Abstract:
:Several discrete strategies have been suggested to prevent or reduce microbial resistance to antimicrobials, including optimal use of the agents (also known as good stewardship); control, removal, or restriction of antimicrobials; use of antimicrobials in combination; and rotational or cyclic use of antimicrobials. The latter strategy is attractive because it periodically removes from the institutional environment certain classes or specific agents that could induce or select resistance. Hospitalwide studies of aminoglycoside substitution employed from the late 1970s through the early 1990s, although not originally intended to test cycling or rotation of aminoglycosides, serendipitously provided data that may be useful in designing future studies. In particular, one 10-year study at the Minneapolis Veterans' Affairs Medical Center (MVAMC) rotated amikacin and gentamicin use over cycles of 12 to 51 months' duration. Significantly reduced resistance to gentamicin was found when amikacin was used, but resistance to gentamicin returned with the first gentamicin recycle. This was followed by reintroduction of amikacin a second time with decreased resistance to gentamicin and, finally, a second reintroduction of gentamicin without resistance to it recurring. Thus, some evidence of proof of principal can be garnered, albeit subject to considerable criticism. Critical examination of the design of the aminoglycoside rotation study and the unforeseen pitfalls is provided as a 13-element guidance list for design of future rotational studies. Rotational usage practices are likely to be most appropriate for drugs active against gram-negative bacilli because of the wide choices available for rotation. Future availability of new agents active against resistant gram-positive organisms will present the opportunity to cycle these agents as vancomycin substitutes. Careful monitoring of clinical outcomes and resistance will be required. Multicenter controlled trials that follow carefully designed protocols are most likely to produce statistically significant and clinically meaningful results.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Gerding DNdoi
10.1086/503168subject
Has Abstractpub_date
2000-01-01 00:00:00pages
S12-7issue
1 Suppleissn
0899-823Xissn
1559-6834pii
ICHE210112journal_volume
21pub_type
杂志文章,评审abstract:OBJECTIVE:To develop new evaluation indices of infection control and to use them to evaluate Korean infection surveillance and control programs (ISCPs). DESIGN:We performed a questionnaire-based survey to 164 acute care general hospitals throughout the Republic of Korea that had more than 300 beds. Study methods were ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/512632
更新日期:2007-04-01 00:00:00
abstract::Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat because it can cause severe infections with frequent mortality in more than a dozen countries. It can survive on healthcare environmental surfaces for at least 7 da...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.1
更新日期:2019-03-01 00:00:00
abstract::We used mandatory public reporting as an impetus to perform a statewide study to define risk factors for surgical site infection. Among women who underwent abdominal hysterectomy, blood transfusion was a significant risk factor for surgical site infection in patients who experienced blood loss of less than 500 mL. ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/663341
更新日期:2012-01-01 00:00:00
abstract::An outbreak of vancomycin-resistant enterococci (VRE) began at the University of Massachusetts Medical Center in May 1993. As of September 1995, we had a total of 253 patients infected or colonized with VRE, with consequent increasing demand for private rooms. We analyzed results of surveillance cultures for VRE of 49...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 00:00:00
abstract::The Food and Drug Administration (FDA) healthcare personnel handwash procedure allows for the use of a non-neutralizing stripping fluid after washing with an antimicrobial handwash product. The antimicrobial in the handwash product can remain active up until the time of neutralization or plating. A modified healthcare...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646101
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To compare the occurrence of Clostridium difficile among inpatients infected with human immunodeficiency virus (HIV) in two different hospitals. DESIGN:Prospective, observational study. SETTING:Specialized HIV inpatient units. PATIENTS:HIV-infected inpatients at Cook County Hospital (CCH) and Rush Presbyte...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501987
更新日期:2002-11-01 00:00:00
abstract::Though many agents have been proposed as potential biological weapons, the feasibility of biological warfare is largely a matter of conjecture. The unpredictable and indiscriminate devastation caused by natural epidemics during wartime should warn us of the dangers of employing microbes as weapons. ...
journal_title:Infection control and hospital epidemiology
pub_type: 历史文章,杂志文章
doi:10.1086/646358
更新日期:1991-06-01 00:00:00
abstract::A 19-item survey instrument was designed and mailed by the Infectious Diseases Society of America to its membership to determine the media preferred by infectious diseases physicians for continuing medical education on general topics and on antimicrobial resistance. The objective of the survey was to offer the develop...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/505922
更新日期:2006-08-01 00:00:00
abstract::Typing systems for differentiating among strains of methicillin-resistant Staphylococcus aureus (MRSA) can be valuable tools for the epidemiologist and the clinician. Specific criteria for evaluating such systems are typeability, reproducibility, and discriminatory power. An ideal typing system also would be rapid, in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646234
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that antibiotic use could be controlled or improved in a community teaching hospital, with improvement defined as reductions in overall use, overall cost, and antimicrobial resistance. DESIGN:Interventional study with historical comparison. SETTING:A not-for-profit, 900-bed community ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/500419
更新日期:2006-03-01 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::The technology of intravenous catheter access ports has evolved from open ports covered by removable caps to more-sophisticated, closed versions containing mechanical valves. We report a significant increase in catheter-related bloodstream infections after the introduction of a new needle-free positive-pressure mechan...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/499166
更新日期:2006-01-01 00:00:00
abstract::We investigated a cluster of methicillin-resistant Staphylococcus aureus infections in college football players. Risk factors included a history of recurrent skin infections and contact with the skin lesions of persons outside college. The infections were controlled through treatment of carriers with topical mupirocin...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/587971
更新日期:2008-05-01 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::Nine hundred sixteen cultures were obtained from homes of patients with cystic fibrosis, control homes, salad bars, and food markets, and analyzed for the presence of Pseudomonas cepacia and related bacteria. P cepacia was recovered from 5 (18%) of 27 homes, and from 20 (4%) of 509 cultures collected outside of homes....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646999
更新日期:1995-01-01 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 determine the prevalence of asymptomatic carriage of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) among healthcare professionals (HCPs) who experience varying degrees of exposure to ambulatory patients and to genetically characterize isolates. METHODS:This single-center, cross-sectiona...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/652525
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:An epidemiological investigation was conducted to determine risk factors for adverse reactions among patients in hospitals and the possibility of extrinsic or intrinsic contamination of intravenous solutions. DESIGN:A retrospective cohort study was conducted to identify solutions associated with adverse reac...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/504360
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVE:To compare patient outcomes when percutaneous feeding tubes were changed routinely each month or only when necessary (prn). DESIGN:Prospective, randomized, nonblinded crossover study of 6 months of routine monthly changes compared with 6 months of prn changes. SETTING:416-bed long-term-care facility. PATIE...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/647218
更新日期:1996-11-01 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:OBJECTIVE:To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them. DESIGN:This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from A...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502461
更新日期:2004-08-01 00:00:00
abstract::Water samples taken from extracorporeal membrane oxygenator (ECMO) devices used at University Hospitals Birmingham yielded high total viable counts (TVCs) containing a variety of microorganisms, including M. chimaera. Disinfection resulted in the reduction of TVCs and eradication of Mycobacterium chimaera. Weekly disi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.163
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:Rising antibiotic resistance could reduce the effectiveness of antibiotics in preventing postoperative infections. We investigated trends in the efficacy of antibiotic prophylaxis regimens for 3 commonly performed surgical procedures-appendectomy, cesarean section, and colorectal surgery-and 1 invasive diagno...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,meta分析
doi:10.1017/ice.2018.295
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To determine the comparative virulence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S aureus (MSSA) by consideration of predisposing factors and outcomes in patients infected with these organisms in the healthcare setting. DESIGN:Analysis of an historical cohort of 504 bact...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501707
更新日期:2000-10-01 00:00:00
abstract::Current evidence concerning the prevalence of inappropriate care indicates that there is an opportunity for significant utilization and cost reductions. Although the efficacy of some methods of utilization control has been demonstrated, the clinical impact and safety of these techniques are unclear. Although financial...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645912
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:The sterility assurance level of 10(-6) is an established standard that defines the quality of sterile products. The aim of the present study was to develop a method that correlated the results from microbial-barrier testing of flexible sterile barrier systems with the estimated microbial challenge that the p...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/593208
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To analyze the secular trends of candidemia in a large tertiary-care hospital to determine the overall incidence, as well as the incidence by ward and by species, and to detect the occurrence of outbreaks. DESIGN:Retrospective descriptive analysis. Secular trends were calculated using the Mantel-Haenszel tes...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502582
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To investigate the possibility that contaminated commercial activated charcoal may serve as a source for fungal colonization or infection of the lower respiratory tract. DESIGN:The clinical course of a patient who aspirated commercial activated charcoal was reviewed. Fungal cultures were performed for 2 samp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646281
更新日期:1991-12-01 00:00:00
abstract::We report the effect of prospective audit and feedback (PAF) on inpatient fluoroquinolone (FQN) prescriptions. During the PAF period, FQN use decreased from 39.19 to 29.58 days of therapy per 1,000 patient days (P < .001) and appropriateness improved from 68% to 88% (P < .001). High-yield indications to target include...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.339
更新日期:2020-12-01 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