Infection Control & Hospital Epidemiology最新文献_第8页

A Randomized Trial to Determine the Impact of an Educational Patient Hand-Hygiene Intervention on Contamination of Hospitalized Patient’s Hands with Healthcare-Associated Pathogens 一项随机试验，旨在确定患者手卫生教育干预对住院患者手部沾染卫生保健相关病原体的影响

Infection Control & Hospital Epidemiology Pub Date : 2017-01-05 DOI: 10.1017/ice.2016.323

V. Sunkesula, S. Kundrapu, Shanina C. Knighton, J. Cadnum, C. Donskey

引用次数: 24

Preferential Use of Nitrofurantoin Over Fluoroquinolones for Acute Uncomplicated Cystitis and Outpatient Escherichia coli Resistance in an Integrated Healthcare System 在一个综合医疗系统中，治疗急性无并发症膀胱炎和门诊大肠杆菌耐药性的硝基呋喃妥因优先于氟喹诺酮类药物

Infection Control & Hospital Epidemiology Pub Date : 2017-01-05 DOI: 10.1017/ice.2016.315

Rebecca L Pedela, Katherine C. Shihadeh, Bryan C. Knepper, M. Haas, W. Burman, T. Jenkins

{"title":"Preferential Use of Nitrofurantoin Over Fluoroquinolones for Acute Uncomplicated Cystitis and Outpatient Escherichia coli Resistance in an Integrated Healthcare System","authors":"Rebecca L Pedela, Katherine C. Shihadeh, Bryan C. Knepper, M. Haas, W. Burman, T. Jenkins","doi":"10.1017/ice.2016.315","DOIUrl":"https://doi.org/10.1017/ice.2016.315","url":null,"abstract":"OBJECTIVES To evaluate changes in outpatient fluoroquinolone (FQ) and nitrofurantoin (NFT) use and resistance among E. coli isolates after a change in institutional guidance to use NFT over FQs for acute uncomplicated cystitis. DESIGN Retrospective preintervention–postintervention study. SETTING Urban, integrated healthcare system. PATIENTS Adult outpatients treated for acute cystitis. METHODS We compared 2 time periods: January 2003–June 2007 when FQs were recommended as first-line therapy, and July 2007–December 2012, when NFT was recommended. The main outcomes were changes in FQ and NFT use and FQ- and NFT-resistant E. coli by time-series analysis. RESULTS Overall, 5,714 adults treated for acute cystitis and 11,367 outpatient E. coli isolates were included in the analysis. After the change in prescribing guidance, there was an immediate 26% (95% CI, 20%–32%) decrease in FQ use (P<.001), and a nonsignificant 6% (95% CI, −2% to 15%) increase in NFT use (P=.12); these changes were sustained over the postintervention period. Oral cephalosporin use also increased during the postintervention period. There was a significant decrease in FQ-resistant E. coli of −0.4% per quarter (95% CI, −0.6% to −0.1%; P=.004) between the pre- and postintervention periods; however, a change in the trend of NFT-resistant E. coli was not observed. CONCLUSIONS In an integrated healthcare system, a change in institutional guidance for acute uncomplicated cystitis was associated with a reduction in FQ use, which may have contributed to a stabilization in FQ-resistant E. coli. Increased nitrofurantoin use was not associated with a change in NFT resistance. Infect Control Hosp Epidemiol 2017;38:461–468","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"65 1","pages":"461 - 468"},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90336853","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

Inpatient Urine Cultures Are Frequently Performed Without Urinalysis or Microscopy: Findings From a Large Academic Medical Center 住院病人尿培养经常在没有尿液分析或显微镜的情况下进行:来自一个大型学术医疗中心的发现

Infection Control & Hospital Epidemiology Pub Date : 2017-01-05 DOI: 10.1017/ice.2016.311

Abigail L. Carlson, S. Munigala, A. Russo, K. McMullen, Helen Wood, R. Jackups, D. Warren

{"title":"Inpatient Urine Cultures Are Frequently Performed Without Urinalysis or Microscopy: Findings From a Large Academic Medical Center","authors":"Abigail L. Carlson, S. Munigala, A. Russo, K. McMullen, Helen Wood, R. Jackups, D. Warren","doi":"10.1017/ice.2016.311","DOIUrl":"https://doi.org/10.1017/ice.2016.311","url":null,"abstract":"OBJECTIVE To describe the frequency of urine cultures performed in inpatients without additional testing for pyuria DESIGN Retrospective cohort study SETTING A 1,250-bed academic tertiary referral center PATIENTS Hospitalized adults METHODS This study included urine cultures drawn on 4 medical and 2 surgical wards from 2009 to 2013 and in the medical and surgical intensive care units (ICUs) from 2012 to 2013. Patient and laboratory data were abstracted from the hospital’s medical informatics database. We identified catheter-associated urinary tract infections (CAUTIs) in the ICUs by routine infection prevention surveillance. Cultures without urinalysis or urine microscopy were defined as “isolated.” The primary outcome was the proportion of isolated urine cultures obtained. We used multivariable logistic regression to assess predictors of isolated cultures. RESULTS During the study period, 14,743 urine cultures were obtained (63.5 cultures per 1,000 patient days) during 11,820 patient admissions. Of these, 2,973 cultures (20.2%) were isolated cultures. Of the 61 CAUTIs identified, 31 (50.8%) were identified by an isolated culture. Predictors for having an isolated culture included male gender (adjusted odds ratio [aOR], 1.22; 95%; confidence interval [CI], 1.11–1.35], urinary catheterization (aOR, 2.15; 95% CI, 1.89–2.46), ICU admission (medical ICU aOR, 1.72; 95% CI, 1.47–2.00; surgical ICU aOR, 1.82; 95% CI, 1.51–2.19), and obtaining the urine culture ≥1 calendar day after admission (1–7 days aOR, 1.91; 95% CI. 1.71–2.12; >7 days after admission aOR, 2.81; 95% CI, 2.37–3.34). CONCLUSIONS Isolated urine cultures are common in hospitalized patients, particularly in patients with urinary catheters and those in ICUs. Interventions targeting inpatient culturing practices may improve the diagnosis of urinary tract infections. Infect Control Hosp Epidemiol 2017;38:455–460","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"15 1","pages":"455 - 460"},"PeriodicalIF":0.0,"publicationDate":"2017-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73579547","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: 11

Unique perspectives, unified voice 独特的视角，统一的声音

Infection Control & Hospital Epidemiology Pub Date : 2017-01-01 DOI: 10.1017/ICE.2016.294

L. Dembry, S. Dolan

引用次数: 3

ICE volume 38 issue 1 Cover and Back matter ICE第38卷第1期封面和封底

Infection Control & Hospital Epidemiology Pub Date : 2017-01-01 DOI: 10.1017/ice.2016.313

引用次数: 0

ICE volume 38 issue 1 Cover and Front matter ICE第38卷第1期封面和封面问题

Infection Control & Hospital Epidemiology Pub Date : 2017-01-01 DOI: 10.1017/ice.2016.312

引用次数: 0

Improving the Culture of Culturing: Critical Asset to Antimicrobial Stewardship 改善培养:抗菌药物管理的关键资产

Infection Control & Hospital Epidemiology Pub Date : 2016-12-29 DOI: 10.1017/ice.2016.319

M. Fakih, R. Khatib

引用次数: 9

Unit-Specific Rates of Hand Hygiene Opportunities in an Acute-Care Hospital 某急症护理医院的单位特定手卫生机会率

Infection Control & Hospital Epidemiology Pub Date : 2016-12-28 DOI: 10.1017/ice.2016.308

A. Han, Laurie J. Conway, C. Moore, Liz J. McCreight, K. Ragan, Jannice So, E. Borgundvaag, Michael Larocque, B. Coleman, A. McGeer

{"title":"Unit-Specific Rates of Hand Hygiene Opportunities in an Acute-Care Hospital","authors":"A. Han, Laurie J. Conway, C. Moore, Liz J. McCreight, K. Ragan, Jannice So, E. Borgundvaag, Michael Larocque, B. Coleman, A. McGeer","doi":"10.1017/ice.2016.308","DOIUrl":"https://doi.org/10.1017/ice.2016.308","url":null,"abstract":"OBJECTIVE To explore the frequency of hand hygiene opportunities (HHOs) in multiple units of an acute-care hospital. DESIGN Prospective observational study. SETTING The adult intensive care unit (ICU), medical and surgical step-down units, medical and surgical units, and the postpartum mother–baby unit (MBU) of an academic acute-care hospital during May–August 2013, May–July 2014, and June–August 2015. PARTICIPANTS Healthcare workers (HCWs). METHODS HHOs were recorded using direct observation in 1-hour intervals following Public Health Ontario guidelines. The frequency and distribution of HHOs per patient hour were determined for each unit according to time of day, indication, and profession. RESULTS In total, 3,422 HHOs were identified during 586 hours of observation. The mean numbers of HHOs per patient hour in the ICU were similar to those in the medical and surgical step-down units during the day and night, which were higher than the rates observed in medical and surgical units and the MBU. The rate of HHOs during the night significantly decreased compared with day (P<.0001). HHOs before an aseptic procedure comprised 13% of HHOs in the ICU compared with 4%–9% in other units. Nurses contributed >92% of HHOs on medical and surgical units, compared to 67% of HHOs on the MBU. CONCLUSIONS Assessment of hand hygiene compliance using product utilization data requires knowledge of the appropriate opportunities for hand hygiene. We have provided a detailed characterization of these estimates across a wide range of inpatient settings as well as an examination of temporal variations in HHOs. Infect Control Hosp Epidemiol 2017;38:411–416","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"22 1","pages":"411 - 416"},"PeriodicalIF":0.0,"publicationDate":"2016-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85060897","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: 7

Distribution of Central Line-Associated Bloodstream Infections Determined From Washington State’s Annual Reporting Validation Program, 2009–2013 2009-2013年华盛顿州年度报告验证计划确定的中央静脉相关血流感染分布

Infection Control & Hospital Epidemiology Pub Date : 2016-12-28 DOI: 10.1017/ice.2016.303

Jason M Lempp, M. Cummings, D. Birnbaum

引用次数: 0

Pathogen and Procedure Trends Among Surgical-Site Infections at a Children’s Hospital: A 20-Year Experience 一家儿童医院手术部位感染的病原体和操作趋势:20年的经验

Infection Control & Hospital Epidemiology Pub Date : 2016-12-28 DOI: 10.1017/ice.2016.310

Jon Woltmann, J. Schaffzin, M. Washam, B. Connelly

引用次数: 4

Infection Control &#x0026; Hospital Epidemiology最新文献

Infection Control & Hospital Epidemiology最新文献