Infection Control & Hospital Epidemiology最新文献

{"title":"ICE volume 38 issue 1 Cover and Back matter","authors":"","doi":"10.1017/ice.2016.313","DOIUrl":"https://doi.org/10.1017/ice.2016.313","url":null,"abstract":"","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"12 1","pages":"b1 - b5"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89168672","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}

{"title":"ICE volume 38 issue 1 Cover and Front matter","authors":"","doi":"10.1017/ice.2016.312","DOIUrl":"https://doi.org/10.1017/ice.2016.312","url":null,"abstract":"","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"1 1","pages":"f1 - f6"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82154354","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}

{"title":"Improving the Culture of Culturing: Critical Asset to Antimicrobial Stewardship","authors":"M. Fakih, R. Khatib","doi":"10.1017/ice.2016.319","DOIUrl":"https://doi.org/10.1017/ice.2016.319","url":null,"abstract":"Affiliations: 1. Hospital Mãe de Deus, Porto Alegre, Brazil; 2. Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; 3. Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil. Address correspondence to Leandro Reus Rodrigues Perez, PhD, Microbiology Unit, Hospital Mãe de Deus, 286, José de Alencar Street, 90610-000, Porto Alegre – RS, Brazil (leandro.reus@gmail.com).","PeriodicalId":13655,"journal":{"name":"Infection Control & Hospital Epidemiology","volume":"39 12","pages":"377 - 379"},"PeriodicalIF":0.0,"publicationDate":"2016-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72632411","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}

{"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 &#x0026; 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}

{"title":"Distribution of Central Line-Associated Bloodstream Infections Determined From Washington State’s Annual Reporting Validation Program, 2009–2013","authors":"Jason M Lempp, M. Cummings, D. Birnbaum","doi":"10.1017/ice.2016.303","DOIUrl":"https://doi.org/10.1017/ice.2016.303","url":null,"abstract":"Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State’s validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure that hospital reporting accuracy is maintained. This paper details findings and costs from our experience. Infect Control Hosp Epidemiol 2017;38:489–492","PeriodicalId":13655,"journal":{"name":"Infection Control &#x0026; Hospital Epidemiology","volume":"40 19","pages":"489 - 492"},"PeriodicalIF":0.0,"publicationDate":"2016-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91400041","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}

{"title":"Pathogen and Procedure Trends Among Surgical-Site Infections at a Children’s Hospital: A 20-Year Experience","authors":"Jon Woltmann, J. Schaffzin, M. Washam, B. Connelly","doi":"10.1017/ice.2016.310","DOIUrl":"https://doi.org/10.1017/ice.2016.310","url":null,"abstract":"Affiliations: 1. Center for Anti-infective Research and Development, Hartford Hospital, Hartford, Connecticut; 2. Department of Microbiology, Eastern Connecticut Health Network, Manchester, Connecticut; 3. Department of Microbiology, Veterans’ Affairs Boston Health Care System, West Roxbury, Massachusetts; 4. Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts; 5. Department of Microbiology, Hartford Hospital, Hartford, Connecticut; 6. Division of Infectious Diseases, Hartford Hospital, Hartford, Connecticut Address correspondence to David P. Nicolau, PharmD, FCCP, FIDSA, Center for Anti-infective Research and Development, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102 (david.nicolau@hhchealth.org). Infect Control Hosp Epidemiol 2017;38:379–380 © 2017 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2017/3803-0024. DOI: 10.1017/ice.2016.325","PeriodicalId":13655,"journal":{"name":"Infection Control &#x0026; Hospital Epidemiology","volume":"55 1","pages":"380 - 382"},"PeriodicalIF":0.0,"publicationDate":"2016-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80196261","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}

{"title":"Optimizing Inpatient Urine Culture Ordering Practices Using the Electronic Medical Record: A Pilot Study","authors":"D. Shirley, Harry Scholtz, Kurt Osterby, Jackson S. Musuuza, B. Fox, N. Safdar","doi":"10.1017/ice.2016.301","DOIUrl":"https://doi.org/10.1017/ice.2016.301","url":null,"abstract":"A prospective quasi-experimental before-and-after study of an electronic medical record–anchored intervention of embedded education on appropriate urine culture indications and indication selection reduced the number of urine cultures ordered for catheterized patients at an academic medical center. This intervention could be a component of CAUTI-reduction bundles. Infect Control Hosp Epidemiol 2017;38:486–488","PeriodicalId":13655,"journal":{"name":"Infection Control &#x0026; Hospital Epidemiology","volume":"46 1","pages":"486 - 488"},"PeriodicalIF":0.0,"publicationDate":"2016-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82359514","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}

{"title":"Antiseptic Effect of Conventional Povidone–Iodine Scrub, Chlorhexidine Scrub, and Waterless Hand Rub in a Surgical Room: A Randomized Controlled Trial","authors":"J. Tsai, Yen-Kuang Lin, Yen-Jung Huang, E. Loh, Hsiao-Yun Wen, Chia-Hui Wang, Y. Tsai, Wen-Shyang Hsieh, K. Tam","doi":"10.1017/ice.2016.296","DOIUrl":"https://doi.org/10.1017/ice.2016.296","url":null,"abstract":"OBJECTIVE Effective perioperative hand antisepsis is crucial for the safety of patients and medical staff in surgical rooms. The antimicrobial effectiveness of different antiseptic methods, including conventional hand scrubs and waterless hand rubs, has not been well evaluated. DESIGN, SETTING, AND PARTICIPANTS A randomized controlled trial was conducted to investigate the effectiveness of the 3 antiseptic methods among surgical staff of Taipei Medical University—Shuang Ho Hospital. For each method used, a group of 80 participants was enrolled. INTERVENTION Surgical hand cleansing with conventional 10% povidone–iodine scrub, conventional 4% chlorhexidine scrub, or waterless hand rub (1% chlorhexidine gluconate and 61% ethyl alcohol). RESULTS Colony-forming unit (CFU) counts were collected using the hand imprinting method before and after disinfection and after surgery. After surgical hand disinfection, the mean CFU counts of the conventional chlorhexidine (0.5±0.2, P<0.01) and waterless hand rub groups (1.4±0.7, P<0.05) were significantly lower than that of the conventional povidone group (4.3±1.3). No significant difference was observed in the mean CFU count among the groups after surgery. Similar results were obtained when preexisting differences before disinfection were considered in the analysis of covariance. Furthermore, multivariate regression indicated that the antiseptic method (P=.0036), but not other variables, predicted the mean CFU count. CONCLUSIONS Conventional chlorhexidine scrub and waterless hand rub were superior to a conventional povidone–iodine product in bacterial inhibition. We recommend using conventional chlorhexidine scrub as a standard method for perioperative hand antisepsis. Waterless hand rub may be used if the higher cost is affordable. Infect Control Hosp Epidemiol 2017;38:417–422","PeriodicalId":13655,"journal":{"name":"Infection Control &#x0026; Hospital Epidemiology","volume":"23 1","pages":"417 - 422"},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87088479","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}

{"title":"A Comparison of Administrative Data Versus Surveillance Data for Hospital-Associated Methicillin-Resistant Staphylococcus aureus Infections in Canadian Hospitals","authors":"Jessica Y Ramirez Mendoza, N. Daneman, M. Elias, J. Amuah, K. Bush, C. Couris, K. Leeb","doi":"10.1017/ice.2016.302","DOIUrl":"https://doi.org/10.1017/ice.2016.302","url":null,"abstract":"BACKGROUND In Canadian hospitals, clinical information is coded according to national coding standards and is routinely collected as administrative data. Administrative data may complement active surveillance programs by providing in-hospital MRSA infection data in a standardized and efficient manner, but only if infections are accurately captured. OBJECTIVE To assess the accuracy of administrative data regarding in-hospital bloodstream infections (BSIs) and all-body-site infections due to MRSA. METHODS A retrospective study of all (adult and pediatric) in-hospital MRSA infections was conducted by comparing administrative data against surveillance data from 217 acute Canadian hospitals (124 in Ontario, 93 in Alberta) over a 12-month period. Hospital-associated MRSA BSI cases in Ontario, and for all-body-site MRSA infections in Alberta were identified. Pearson correlation coefficients were used to compare the number of hospital-level MRSA cases within administrative versus surveillance datasets. The correlation of all-body-site MRSA infections versus MRSA BSIs was also assessed using the Ontario administrative data. RESULTS Strong correlations between hospital-level MRSA cases in administrative and surveillance datasets were identified for Ontario (r=0.79; 95% CI, 0.72–0.85) and Alberta (r=0.92; 95% CI, 0.88–0.94). A strong correlation between all-body-site and bloodstream-only MRSA infection rates was identified across Ontario hospitals (r=0.95; P<.0001; 95% CI, 0.93–0.96). CONCLUSIONS This study provides good evidence of the comparability of administrative and surveillance datasets in identifying in-hospital MRSA infections. With standard definitions, administrative data can provide estimates of in-hospital infections for monitoring and/or comparisons across hospitals. Infect Control Hosp Epidemiol 2017;38:436–443","PeriodicalId":13655,"journal":{"name":"Infection Control &#x0026; Hospital Epidemiology","volume":"54 1","pages":"436 - 443"},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79338249","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}

{"title":"Improving Compliance With Antibiotic Stewardship: What Is the Role of Initial Microscopy on the Management of Mechanically Ventilated Patients?","authors":"L. Perez, G. Narvaez, C. Dias","doi":"10.1017/ice.2016.305","DOIUrl":"https://doi.org/10.1017/ice.2016.305","url":null,"abstract":"To the Editor—Ventilator-associated pneumonia (VAP) is one of the most serious healthcare-associated infections; it has a high mortality rate, especially in intensive care units (ICUs). Diagnosing VAP is a complex issue, and the precise role of microbiologic parameters such as cultures (if qualitative or quantitative), as well as Gram stain, remain unclear. Microscopic evaluation by Gram stain of easily obtained respiratory secretions, such as endotracheal aspirate (EA), could provide a potentially useful guide to appropriate antimicrobial therapy in patients with suspected VAP. To evaluate the performance of microscopic examinations by Gram staining of endotracheal aspirates (EAs) recovered from intensive care patients, a prospective study was performed. Endotracheal aspirates were consecutively recovered from mechanically ventilated patients in an adult ICU in a tertiary hospital of Porto Alegre, southern Brazil, between January 1 and October 3, 2016. Smears were stained with Gram stain and were then cultured quantitatively. As selection criteria, only specimens with <10 squamous epithelial cells by microscopic examination in a low-power field were included in the study. Also, microorganisms presenting growth ≥10 colony forming units (CFU) per milliliter of sample plated were considered a positive culture. Results from microscopy and culture were obtained independently and carried out by double-blind analysis. A total of 717 EAs were obtained. Among them, 52 EAs were excluded due to the presence of >10 epithelial cells, and 13 (1.8%) were excluded due to inconsistent results in the culture (growth of non-pathogenic organisms such as yeasts). In the remaining 652 samples, a negative culture (ie, no bacterial growth ≥10CFU/mL) was observed in 415 (63.6%). Among the 237 positive cultures, gram-negative rods were recovered from 218 (92%) and gram-positive cocci were recovered from 19 (8%). For gram-positive cocci, only S. aureus were recovered in sufficient numbers to meet study criteria; only 2 of these (10.5%) were methicillin-resistant (MRSA). Overall, 560 of 652 (85.9%) samples showed agreement between Gram stain and culture results. The sensitivity, specificity, positive and negative predictive values, and their confidence intervals (95% CI) for clustered gram-positive cocci and gram-negative rods are shown in Table 1. Fast and accurate microbiological diagnosis of VAP is a major challenge, and no generally accepted gold standard exists for its diagnosis. In recent guidelines by the Infectious Diseases Society of America and the American Thoracic Society on the management of adults with hospital-acquired pneumonia and VAP, noninvasive sampling with semiquantitative cultures has been suggested instead of invasive sampling with quantitative cultures. Although universally accepted as a useful tool for evaluating clinical specimens, the real value of the Gram stain to guide an empirical approach is also controversial. Detection of gram-positive co","PeriodicalId":13655,"journal":{"name":"Infection Control &#x0026; Hospital Epidemiology","volume":"6 1","pages":"376 - 377"},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85158032","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}