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Infection Control

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This article provides the current recommendations of the Society for Healthcare Epidemiology of America (SHEA) regarding the management of healthcare workers infected with hepatitis B virus (HBV), hepatitis C virus (HCV), or the human immunodeficiency virus (HIV). For the reasons cited in the article, SHEA now maintains that separate virus-specific management strategies are appropriate for healthcare workers who are infected with these unrelated viruses. SHEA emphasizes the use of appropriate infection control procedures to minimize exposure of patients or providers to blood, emphasizes that transfers of blood from patients to providers and from providers to patients should be avoided, and argues that infected healthcare workers should not be prohibited from participating in patient-care activities solely on the basis of their blood-borne pathogen infection...
May 1997: Infection Control and Hospital Epidemiology
Mark S Sulkowski, Stuart C Ray, David L Thomas
Hepatitis C virus (HCV) transmission following a needlestick is an important threat to health care workers. We present the case of a 29-year-old medical intern who sustained a needlestick injury from a source patient known to be infected with both human immunodeficiency virus and HCV. The case patient subsequently developed acute HCV infection. The optimal strategy for diagnosing HCV infection after occupational exposures has not been defined. At a minimum, HCV antibody and alanine aminotransferase testing should be done within several days of exposure (to assess if the health care worker is already infected with HCV) and 6 months after percutaneous, mucosal, or nonintact skin exposure to blood or infectious body fluids from an HCV-infected patient...
May 8, 2002: JAMA: the Journal of the American Medical Association
D M Cardo, D H Culver, C A Ciesielski, P U Srivastava, R Marcus, D Abiteboul, J Heptonstall, G Ippolito, F Lot, P S McKibben, D M Bell
BACKGROUND: The average risk of human immunodeficiency virus (HIV) infection after percutaneous exposure to HIV-infected blood is 0.3 percent, but the factors that influence this risk are not well understood. METHODS: We conducted a case-control study of health care workers with occupational, percutaneous exposure to HIV-infected blood. The case patients were those who became seropositive after exposure to HIV, as reported by national surveillance systems in France, Italy, the United Kingdom, and the United States...
November 20, 1997: New England Journal of Medicine
JaHyun Kang, Emily E Sickbert-Bennett, Vickie M Brown, David J Weber, William A Rutala
BACKGROUND: Data on health care-associated infections (HAIs) outside of intensive care units (ICU) are scarce. We assessed hospital-wide changes in the incidence of health care-associated pathogens by infection site and by service between 2005 and 2011. METHODS: All data on health care-associated pathogens in 2005-2011 based on comprehensive hospital-wide surveillance were extracted from an electronic database. The incidence of HAI by pathogen was calculated per 1000 patient-days and per 1000 device-days...
July 2014: American Journal of Infection Control
R Monina Klevens, Jonathan R Edwards, Mary L Andrus, Kelly D Peterson, Margaret A Dudeck, Teresa C Horan
Thirty-two outpatient hemodialysis providers in the United States voluntarily reported 3699 adverse events to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) during 2006. These providers were previously enrolled in the Dialysis Surveillance Network. The pooled mean rates of hospitalization among patients with arteriovenous fistulas, grafts, permanent and temporary central venous catheters were 7.7, 9.2, 15.7, and 34.7 per 100 patient-months, respectively. For bloodstream infection the pooled mean rates were 0...
January 2008: Seminars in Dialysis
R Güerri-Fernández, J Villar-García, S Herrera-Fernández, M Trenchs-Rodríguez, J Fernández-Morato, L Moro, J Sancho, L Grande, A Clará, S Grau, J P Horcajada
We report a quasi-experimental study of the implementation of an antimicrobial stewardship program in two surgical wards, with a pre-intervention period with just assessment of prescription and an intervention period with a prospective audit on antibiotic prescription model. There was a significant reduction of length of stay and the total days of antimicrobial administration. There were no differences in mortality between groups. The antimicrobial stewardship program led to the early detection of inappropriate empirical antibiotic treatment and was associated with a significant reduction in length of stay and the total duration of antimicrobial therapy...
June 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Michael W Climo, Deborah S Yokoe, David K Warren, Trish M Perl, Maureen Bolon, Loreen A Herwaldt, Robert A Weinstein, Kent A Sepkowitz, John A Jernigan, Kakotan Sanogo, Edward S Wong
BACKGROUND: Results of previous single-center, observational studies suggest that daily bathing of patients with chlorhexidine may prevent hospital-acquired bloodstream infections and the acquisition of multidrug-resistant organisms (MDROs). METHODS: We conducted a multicenter, cluster-randomized, nonblinded crossover trial to evaluate the effect of daily bathing with chlorhexidine-impregnated washcloths on the acquisition of MDROs and the incidence of hospital-acquired bloodstream infections...
February 7, 2013: New England Journal of Medicine
Isaac See, Alison G Freifeld, Shelley S Magill
BACKGROUND: Recent antimicrobial resistance data are lacking from inpatient oncology settings to guide infection prophylaxis and treatment recommendations. We describe central line-associated bloodstream infection (CLABSI) pathogens and antimicrobial resistance patterns reported from oncology locations to the Centers for Disease Control and Prevention's National Healthcare Safety Network (NHSN). METHODS: CLABSI data reported to NHSN from 2009 to 2012 from adult inpatient oncology locations were compared to data from nononcology adult locations within the same hospitals...
May 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Hajime Kanamori, William A Rutala, Emily E Sickbert-Bennett, David J Weber
Hospital construction and renovation activities are an ever-constant phenomenon in healthcare facilities, causing dust contamination and possible dispersal of fungal spores. We reviewed fungal outbreaks that occurred during construction and renovation over the last 4 decades as well as current infection prevention strategies and control measures. Fungal outbreaks still occur in healthcare settings, especially among patients with hematological malignancies and those who are immunocompromised. The causative pathogens of these outbreaks were usually Aspergillus species, but Zygomycetes and other fungi were occasionally reported...
August 1, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
David J Weber, William A Rutala
Approximately 80,000 central venous line-associated bloodstream infections (CLA-BSI) occur in the United States each year. CLA-BSI is most commonly caused by coagulase-negative staphylococci, Staphylococcus aureus, Candida spp, and aerobic gram-negative bacilli. These organisms commonly gain entrance in into the bloodstream via the catheter-skin interface (insertion site) or via the catheter hub. Use of strict aseptic technique for insertion is the key method for the prevention of CLA-BSI. Various methods can be used to reduce unacceptably high rates of CLA-BSI, including use of an antiseptic- or antibiotic-impregnated catheter, daily chlorhexidine baths/washes, and placement of a chlorhexidine-impregnated sponge over the insertion site...
March 2011: Infectious Disease Clinics of North America
William A Rutala, David J Weber
No abstract text is available yet for this article.
June 2015: Infection Control and Hospital Epidemiology
Philip C Carling, Jennifer Perkins, JoAnn Ferguson, Anita Thomasser
BACKGROUND: Despite an increasing understanding of the importance of near-patient surfaces in the transmission of healthcare-associated pathogens, there remains a need to define the relative clinical effectiveness of disinfection interventions. DESIGN: A serial 2-phase evaluation of the clinical effectiveness of 2 surface disinfectants. SETTING: A general acute care hospital. METHODS: A unique system for quantifying bioburden reduction while monitoring the possible impact of differences in cleaning thoroughness was used to compare the clinical effectiveness of a traditional quaternary ammonium compound (QAC) and a novel peracetic acid/hydrogen peroxide disinfectant (ND) as part of terminal room cleaning...
November 2014: Infection Control and Hospital Epidemiology
Michael L Rinke, David G Bundy, Allen R Chen, Aaron M Milstone, Elizabeth Colantuoni, Miriana Pehar, Cynthia Herpst, Lisa Fratino, Marlene R Miller
OBJECTIVE: Pediatric oncology patients are frequently managed with central lines as outpatients, and these lines confer significant morbidity in this immune-compromised population. We aimed to investigate whether a multidisciplinary, central line maintenance care bundle reduces central line-associated bloodstream infections (CLABSIs) and bacteremias in ambulatory pediatric oncology patients. METHODS: We conducted an interrupted time-series study of a maintenance bundle concerning all areas of central line care...
November 2013: Pediatrics
David G Bundy, Aditya H Gaur, Amy L Billett, Bing He, Elizabeth A Colantuoni, Marlene R Miller
OBJECTIVES: Central lines (CLs) are essential for the delivery of modern cancer care to children. Nonetheless, CLs are subject to potentially life-threatening complications, including central line-associated bloodstream infections (CLABSIs). The objective of this study was to assess the feasibility of a multicenter effort to standardize CL care and CLABSI tracking, and to quantify the impact of standardizing these processes on CLABSI rates among pediatric hematology/oncology inpatients...
December 2014: Pediatrics
Dale W Bratzler, Peter M Houck
In January 2003, leadership of the Medicare National Surgical Infection Prevention Project hosted the Surgical Infection Prevention Guideline Writers Workgroup (SIPGWW) meeting. The objectives were to review areas of agreement among the most-recently published guidelines for surgical antimicrobial prophylaxis, to address inconsistencies, and to discuss issues not currently addressed. The participants included authors from most of the groups that have published North American guidelines for antimicrobial prophylaxis, as well as authors from several specialty colleges...
June 15, 2004: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
M Todd Greene, Mohamad G Fakih, Karen E Fowler, Jennifer Meddings, David Ratz, Nasia Safdar, Russell N Olmsted, Sanjay Saint
OBJECTIVE: To examine regional variation in the use and appropriateness of indwelling urinary catheters and catheter-associated urinary tract infection (CAUTI). DESIGN AND SETTING: Cross-sectional study. PARTICIPANTS: US acute care hospitals. METHODS: Hospitals were divided into 4 regions according to the US Census Bureau. Baseline data on urinary catheter use, catheter appropriateness, and CAUTI were collected from participating units...
October 2014: Infection Control and Hospital Epidemiology
Jennifer Meddings, Sanjay Saint, Karen E Fowler, Elissa Gaies, Andrew Hickner, Sarah L Krein, Steven J Bernstein
Interventions to reduce urinary catheter use involve lists of "appropriate" indications developed from limited evidence without substantial multidisciplinary input. Implementing these lists, however, is challenging given broad interpretation of indications, such as "critical illness." To refine criteria for appropriate catheter use-defined as use in which benefits outweigh risks-the RAND/UCLA Appropriateness Method was applied. After reviewing the literature, a 15-member multidisciplinary panel of physicians, nurses, and specialists in infection prevention rated scenarios for catheter use as appropriate, inappropriate, or of uncertain appropriateness by using a standardized, multiround rating process...
May 5, 2015: Annals of Internal Medicine
Shelley S Magill, Michael Klompas, Robert Balk, Suzanne M Burns, Clifford S Deutschman, Daniel Diekema, Scott Fridkin, Linda Greene, Alice Guh, David Gutterman, Beth Hammer, David Henderson, Dean Hess, Nicholas S Hill, Teresa Horan, Marin Kollef, Mitchell Levy, Edward Septimus, Carole VanAntwerpen, Don Wright, Pamela Lipsett
OBJECTIVE: To develop and implement an objective, reliable approach to surveillance for ventilator-associated events in adult patients. DESIGN: The Centers for Disease Control and Prevention (CDC) convened a Ventilator-Associated Pneumonia (VAP) Surveillance Definition Working Group in September 2011. Working Group members included representatives of stakeholder societies and organizations and federal partners. MAIN RESULTS: The Working Group finalized a three-tier, adult surveillance definition algorithm for ventilator-associated events...
November 2013: Critical Care Medicine
Peter Pronovost, Dale Needham, Sean Berenholtz, David Sinopoli, Haitao Chu, Sara Cosgrove, Bryan Sexton, Robert Hyzy, Robert Welsh, Gary Roth, Joseph Bander, John Kepros, Christine Goeschel
BACKGROUND: Catheter-related bloodstream infections occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. METHODS: We conducted a collaborative cohort study predominantly in ICUs in Michigan. An evidence-based intervention was used to reduce the incidence of catheter-related bloodstream infections. Multilevel Poisson regression modeling was used to compare infection rates before, during, and up to 18 months after implementation of the study intervention...
December 28, 2006: New England Journal of Medicine
Edward J Septimus, Mary K Hayden, Ken Kleinman, Taliser R Avery, Julia Moody, Robert A Weinstein, Jason Hickok, Julie Lankiewicz, Adrijana Gombosev, Katherine Haffenreffer, Rebecca E Kaganov, John A Jernigan, Jonathan B Perlin, Richard Platt, Susan S Huang
OBJECTIVE: To determine rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization. DESIGN: Pragmatic cluster-randomized trial. SETTING: Forty-three hospitals with 74 ICUs; 42 of 43 were community hospitals. PATIENTS: Patients admitted to adult ICUs from July 1, 2009, to September 30, 2011...
October 2014: Infection Control and Hospital Epidemiology
2016-05-18 18:07:59
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