Abstract:
BACKGROUND:States have established public reporting of hospital-associated (HA) infections-including those of methicillin-resistant Staphylococcus aureus (MRSA)-but do not account for hospital case mix or postdischarge events. OBJECTIVE:Identify facility-level characteristics associated with HA-MRSA infection admissions and create adjusted hospital rankings. METHODS:A retrospective cohort study of 2009-2010 California acute care hospitals. We defined HA-MRSA admissions as involving MRSA pneumonia or septicemia events arising during hospitalization or within 30 days after discharge. We used mandatory hospitalization and US Census data sets to generate hospital population characteristics by summarizing across admissions. Facility-level factors associated with hospitals' proportions of HA-MRSA infection admissions were identified using generalized linear models. Using state methodology, hospitals were categorized into 3 tiers of HA-MRSA infection prevention performance, using raw and adjusted values. RESULTS:Among 323 hospitals, a median of 16 HA-MRSA infections (range, 0-102) per 10,000 admissions was found. Hospitals serving a greater proportion of patients who had serious comorbidities, were from low-education zip codes, and were discharged to locations other than home were associated with higher HA-MRSA infection risk. Total concordance between all raw and adjusted hospital rankings was 0.45 (95% confidence interval, 0.40-0.51). Among 53 community hospitals in the poor-performance category, more than 20% moved into the average-performance category after adjustment. Similarly, among 71 hospitals in the superior-performance category, half moved into the average-performance category after adjustment. CONCLUSIONS:When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Tehrani DM,Phelan MJ,Cao C,Billimek J,Datta R,Nguyen H,Kwark H,Huang SSdoi
10.1086/678069subject
Has Abstractpub_date
2014-10-01 00:00:00pages
1263-70issue
10eissn
0899-823Xissn
1559-6834pii
S0195941700094364journal_volume
35pub_type
杂志文章abstract::We investigated alternative measurement methodology for infrared body thermometry to increase accuracy for outdoor fever screening during the 2003 SARS epidemic. Our results indicate that the auditory meatus temperature is a superior alternative compared with the forehead body surface temperature due to its close appr...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
doi:10.1086/502351
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abstract:OBJECTIVES:To determine the rates of surgical-site infections (SSIs) after spinal surgery and to identify the risk factors associated with infection. DESIGN:SSIs had been identified by active prospective surveillance. A case-control study to identify risk factors was performed retrospectively. SETTING:University-asso...
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doi:10.1086/502259
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abstract:OBJECTIVE:To evaluate the efficacy of Centers for Disease Control and Prevention (CDC)-recommended infection control measures implemented in response to an outbreak of multidrug-resistant (MDR) tuberculosis (TB). DESIGN:Retrospective cohort studies of acquired immunodeficiency syndrome (AIDS) patients and healthcare w...
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pub_type: 杂志文章
doi:10.1086/647075
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:We assessed the frequency and relatedness of methicillin-resistant Staphylococcus aureus (MRSA) isolates to determine whether healthcare workers, the environment, or admitted patients could be a reservoir for MRSA on a burn trauma unit (BTU). We also assessed risk factors for MRSA colonization among BTU patie...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/668032
更新日期:2012-11-01 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: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: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::In this prospective study, we monitored 4 epidemiologically important pathogens (EIPs): methicillin-resistane Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant (MDR) Acinetobacter to assess the effectiveness of 3 enhanced disinfection strategies for te...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2018.165
更新日期:2018-09-01 00:00:00
abstract::Methicillin-resistant Staphylococcus aureus (MRSA) has been notifiable in Western Australia since 1985. This article reviews the notification data from 1994 to 1997, focusing on increases in MRSA notifications and the proportion that are local strains; changes in the geographical distribution of MRSA; and changes in a...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501594
更新日期:1999-02-01 00:00:00
abstract:BACKGROUND:Existing knowledge of emergency department (ED) catheter-associated urinary tract infection (CAUTI) prevention is limited. We aimed to describe the motivations, perceived risks for CAUTI acquisition, and strategies used to address CAUTI risk among EDs that had existing CAUTI prevention programs. METHODS:In ...
journal_title:Infection control and hospital epidemiology
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doi:10.1017/ice.2015.267
更新日期:2016-02-01 00:00:00
abstract::Malassezia furfur, a lipophilic yeast, has become recognized as a cause of sepsis in infants receiving parenteral fat emulsions via indwelling deep venous catheters. Colonization of infants' skin may be a prerequisite to colonization of the intravascular catheter and subsequent infection with M furfur. Three hundred n...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645819
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Healthcare-associated transmission of respiratory viruses is a concerning patient safety issue. DESIGN:Surveillance for influenza virus among a cohort of healthcare workers (HCWs) was conducted in a tertiary care children's hospital from November 2009 through April 2010 using biweekly nasal swab specimen co...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/669857
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To assess healthcare workers' attitudes and concerns regarding seasonal and pandemic influenza vaccines in order to improve vaccination campaign communications. DESIGN:Cross-sectional survey. SETTING:All 6 health authorities in British Columbia, Canada. METHODS:An anonymous, self-administered online survey...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/655465
更新日期:2010-10-01 00:00:00
abstract::Five of 18 samples of working dilutions of disinfectants used in the University of Ilorin Teaching Hospital, the University Clinic, and three other urban medical centers were found to be contaminated with bacteria. The results confirmed that disinfectants in storage support the growth of infectious agents, underlining...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646986
更新日期:1994-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673142
更新日期:2013-10-01 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::Of the more than 200,000 patients who undergo open heart surgery annually in the United States, 2% to 10% will develop a post-operative infection related to their surgery. The economic impact of such infections on hospitals under the prospective payment system is unclear. To study the effect of such infections on hosp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646127
更新日期:1990-02-01 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::BACKGROUND The National Healthcare Safety Network (NHSN) catheter-associated urinary tract infection (CAUTI) definition was revised as of January 2015 to exclude funguria and lower bacteriuria levels. We evaluated the effect of the CAUTI definition change on NHSN-defined central-line-associated bloodstream infection (...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.41
更新日期:2017-06-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/657133
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/516656
更新日期:2007-05-01 00:00:00
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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: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...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/674389
更新日期:2014-01-01 00:00:00
abstract::Quality assurance is rapidly encroaching on the fields of epidemiology and infection control. If we are to lead this most recent revolution in medical care, we must ensure that our approach is structured, that we reassess our goals and methods regularly and that we achieve the maximal benefit from the resources we con...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646164
更新日期:1990-05-01 00:00:00
abstract::OBJECTIVE To evaluate interventions to reduce avoidable antibiotic use on pediatric oncology and hematopoietic stem cell transplantation (HSCT) services. DESIGN Interrupted time series. SETTING Academic pediatric hospital with separate oncology and HSCT services. PARTICIPANTS Children admitted to the services during b...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.118
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:To assess the efficacy of a standard cleaning and sterilization protocol employed during reuse of cardiac electrophysiology catheters on the infectivity of duck hepatitis B virus (DHBV; a surrogate for human hepatitis B virus), bovine viral diarrhea virus (BVDV; a surrogate for human hepatitis C virus), and h...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502609
更新日期:2005-08-01 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:BACKGROUND:Clostridium difficile is a major cause of infectious diarrhea in hospitalized patients. Between August 2003 and January 2004, we experienced an increase in the incidence of C. difficile-associated disease. We describe the investigation into and management of the outbreak in this article. METHODS:A total of ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/519181
更新日期:2007-08-01 00:00:00
abstract::We describe the prevalence of and risk factors for colonization with extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-EB) in the long-term care facility (LTCF) setting. Colonization prevalence differed significantly across the 3 LTCFs evaluated in the study, with recent use of levofloxacin and fecal in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
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更新日期:2012-03-01 00:00:00