Abstract:
OBJECTIVE:To investigate and control an outbreak of colonization and infection caused by vancomycin-resistant enterococci (VRE) in a burn intensive care unit (BICU). DESIGN:Epidemiological investigation, including multiple point-prevalence culture surveys of patients and environment, cultures from hands of healthcare workers (HCWs), pulsed-field gel electrophoresis (PFGE) typing of patient and environmental isolates, case-control study, and institution and monitoring of control measures. SETTING:BICU in an 800-bed university medical center in Galveston, Texas. RESULTS:Between June 6, 1996, and July 14, 1997, 21 patients were colonized by VRE, and 4 of these patients developed bacteremia. Of 2,844 environmental cultures, 338 (11.9%) were positive, but all hand cultures from HCWs were negative. PFGE typing indicated that the outbreak was clonal, with VRE isolates from patients differing by < or =4 bands from the index case. Thirteen of 14 environmental isolates varied by < or =4 bands from the pattern of the index case. A case-control study analyzed by exact logistic regression identified diarrhea (odds ratio [OR], 43.9; 95% confidence interval [CI95], 5.5-infinity; P=.0001) and administration of an antacid (OR, 24.2; CI95, 2.9-infinity; P=.002) as independent risk factors for acquisition of VRE. During a 5-week period in October and November 1996, all patient and 317 environmental cultures were negative for VRE. The outbreak recurred from a contaminated electrocardiogram lead that had not been identified during the prior 5 weeks. VRE were finally eradicated from the BICU in July 1997, using barrier isolation and a very aggressive environmental decontamination program. CONCLUSIONS:A VRE outbreak in a BICU over 13 months was caused by a single clone. After apparent eradication of VRE from a BICU, recrudescence of the outbreak occurred, evidently from a small inapparent source of environmental contamination. Changes in gastrointestinal (GI) tract function (motility) and administration of medications, other than antibiotics, that have an effect on the GI tract may increase the risk of GI tract colonization by VRE in burn patients. Application of barrier isolation and an aggressive environmental decontamination program can eradicate VRE from a burn population.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Falk PS,Winnike J,Woodmansee C,Desai M,Mayhall CGdoi
10.1086/501806subject
Has Abstractpub_date
2000-09-01 00:00:00pages
575-82issue
9eissn
0899-823Xissn
1559-6834pii
ICHE7128journal_volume
21pub_type
杂志文章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:OBJECTIVE:To assess the accuracy of nosocomial infections data reported on patients in the intensive-care unit by nine hospitals participating in the National Nosocomial Infections Surveillance (NNIS) System. DESIGN:A pilot study was done in two phases to review the charts of selected intensive-care-unit patients who ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/647820
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:Laboratory investigations were initiated with a povidone-iodine antiseptic solution that was intrinsically contaminated with Pseudomonas cepacia. These investigations were helpful in understanding the microbicidal and chemical properties of iodophor solutions and the mechanism by which P cepacia can survive i...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646342
更新日期:1991-05-01 00:00:00
abstract:OBJECTIVE:To study risk factors for the highly variable local colonization rates with unrelated Enterobacter species strains previously found in 22 Swedish neonatal units (0% to 32.4% of the infants). PATIENTS AND SETTING:The fecal Enterobacter species carriage rates among 953 infants in the 22 special-care neonatal u...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646641
更新日期:1993-10-01 00:00:00
abstract::OBJECTIVE. To quantify the association between admission to an intensive care unit (ICU) room most recently occupied by a patient positive for extended-spectrum β-lactamase (EBSL)-producing gram-negative bacteria and acquisition of infection or colonization with that pathogen. DESIGN. Retrospective cohort study. SETTI...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/670216
更新日期:2013-05-01 00:00:00
abstract::Benchmarks for antimicrobial consumption measured in antimicrobial days are beginning to emerge. The relationship between the traditional measure of days of therapy and antimicrobial days is unclear. We observed a high intermethod correlation (R2=0.99): antimicrobial days were 1.9-fold lower than days of therapy acros...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.109
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1). DESIGN:Retrospective review of electronic medical records. PATIENT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/661912
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In August 2002, the Oklahoma State Department of Health received a report of six patients with unexplained hepatitis C virus (HCV) infection treated in the same pain remediation clinic. We investigated the outbreak's extent and etiology. DESIGN, SETTING, AND PARTICIPANTS:We conducted a retrosp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502442
更新日期:2004-07-01 00:00:00
abstract::Group A streptococci account for less than 1% of all surgical wound infections but are an important cause of nosocomial outbreaks. We report here a cluster of four group A streptococcal infections that occurred within an 11-day period on a single surgical service. The index case presented with toxic shock-like syndrom...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646732
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:To describe the characteristics of and trends in nosocomial infection among human immunodeficiency virus (HIV)-infected patients. DESIGN:Multicenter prospective cohort study. SETTING/PATIENTS:HIV-infected patients were enrolled at time of first inpatient admission at five Veterans' Administration Medical Ce...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/647652
更新日期:1997-07-01 00:00:00
abstract::OBJECTIVE To describe the investigation and control of a cluster of Serratia marcescens bacteremia in a 505-bed tertiary-care center. METHODS Cluster cases were defined as all patients with S. marcescens bacteremia between March 2 and April 7, 2014, who were found to have identical or related blood isolates determined...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.137
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:To reconstruct the infection curve for the 2003 severe acute respiratory syndrome (SARS) epidemic in Taiwan and to ascertain the temporal changes in the daily number of infections that occurred during the course of the outbreak. METHOD:Back-projection method. RESULTS:The peaks of the epidemic correspond we...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/516656
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To determine trends, patient characteristics, and outcome of patients with healthcare-associated influenza in Canadian hospitals. DESIGN:Prospective surveillance of laboratory-confirmed influenza among hospitalized adults was conducted from 2006 to 2012. Adults with positive test results at or after admissio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/674858
更新日期:2014-02-01 00:00:00
abstract::Because the severe acute respiratory syndrome (SARS) outbreak in Taiwan in 2003 was worsened by hospital infections, we analyzed 229 questionnaires (84.8% of 270 sent) completed by surveyed healthcare workers who cared for patients with SARS in 3 types of hospitals, to identify surveillance problems. Atypical clinical...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/508835
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:Reduce the frequency of contaminated blood cultures that meet National Healthcare Safety Network definitions for a central line-associated bloodstream infection (CLABSI). DESIGN:An observational study. SETTING:A 500-bed university-affiliated hospital. METHODS:A new blood culture policy discouraged drawing ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673142
更新日期:2013-10-01 00:00:00
abstract::This retrospective case-control study examined whether there was a difference in length of time awaiting long-term-care placement for patients identified as having methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus compared to controls. Thirty-nine patients with methicillin-resistant Stap...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501757
更新日期:2000-04-01 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: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::In a hospital in Lima, Peru, a review of 103 Staphylococcus aureus infections was conducted during 2002. The prevalence of oxacillin-resistant S. aureus strains was 68%; 25% of strains were resistant to multiple drugs. Previous use of antibiotics and undergoing a surgical procedure during the current hospital stay wer...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/500650
更新日期:2006-02-01 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::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. Th...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/503168
更新日期:2000-01-01 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 establish a new, rapid, and reliable genotypic fingerprinting technique for methicillin-resistant Staphylococcus aureus (MRSA) typing in routine epidemiological surveillance. DESIGN:The method is based on polymerase chain reaction (PCR) restriction fragment-length polymorphism (RFLP) following HaeII diges...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501903
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of a multifaceted hospitalwide quality improvement program that featured an intervention to remind physicians to remove unnecessary urinary catheters. METHODS:A hospitalwide preintervention-postintervention study was conducted over 2 years (July 1, 2004, through June 30, 2006). The i...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/518453
更新日期:2007-07-01 00:00:00
abstract::We compared cleaning rates associated with use of a white ultraviolet (UV) powder versus a transparent UV gel among units with various degrees of previous experience with UV powder. The study outcome was the presence of discordant cleaning (removal of powder without the removal of gel, or vice versa). We found higher ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/663713
更新日期:2012-02-01 00:00:00
abstract::More than 50% of women with clinically apparent infection after mastectomy did not meet the 2020 National Healthcare Safety Network (NHSN) definition for surgical site infection (SSI). Implant loss was similar whether the 2020 NHSN SSI definition was met or not, suggesting equivalent adverse outcomes regardless of res...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.1288
更新日期:2020-11-17 00:00:00
abstract:OBJECTIVE:To ascertain the etiology and outcome of episodes of bacteremia and fungemia over a three-year period (1990-1992) in patients with hematological malignancies. DESIGN:Retrospective study. SETTING:Hematology service of a 1,500-bed Spanish university hospital. RESULTS:Of a total of 178 episodes of significant...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/646869
更新日期:1994-02-01 00:00:00
abstract::To ascertain the microbiology of skin abscesses, emergency department records were reviewed to identify patients with debrided skin abscesses. Methicillin-resistant Staphylococcus aureus was isolated from 255 (67.6%) of 377 culture samples from episodes in the adult cohort and from 145 (79.7%) of 182 culture samples f...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/516799
更新日期:2007-06-01 00:00:00
abstract::In 2011, institutional requirements for pertussis vaccination of healthcare personnel were reported by nearly one-third of surveyed US hospitals. Requirements often applied to personnel with certain clinical responsibilities, such as those caring for infants. Healthcare personnel who were not on an institution's payro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/662711
更新日期:2011-12-01 00:00:00
abstract::Twelve nosocomial outbreaks over 14 years at a tertiary-care center in Mexico are described. Overall mortality was 25.8%, one half due to pneumonia. The most common organism was Pseudomonas aeruginosa. Incidence was three outbreaks per 10,000 discharges; outbreak-related infections comprised 1.56% of all nosocomial in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501800
更新日期:2000-08-01 00:00:00