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 general hospital with residents in medicine, surgery, obstetrics-gynecology, and psychiatry. PARTICIPANTS:Physicians who requested any of the targeted antibiotics. INTERVENTIONS:Three categories of inpatient antibiotic orders were monitored beginning in April 2001: conversion from intravenous to oral administration for selected highly bioavailable antimicrobials, cessation of perioperative prophylaxis within 24 hours for patients undergoing clean and clean-contaminated surgery, and consultation with an infectious diseases physician before continuing administration of selected drugs beyond 48 hours. Data were analyzed after the first 33 months. Patient outcomes were reviewed during the hospital stay and at readmission if it occurred within 30 days after discharge. RESULTS:From April 2001 through December 2003, a total of 1426 requests for antimicrobial therapy met criteria for intervention. Overall physician compliance with the program was 76%, ranging from 57% for perioperative prophylaxis to 92% for intravenous to oral conversion. Antimicrobial costs per patient-day decreased by 31%, from 13.67 US dollars in 2000 (before program implementation) to 9.41 US dollars in 2003. Total savings in acquisition costs were 1,841,203 US dollars for the 3-year period. Resistance to numerous drugs among Klebsiella pneumoniae isolates was also significantly reduced. CONCLUSIONS:A program to improve the use of antibiotics in a community hospital was successful in reducing overall use, overall cost, and antimicrobial resistance.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Philmon C,Smith T,Williamson S,Goodman Edoi
10.1086/500419subject
Has Abstractpub_date
2006-03-01 00:00:00pages
239-44issue
3eissn
0899-823Xissn
1559-6834pii
ICHE2004149journal_volume
27pub_type
杂志文章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::US hospitals are engaged in an infection control arms race. Hospitals, specialties, and professional groups are spurring one another on to adopt progressively more aggressive measures in response to COVID-19 that often exceed federal and international standards. Examples include universal masking of providers and pati...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.211
更新日期:2020-11-01 00:00:00
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::In 2001, New York State health officials were notified about 2 patients with Creutzfeldt-Jakob disease who had undergone neurosurgical procedures at the same hospital within 43 days of each other. One patient had Creutzfeldt-Jakob disease at the time of surgery; the other patient developed Creutzfeldt-Jakob disease 6....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503017
更新日期:2006-03-01 00:00:00
abstract::We describe an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) ST398 in a nursing home in the Netherlands. Seven residents and 4 healthcare workers were identified with MRSA ST398, but 2 of the healthcare workers carried other strains. This study demonstrates that MRSA ST398 can spread in nursing homes....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/665726
更新日期:2012-06-01 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:OBJECTIVE:To assess the safety, sustainability, and effectiveness of a laboratory intervention to reduce processing of midstream urine (MSU) cultures. DESIGN:Prospective observational cohort. SETTING:Medical and surgical inpatients in a tertiary-care hospital. PARTICIPANTS:The study included 1,678 adult inpatients w...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.385
更新日期:2021-01-01 00:00:00
abstract::In 1997 the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in out-of-hospital settings....
journal_title:Infection control and hospital epidemiology
pub_type: 共识发展会议,指南,杂志文章,评审
doi:10.1086/501569
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To describe factors associated with a rectal swab or stool sample positive for norovirus, rotavirus, or adenovirus. DESIGN:Retrospective study. SETTING:Charleston Area Medical Center, a regional academic medical center in Charleston, West Virginia. METHODS:Rectal swab or stool samples were obtained from pa...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/654004
更新日期:2010-08-01 00:00:00
abstract::Observational studies compare outcomes among subjects with and without an exposure of interest, without intervention from study investigators. Observational studies can be designed as a prospective or retrospective cohort study or as a case-control study. In healthcare epidemiology, these observational studies often t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2016.118
更新日期:2016-10-01 00:00:00
abstract::The effectiveness and efficiency of 17 housekeepers in terminal cleaning 292 hospital rooms was evaluated through adenosine triphosphate detection. A subgroup of housekeepers was identified who were significantly more effective and efficient than their coworkers. These optimum outliers may be used in performance impro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/676431
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:The National Nosocomial Infections Surveillance (NNIS) System personnel report trends in antimicrobial-resistant pathogens. To validate select antimicrobial susceptibility testing results and to identify test methods that tend to produce errors, we conducted proficiency testing among NNIS System hospital labo...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502214
更新日期:2003-05-01 00:00:00
abstract::Hospital antibiotic use in Argentina has not been described. We present results of point prevalence surveys on antibiotic use conducted in 109 Argentinian hospitals in November 2018 and submitted to the National Program of Epidemiology and Control of Hospital-Acquired Infections, and we discuss potential areas for imp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.243
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To review cases of community-onset Staphylococcus aureus bacteremia and to evaluate whether the risk factors and epidemiology of methicillin-resistant S. aureus (MRSA) bacteremia have changed from early reports. DESIGN:Retrospective case-comparison study of community-onset MRSA (n = 26) and methicillin-susc...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502227
更新日期:2003-06-01 00:00:00
abstract::Multiple cultures were positive for Bacillus cereus during routine quality assurance testing of a pharmacy robot that prepares intravenous medications. An investigation confirmed bacterial contamination of the robot as well as drug product made by the robot. The process and outcomes of the investigation are described ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/665316
更新日期:2012-05-01 00:00:00
abstract::The outbreak of H5N1 avian influenza in Asia has reignited concerns about an influenza pandemic. It is clear that influenza vaccine will be in short supply (or nonexistent) early in an influenza pandemic. Without vaccine, the role of antiviral agents, especially oseltamivir, in treatment and prophylaxis is of paramoun...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502507
更新日期:2005-11-01 00:00:00
abstract::We evaluated the impact of reflex urine culture screen results on antibiotic initiation. More patients with positive urine screen but negative culture received antibiotics than those with a negative screen (30.5 vs 7.1%). Urine screen results may inappropriately influence antibiotic initiation in patients with a low l...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.230
更新日期:2020-09-01 00:00:00
abstract::Infection control in British nursing homes is different from that in U.S. nursing homes in seveal ways. Most British nursing homes, for example, do not have a designated on-site infection control nurse, and several agencies are responsible for regulatory oversight. This article discusses the state of infection control...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502198
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To curtail the prevalence and cross-transmission of methicillin-resistant Staphylococcus aureus (MRSA) in a rural healthcare setting. DESIGN:Before-after, quasi-experimental quality improvement study. SETTING:A regional-referral hospital, 5 affiliated nursing homes, and an outpatient MRSA clinic. INTERVENT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/650445
更新日期:2010-03-01 00:00:00
abstract::Aerobic gram-negative bacillus (AGNB) groin skin carriage was prospectively studied in ambulatory geriatric outpatients: 42 from three nursing homes and 44 from private homes. Initially, 12 (28.6%) Proteeae carriers were in the former group and 3 (6.8%) were in the latter (P = 0.01). At one year, 6 of 7 surviving nurs...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645990
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of 1-week ventilator circuit change on ventilator-associated pneumonia and its cost-effectiveness compared with a 2-day change. DESIGN:An observational cohort study. SETTING:A tertiary level neonatal intensive care unit in a university-affiliated teaching hospital in Taiwan. Patien...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2014.48
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To develop an automated method for ventilator-associated condition (VAC) surveillance and to compare its accuracy and efficiency with manual VAC surveillance SETTING:The intensive care units (ICUs) of 4 hospitals METHODS:This study was conducted at Detroit Medical Center, a tertiary care center in metropoli...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.127
更新日期:2015-09-01 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 summarize and discuss logistic and administrative challenges we encountered during the Benefits of Enhanced Terminal Room (BETR) Disinfection Study and lessons learned that are pertinent to future utilization of ultraviolet (UV) disinfection devices in other hospitals DESIGN Multicenter cluster randomized...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1017/ice.2017.268
更新日期:2018-02-01 00:00:00
abstract::A nonrandomized, retrospective comparison of Staphylococcus aureus bacteremia between an academic hospital setting (n=53) and a community hospital setting (n=245) within a single healthcare system was performed. Despite infectious disease consultations, S. aureus bacteremia management recommendations based on Infectio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.30
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To determine whether disinfection protocols currently used for gastroscopes are effective against cultures of Tropheryma whipplei. DESIGN:The bactericidal activity of 2% glutaraldehyde and two peracetic acids on the Twist-Marseille strain of T. whipplei grown in cell monolayers was determined. PATIENTS:Two ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502188
更新日期:2003-03-01 00:00:00
abstract::Hospital epidemiologists have an opportunity to apply their skills to hospital quality problems other than infection control. Soon, hospitals will be required to collect and report numerous quality indicators, whose results will require epidemiologic interpretation. For those who choose to make the transition into qua...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647065
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:Standard precautions are advocated for reducing the number of injuries caused by needles and sharp medical devices ("sharps injuries"), but the effectiveness of gloves in preventing such injuries has not been established. We evaluated factors associated with gloving practices and identified associations betwe...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/655839
更新日期:2010-09-01 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:BACKGROUND:The role of coagulase-negative staphylococci (CNS) in bacteremias continues to be controversial. Until the 1970s, CNS were mostly recognized as contaminants, being part of the cutaneous flora. Since then, several studies have reported increasing incidence and severity of infections due to CNS. PURPOSE:To re...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647878
更新日期:1998-08-01 00:00:00