Abstract:
OBJECTIVE:To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates. DESIGN:Sensitivity analysis. SETTING:A total of 124 New York hospitals in 2010. METHODS:New York NHSN CDI events from audited hospitals were matched to New York hospital discharge billing records to obtain additional information on patient age, length of stay, and previous hospital discharges. "Corrected" hospital-onset (HO) CDI rates were calculated after (1) correcting inaccurate case reporting found during audits, (2) incorporating knowledge of laboratory results from outside hospitals, (3) excluding days when patients were not at risk from the denominator of the rates, and (4) adjusting for patient age. Data sets were simulated with each of these sources of bias reintroduced individually and combined. The simulated rates were compared with the corrected rates. Performance (ie, better, worse, or average compared with the state average) was categorized, and misclassification compared with the corrected data set was measured. RESULTS:Counting days patients were not at risk in the denominator reduced the state HO rate by 45% and resulted in 8% misclassification. Age adjustment and reporting errors also shifted rates (7% and 6% misclassification, respectively). CONCLUSIONS:Changing the NHSN protocol to require reporting of age-stratified patient-days and adjusting for patient-days at risk would improve comparability of rates across hospitals. Further research is needed to validate the risk-adjustment model before these data should be used as hospital performance measures.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Haley VB,DiRienzo AG,Lutterloh EC,Stricof RLdoi
10.1086/674389subject
Has Abstractpub_date
2014-01-01 00:00:00pages
1-7issue
1eissn
0899-823Xissn
1559-6834journal_volume
35pub_type
杂志文章abstract::The geriatric population represents the largest reservoir of Mycobacterium tuberculosis infection in developed nations, including the United States. Tuberculosis (TB) case rates in the United States are highest for this age group compared with other age categories. The subtle clinical manifestations of TB in the elder...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501816
更新日期:2000-09-01 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:OBJECTIVE:To determine the appropriateness of antibiotic prophylaxis regimens for major surgery in Korea. DESIGN:Retrospective study using a written survey for each patient who underwent arthroplasty, colon surgery, or hysterectomy. SETTING:Six tertiary hospitals in Seoul and Gyeonggi Province. PATIENTS:From each ho...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/519180
更新日期:2007-08-01 00:00:00
abstract::In 2011, institutional requirements for pertussis vaccination of healthcare personnel were reported by nearly one-third of surveyed US hospitals. Requirements often applied to personnel with certain clinical responsibilities, such as those caring for infants. Healthcare personnel who were not on an institution's payro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/662711
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:Identify independent risk factors associated with the development of nosocomial bacteremia. DESIGN:Exploratory, unmatched, case-control study. SETTING:A 970-bed Spanish university hospital. PATIENTS:All non-neutropenic adult patients with nosocomial bacteremia admitted during a 12-month period were eligibl...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646308
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:Describe the clinical and molecular epidemiology of incident Clostridium difficile infection (CDI) cases in Chicago area acute healthcare facilities (HCFs). DESIGN AND SETTING:Laboratory, clinical, and epidemiologic information was collected for patients with incident CDI who were admitted to acute HCFs in F...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/661283
更新日期:2011-09-01 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::We conducted a survey of 16,914 patients to determine the point prevalence of healthcare-associated catheter-associated urinary tract infection (HA-CAUTI) and urinary catheter care in public hospitals in Hong Kong. Overall HA-CAUTI prevalence was 0.27%. Compliance was generally good, except for documenting the date of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.370
更新日期:2020-03-01 00:00:00
abstract::We studied the association between chlorhexidine gluconate (CHG) concentration on skin and resistant bacterial bioburden. CHG was almost always detected on the skin, and detection of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Enterobacteriaceae, and vancomycin-resistant Enterococcus on skin site...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.265
更新日期:2019-12-01 00:00:00
abstract::An outbreak of metallo-β-lactamase (MBL) producing Klebsiella pneumoniae occurred at a children's hospital in Japan. MBL-producing K. pneumoniae was detected in tea dispenser in the hospital, the use of which was associated with the acquisition of the MBL-producing Enterobacteriaceae. The outbreak ceased after use of ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.331
更新日期:2018-12-27 00:00:00
abstract::OBJECTIVE To compare central line use and central line-associated bloodstream infection in newborn infants before and after the introduction of a central line infection prevention bundle in order to determine the effectiveness of the bundle and to identify areas for further improvement. DESIGN Retrospective cohort ana...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.127
更新日期:2016-09-01 00:00:00
abstract::We prospectively surveyed for rectal colonization with vancomycin-resistant Enterococcus among 93 high-risk pediatric patients who were hospitalized at least 5 (median, 20) days. Fifty-two patients (56%) had enterococcal colonization; none had active infection with Enterococcus. All enterococci were vancomycin-suscept...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647777
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVES:To determine the predictors of 7-day mortality in older adult patients with Staphylococcus aureus bacteremia after controlling for comorbidity using the Charlson weighted index of comorbidity (WIC) and to identify the risk factors associated with bacteremia due to methicillin-resistant S. aureus (MRSA). DES...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507924
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To elucidate behavioral determinants of handwashing among nurses. DESIGN:Statistical modeling using the Theory of Planned Behavior and relevant components to handwashing behavior by nurses that were derived from focus-group discussions and literature review. SETTING:The community and 3 tertiary care hospita...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503335
更新日期:2006-05-01 00:00:00
abstract::This cross-sectional study at a tertiary-care hospital in Botswana from 2000 to 2007 was performed to determine the epidemiologic characteristics of Staphylococcus aureus bacteremia. We identified a high prevalence (11.2% of bacteremia cases) of methicillin-resistant S. aureus (MRSA) bacteremia. MRSA isolates had high...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/599003
更新日期:2009-08-01 00:00:00
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 ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/500419
更新日期:2006-03-01 00:00:00
abstract::Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line-associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 me...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.120
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To compare the occurrence of Clostridium difficile among inpatients infected with human immunodeficiency virus (HIV) in two different hospitals. DESIGN:Prospective, observational study. SETTING:Specialized HIV inpatient units. PATIENTS:HIV-infected inpatients at Cook County Hospital (CCH) and Rush Presbyte...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501987
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for and modes of transmission of Xanthomonas maltophilia infection/colonization. DESIGN:Surveillance and cohort study. SETTING:A 470-bed tertiary trauma-referral community hospital. PATIENTS:From January 1, 1988 to March 17, 1989, 106 intensive care unit patients developed X malto...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646510
更新日期:1992-04-01 00:00:00
abstract::With use of the Nationwide Inpatient Sample, we conducted a study to determine whether rates of Clostridium difficile infection for delivery-associated hospitalizations are increasing. From 1998 to 2006, the number and incidence of C. difficile infection among peripartum women increased significantly. These increases ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/652454
更新日期:2010-05-01 00:00:00
abstract::Micrococcus bacteria are frequently isolated from blood cultures and could represent a cause of infections associated with medical devices, particularly in immunocompromised patients; however, there is a lack of information on the management of micrococcal bacteremia. We report what is, to our knowledge, the largest s...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592705
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Treatment of Staphylococcus aureus colonization before surgery reduces risk of surgical site infection (SSI). The regimen of nasal mupirocin ointment and topical chlorhexidine gluconate is effective, but cost and patient compliance may be a barrier. Nasal povidone-iodine solution may provide an alternative t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1086/676872
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiology, interventions, and molecular typing methods used during the investigation and control of concurrent outbreaks of Serratia marcescens and methicillin-resistant Staphylococcus aureus (MRSA) infections in a neonatal intensive-care unit (NICU). SETTING:A 206-bed women's and infants'...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To assess the ability of Medicare claims to identify US hospitals with high rates of surgical site infection (SSI) after hip arthroplasty. DESIGN:Retrospective cohort study. SETTING:Acute care US hospitals. PARTICIPANTS:Fee-for-service Medicare patients 65 years of age and older who underwent hip arthropla...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/668785
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To describe the frequency of selected antimicrobial resistance patterns among pathogens causing device-associated and procedure-associated healthcare-associated infections (HAIs) reported by hospitals in the National Healthcare Safety Network (NHSN). METHODS:Data are included on HAIs (ie, central line-associ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591861
更新日期:2008-11-01 00:00:00
abstract::Evidence that genes were transferred during evolution from plants to bacteria was obtained from nucleotide and protein sequence analyses. However, the extent of such transfers among phylogenetically distant organisms is limited by various factors, including those related to complexity of the environment and those endo...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/501779
更新日期:2000-06-01 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::Benchmarks for antimicrobial consumption measured in antimicrobial days are beginning to emerge. The relationship between the traditional measure of days of therapy and antimicrobial days is unclear. We observed a high intermethod correlation (R2=0.99): antimicrobial days were 1.9-fold lower than days of therapy acros...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.109
更新日期:2016-08-01 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:OBJECTIVE:Evaluate the clinical impact of the implementation of VERIGENE gram-positive blood culture testing (BC-GP) coupled with antimicrobial stewardship result notification for children with positive blood cultures. DESIGN:Quasi-experimental study. SETTING:Quaternary children's hospital. PATIENTS:Hospitalized chi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.191
更新日期:2020-08-01 00:00:00