Abstract:
OBJECTIVE:To compare the impacts of different methicillin-resistant Staphylococcus aureus (MRSA) screening test options (eg, polymerase chain reaction [PCR], rapid culture) and program characteristics on the clinical outcomes and budget of a typical US hospital. METHODS:We developed an Excel-based decision-analytic model, using published literature to calculate and compare hospital costs and MRSA infection rates for PCR- or culture-based MRSA screening and then used multivariate sensitivity analysis to evaluate key variables. Same-day PCR testing for a representative 370-bed teaching hospital in the United States was assessed in different populations (high-risk patients, intensive care unit [ICU] patients, or all patients) and compared with other test options. RESULTS:Different screening program populations (all patients, high-risk patients, ICU patients, or patients with previous MRSA colonization or infection only) represented a potential savings of $12,158-$76,624 per month over no program ($188,618). Analysis of multiple test options in high-risk population screening indicated that same-day PCR testing of high-risk patients resulted in fewer infections over 1,720 patient-days (2.9, compared with 3.5 for culture on selective media and 3.8 for culture on nonselective media) and the lowest total cost ($112,012). The costs of other testing approaches ranged from $113,742 to $123,065. Sensitivity analysis revealed that variations in transmission rate, conversion to infection, prevalence increases, and hospital size are important to determine program impact. Among test characteristics, turnaround time is highly influential. CONCLUSION:All screening options showed reductions in infection rates and cost impact improvement over no screening program. Among the options, same-day PCR testing for high-risk patients slightly edges out the others in terms of fewest infections and greatest potential cost savings.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Olchanski N,Mathews C,Fusfeld L,Jarvis Wdoi
10.1086/658332subject
Has Abstractpub_date
2011-03-01 00:00:00pages
250-7issue
3eissn
0899-823Xissn
1559-6834journal_volume
32pub_type
杂志文章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:Better understand the incidence, risk factors, and outcomes of peripheral venous catheter (PVC)-related Staphylococcus aureus bacteremia. DESIGN:Retrospective study of PVC-related S. aureus bacteremias in adult patients from July 2005 through March 2008. A point-prevalence survey was performed January 9, 200...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/660099
更新日期:2011-06-01 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:OBJECTIVE:To evaluate the prevalence, epidemiologic features, and molecular characteristics of colonization with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among hospitalized dialysis patients and their healthcare workers (HCWs). DESIGN:Prospective observational clinical and laboratory ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592983
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Patients in the neonatal intensive care unit (NICU) are at high risk for healthcare-associated infections. Variability in reported infection rates among NICUs exists, possibly related to differences in prevention strategies. A better understanding of current prevention practices may help identify prevention ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/677636
更新日期:2014-09-01 00:00:00
abstract::Across 36 US pediatric oncology centers, 576 central line-associated bloodstream infections (CLABSIs) were reported over a 21-month period. Most infections occurred in those with leukemia and/or profound neutropenia. The contribution of viridans streptococci infections was striking. Study findings depict the contempor...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/669513
更新日期:2013-03-01 00:00:00
abstract::Timely identification of outbreaks of hospital-associated infections is needed to implement control measures and minimize impact. Survey results from 33 hospitals indicated that most hospitals lacked a formal cluster definition and all targeted a very limited group of prespecified pathogens. Standardized, statisticall...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2015.325
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:Two pilot studies were conducted to produce efficacy data on an observational tool designed to assess the use of Universal Precautions (UP) in patient care settings. The instrument addresses barrier precautions, hand-washing, handling of sharps, and avoidance of unprotected mouth to mouth resuscitation. DES...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646248
更新日期:1991-10-01 00:00:00
abstract::In 1980, the Public Health Service established an objective of immunizing 60% of high-risk persons with influenza vaccine annually by the year 1990. As no more than 32% of high-risk persons currently receive influenza vaccine each year, the Health Care Financing Administration (HCFA) has undertaken an influenza vaccin...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646187
更新日期:1990-07-01 00:00:00
abstract::BACKGROUND Despite significant advances in technological methods for hand hygiene surveillance, a lack of evidence prohibits comparison of systems to one another or against the current gold standard of direct observation. OBJECTIVE To validate a hand hygiene monitoring technology (HHMT) designed to capture hand hygien...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.298
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) rates after orthopedic surgery. SETTING:Nine hospitals participating in the Finnish Hospital Infection Program. PATIENTS:All patients who underwent hip or knee arthroplasty or open reduction of a femur fracture during 1999...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/509840
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Hand hygiene noncompliance is a major cause of nosocomial infection. Nosocomial infection cost data exist, but the effect of hand hygiene noncompliance is unknown. OBJECTIVE:To estimate methicillin-resistant Staphylococcus aureus (MRSA)-related cost of an incident of hand hygiene noncompliance by a healthca...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/651096
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:In 2002, the Chicago Department of Public Health (CDPH; Chicago, Illinois) convened the Chicago-Area Neonatal MRSA Working Group (CANMWG) to discuss and compare approaches aimed at control of methicillin-resistant Staphylococcus aureus (MRSA) in neonatal intensive care units (NICUs). To better understand thes...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501216
更新日期:2006-02-01 00:00:00
abstract::Although Corynebacterium minutissimum is well-known as the cause of erythrasma, it is noted as the etiologic agent of nondermatologic disease only rarely. We document this organism as a cause of central venous catheter-associated bacteremia and report the use of pulsed-field gel electrophoresis to characterize its mol...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647726
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:Surgical site infection (SSI) surveillance represents a key method of nosocomial infection control programs worldwide. However, most SSI surveillance systems are considered to be poorly cost effective regarding human and economic resources required for data collection and patient follow up. This study aims to...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/676423
更新日期:2014-06-01 00:00:00
abstract::We describe an outbreak of Pseudomonas aeruginosa respiratory tract infections related to intrinsically contaminated ultrasound gel used for intraoperative transesophageal echocardiograms in cardiovascular surgery patients. This investigation led to a product safety alert by the Food and Drug Administration and the de...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671268
更新日期:2013-08-01 00:00:00
abstract::OBJECTIVE The relationship between hospital antibiotic use and antibiotic resistance is poorly understood. We evaluated the association between antibiotic utilization and resistance in academic and community hospitals in Ontario, Canada. METHODS We conducted a multicenter observational ecological study of 37 hospitals...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2017.222
更新日期:2017-12-01 00:00:00
abstract::We demonstrated a 20% rate of subsequent carbapenem-resistant Enterobacteriaceae (CRE)-associated infections among hospitalized CRE carriers. Independent factors associated with the infections were number of colonization sites, central-line insertion, and receiving vancomycin before colonization. These findings unders...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.220
更新日期:2020-09-01 00:00:00
abstract::The prevalence of antibiotic-resistant bacteria in the long-term-care setting and the risk to nursing home residents is still unknown. Few studies have been done in community-based nursing homes, and most have focused on colonization rather than infection rates. Concerns about methicillin-resistant Staphylococcus aure...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/501637
更新日期:1999-05-01 00:00:00
abstract::Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. CRE colonization at unit admission was infrequent (3.9%). Most CRE...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.236
更新日期:2018-12-01 00:00:00
abstract::Overall IDSA/SIS intra-abdominal infection guideline compliance was not associated with improved outcomes; however, there was a longer time to active therapy (P=.024) and higher mortality (P=.077) if empiric therapy was too narrow per guidelines. These findings support the need for the implementation of customized ins...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.64
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:Most nosocomial acquistion of vancomycin-resistant enterococci (VRE) is due to cross-transmission. We sought to identify risk factors for acquisition of VRE by roommates of patients colonized or infected with VRE. DESIGN:Retrospective cohort study. SETTING:A 472-bed tertiary care teaching hospital. METHODS...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/587187
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:The present study investigated regional variations in antibiotic use for the treatment of hospital-acquired infections (HAIs) in France by means of a multilevel analysis, to identify targets for quality improvement. METHODS:Data were obtained from the 2001 and 2006 French national point-prevalence surveys of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/657909
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of an educational program for the prevention of catheter colonization. DESIGN:Two cross-sectional studies were carried out in a 500-bed randomly selected area of the hospital, separated by an educational program on the care of intravenous lines based on the Centers for Disease Contro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1994-04-01 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:OBJECTIVE:To determine knowledge and attitudes about pertussis and pertussis vaccination among healthcare workers (HCWs). DESIGN:Self-administered, Web-based survey. SETTING:Tertiary-care academic medical center. PARTICIPANTS:Medical center employees who participated in direct patient care were recruited to complete...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/521654
更新日期:2007-11-01 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::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::We created a 2013 combination antibiogram of healthcare-associated urinary tract infection. The 2013 antibiogram-determined regimen was evaluated in a 2014 cohort who had received empirical therapy. The regimen was statistically more likely to represent adequate treatment than actual prescriptions. A customized antibi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.108
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To determine the safety and cost-effectiveness of replacing the intravenous (IV) tubing sets in hospitalized patients at 4- to 7-day intervals instead of every 72 hours. DESIGN:Prospective, randomized study of infusion-related contamination associated with changing IV tubing sets within 3 days versus within ...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/501879
更新日期:2001-03-01 00:00:00