Abstract:
OBJECTIVE:To determine the attributable risk of death due to catheter-related septicemia (CRS) in critically ill patients when taking into account severity of illness during the intensive-care unit (ICU) stay but before CRS. DESIGN:Pairwise-matched (1:2) exposed-unexposed study. SETTING:10-bed medical-surgical ICU and an 18-bed medical ICU. PATIENTS:Patients admitted to either ICU between January 1, 1990, and December 31, 1995, were eligible. Exposed patients were defined as patients with CRS; unexposed controls were selected according to matching variables. METHODS:Matching variables were diagnosis at ICU admission, length of central catheterization before the infection, McCabe Score, Simplified Acute Physiologic Score (SAPS) II at admission, age, and gender. Severity scores (SAPS II, Organ System Failure Score, Organ Dysfunction and Infection Score, and Logistic Organ Dysfunction System) were calculated four times for each patient: the day of ICU admission, the day of CRS onset, and 3 and 7 days before CRS. Matching was successful for 38 exposed patients. Statistical analysis was based on nonparametric tests for epidemiological data and on Cox's models for the exposed-unexposed study, with adjustment on matching variables and prognostic factors of mortality. RESULTS:CRS complicated 1.17 per 100 ICU admissions during the study period. Twenty (53%) of the CRS cases were associated with septic shock. CRS was associated with a 28% increase in SAPS II. Crude ICU mortality rates from exposed and unexposed patients were 50% and 21%, respectively. CRS remained associated with mortality even when adjusted on other prognostic factors at ICU admission (relative risk [RR], 2.01; 95% confidence interval [CI95], 1.08-3.73; P=.03). However, after adjustment on severity scores calculated between ICU admission and 1 week before CRS, the increased mortality was no longer significant (RR, 1.41; CI95, 0.76-2.61; P=.27). CONCLUSION:CRS is associated with subsequent morbidity and mortality in the ICU, even when adjusted on severity factors at ICU admission. However, after adjustment on severity factors during the ICU stay and before the event, there was only a trend toward CRS-attributable mortality. The evolution of patient severity should be taken into account when evaluating excess mortality induced by nosocomial events in ICU patients.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Soufir L,Timsit JF,Mahe C,Carlet J,Regnier B,Chevret Sdoi
10.1086/501639subject
Has Abstractpub_date
1999-06-01 00:00:00pages
396-401issue
6eissn
0899-823Xissn
1559-6834pii
ICHE7311journal_volume
20pub_type
杂志文章abstract:OBJECTIVE:To determine the prevalence of central venous catheter (CVC) use among patients both within and outside the ICU setting. DESIGN:A 1-day prevalence survey of CVC use among adult inpatients at six medical centers participating in the Prevention Epicenter Program of the CDC. Using a standardized form, observers...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502163
更新日期:2003-12-01 00:00:00
abstract::An outbreak of invasive Mycobacterium chimaera infections associated with heater-cooler devices (HCDs) has now affected patients in several countries on different continents. Clinical infections are characterized by delayed diagnosis, inadequate treatment response to antimicrobial agents, and poor prognosis. Outbreak ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2016.283
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Case-control studies analyzing antibiotic exposure as a risk factor for antimicrobial resistance usually assume single-drug resistance in the bacteria under study, even though resistance to multiple antimicrobials may be present. Since antibiotic selection pressures differ depending on the susceptibility pro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/505917
更新日期:2006-07-01 00:00:00
abstract::Manual surveillance of surgical site infections (SSIs) after total hip or knee arthroplasty is time-consuming and prone to error. Semiautomated surveillance based on routine care data extracted from electronic health records can retrospectively identify deep SSIs and substantially reduce workload while maintaining 100...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.37
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVES:To determine risk factors for ceftazidime-resistant Klebsiella pneumoniae infection and the effect of ceftazidime-resistant K. pneumoniae infection on mortality during an isolated outbreak. DESIGN:Case-control investigation using clinical and molecular epidemiology and prospective analysis of infection cont...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502488
更新日期:2005-01-01 00:00:00
abstract::SHEA and the American Society for Quality's Health Care Division have been collaborating in areas of common concern to improve healthcare quality. We each possess a heritage of different but complementary approaches and stand a better chance of success together than apart. This presentation describes rapid growth of o...
journal_title:Infection control and hospital epidemiology
pub_type:
doi:10.1086/501957
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of a standardized regimen for decolonization of methicillin-resistant Staphylococcus aureus (MRSA) carriers and to identify factors influencing decolonization treatment failure. DESIGN:Prospective cohort study from January 2002 to April 2007, with a mean follow-up period of 36 months...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/588201
更新日期:2008-06-01 00:00:00
abstract::This study was conducted to evaluate the effect of normal use on latex glove integrity in a flow cytometry laboratory. The gloves were tested using the 1,000 microL water-tight test and met industrial standards (less than 4% leakage) before, but not after use. More durable gloves, or more frequent changes of gloves, m...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647643
更新日期:1997-06-01 00:00:00
abstract:BACKGROUND:Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Inc18-like plasmids in V...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671735
更新日期:2013-09-01 00:00:00
abstract::The Quality Indicator Study Group was created by the governing boards of three national professional organizations that have interest and experience in epidemiology, nosocomial infection control and prevention, and quality of care improvement. The Study Group has reviewed the existing literature concerning quality ind...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647112
更新日期:1995-05-01 00:00:00
abstract::Among 300 advanced cancer patients with potential urinary tract infection (UTI), 19 had symptomatic UTI. Among remaining patients (n = 281), 21% had asymptomatic bacteriuria or candiduria, and 14% received inappropriate therapy for 279 antimicrobial days. Bacteriuria or candiduria predicted antimicrobial therapy. At 1...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.22
更新日期:2019-04-01 00:00:00
abstract::A before-after-before direct comparison between catheters lined with chlorhexidine and silver sulfadiazine (CHSS) versus silver ionotrophes (SI) with a primary objective of comparison of rate of central-line-associated infection (CLABSI) in three 10-month windows. The CHSS catheters were associated with a lower rate o...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.423
更新日期:2020-09-11 00:00:00
abstract:OBJECTIVE:To describe the incidence of device-associated nosocomial infections in medical-surgical intensive care units (MS ICUs) in a university hospital in Turkey and compare it with National Nosocomial Infections Surveillance (NNIS) system rates. DESIGN:Prospective surveillance study during a period of 27 months. D...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503344
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To analyze the rate of occupational exposure to blood and body fluids from all sources and specifically from human immunodeficiency virus (HIV)-infected sources among hospital workers, by job category and work area. DESIGN:Multicenter prospective study. Occupational exposure data (numerator) and full-time eq...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/501890
更新日期:2001-04-01 00:00:00
abstract::Malassezia furfur, a lipophilic yeast, has become recognized as a cause of sepsis in infants receiving parenteral fat emulsions via indwelling deep venous catheters. Colonization of infants' skin may be a prerequisite to colonization of the intravascular catheter and subsequent infection with M furfur. Three hundred n...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645819
更新日期:1988-04-01 00:00:00
abstract:OBJECTIVE:To evaluate clonal dissemination of methicillin-resistant coagulase-negative staphylococci (CNS). SETTING:Neonatal intensive care unit of a 180-bed, university-affiliated general hospital. PATIENTS:Neonates admitted to the neonatal intensive care unit between March 1999 and October 2000, from whom CNS were ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502083
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:Surgical site infection (SSI) surveillance represents a key method of nosocomial infection control programs worldwide. However, most SSI surveillance systems are considered to be poorly cost effective regarding human and economic resources required for data collection and patient follow up. This study aims to...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/676423
更新日期:2014-06-01 00:00:00
abstract::Air conditioner condensates have not been previously associated with cases of Legionnaires' disease. We report the possible transmission of Legionella pneumophila serogroup 1 from a malfunctioning automobile air conditioning system's leaking water onto the floorboard of a car driven for a long distance by the patient....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502025
更新日期:2002-03-01 00:00:00
abstract::During the 1984-1985 influenza season, outbreaks of influenza A (H3N2) occurred in three Connecticut nursing homes. Influenza vaccination rates were 67% (96 out of 144), 35% (30 out of 85) and 69% (332 out of 483), respectively. The relative risk of illness for vaccinated compared to unvaccinated residents was 1.8 (95...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646214
更新日期:1990-09-01 00:00:00
abstract::To determine the effectiveness of infection control strategies to reduce transmission of vancomycin-resistant enterococci (VRE), a cohort study was performed in a university hospital. Contact precautions alone were not effective in reducing transmission of VRE. Strict isolation of affected patients in private rooms, i...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/513024
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:To document the costs and the benefits (both in terms of costs averted and of injuries averted) of education sessions and replacement of phlebotomy devices to ensure that needle recapping did not take place. DESIGN:The percentage of recapped needles and the rate of needlestick injuries were evaluated in 1990...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501681
更新日期:1999-09-01 00:00:00
abstract::We evaluated vancomycin use in a hospital with endemic vancomycin-resistant enterococci and a vancomycin restriction program. Only 68% of vancomycin was prescribed appropriately. Inappropriate use was due primarily to empirical therapy. In the patients with a microbiological diagnosis following empirical therapy, 83% ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501548
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:To screen copper and noncopper paints for their bactericidal effectiveness in rendering surfaces self-disinfecting. DESIGN:Tested paints were applied to glass coverslips, cured, inoculated with test organisms (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis), and dr...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/648361
更新日期:1995-08-01 00:00:00
abstract::OBJECTIVETo evaluate probiotics for the primary prevention of Clostridium difficile infection (CDI) among hospital inpatients.DESIGNA before-and-after quality improvement intervention comparing 12-month baseline and intervention periods.SETTINGA 694-bed teaching hospital.INTERVENTIONWe administered a multispecies prob...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.76
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Treatment of Staphylococcus aureus colonization before surgery reduces risk of surgical site infection (SSI). The regimen of nasal mupirocin ointment and topical chlorhexidine gluconate is effective, but cost and patient compliance may be a barrier. Nasal povidone-iodine solution may provide an alternative t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1086/676872
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. DESIGN:Prospective SSI surveillance with voluntary PDS. Recommended methods for...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/506403
更新日期:2006-08-01 00:00:00
abstract::An outbreak of gastroenteritis caused by Norwalk-like virus occurred in two areas of the hospital: area 1, consisting of three adjacent and interconnected wards, with mostly elderly patients; and area 22, an acute ward in a separate building with elderly patients. In area 1, 40 patients and 20 staff were affected; in ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647676
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:Evaluate the clinical impact of the implementation of VERIGENE gram-positive blood culture testing (BC-GP) coupled with antimicrobial stewardship result notification for children with positive blood cultures. DESIGN:Quasi-experimental study. SETTING:Quaternary children's hospital. PATIENTS:Hospitalized chi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.191
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To determine the influence of catheter site and type (single- vs triple-lumen) on infection rates associated with central venous catheterization. DESIGN:Prospective observational study of all nontunneled central venous catheters over a 28-month period. Data collected included patient characteristics, inserti...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647742
更新日期:1998-11-01 00:00:00
abstract::Traditional antibiograms can guide empiric antibiotic therapy, but they may miss differences in resistance across patient subpopulations. In this retrospective descriptive study, we constructed and validated antibiograms using International Classification of Disease, Tenth Revision (ICD-10) codes and other discrete da...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.246
更新日期:2018-12-01 00:00:00