Abstract:
BACKGROUND:Current recommendations for the prevention of central venous catheter-associated bloodstream infections (CA-BSIs) are mostly based on data from intensive care units (ICUs). The rates of CA-BSIs appear to be higher in non-ICU wards. Until this year, no published data were available on non-ICU CA-BSIs in the United States. This article is a summary of a talk given at an industry-sponsored conference on CA-BSIs. It summarizes an original article of ours previously published in a peer-reviewed journal. OBJECTIVE:The objective of this study was to determine the rate of CA-BSIs in non-ICU medical patients by developing a prospective surveillance program in a major tertiary care hospital. All positive blood cultures electronically detected from April 1, 2002, to April 30, 2003, were reviewed and clinical data collected by chart review. DEFINITIONS:Catheter utilization ratio = total number of days with a central venous catheter (CVC)/total number of patient-days; catheter-associated BSIs = defined by Centers for Disease Control and Prevention criteria, eg, a patient had to have a catheter at least 48 hours before detection of infection; CA-BSI rate = CA-BSIs/1000 catheter-days. RESULTS:The 13-month study included 7337 catheter-days and 33,174 patient-days. The overall catheter-utilization ratio was 0.22 (range, 0.19-0.25). Of 42 cases of CA-BSIs, gram-positive organisms were recovered in 24 (57%); gram-negative bacteria in 7 (17%); and Candida spp in 6 (14%). The CA-BSI rate was 5.7 (95% confidence interval: 3.4-8.0) and varied from 4.3 to 8.0. There were no significant differences in CA-BSI rates among the wards (chi(2) for linear trend, 0.42; P = .52). The overall rate of CA-BSIs decreased steadily during the study period, from 7.8 during the first 6 months to 3.9 during the following 7 months, representing a rate ratio of 0.5 (95% confidence interval: 0.27-0.93). CONCLUSION:Benchmark data for hospital infections in the non-ICU setting are starting to become available and efforts to improve care may have greater impact here than in the ICU. Upon patient transfer out of the ICU, it should be determined whether the catheter can be removed. Educational measures targeted at non-ICU wards are warranted. First results of computer-assisted methods to facilitate surveillance of larger number of patients are promising. The Healthcare Infection Control Practices Advisory Committee recommends that CA-BSIs be publicly reported. CA-BSIs in non-ICU patients could soon be part of a mandatory reporting.
journal_name
Am J Infect Controljournal_title
American journal of infection controlauthors
Marschall Jdoi
10.1016/j.ajic.2008.10.005subject
Has Abstractpub_date
2008-12-01 00:00:00pages
S172.e5-8issue
10eissn
0196-6553issn
1527-3296pii
S0196-6553(08)00790-6journal_volume
36pub_type
杂志文章abstract:BACKGROUND:An episode of breakthrough bacteremia, which was defined as positive blood cultures despite appropriate antibiotic therapy, imposes a treatment challenge in the neonatal intensive care unit (NICU). METHODS:All episodes of breakthrough bacteremia from a tertiary level NICU in Taiwan between 2004 and 2011 wer...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2014.09.022
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:We determined the incidence and circumstances of needlestick injuries and other body substance exposures among police officers in a city police department. METHODS:We analyzed data extracted from the city's centralized human resource database on all incidents from January 1, 2011, to December 31, 2016, and ...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2018.08.018
更新日期:2019-03-01 00:00:00
abstract::Catheter-associated urinary tract infections represent a significant medical burden in critically ill children. Ethanol locks have been shown to be effective and safe for central line-associated bloodstream infection prevention and we propose utilizing this strategy for urinary catheters. Because this has never been d...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.05.012
更新日期:2015-10-01 00:00:00
abstract::Necrotizing fasciitis is a severe polybacterial infection characterized by necrosis of the fascia and adjacent soft tissues with rapid expansion of the infection along the fascial planes. It is a rare and potentially fatal entity in the head and neck region. We present 2 patients with head and neck cancers who develop...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.01.010
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Health care-associated infections (HCAIs) are preventable with adoption of recognized preventive measures. The first step is to identify patients at higher risk of HCAI. This study aimed to identify patient risk factors (RFs) present on admission and acquired during inpatient stay which could be associated w...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2017.03.036
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Ventilator-associated events are common in mechanically ventilated patients. They are associated with more days on mechanical ventilation, longer intensive care unit (ICU) stay, and increased risk of mortality. Theoretically, interventions that prevent ventilator-associated events should also reduce associat...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2018.06.022
更新日期:2019-01-01 00:00:00
abstract::Air treatment with a mobile Plasmair air-decontamination unit significantly reduces the fungal spore load in hematology wards. We report that this system used at a low aspiration flow does not perform total biodecontamination against filamentous fungi. Moreover, the filamentous fungus load remaining in rooms equipped ...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2008.12.006
更新日期:2009-10-01 00:00:00
abstract::Electronic monitoring of hand hygiene compliance using the World Health Organization's My 5 Moments for Hand Hygiene is a new innovation that has not yet been shown to reduce hospital infections. We analyzed existing data from 23 inpatient units over a 33-month period and found a significant correlation between unit-s...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2016.04.215
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Multidrug-resistant (MDR) Acinetobacter baumannii (MDR-AB) is an important nosocomial pathogen associated with significant morbidity and mortality. METHODS:We conducted a prospective cohort study of intensive care unit patients colonized or infected with MDR-AB at a tertiary care hospital from October 2008 ...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2010.09.005
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Surgical site infections (SSIs) are a serious and costly post-op complication. Generating SSI rates often requires labor-intensive methods, but increasing numbers of publications reported SSI rates using administrative data. METHODS:Index laminectomy and spinal fusion procedures were identified using Canadia...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2020.10.010
更新日期:2020-10-20 00:00:00
abstract:BACKGROUND:Minimal structure is required for effective prevention of health care-associated infection (HAI). The objective of this study was to evaluate the structure for prevention of HAI in a sample of Brazilian hospitals. METHODS:This was a cross-sectional study from hospitals in 5 Brazilian regions (n = 153; total...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.08.004
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Stethoscopes may serve as vehicles for transmission of bacteria among patients. The aim of this study was to assess the efficacy of antimicrobial copper surfaces to reduce the bacterial concentration associated with stethoscope surfaces. METHODS:A structured prospective trial involving 21 health care provid...
journal_title:American journal of infection control
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajic.2017.01.030
更新日期:2017-06-01 00:00:00
abstract::The infection control team in a university hospital designed, implemented, and evaluated a program to audit infection control policies. Process surveillance techniques of observation and monitoring were used during surveys of patient care areas to evaluate infection control practices. Nineteen unit surveys have been c...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/0196-6553(84)90113-5
更新日期:1984-08-01 00:00:00
abstract::In-hospital surveillance of surgical site infections (SSI) was conducted on 599 patients in a German university hospital. On a subgroup of 342 patients, SSI was assessed after discharge from hospital based on data of a questionnaire and telephone interviews. Postdischarge surveillance revealed substantially higher inf...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2008.10.025
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:The COVID-19 outbreak has gravely impacted the physical and psychological health of people. As the outbreak is ongoing, it is crucial to equip the emergency healthcare workers (HCWs) to be medically and psychologically prepared. OBJECTIVE:To examine the psychological impact of COVID-19 on emergency HCWs and...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2020.06.214
更新日期:2020-07-07 00:00:00
abstract:BACKGROUND:Health care workers are exposed to bloodborne pathogens through occupational injuries, and the replacement of sharps by safety-engineered devices has been recommended as a key preventive measure. This recommendation has been difficult to implement in Brazil. METHODS:We conducted a retrospective study of sel...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2013.07.017
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Hospital-acquired Legionnaires' disease is associated with the presence of Legionella pneumophila in hospital water systems. In the United Kingdom, the Department of Health recommends maintaining hot water temperatures >55°C and cold water temperatures <20°C at the point of delivery to prevent proliferation ...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2018.12.005
更新日期:2019-07-01 00:00:00
abstract::In a simultaneous assessment of 250 environmental surfaces after terminal cleaning using aerobic cultures as a gold standard, both fluorescent marker and an adenosine triphosphate bioluminescence assay system demonstrated better diagnosticity compared with subjective visual inspection. These results support the use of...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2012.09.019
更新日期:2013-08-01 00:00:00
abstract::Nurses satisfied with their jobs report less job stress, more effective nurse-physician collaboration, and higher patient satisfaction scores. It is unknown if job satisfaction influences adherence to best practices or patient outcomes. This secondary data analysis investigated the relationship between job satisfactio...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2017.10.023
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:The implementation of a time- and cost-effective system for the surveillance of the nosocomial infection (NI) is a challenge for infection control practitioners. OBJECTIVES:The aim of this study was to assess the sensitivity and the time reduction using a selective surveillance method (SSM) for the detectio...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1067/mic.2003.72
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Antibiotic resistance is a challenge in long-term care facilities (LTCFs). The objective of this study was to demonstrate that a novel, minimally invasive program not interfering with activities of daily living or socialization could lower methicillin-resistant Staphylococcus aureus (MRSA) disease. METHODS:...
journal_title:American journal of infection control
pub_type: 临床试验,杂志文章
doi:10.1016/j.ajic.2016.04.251
更新日期:2016-12-01 00:00:00
abstract::Although substantial improvements in hand hygiene practices have occurred in recent years, many health care facilities continue to encounter challenges in achieving and maintaining high levels of hand hygiene compliance. Issues of current interest include the optimum dose of alcohol-based handrub (ABHR) that should be...
journal_title:American journal of infection control
pub_type: 杂志文章,评审
doi:10.1016/j.ajic.2019.03.024
更新日期:2019-06-01 00:00:00
abstract:INTRODUCTION:Reverse osmosis (RO), a major advance in hemodialysis (HD) safety, effectively clears most water organisms. Delftia acidovorans is an environmental water-borne pathogen that is rarely reported to cause human infections. We report a pseudo outbreak caused by colonization of RO machines with D acidovorans wi...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2019.11.027
更新日期:2020-03-01 00:00:00
abstract::Molecular evidence of Listeria monocytogenes cross-contamination in a nursery is presented. Listeria monocytogenes serotype 4b was isolated from the blood and the conjunctiva of a baby with neonatal sepsis who was born after septic amnionitis and premature rupture of membrane. Nine days later, the same bacterium was i...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1067/mic.2003.25
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Bacillus cereus can cause severe infections in immunocompromised persons. METHODS:We report 3 cases of bacteremia/septicemia (1 fatal) among oncology patients in a children's hospital. Because all cases occurred during a 10-day period, a common source outbreak was suspected. An epidemiologic investigation w...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/s0196-6553(99)70034-9
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Debate remains over the core activities of infection control (IC) programs. Differences in stakeholder opinions must be considered if consensus panel guidelines and recommendations are to be broadly applied. This article describes a survey of administrators and clinicians employed in hospitals in New South W...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1067/mic.2001.117037
更新日期:2001-08-01 00:00:00
abstract::Growing evidence reveals the importance of improving safety culture in efforts to eliminate health care-associated infections. This multisite, cross-sectional survey examined the association between professional role and health care experience on infection prevention safety culture at 5 hospitals. The findings suggest...
journal_title:American journal of infection control
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajic.2012.09.006
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:The incidence of postoperative surgical site infections (SSIs) is difficult to estimate because of the current trend of early discharge after surgery. Both operation-related and host factors should be taken into consideration in the prevention of SSIs. We wanted to determine the actual incidence of SSIs and ...
journal_title:American journal of infection control
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-6553(97)90082-1
更新日期:1997-10-01 00:00:00
abstract::This is the first in a series of case studies that will be published in American Journal of Infection Control following the Centers for Disease Control and Prevention/National Healthcare Safety Network (NHSN) surveillance definition update of 2013. These cases reflect some of the complex patient scenarios infection pr...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2013.05.009
更新日期:2013-10-01 00:00:00
abstract::Vancomycin-resistant Staphylococcus aureus (VRSA) and methicillin-resistant S aureus (MRSA) strains were examined in hospital effluents. Most S aureus strains are resistant to methicillin (MRSA), followed by tetracycline. Approximately 15% of MRSA strains are also resistant to vancomycin (VRSA). All VRSA strains devel...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.08.015
更新日期:2015-12-01 00:00:00