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Antimicrobial use in Finnish acute care hospitals: data from national prevalence survey, 2005.

https://arctichealth.org/en/permalink/ahliterature163169
Source
J Antimicrob Chemother. 2007 Aug;60(2):440-4
Publication Type
Article
Date
Aug-2007
Author
Mari Kanerva
Jukka Ollgren
Outi Lyytikäinen
Author Affiliation
Finnish Hospital Infection Program (SIRO), National Public Health Institute, Department of Infectious Disease Epidemiology, and Department of Medicine, Helsinki University Central Hospital, Finland. mari.kanerva@hus.fi
Source
J Antimicrob Chemother. 2007 Aug;60(2):440-4
Date
Aug-2007
Language
English
Publication Type
Article
Keywords
Acute Disease
Anti-Bacterial Agents - therapeutic use
Cross Infection - drug therapy - epidemiology
Drug Utilization
Finland - epidemiology
Health Care Surveys
Hospitals - statistics & numerical data
Humans
Intensive Care
Retrospective Studies
Abstract
In Finland, use of antimicrobials in ambulatory care is moderate, but some reports suggest that hospital use is higher than in other European countries. We evaluated the amount and type of antimicrobials administered in Finnish acute care hospitals.
We analysed data collected in the national prevalence survey of nosocomial infections (NIs) during February-March 2005 in all tertiary care, all secondary care and 25% of other acute care hospitals. All inpatients present on the study day in acute care wards for adults were included (n=8234). The names and use-days of antimicrobials in Anatomical Therapeutic Class groups J01-J05 were collected on the study day and retrospectively for the previous 6 days.
On the study day, 39% of patients had received at least one, 14% at least two and 3% at least three antimicrobials; patients with NI represented 21%, 29% and 45% of these groups, respectively. The prevalence of patients receiving any antimicrobial was 53% in intensive care patients and varied in other specialties from 0% in ophthalmology to 63% in dental and oral surgery. Within a 7 day period, the total use of antibacterial agents (J01) was 64 use-days per 100 patient-days. Cephalosporins were the most frequently used antimicrobials, followed by quinolones and metronidazole.
The prevalence and spectrum of antimicrobial use in Finnish acute care hospitals were high. NI patients contributed markedly to the total usage. The NI survey with a 7 day data collection period provided insights into the use-density of antimicrobials.
PubMed ID
17550886 View in PubMed
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Assessing prevalence of antimicrobial use and infections using the minimal data set in Finnish long-term care facilities.

https://arctichealth.org/en/permalink/ahliterature117122
Source
Am J Infect Control. 2013 Apr;41(4):e35-7
Publication Type
Article
Date
Apr-2013
Author
Maija-Liisa Rummukainen
Matti Mäkelä
Anja Noro
Harriet Finne-Soveri
Outi Lyytikäinen
Author Affiliation
Central Finland Healthcare District, Keskussairaalantie, Jyväskylä, Finland. maija-liisa.rummukainen@ksshp.fi
Source
Am J Infect Control. 2013 Apr;41(4):e35-7
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Bacterial Infections - drug therapy - epidemiology
Data Collection - methods
Drug Utilization
Female
Finland - epidemiology
Health facilities
Humans
Long-Term Care
Male
Pneumonia, Bacterial - drug therapy - epidemiology
Prevalence
Urinary Tract Infections - drug therapy - epidemiology
Wound Infection - drug therapy - epidemiology
Abstract
Of all residents (n = 12,784) for whom a minimum data set 2.0 form was completed in long-term care facilities (n = 253) using a Resident Assessment Instrument in April and September 2011 in Finland, 16% received antimicrobials, most commonly methenamine (42%) and trimethoprim (24%). The prevalence of urinary tract infections was 8%, wound infection 2%, and pneumonia 2%. Minimum data set form provides a feasible tool for collecting data on antibiotic use and infections in long-term care facilities.
PubMed ID
23332375 View in PubMed
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Bloodstream infections among children with juvenile idiopathic arthritis: a prospective study from the onset of disease.

https://arctichealth.org/en/permalink/ahliterature261061
Source
Clin Exp Rheumatol. 2014 Nov-Dec;32(6):979-83
Publication Type
Article
Author
Päivi H Salonen
Hanna Säilä
Juha H Salonen
Marjo Vuorela
Hannu Kautiainen
Outi Lyytikäinen
Markku J Kauppi
Marjatta Leirisalo-Repo
Heikki Repo
Source
Clin Exp Rheumatol. 2014 Nov-Dec;32(6):979-83
Language
English
Publication Type
Article
Keywords
Adolescent
Anti-Bacterial Agents - therapeutic use
Antirheumatic Agents - therapeutic use
Arthritis, Juvenile - diagnosis - drug therapy - epidemiology
Bacterial Infections - diagnosis - drug therapy - epidemiology - microbiology
Child, Preschool
Escherichia coli Infections - epidemiology - microbiology
Female
Finland - epidemiology
Fusobacteriaceae Infections - epidemiology - microbiology
Humans
Immunosuppressive Agents - therapeutic use
Incidence
Male
Pneumococcal infections - epidemiology - microbiology
Prospective Studies
Registries
Risk factors
Staphylococcal Infections - epidemiology - microbiology
Time Factors
Treatment Outcome
Abstract
To describe the incidence and nature of bloodstream infections (BSI) among children with juvenile idiopathic arthritis (JIA) followed-up prospectively from disease onset.
The Social Insurance Institution's (SII) national register on individuals with reimbursement for medication of chronic diseases was used to identify children with JIA from 2004 through 2011 and their medications. The National Infectious Disease Register (NIDR) collects data of all blood culture positive samples from all microbiology laboratories in Finland. We combined the NIDR and SII registers to identify JIA patients with BSI. Clinical and laboratory data of each JIA-BSI patient were collected from hospital records.
There were 1604 JIA patients and 6630 person-years of follow-up. Five patients had BSI. During the first 5 years after diagnosis the cumulative emergence of BSI was 0.38% [95% confidence interval (CI) 0.16% to 0.92%]. The incidence rates were 7.5/10 000 follow-up years for JIA (95% CI 2.4-17.6) and 2.8/10 000 follow-up years for the age-matched general population (95% CI 2.7-2.9). The standardised incidence ratio was 3.0 (95% CI 1.2 to 7.2). The causative bacteria were Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli and Fusobacterium necrophorum. Three patients were on anti-rheumatic drugs, including two on TNF inhibitors. All patients responded rapidly to antimicrobial therapy and recovered uneventfully.
Although BSI is rare among children with JIA, the incidence is 3-fold higher than among the general population.
PubMed ID
25436839 View in PubMed
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Early deaths in bloodstream infections: a population-based case series.

https://arctichealth.org/en/permalink/ahliterature278391
Source
Infect Dis (Lond). 2016;48(5):379-85
Publication Type
Article
Date
2016
Author
Keiju S K Kontula
Kirsi Skogberg
Jukka Ollgren
Asko Järvinen
Outi Lyytikäinen
Source
Infect Dis (Lond). 2016;48(5):379-85
Date
2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Bacteremia - drug therapy - epidemiology - microbiology - mortality
Child
Child, Preschool
Community-Acquired Infections - drug therapy - epidemiology - microbiology - mortality
Cross Infection - drug therapy - epidemiology - microbiology - mortality
Female
Finland - epidemiology
Humans
Infant
Infant, Newborn
Male
Middle Aged
Retrospective Studies
Young Adult
Abstract
A notable portion of deaths in bloodstream infections (BSI) have previously been shown to occur within 2 days after taking the first positive blood culture specimen. The aim of this study was to analyse patients' characteristics and causative pathogens of BSIs, leading to early deaths in order to explore possibilities for prevention. Patients with BSI in Helsinki and Uusimaa region (population = 1.5 million) in 2007 were identified from the National Infectious Disease Register (n = 2181) and their deaths within 2 days after the first positive blood culture from the Population Information System (n = 76). Of the early fatal BSIs, 42 (55%) were community-acquired (CA-BSI) and 34 (45%) healthcare-associated (HA-BSI). Charlson comorbidity index was moderate-to-high (index = 3) in 71% of HA-BSIs and 60% of CA-BSIs. The most common pathogens in CA-BSIs were Streptococcus pneumoniae (29%) and Escherichia coli (24%) and in HA-BSIs Pseudomonas aeruginosa (24%) and Staphylococcus aureus (18%). The respiratory tract (50%) was the most common focus of infection. Empiric antimicrobial treatment was more often appropriate in CA-BSIs vs HA-BSIs (81% vs 41%, p
PubMed ID
26763410 View in PubMed
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Nosocomial bloodstream infections caused by Escherichia coli and Klebsiella pneumoniae resistant to third-generation cephalosporins, Finland, 1999-2013: Trends, patient characteristics and mortality.

https://arctichealth.org/en/permalink/ahliterature274045
Source
Infect Dis (Lond). 2016;48(3):229-34
Publication Type
Article
Date
2016
Author
Timi Martelius
Jari Jalava
Tommi Kärki
Teemu Möttönen
Jukka Ollgren
Outi Lyytikäinen
Source
Infect Dis (Lond). 2016;48(3):229-34
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Bacteremia - drug therapy - epidemiology - mortality
Cephalosporin Resistance
Cephalosporins - pharmacology - therapeutic use
Cross Infection - drug therapy - epidemiology - mortality
Escherichia coli - drug effects - enzymology - isolation & purification
Escherichia coli Infections - drug therapy - epidemiology - mortality
Female
Finland - epidemiology
Humans
Infant, Newborn
Klebsiella Infections - drug therapy - epidemiology - mortality
Klebsiella pneumoniae - drug effects - enzymology - isolation & purification
Middle Aged
Prospective Studies
beta-Lactamases - biosynthesis
Abstract
Few systematically collected multi-centre surveillance data on nosocomial bloodstream infections (BSI) caused by extended-spectrum ß-lactamase (ESBL) producing Escherichia coli or Klebsiella pneumoniae have been published.
To evaluate trends, patient characteristics and mortality of such infections, nosocomial BSI data reported by the 4-17 hospitals participating in the prospective laboratory-based surveillance during 1999-2013 were analysed.
Data were collected by local infection control nurses, patient-days were obtained from the hospital's administrative database, and dates of deaths from the population registry. Resistance to third-generation cephalosporins was further examined in the national reference laboratory.
A total of 16 028 nosocomial BSIs were identified; 2217 (14%) were caused by E. coli and 661 (4%) by K. pneumoniae; 207 (7%) were non-susceptible to third-generation cephalosporins, with an increasing trend from 0% in 1999 to 17% in 2013. Patient characteristics did not differ significantly between BSIs caused by third-generation susceptible and resistant E. coli and K. pneumonia, but the case fatality tended to be higher. Most (88%) of the isolates reported as non-susceptible to third-generation cephalosporins had ESBL phenotype, CTX-M (79%) being the most common enzyme.
A sharp increase in nosocomial BSIs caused by ESBL producing bacteria was observed. Identification of patients for screening pose a challenge, emphasising the role of infection control guidelines and antibiotic policy in prevention.
PubMed ID
26577519 View in PubMed
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Promoting hand hygiene and prudent use of antimicrobials in long-term care facilities.

https://arctichealth.org/en/permalink/ahliterature153057
Source
Am J Infect Control. 2009 Mar;37(2):168-71
Publication Type
Article
Date
Mar-2009
Author
Maija Rummukainen
Aino Jakobsson
Pertti Karppi
Hannu Kautiainen
Outi Lyytikäinen
Author Affiliation
Department of Hospital Hygiene and Infections, Central Finland Health Care District Jyväskylä, Finland. maija-liisa.rummukainen@ksshp.fi
Source
Am J Infect Control. 2009 Mar;37(2):168-71
Date
Mar-2009
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Cross Infection - prevention & control
Drug Utilization - statistics & numerical data
Female
Finland
Guideline Adherence - trends
Guidelines as Topic
Hand Disinfection
Health facilities
Health Services Research
Humans
Long-Term Care
Male
Abstract
A multidisciplinary team visited all long-term care facilities (n = 123) for elderly persons in the Central Finland health care district (population, 265,000) during 2004-2005. Use of alcohol-based hand rubs and ongoing systematic antimicrobials were assessed. Thereafter, regional guidelines for prudent use of antimicrobials were published. One year after the visits, a significant increase in the mean amount of alcohol-based hand rubs used was detected while usage of antimicrobials for the prevention of urinary tract reinfections had decreased.
PubMed ID
19155095 View in PubMed
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Reduction in inappropriate prevention of urinary tract infections in long-term care facilities.

https://arctichealth.org/en/permalink/ahliterature127410
Source
Am J Infect Control. 2012 Oct;40(8):711-4
Publication Type
Article
Date
Oct-2012
Author
Maija-Liisa Rummukainen
Aino Jakobsson
Maire Matsinen
Salme Järvenpää
Antti Nissinen
Pertti Karppi
Outi Lyytikäinen
Author Affiliation
Central Finland Healthcare District, Jyväskylä, Finland. maija-liisa.rummukainen@ksshp.fi
Source
Am J Infect Control. 2012 Oct;40(8):711-4
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibiotic Prophylaxis - standards - statistics & numerical data
Cross Infection - drug therapy - microbiology - prevention & control
Female
Finland
Homes for the Aged
Humans
Infection Control - trends
Long-Term Care
Male
Nursing Homes
Questionnaires
Urinary Tract Infections - drug therapy - microbiology - prevention & control
Abstract
Urinary tract infection (UTI) is the most common diagnosis made in prescribing antimicrobials in long-term care facilities (LTCF). The diagnostic criteria for UTI vary among institutions and prescribers. Our aim was to reduce the inappropriate use of antimicrobials in LTCFs.
A team comprising infectious disease consultant, infection control nurse, and geriatrician visited all LTCFs for older persons (2,321 patients in 25 primary care hospitals and 39 nursing homes and dementia units) in the Central Finland Healthcare District (population 267,000) during 2004-2005. The site visits consisted of a structured interview concerning patients, ongoing systematic antimicrobials, and diagnostic practices for UTI. Following the visits, regional guidelines for prudent use of antimicrobials in LTCFs were published, and the use of antimicrobials was followed up by an annual questionnaire.
The proportions of patients receiving antimicrobials in 2005, 2006, 2007, and 2008 were 19.9%, 16.9%, 16.2%, and 15.4%, respectively. Most of the antibiotics were used for UTI (range by year, 66.6%-81.1%). From 2005 through 2008, the proportion of patients on antibiotic prophylaxis for UTI decreased from 13% to 6%. The decrease was statistically significant in both types of settings.
The visits and guidelines were associated with a reduction in the usage of antimicrobials. To sustain this, UTI surveillance and close collaboration between infection control experts and LTCFs are crucial.
PubMed ID
22297240 View in PubMed
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Respiratory diphtheria in an asylum seeker from Afghanistan arriving to Finland via Sweden, December 2015.

https://arctichealth.org/en/permalink/ahliterature273130
Source
Euro Surveill. 2016;21(2)
Publication Type
Article
Date
2016
Author
Jussi Sane
Tiina Sorvari
Micael Widerström
Heikki Kauma
Ulla Kaukoniemi
Eveliina Tarkka
Taneli Puumalainen
Markku Kuusi
Mika Salminen
Outi Lyytikäinen
Source
Euro Surveill. 2016;21(2)
Date
2016
Language
English
Publication Type
Article
Keywords
Administration, Intravenous
Administration, Oral
Adolescent
Afghanistan
Anti-Bacterial Agents - therapeutic use
Cefuroxime - therapeutic use
Corynebacterium Infections - diagnosis - drug therapy
Corynebacterium diphtheriae - genetics - isolation & purification
Diphtheria - diagnosis
Diphtheria Antitoxin - genetics
Finland
Humans
Male
Polymerase Chain Reaction
Refugees
Roxithromycin - therapeutic use
Sweden
Travel
Treatment Outcome
Abstract
In December 2015, an asylum seeker originating from Afghanistan was diagnosed with respiratory diphtheria in Finland. He arrived in Finland from Sweden where he had already been clinically suspected and tested for diphtheria. Corynebacterium diphtheriae was confirmed in Sweden and shown to be genotypically and phenotypically toxigenic. The event highlights the importance of early case detection, rapid communication within the country and internationally as well as preparedness plans of diphtheria antitoxin availability.
PubMed ID
26840007 View in PubMed
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Urinary tract infections and antimicrobial use among Finnish home care clients, April-September 2014.

https://arctichealth.org/en/permalink/ahliterature287320
Source
Am J Infect Control. 2016 Nov 01;44(11):1390-1392
Publication Type
Article
Date
Nov-01-2016
Author
Triin Pärn
Matti Mäkelä
Outi Lyytikäinen
Source
Am J Infect Control. 2016 Nov 01;44(11):1390-1392
Date
Nov-01-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Antibiotic Prophylaxis - utilization
Drug Utilization
Female
Finland - epidemiology
Home Care Services
Humans
Male
Risk factors
Urinary Tract Infections - drug therapy - epidemiology
Abstract
The 30-day prevalence of urinary tract infection (UTI) among Finnish home care clients (N?=?6,887) estimated by the Resident Assessment Instrument was 4.5%, and 5.9% of the clients received antimicrobial agents, most commonly for UTI prophylaxis. Urinary catheter and female gender were the strongest factors independently associated with antimicrobial use and UTI. The Resident Assessment Instrument provides data that could be used when training home care providers and primary health care workers in the appropriate use of antimicrobial agents and UTI prevention.
PubMed ID
27311509 View in PubMed
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9 records – page 1 of 1.