Infection Control & Hospital Epidemiology最新文献_第10页

Postdischarge Surveillance: Value and Problems Perceived by Infection Control Practitioners in Switzerland 出院后监测:瑞士感染控制从业人员感知的价值和问题

Infection Control & Hospital Epidemiology Pub Date : 2016-12-19 DOI: 10.1017/ice.2016.270

G. Santoro, E. Tabori, A. Rytz, S. Schulz-Stübner

{"title":"Postdischarge Surveillance: Value and Problems Perceived by Infection Control Practitioners in Switzerland","authors":"G. Santoro, E. Tabori, A. Rytz, S. Schulz-Stübner","doi":"10.1017/ice.2016.270","DOIUrl":"https://doi.org/10.1017/ice.2016.270","url":null,"abstract":"To the Editor—Switzerland is one of the few countries where routine postdischarge surveillance (PDS) for the surveillance of surgical site infections (SSIs) is practiced by telephone interview 1 month (and for implanted devices a second interview at 12 months) after the procedure, which is comparable with the system in the Netherlands. This survey was designed to analyze the perceptions on work load and value of PDS by Swiss infection control practitioners in order to assess the efficiency of resource utilization. The online questionnaire was distributed in December 2015 and January 2016. A major limitation of the study is the subjective assessment method of the survey, but the high response rate of 76 (62.3%) of the 122 Swiss hospitals that were asked to participate provides a representative sample. Although the practical value of PDS related to clinical infection control is rated moderate on an 8-item Likert scale, the work load is rated high compared with other duties (Figure 1). A total of 23 (37.1%) of the 62 respondents for this item say that they definitely have curtailed other duties owing to the requirements of PDS and 13 (20.9%) feel that sometimes they neglect other duties because time is needed for PDS. A total of 30 respondents (48.4%) would define the costs and effort for PDS for the hospital as high but 34 (55.8%) agree that without PDS many SSIs would not be detected. The time effort for one telephone interview and data logging was","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"34 1","pages":"250 - 251"},"PeriodicalIF":0.0,"publicationDate":"2016-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82815023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Risk Factors for Surgical Site Infections Following Neurosurgical Spinal Fusion Operations: A Case Control Study 神经外科脊柱融合术后手术部位感染的危险因素:一项病例对照研究

Infection Control & Hospital Epidemiology Pub Date : 2016-12-19 DOI: 10.1017/ice.2016.307

T. Walsh, Ashley M. Querry, S. Mccool, Alison L. Galdys, K. Shutt, M. Saul, Carlene A. Muto

{"title":"Risk Factors for Surgical Site Infections Following Neurosurgical Spinal Fusion Operations: A Case Control Study","authors":"T. Walsh, Ashley M. Querry, S. Mccool, Alison L. Galdys, K. Shutt, M. Saul, Carlene A. Muto","doi":"10.1017/ice.2016.307","DOIUrl":"https://doi.org/10.1017/ice.2016.307","url":null,"abstract":"OBJECTIVE To determine risk factors for the development of surgical site infections (SSIs) in neurosurgery patients undergoing spinal fusion. DESIGN Retrospective case-control study. SETTING Large, academic, quaternary care center. PATIENTS The study population included all neurosurgery patients who underwent spinal fusion between August 1, 2009, and August 31, 2013. Cases were defined as patients in the study cohort who developed an SSI. Controls were patients in the study cohort who did not develop an SSI. METHODS To achieve 80% power with an ability to detect an odds ratio (OR) of 2, we performed an unmatched case-control study with equal numbers of cases and controls. RESULTS During the study period, 5,473 spinal fusion procedures were performed by neurosurgeons in our hospital. With 161 SSIs recorded during the study period, the incidence of SSIs associated with these procedures was 2.94%. While anterior surgical approach was found to be a protective factor (OR, 0.20; 95% confidence interval [CI], 0.08–0.52), duration of procedure (OR, 1.58; 95% CI, 1.29–1.93), American Society of Anesthesiologists score of 3 or 4 (OR, 1.79; 95% CI, 1.00–3.18), and hospitalization within the prior 30 days (OR, 5.8; 95% CI, 1.37–24.57) were found in multivariate analysis to be independent predictors of SSI following spinal fusion. Prior methicillin-resistant Staphylococcus aureus (MRSA) nares colonization was highly associated with odds 20 times higher of SSI following spinal fusion (OR, 20.30; 95% CI, 4.64–8.78). CONCLUSIONS In additional to nonmodifiable risk factors, prior colonization with MRSA is a modifiable risk factor very strongly associated with development of SSI following spinal fusion. Infect Control Hosp Epidemiol 2017;38:348–352","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"1992 1","pages":"340 - 347"},"PeriodicalIF":0.0,"publicationDate":"2016-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89874252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Validation of ICD-9-CM Diagnosis Codes for Surgical Site Infection and Noninfectious Wound Complications After Mastectomy 乳房切除术后手术部位感染和非感染性伤口并发症的ICD-9-CM诊断规范的验证

Infection Control & Hospital Epidemiology Pub Date : 2016-12-15 DOI: 10.1017/ice.2016.271

M. Olsen, Kelly E. Ball, K. Nickel, A. Wallace, V. Fraser

{"title":"Validation of ICD-9-CM Diagnosis Codes for Surgical Site Infection and Noninfectious Wound Complications After Mastectomy","authors":"M. Olsen, Kelly E. Ball, K. Nickel, A. Wallace, V. Fraser","doi":"10.1017/ice.2016.271","DOIUrl":"https://doi.org/10.1017/ice.2016.271","url":null,"abstract":"BACKGROUND Few studies have validated ICD-9-CM diagnosis codes for surgical site infection (SSI), and none have validated coding for noninfectious wound complications after mastectomy. OBJECTIVES To determine the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes in health insurer claims data to identify SSI and noninfectious wound complications, including hematoma, seroma, fat and tissue necrosis, and dehiscence, after mastectomy. METHODS We reviewed medical records for 275 randomly selected women who were coded in the claims data for mastectomy with or without immediate breast reconstruction and had an ICD-9-CM diagnosis code for a wound complication within 180 days after surgery. We calculated the positive predictive value (PPV) to evaluate the accuracy of diagnosis codes in identifying specific wound complications and the PPV to determine the accuracy of coding for the breast surgical procedure. RESULTS The PPV for SSI was 57.5%, or 68.9% if cellulitis-alone was considered an SSI, while the PPV for cellulitis was 82.2%. The PPVs of individual noninfectious wound complications ranged from 47.8% for fat necrosis to 94.9% for seroma and 96.6% for hematoma. The PPVs for mastectomy, implant, and autologous flap reconstruction were uniformly high (97.5%–99.2%). CONCLUSIONS Our results suggest that claims data can be used to compare rates of infectious and noninfectious wound complications after mastectomy across facilities, even though PPVs vary by specific type of postoperative complication. The accuracy of coding was highest for cellulitis, hematoma, and seroma, and a composite group of noninfectious complications (fat necrosis, tissue necrosis, or dehiscence). Infect Control Hosp Epidemiol 2017;38:334–339","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"120 16","pages":"334 - 339"},"PeriodicalIF":0.0,"publicationDate":"2016-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91408109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Subjective Qualitative Hand Hygiene Compliance Observation: A Feasibility Trial 主观定性手卫生依从性观察:可行性试验

Infection Control & Hospital Epidemiology Pub Date : 2016-12-14 DOI: 10.1017/ice.2016.300

J. Bierwirth, S. Schulz-Stübner

{"title":"Subjective Qualitative Hand Hygiene Compliance Observation: A Feasibility Trial","authors":"J. Bierwirth, S. Schulz-Stübner","doi":"10.1017/ice.2016.300","DOIUrl":"https://doi.org/10.1017/ice.2016.300","url":null,"abstract":"average costs per interview calculated with 19.69 CHF (Swiss francs). This corresponds to approximately 1,510,892 CHF for 76,734 telephone interviews in the surveillance period 2013-2014. Although PDS is able to produce more reliable SSI data compared with surveillance systems that limit the data acquisition period to the time in the hospital and readmissions, most additional captured SSIs are superficial ones, so the cost-effectiveness of routine PDS has been questioned. In Germany efforts are underway to conduct SSI surveillance for all inpatient and outpatient surgical procedures with an algorithm based on health insurance data and using International Classification of Diseases (ICD) codes, German procedure codes, and diagnosis-related group administrative datasets as part of the mandatory quality assurance program starting in January 2017. This approach will include the postdischarge period but will not need any input by infection control practitioners, thus freeing up their time. However, physicians who treat a case of presumed SSI detected by the automatic algorithm will be required to fill out a short questionnaire to verify the classification. International benchmarking will become more difficult, given the variety of surveillance systems from active PDS in Switzerland and the Netherlands to future “big data” mining in Germany to classical active surveillance reporting using standardized definitions. Therefore, we believe that an internationally synchronized effort to streamline a cost-effective surveillance approach to detect SSIs is warranted, keeping in mind the RUMBA rule of meaningful quality indicators: Reliable, Understandable, Measureable, Behaviorable, and Achievable.","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"9 1","pages":"251 - 252"},"PeriodicalIF":0.0,"publicationDate":"2016-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83515269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Phantom Prescribing: Examining the Frequency of Antimicrobial Prescriptions Without a Patient Visit 幻影处方:检查抗菌药物处方的频率没有病人访问

Infection Control & Hospital Epidemiology Pub Date : 2016-12-13 DOI: 10.1017/ice.2016.269

B. Riedle, Linnea A. Polgreen, J. Cavanaugh, M. Schroeder, P. Polgreen

{"title":"Phantom Prescribing: Examining the Frequency of Antimicrobial Prescriptions Without a Patient Visit","authors":"B. Riedle, Linnea A. Polgreen, J. Cavanaugh, M. Schroeder, P. Polgreen","doi":"10.1017/ice.2016.269","DOIUrl":"https://doi.org/10.1017/ice.2016.269","url":null,"abstract":"OBJECTIVE To investigate the scale of antimicrobial prescribing without a corresponding visit, and to compare the attributes of patients who received antimicrobials with a corresponding visit with those who did not have a visit. DESIGN Retrospective cohort. METHODS We followed up 185,010 Medicare patients for 1 year after an acute myocardial infarction. For each antimicrobial prescribed, we determined whether the patient had an inpatient, outpatient, or provider claim in the 7 days prior to the antimicrobial prescription being filled. We compared the proportions of patient characteristics for those prescriptions associated with a visit and without a visit (ie, phantom prescriptions). We also compared the rates at which different antimicrobials were prescribed without a visit. RESULTS We found that of 356,545 antimicrobial prescriptions, 14.75% had no evidence of a visit in the week prior to the prescription being filled. A higher percentage of patients without a visit were identified as white (P<.001) and female (P<.001). Patients without a visit had a higher likelihood of survival and fewer additional cardiac events (acute myocardial infarction, cardiac arrest, stroke, all P<.001). Among the antimicrobials considered, amoxicillin, penicillin, and agents containing trimethoprim and methenamine were much more likely to be prescribed without a visit. In contrast, levofloxacin, metronidazole, moxifloxacin, vancomycin, and cefdinir were much less likely to be prescribed without a visit. CONCLUSIONS Among this cohort of patients with chronic conditions, phantom prescriptions of antimicrobials are relatively common and occurred more frequently among those patients who were relatively healthy. Infect Control Hosp Epidemiol 2017;38:273–280","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"121 1","pages":"273 - 280"},"PeriodicalIF":0.0,"publicationDate":"2016-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80777609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Outbreak of Klebsiella pneumoniae Carbapenemase–Producing Citrobacter freundii at a Tertiary Acute Care Facility in Miami, Florida 在佛罗里达州迈阿密一家三级急症护理机构爆发的产碳青霉烯酶肺炎克雷伯菌弗伦地柠檬酸杆菌

Infection Control & Hospital Epidemiology Pub Date : 2016-12-07 DOI: 10.1017/ice.2016.273

A. Jimenez, José G. Castro, L. Munoz-Price, Dennise de Pascale, L. Shimose, M. Mustapha, Caressa N. Spychala, R. Mettus, V. Cooper, Y. Doi

{"title":"Outbreak of Klebsiella pneumoniae Carbapenemase–Producing Citrobacter freundii at a Tertiary Acute Care Facility in Miami, Florida","authors":"A. Jimenez, José G. Castro, L. Munoz-Price, Dennise de Pascale, L. Shimose, M. Mustapha, Caressa N. Spychala, R. Mettus, V. Cooper, Y. Doi","doi":"10.1017/ice.2016.273","DOIUrl":"https://doi.org/10.1017/ice.2016.273","url":null,"abstract":"OBJECTIVE To describe the investigation and control of a rare cluster of Klebsiella pneumoniae carbapenemase–producing Citrobacter freundii in a hospital in southern Florida. METHODS An epidemiologic investigation, review of infection prevention procedures, and molecular studies including whole genome sequencing were conducted. RESULTS An outbreak of K. pneumoniae carbapenemase–3-producing C. freundii was identified at a tertiary hospital in Florida in 2014. Of the 6 cases identified, 3 occurred in the same intensive care unit and were caused by the same clone. For 2 of the 3 remaining cases, the isolates had low carbapenem minimum inhibitory concentrations and were unrelated by whole genome sequencing. As a response to the outbreak, supplementary environmental cleaning was implemented, including closure and terminal cleaning of the unit where the 3 cases clustered, in addition to the infection control bundle already in place at the time. No further cases were identified after these additional interventions. CONCLUSIONS Although C. freundii is not a species that commonly demonstrates carbapenem resistance, our findings suggest that carbapenemase-producing C. freundii may be underdetected even when active surveillance is in place and has a potential to cause hospital outbreak. Infect Control Hosp Epidemiol 2017;38:320–326","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"22 1","pages":"320 - 326"},"PeriodicalIF":0.0,"publicationDate":"2016-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73999213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Emergence of OXA-72-producing Acinetobacter baumannii Belonging to High-Risk Clones (CC15 and CC79) in Different Brazilian States 产oxa -72的鲍曼不动杆菌属于高危克隆(CC15和CC79)在巴西不同州的出现

Infection Control & Hospital Epidemiology Pub Date : 2016-12-06 DOI: 10.1017/ice.2016.287

M. Pagano, L. Rocha, J. Sampaio, A. F. Martins, A. Barth

{"title":"Emergence of OXA-72-producing Acinetobacter baumannii Belonging to High-Risk Clones (CC15 and CC79) in Different Brazilian States","authors":"M. Pagano, L. Rocha, J. Sampaio, A. F. Martins, A. Barth","doi":"10.1017/ice.2016.287","DOIUrl":"https://doi.org/10.1017/ice.2016.287","url":null,"abstract":"hand hygiene compliance observations and consecutive training efforts is important, given that <10% of all hand disinfections were performed correctly in an observational study by Tschudin-Sutter et al, who observed the 6-step technique. Appropriate hand-surface coverage was reached in only 7.9% of hand hygiene procedures observed by Park et al, despite a high rate of compliance with the correct indications. Shah et al performed a video observation of hand washing. Of 1,081 recordings, 403 (37.3%) were excellent, 521 (48.2%) were acceptable, and 157 (14.5%) were unacceptable. A limitation of our study is the lack of bacterial counts, but the results of Riley et al, who showed no correlation between hand coverage and bacterial counts with a 6-step technique compared to a 3-step approach, had not been published at the time of our experiment. Another limitation is the small number of participants and the experimental setting of this proof-of-principle study. However, we believe that based on our results, the addition of dichotomous subjective quality assessment using the parameters time and skin coverage during live observation by experienced infection control staff is feasible and could be a valuable addition to conventional hand hygiene observation.","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"60 1","pages":"252 - 254"},"PeriodicalIF":0.0,"publicationDate":"2016-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80465827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

A Silent Epidemic of Colistin- and Carbapenem-Resistant Enterobacteriaceae at a Turkish University Hospital 在土耳其大学医院的粘菌素和碳青霉烯耐药肠杆菌科的无声流行

Infection Control & Hospital Epidemiology Pub Date : 2016-12-05 DOI: 10.1017/ice.2016.255

G. Metan, A. İlbay, O. Eser, S. Unal, P. Zarakolu

引用次数: 6

Evaluation of an Ethanol-Based Spray Disinfectant for Decontamination of Cover Gowns Prior to Removal 以乙醇为基础的喷雾消毒剂在脱下防护服前进行除污的评估

Infection Control & Hospital Epidemiology Pub Date : 2016-12-05 DOI: 10.1017/ice.2016.295

Sreelatha Koganti, Heba Alhmidi, Myreen E. Tomas, J. Cadnum, Christopher Sass, A. Jencson, C. Donskey

引用次数: 7

Quantifying Antimicrobial Exposure: Hazards in Populations With End-Stage Renal Disease 量化抗菌素暴露:终末期肾脏疾病人群的危害

Infection Control & Hospital Epidemiology Pub Date : 2016-12-05 DOI: 10.1017/ice.2016.290

G. Snyder, Christopher M. McCoy, E. D’Agata

引用次数: 0

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