Abstract:
OBJECTIVES:Describe an outbreak of surgical wound infections associated with total hip arthroplasty; identify risk factors for surgical wound infection during the pre-outbreak and outbreak periods. SETTING:A 100-bed hospital. From May 1 to September 30, 1988, 7 of 15 patients who underwent total hip arthroplasty developed surgical wound infections from Staphylococcus aureus (5), Enterobacter cloacae (1), beta-hemolytic streptococci (1), enterococci (1), coagulase-negative staphylococci (1), and Escherichia coli (1) (attack rate = 46.7%). DESIGN:Retrospective cohort studies comparing surgical wound infection rates by patient- and procedure-related risk factors during the pre-outbreak and outbreak periods were conducted. Drop plate quantitative air culturing was conducted in 10 consecutive total hip arthroplasties in the subsequent 6 months. RESULTS:Rates of surgical wound infection were surgically higher for arthroplasties in which no intraoperative prophylactic antimicrobials were given (44% versus 8%, relative risk [RR] = 5.4, p = .01), or in which the posterior approach (20% versus 3%, RR = 6.7, p = .04) or a specific prosthesis (39% versus 5%, RR = 6.3, p = 0.01) was used. The surgical wound infection rate was highest when one circulating nurse, Nurse A, assisted (47% versus 4%, RR = 12.8, p less than .001). Logistic regression analysis identified use of the posterior approach (RR = 1.8, p = .04) and Nurse A's participation (RR = 5.0, p less than .001) as independent risk factors for surgical wound infection. Interviews of the nursing supervisor indicated that Nurse A had recurrent dermatitis on her hands. During 6 months following Nurse A's reassignment, the rate declined significantly (from 7/15 to 0/10, p = .01). Drop plate culturing yielded 2 to 10 colonies per plate of organisms that did not match outbreak organisms. CONCLUSIONS:Outbreaks associated with personnel generally involve only 1 species. In this outbreak, Nurse A (possibly because of her dermatitis), technique, the posterior approach, and/or other undetermined factors were the primary predictors of surgical wound infection.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Beck-Sague CM,Chong WH,Roy C,Anderson R,Jarvis WRdoi
10.1086/646592subject
Has Abstractpub_date
1992-09-01 00:00:00pages
526-34issue
9eissn
0899-823Xissn
1559-6834journal_volume
13pub_type
杂志文章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 ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501806
更新日期:2000-09-01 00:00:00
abstract::An organic load of 5%-10% fetal calf serum significantly reduced hypochlorite and UV radiation killing of Clostridium difficile spores, but organic material collected from hospital surfaces did not affect hypochlorite and only modestly affected UV killing of spores. Hypochlorite reduced aerobic microorganisms on uncle...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673148
更新日期:2013-10-01 00:00:00
abstract::We present basic information that a hospital epidemiologist needs when designing a surveillance system for noninfectious adverse outcomes of care. Specific topics reflect key characteristics of such a surveillance system: the purpose, rationale, priorities, definitions, data collection tools, data collection, analysis...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647142
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:Data on the resources and staff compensation of hospital epidemiology and infection control (HEIC) departments are limited and do not reflect current roles and responsibilities, including the public reporting of healthcare-associated infections. This study aimed to obtain information to assist HEIC profession...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/650199
更新日期:2010-02-01 00:00:00
abstract::OBJECTIVE To investigate whether the safety culture of a hospital unit is associated with the ability to improve. DESIGN Qualitative investigation of safety culture on hospital units following a before-and-after trial on hand hygiene. SETTING VU University Medical Center, a tertiary-care hospital in the Netherlands. M...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.209
更新日期:2017-11-01 00:00:00
abstract::A surgeon-specific computer-generated monthly questionnaire was used to improve surveillance of surgical wound infections in outpatients as well as inpatients following discharge. From July 1988 through June 1989, 20,536 surgical procedures were performed at our medical center, of which 53% were for outpatients. The t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646084
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:To determine whether alcohol hand disinfection is an effective alternative to traditional agents for the pre-surgical scrub. DESIGN:A prospective clinical trial of a 70% isopropanol pre-surgical hand disinfectant. SETTING:The operating room suites at two hospital sites in British Columbia. METHODS:Cases we...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501835
更新日期:2001-10-01 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::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::In this prospective study, we monitored 4 epidemiologically important pathogens (EIPs): methicillin-resistane Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant (MDR) Acinetobacter to assess the effectiveness of 3 enhanced disinfection strategies for te...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2018.165
更新日期:2018-09-01 00:00:00
abstract::Social media, prevention of healthcare-associated infections (HAIs) and antimicrobial stewardship (ASP) each impact every area of medicine. Independently, each have power to change medicine, however, synergistically, the impact could be transformative. Given the profound clinical, financial, and public health impact o...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2019.231
更新日期:2019-11-01 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: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::OBJECTIVESThe risk of cross infection in a busy emergency department (ED) is a serious public health concern, especially in times of pandemic threats. We simulated cross infections due to respiratory diseases spread by large droplets using empirical data on contacts (ie, close-proximity interactions of ≤1m) in an ED t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.61
更新日期:2018-06-01 00:00:00
abstract::We investigated the source of infection in a patient who developed acute hepatitis C virus infection after cardiothoracic surgery. A healthcare worker was found to be infected with hepatitis C virus, and molecular analysis indicated the strain was similar to that found in the patient. The exact mode of transmission wa...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/510807
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:The quality of environmental hygiene in hospitals is under increasing scrutiny from both healthcare providers and consumers because the prevalence of serious infections due to multidrug-resistant pathogens has reached alarming levels. On the basis of the results from a small number of hospitals, we undertook ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/524329
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns. DESIGN:Outbreak investigation and case-control study. SETTING:NICU of a 1,600-bed university hospital in Heidelberg, Germany....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502247
更新日期:2003-07-01 00:00:00
abstract::The usefulness of routine annual tuberculin skin testing (purified protein derivative [PPD]) of hospital employees has been questioned. Between 1984 and the end of 1987 the PPD conversion rates of hospital employees at a university and psychiatric hospital in North Florida were compared. The number of employees in bot...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645922
更新日期:1989-10-01 00:00:00
abstract::BACKGROUND High-level disinfectants (HLDs) are used throughout the healthcare industry to chemically disinfect reusable, semicritical medical and dental devices to control and prevent healthcare-associated infections among patient populations. Workers who use HLDs are at risk of exposure to these chemicals, some of wh...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2014.37
更新日期:2015-02-01 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::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::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:OBJECTIVE:To investigate prospectively the clinical course and risk factors for ventilator-associated tracheobronchitis (VAT) and the impact of VAT on intensive care unit (ICU) morbidity and mortality. DESIGN:Prospective cohort study. SETTING:University Hospital Larissa, Larissa, Greece. PATIENTS:Critical care patie...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671274
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To study the ability of a medical waste disposal process using chlorine dioxide to inactivate human immunodeficiency virus type 1 (HIV-1). DESIGN:Stock HIV-1 (HTLV-IIIB strain) was treated with chlorine dioxide under the following settings: cell culture medium alone, culture medium with 25% blood, culture me...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646798
更新日期:1993-09-01 00:00:00
abstract::If you have calculated a confidence interval for an infection rate and found the interval extending into meaningless negative numbers, chances are the error is due to use of approximation formulae. Many of us unknowingly were taught to use the Wald approximation, which does not always approximate the exact binomial di...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501701
更新日期:2000-01-01 00:00:00
abstract::We investigated an outbreak of postoperative shoulder arthritis due to Propionibacterium acnes infection in nondebilitated patients. Risk factors were male sex, the order in which surgery was performed during the daily operating schedule, and increased duration of the surgical procedure. After modification of the vent...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507287
更新日期:2006-09-01 00:00:00
abstract::In a laboratory study, we demonstrated that 3 alcohol-based hand gels, commercially available in Brazil, were as effective as the traditional 70% ethyl alcohol (by weight) in removing clinical isolates of methicillin-resistant Staphylococcus aureus, Serratia marcescens, and Candida albicans from heavily contaminated h...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591092
更新日期:2008-10-01 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 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:OBJECTIVE:To identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients. DESIGN:Survey. SETTING:Chronic hemodialysis facilities in the United States. PARTICIPANTS:Equal-probability 2-stage cluster sampling was used to select 87 faciliti...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/659407
更新日期:2011-05-01 00:00:00