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Contact precautions

Kim Tran, Chaim Bell, Nathan Stall, George Tomlinson, Allison McGeer, Andrew Morris, Michael Gardam, Howard B Abrams
BACKGROUND: Isolation precautions have negative effects on patient safety, psychological well-being, and healthcare worker contact. However, it is not known whether isolation precautions affect certain hospital-related outcomes. OBJECTIVE: To examine the effect of isolation precautions on hospital-related outcomes and cost of care. DESIGN: Retrospective, propensity-score matched cohort study of inpatients admitted to general internal medicine (GIM) services at three academic hospitals in Toronto, Ontario, Canada between January 2010 and December 2012...
October 17, 2016: Journal of General Internal Medicine
Jonathan A Otter, Philip Burgess, Frances Davies, Siddharth Mookerjee, Julie Singleton, Mark Gilchrist, Darren Parsons, Eimear T Brannigan, Julie Robotham, Alison H Holmes
OBJECTIVE: To perform an economic evaluation on the cost associated with an outbreak of carbapenemase-producing Enterobacteriaceae (CPE). METHODS: We performed an observational economic evaluation of an outbreak of CPE (NDM-producing Klebsiella pneumoniae) affecting 40 patients in a group of five hospitals across three sites in West London. Costs were split into actual expenditure (including anti-infective costs, enhanced CPE screening, contact precautions, temporary ward-based monitors of hand and environmental practice, and environmental decontamination), and 'opportunity cost' (staff time, bed closures, and elective surgical missed revenue)...
October 13, 2016: Clinical Microbiology and Infection
S Jolivet, M Fines-Guyon, B Nebbad, J C Merle, D Le Pluart, C Brun-Buisson, J-W Decousser, V Cattoir
BACKGROUND: Vancomycin-resistant Enterococcus raffinosus has rarely been associated with nosocomial infection and outbreaks. AIM: To report the successful control of a nosocomial outbreak of vanA-type vancomycin-resistant E. raffinosus in a surgical intensive care unit. METHODS: The investigation of the outbreak is reported with control measures taken. Molecular typing of vancomycin-resistant E. raffinosus isolates was performed by repetitive sequence-based polymerase chain reaction (PCR)...
September 15, 2016: Journal of Hospital Infection
David A Pegues, Jennifer Han, Cheryl Gilmar, Brooke McDonnell, Steven Gaynes
OBJECTIVE To evaluate the impact of no-touch terminal room no-touch disinfection using ultraviolet wavelength C germicidal irradiation (UVGI) on C. difficile infection (CDI) rates on inpatient units with persistently high rates of CDI despite infection control measures. DESIGN Interrupted time-series analysis with a comparison arm. SETTING 3 adult hematology-oncology units in a large, tertiary-care hospital. METHODS We conducted a 12-month prospective valuation of UVGI. Rooms of patients with CDI or on contact precautions were targeted for UVGI upon discharge using an electronic patient flow system...
October 6, 2016: Infection Control and Hospital Epidemiology
Muhammad Laklouk, Ganesan Baranidharan
Capsaicin is a naturally occurring irritant active ingredient found in hot peppers. It is a ligand for transient receptor potential channel vanilloid receptors, which are found in nociceptive nerve terminals in the skin. Initial exposure to topical capsaicin leads to excitation of these receptors, release of vasoactive mediators, erythema, intense burning, pain, and thereafter desensitization of sensory neurons resulting in inhibition of pain transmission. Capsaicin 8% has been licensed for the treatment of postherpetic neuralgia pain in recent years...
2016: Patient Preference and Adherence
Hussein Algahtani, Bader Shirah, Mohammed Hmoud, Ahmad Subahi
Herpes simplex encephalitis (HSE) is a rare disease, but it is the most common form of sporadic encephalitis. HSE is transmitted through direct contact and developing nosocomial HSE is rarely reported in the literature. Nosocomial HSE is difficult to diagnose due to its non-specific clinical features. In this article, we present a case of nosocomial HSE that was responsible for grave consequence. We also explore its causes, outcome, and give recommendations to avoid such fatal occurrence. We stress on strict adherence to the standard precautions and preventive control measures...
September 24, 2016: Journal of Infection and Public Health
A Forcina, R Baldan, V Marasco, P Cichero, A Bondanza, M Noviello, S Piemontese, C Soliman, R Greco, F Lorentino, F Giglio, C Messina, M Carrabba, M Bernardi, J Peccatori, M Moro, A Biancardi, P Nizzero, P Scarpellini, D M Cirillo, N Mancini, C Corti, M Clementi, F Ciceri
Carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) infections are an emerging cause of death after hematopoietic stem cell transplantation (HSCT). In allogeneic transplants, mortality rate may rise up to 60%. We retrospectively evaluated 540 patients receiving a transplant from an auto- or an allogeneic source between January 2011 and October 2015. After an Institutional increase in the prevalence of KPC-Kp bloodstream infections (BSI) in June 2012, from July 2012, 366 consecutive patients received the following preventive measures: (i) weekly rectal swabs for surveillance; (ii) contact precautions in carriers (iii) early-targeted therapy in neutropenic febrile carriers...
September 26, 2016: Bone Marrow Transplantation
Katherine Reyes, Ana Cecilia Bardossy, Marcus Zervos
Vancomycin-resistant enterococci (VRE) infections have acquired prominence as a leading cause of health care-associated infections. Understanding VRE epidemiology, transmission modes in health care settings, risk factors for colonization, and infection is essential to prevention and control of VRE infections. Infection control strategies are pivotal in management of VRE infections and should be based on patient characteristics, hospital needs, and available resources. Hand hygiene is basic to decrease acquisition of VRE...
September 19, 2016: Infectious Disease Clinics of North America
Christopher C Cooper, Robin L P Jump, Teena Chopra
Clostridium difficile is one of the foremost nosocomial pathogens. Preventing infection is particularly challenging. Effective prevention efforts typically require a multifaceted bundled approach. A variety of infection control procedures may be advantageous, including strict hand decontamination with soap and water, contact precautions, and using chlorine-containing decontamination agents. Additionally, risk factor reduction can help reduce the burden of disease. The risk factor modification is principally accomplished though antibiotic stewardship programs...
September 19, 2016: Infectious Disease Clinics of North America
Amy F Rosenberg
PURPOSE: UF Health's participation in a mentored quality-improvement impact program for health professionals as part of an ASHP initiative-"Strategies for Ensuring the Safe Use of Insulin Pens in the Hospital"-is described. SUMMARY: ASHP invited hospitals to participate in its initiative at a time when UF Health was evaluating the risks and benefits of insulin pen use due to external reports of safety concerns and making a commitment to continue insulin pen use and optimize safeguards...
October 1, 2016: American Journal of Health-system Pharmacy: AJHP
Mihriban Yılmaz Civan, U Merve Kara
Indoor dust samples were collected from 40 homes in Kocaeli, Turkey and were analyzed simultaneously for 14 polybrominated diphenyl ethers (PBDEs) and 16 poly aromatic hydrocarbons (PAHs) isomers. The total concentrations of PBDEs (Σ14PBDEs) ranged from 29.32 to 4790 ng g(-1), with a median of 316.1 ng g(-1), while the total indoor dust concentrations of 16 PAHs (Σ16PAHs) extending over three to four orders of magnitude ranged from 85.91 to 40,359 ng g(-1) with a median value of 2489 ng g(-1). Although deca-PBDE products (BDE-209) were the principal source of PBDEs contamination in the homes (median, 138...
September 9, 2016: Environmental Science and Pollution Research International
Alicia M Shams, Laura J Rose, Jonathan R Edwards, Salvatore Cali, Anthony D Harris, Jesse T Jacob, Anna LaFae, Lisa L Pineles, Kerri A Thom, L Clifford McDonald, Matthew J Arduino, Judith A Noble-Wang
OBJECTIVE To determine the typical microbial bioburden (overall bacterial and multidrug-resistant organisms [MDROs]) on high-touch healthcare environmental surfaces after routine or terminal cleaning. DESIGN Prospective 2.5-year microbiological survey of large surface areas (>1,000 cm2). SETTING MDRO contact-precaution rooms from 9 acute-care hospitals and 2 long-term care facilities in 4 states. PARTICIPANTS Samples from 166 rooms (113 routine cleaned and 53 terminal cleaned rooms). METHODS Using a standard sponge-wipe sampling protocol, 2 composite samples were collected from each room; a third sample was collected from each Clostridium difficile room...
September 13, 2016: Infection Control and Hospital Epidemiology
Siobhan M Mor, Anke K Wiethoelter, Amanda Lee, Barbara Moloney, Daniel R James, Richard Malik
BACKGROUND: Animal reservoirs of brucellosis constitute an ongoing threat to human health globally, with foodborne, occupational and recreational exposures creating opportunities for transmission. In Australia and the United States, hunting of feral pigs has been identified as the principal risk factor for human brucellosis due to Brucella suis. Following increased reports of canine B. suis infection, we undertook a review of case notification data and veterinary records to address knowledge gaps about transmission, clinical presentation, and zoonotic risks arising from infected dogs...
2016: BMC Veterinary Research
Mirian de Freitas DalBen, Elisa Teixeira Mendes, Maria Luisa Moura, Dania Abdel Rahman, Driele Peixoto, Sania Alves Dos Santos, Walquiria Barcelos de Figueiredo, Pedro Vitale Mendes, Leandro Utino Taniguchi, Francisco Antonio Bezerra Coutinho, Eduardo Massad, Anna Sara Levin
OBJECTIVE To reduce transmission of carbapenem-resistant Enterobacteriaceae (CRE) in an intensive care unit with interventions based on simulations by a developed mathematical model. DESIGN Before-after trial with a 44-week baseline period and 24-week intervention period. SETTING Medical intensive care unit of a tertiary care teaching hospital. PARTICIPANTS All patients admitted to the unit. METHODS We developed a model of transmission of CRE in an intensive care unit and measured all necessary parameters for the model input...
September 9, 2016: Infection Control and Hospital Epidemiology
Jun Hirai, Takeshi Kinjo, Takaaki Tome, Mao Hagihara, Daisuke Sakanashi, Hideta Nakamura, Shusaku Haranaga, Hiroshige Mikamo, Jiro Fujita
Neisseria meningitidis often causes meningitis and meningococcemia; however, meningococcal pneumonia is quite rare. Herein, we report a case of non-invasive meningococcal pneumonia initially misdiagnosed as pneumonia due to Moraxella catarrhalis on the basis of a Gram stain in a 43-year-old woman with asthma, type 2 diabetes mellitus, and schizophrenia. She visited our hospital following a 3-day history of fever, productive cough, and shortness of breath. Since her sputum smear revealed Gram-negative diplococcus and the chest radiograph showed infiltration in the lower right lung field, her initial diagnosis was pneumonia caused by M...
August 31, 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Lauren E Richey, Yumi Oh, Djeunou M Tchamba, Michelle Engle, Linda S Formby, Cassandra D Salgado
When to discontinue contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA) remains unresolved and policies vary between hospitals. We prospectively performed admission active surveillance cultures on patients known to have been MRSA positive for at least 1 year to determine the proportion who remained positive. The proportion of patients with MRSA who remained positive was 19.9%; however, this significantly decreased over time, particularly after 5 years.
August 30, 2016: American Journal of Infection Control
Heather Isenman, Dale Fisher
PURPOSE OF REVIEW: This article reviews data, particularly from the last 2 years, addressing the prevention and treatment of vancomycin-resistant Enterococcus (VRE). We focus on infection control, particularly active screening, use of contact precautions as well as pharmacologic options for therapy. This is timely given the evolving priorities in efforts towards the prevention and treatment of multidrug-resistant organisms globally. RECENT FINDINGS: Key findings include new data regarding the impact of contact precautions on the incidence of VRE colonization and bloodstream infection, new laboratory screening methods, and novel decolonization strategies and treatments...
August 31, 2016: Current Opinion in Infectious Diseases
Sarah M Bartsch, Susan S Huang, Kim F Wong, Rachel B Slayton, James A McKinnell, Daniel F Sahm, Krystyna Kazmierczak, Leslie E Mueller, John A Jernigan, Bruce Y Lee
Delays often occur between CLSI and FDA revisions of antimicrobial interpretive criteria. Using our RHEA simulation model, we found the 32-month delay in changing CRE breakpoints might have resulted in 1,821 additional carriers in Orange County, CA that could have been avoided by identifying CRE and initiating contact precautions. Policy makers should aim to minimize the delay in the adoption of new breakpoints for antimicrobials for emerging pathogens where containment of spread is paramount, with delays under 1...
August 31, 2016: Journal of Clinical Microbiology
Risturo Arakawa, Nobuaki Mori, Narito Kagawa, Akiko Higuchi, Masashi Tanaka, Yasuko Aoki, Shiko Seki, Ryo Suzuki
Meningococcal infection is among the most devastating diseases. It is rarely seen in Japan. However, several environmental and host factors have been associated with increased risks of Neisseria meningitidis infection. We present a case of invasive N. meningitidis infection that revealed the presence of multiple myeloma. A 55-year-old Japanese man was admitted with fever and altered consciousness. He was sent to the intensive care unit for septic shock and disseminated intravascular coagulation. In addition to standard septic shock and multiple organ failure treatment, polymyxin-B immobilized column direct hemoperfusion was performed...
May 2016: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
Carla Brigagão Pacheco da Silva, Isabelle Prado Julio, Giuliano Engler Donadel, Isarita Martins
INTRODUCTION: There is certainly a great benefit to treatment with antineoplastic drugs for cancer patients with a life-threatening disease. However, for the workers who are exposed to these agents as part of their work practice, precautions should be taken to eliminate or reduce exposure as much as possible. OBJECTIVE: The aim of this study is to develop and validate a wipe sampling procedure followed by liquid chromatographic separation with electrospray ionization and a tandem mass spectrometric detection method for the simultaneous determination of cyclophosphamide (CP), docetaxel (DOC), doxorubicin (DOXO) and 5-fluorouracil (5-FU)...
August 9, 2016: Journal of Pharmacological and Toxicological Methods
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