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. SETTING AND PATIENTS. The study included patients admitted to medical and surgical ICUs of an academic medical center between September 1, 2001, and June 30, 2009. METHODS. Perianal surveillance cultures were obtained at admission to the ICU, weekly, and at discharge from the ICU. Patients were included if they had culture results that were negative for ESBL-producing gram-negative bacteria at ICU admission and had an ICU length of stay longer than 48 hours. Pulsed-field gel electrophoresis (PFGE) was performed on ESBL-positive isolates from patients who acquired the same bacterial species (eg, Klebsiella species or Escherichia coli) as the previous room occupant. RESULTS. Among 9,371 eligible admissions (7,651 unique patients), 267 (3%) involved patients who acquired an ESBL-producing pathogen in the ICU; of these patients, 32 (12%) were hospitalized in a room in which the prior occupant had been positive for ESBL. Logistic regression results suggested that the prior occupant's ESBL status was not significantly associated with acquisition of an ESBL-producing pathogen (adjusted odds ratio, 1.39 [95% confidence interval, 0.94-2.08]) after adjusting for colonization pressure and antibiotic exposure in the ICU. PFGE results suggested that 6 (18%) of 32 patients acquired a bacterial strain that was the same as or closely related to the strain obtained from the prior occupant. CONCLUSIONs. These data suggest that environmental contamination may not play a substantial role in the transmission of ESBL-producing pathogens among ICU patients. Intensifying environmental decontamination may be less effective than other interventions in preventing transmission of ESBL-producing pathogens.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Ajao AO,Johnson JK,Harris AD,Zhan M,McGregor JC,Thom KA,Furuno JPdoi
10.1086/670216subject
Has Abstractpub_date
2013-05-01 00:00:00pages
453-8issue
5eissn
0899-823Xissn
1559-6834journal_volume
34pub_type
杂志文章abstract:OBJECTIVE:To study the spread of strains of Enterobacter aerogenes in our hospital in 1992 and 1993 by using two genotypic markers, and to evaluate these methods for the epidemiological investigation of this species. DESIGN:Ribotyping (using two endonucleases) and arbitrarily primed (AP)-PCR (using two different 10-me...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647094
更新日期:1995-04-01 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::Surgical site infection (SSI) surveillance is performed using a variety of methods with unclear performance characteristics. We used claims data to identify records for review following hysterectomy and colorectal surgery. Claims-enhanced screening identified SSIs missed by routine surveillance and could be used for t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673975
更新日期:2013-12-01 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::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: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::We assessed handrub consumption as a surrogate marker for hand hygiene compliance from 2007 to 2014. Handrub consumption varied substantially between departments but correlated in a mixed effects regression model with the number of patient-days and the observed hand hygiene compliance. Handrub consumption may suppleme...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.47
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To evaluate clonal dissemination of methicillin-resistant coagulase-negative staphylococci (CNS). SETTING:Neonatal intensive care unit of a 180-bed, university-affiliated general hospital. PATIENTS:Neonates admitted to the neonatal intensive care unit between March 1999 and October 2000, from whom CNS were ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502083
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:The diagnosis of central line-associated bloodstream infections (CLABSIs) is often controversial, and existing guidelines differ in important ways. OBJECTIVE:To determine both the range of practices involved in obtaining blood culture samples and how central line-associated infections are diagnosed and to o...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/667379
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To describe an outbreak of imipenem-resistant Acinetobacter baumannii (IR-Ab) and the measures for its control, and to investigate risk factors for IR-Ab acquisition. DESIGN:An observational and a case-control study. SETTING:A surgical intensive care unit (ICU) in a university tertiary care hospital. METHO...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501822
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. DESIGN:Prospective SSI surveillance with voluntary PDS. Recommended methods for...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/506403
更新日期:2006-08-01 00:00:00
abstract::Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat because it can cause severe infections with frequent mortality in more than a dozen countries. It can survive on healthcare environmental surfaces for at least 7 da...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.1
更新日期:2019-03-01 00:00:00
abstract::We describe and compare the epidemiology of catheter-associated urinary tract infection (CAUTI) occurring in non-intensive care unit (ICU) versus ICU wards in a network of community hospitals over a 2-year period. Overall, 72% of cases of CAUTI occurred in non-ICU patients, which indicates that this population is an i...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671000
更新日期:2013-07-01 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 purpose of this study was to determine whether any waste was labeled incorrectly as infectious or contained material that could be recycled. Waste generated in preparation for surgery was separated and weighed. Of 530 lbs of operating room waste, 40 lbs were noninfectious, largely plastic and paper. The results of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647693
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To evaluate changing Clostridioides difficile infection (CDI) testing among inpatients with indeterminate enzyme immunoassay (EIA) results (antigen+/toxin-) from reflexive polymerase chain reaction (PCR) testing to clinician-ordered PCR testing. DESIGN:Multicenter, before-and-after, quasi-experimental study....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.56
更新日期:2020-06-01 00:00:00
abstract::Breathing circuit filters (BCFs) are used in respiratory and critical-care settings for humidification of air and to limit transmission of respiratory pathogens. Three types of BCFs (Pall BB 25A, BB 100, and HME 15-22) were evaluated (in triplicate) for removal of Mycobacterium species. Filters were challenged with ae...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647606
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:The molecular epidemiology of pediatric Clostridium difficile infection (CDI) is poorly understood. We aimed to identify the restriction endonuclease analysis (REA) groups causing CDI and to determine risk factors and outcomes associated with CDI caused by epidemic strains in children. DESIGN:Retrospective c...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2014.89
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To identify risk factors associated with surgical site infection (SSI) after pediatric posterior spinal fusion procedure by examining characteristics related to the patient, the surgical procedure, and tissue hypoxia. DESIGN:Retrospective case-control study nested in a hospital cohort study. SETTING:A 475-b...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/593952
更新日期:2009-02-01 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:OBJECTIVE:Molecular epidemiologic surveillance of Acinetobacter baumannii by polymerase chain reaction-randomly amplified polymorphic DNA analysis in a university hospital for 3 consecutive study periods. RESULTS:Twelve different Acinetobacter baumannii genotypes (A-L) were detected. Although only 2 genotypes were det...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503349
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To assess the impact of an automated intraoperative alert to redose prophylactic antibiotics in prolonged cardiac operations. DESIGN:Randomized, controlled, evaluator-blinded trial. SETTING:University-affiliated hospital. PATIENTS:Patients undergoing cardiac surgery that lasted more than 4 hours after the ...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/502109
更新日期:2003-01-01 00:00:00
abstract::Nosocomial infections appear to be increased in patients with acquired immunodeficiency syndrome (AIDS), compared to individuals with asymptomatic infection due to human immunodeficiency virus (HIV). Risk factors for bacterial colonization and infection include immunosuppression, prior treatment with some antibiotics,...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647300
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:To study the cost-effectiveness of vaccination for hepatitis A. SETTING:Hypothetical analysis of students currently enrolled in medical school in the United States. METHOD:A Markov-based model was developed using data from the literature, actual hospital costs, and an annual discount rate of 5%. The inciden...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647513
更新日期:1997-10-01 00:00:00
abstract::The cumulative risk of human immunodeficiency virus (HIV) infection over a healthcare career has rarely been estimated, but is more relevant to the description of an occupational hazard than the risk of seroconversion from a single exposure. We describe a model for assessing the individualized risk for HIV infection a...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646161
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVES:Describe an outbreak of influenza A (H3N2); provide an analysis of vaccine efficacy; measure the sensitivity, specificity, and positive predictive value of 3 clinical case definitions of influenza. SETTING:A nursing home in Washington County, Maryland. The outbreak involved 52 residents (attack rate = 47.7%...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646479
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:Infective endocarditis caused by Staphylococcus aureus is an ominous prognosis associated with a high prevalence of embolic episodes and neurological involvement. Whether methicillin resistance decreases the risk of embolism in infective endocarditis is unclear. We sought to assess the association between met...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/518727
更新日期:2007-07-01 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:OBJECTIVE:To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure. METHODS:Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phl...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1086/674398
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:Current efforts to contain anti-microbial costs in hospitals are based on restricting drugs. We explored the effects of unsolicited case-specific recommendations to physicians to discontinue parenteral antimicrobial therapy in medically stable patients with pneumonia, in order to shorten hospital length of s...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/646419
更新日期:1992-01-01 00:00:00