillance of microbiological sentinel events (SEs) carried out between 2012 and 2014 at the Neurological Hospital Carlo Besta, Milano, Italy. The setting is inpatient care with multidrug-resistant infections. The aim of the procedure is to formalize the management mode, reporting and transmission of SEs. Categorical variables were described by counts and percentages, as mean and sd or median and interquartile range. The incidence rates of SE were calculated per 1000 patient-days and for 100 admissions using Poisson distribution. The incidence rate of isolation for 1000 patient-days varies from a minimum of 0.52 (95 % confidence interval, 0.23-1.15) for the second quarter of 2014 to a maximum value of 4.16 (95 % confidence interval, 3.20-5.40) for the first quarter of 2013. A decrease followed from the third quarter of 2013 that remained constant in 2014, reaching values similar to those of 2012. Preventive actions and their effectiveness on Acinetobacterbaumannii, the primary cause in our division of multidrug-resistant infections in 2012, have ensured a reduction of the incidence of the same; preventive actions and their effectiveness allowed us to intercept microbiological SE and trigger appropriate precautionary behaviour and isolation. Surveillance of healthcare-associated infections is fundamental in understanding the sources that are contributing to the growing reservoir within hospital communities.