Abstract:
:OBJECTIVES Hospital-acquired infections (HAIs) develop rapidly after brief and transient exposures, and ecological exposures are central to their etiology. However, many studies of HAIs risk do not correctly account for the timing of outcomes relative to exposures, and they ignore ecological factors. We aimed to describe statistical practice in the most cited HAI literature as it relates to these issues, and to demonstrate how to implement models that can be used to account for them. METHODS We conducted a literature search to identify 8 frequently cited articles having primary outcomes that were incident HAIs, were based on individual-level data, and used multivariate statistical methods. Next, using an inpatient cohort of incident Clostridium difficile infection (CDI), we compared 3 valid strategies for assessing risk factors for incident infection: a cohort study with time-fixed exposures, a cohort study with time-varying exposures, and a case-control study with time-varying exposures. RESULTS Of the 8 studies identified in the literature scan, 3 did not adjust for time-at-risk, 6 did not assess the timing of exposures in a time-window prior to outcome ascertainment, 6 did not include ecological covariates, and 6 did not account for the clustering of outcomes in time and space. Our 3 modeling strategies yielded similar risk-factor estimates for CDI risk. CONCLUSIONS Several common statistical methods can be used to augment standard regression methods to improve the identification of HAI risk factors. Infect.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Brown KA,Daneman N,Stevens VW,Zhang Y,Greene TH,Samore MH,Arora Pdoi
10.1017/ice.2015.312subject
Has Abstractpub_date
2016-04-01 00:00:00pages
411-9issue
4eissn
0899-823Xissn
1559-6834pii
S0899823X15003128journal_volume
37pub_type
杂志文章,评审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::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::Surveillance for methicillin-resistant Staphylococcus aureus (MRSA) was implemented in Rio de Janeiro and Uberlândia University Hospitals, which had different policies on use of mupirocin. One hundred fourteen multiresistant MRSA strains were isolated from 62 patients. Mupirocin resistance was observed in 63% of strai...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1996-12-01 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 persistence of coagulase-negative staphylococci (CNS) on a hematology-oncology ward and to determine the value of phenotypic and genotypic procedures for establishing clonality among CNS isolates. DESIGN:Strains of CNS isolated from bacteremic patients (n = 139) were typed by biochemical reactiv...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1996-10-01 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::Whole-genome sequencing (WGS) has yielded new insights into the transmission patterns of healthcare facility-onset Clostridioides difficile infection (HO-CDI). WGS results prompted a focused diagnostic stewardship program, which was associated with a significant and sustained decrease in HO-CDI at large, urban hospita...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.124
更新日期:2019-07-01 00:00:00
abstract::Twelve nosocomial outbreaks over 14 years at a tertiary-care center in Mexico are described. Overall mortality was 25.8%, one half due to pneumonia. The most common organism was Pseudomonas aeruginosa. Incidence was three outbreaks per 10,000 discharges; outbreak-related infections comprised 1.56% of all nosocomial in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501800
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To determine the comparative virulence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S aureus (MSSA) by consideration of predisposing factors and outcomes in patients infected with these organisms in the healthcare setting. DESIGN:Analysis of an historical cohort of 504 bact...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501707
更新日期:2000-10-01 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::More than 50% of women with clinically apparent infection after mastectomy did not meet the 2020 National Healthcare Safety Network (NHSN) definition for surgical site infection (SSI). Implant loss was similar whether the 2020 NHSN SSI definition was met or not, suggesting equivalent adverse outcomes regardless of res...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.1288
更新日期:2020-11-17 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
pub_type: 杂志文章
doi:10.1017/ice.2015.267
更新日期:2016-02-01 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:OBJECTIVE:Bloodstream infections due to methicillin-resistant Staphylococcus aureus (MRSA) have been associated with significant risk of in-hospital mortality. The acute physiology and chronic health evaluation (APACHE) II score was developed and validated for use among intensive care unit (ICU) patients, but its utili...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/665731
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients. DESIGN:Survey. SETTING:Chronic hemodialysis facilities in the United States. PARTICIPANTS:Equal-probability 2-stage cluster sampling was used to select 87 faciliti...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/659407
更新日期:2011-05-01 00:00:00
abstract::We assessed hand hygiene adherence in 2 infectious disease units. In one unit, adherence declined slightly from year 1 (84.2%) to year 4 (71.0%) after a multimodal intervention but remained much higher than before intervention. Adherence dropped in the second unit after a loss of leadership (from 50.7% to 5.7%). Stron...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/675296
更新日期:2014-03-01 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:OBJECTIVE:Laboratory investigations were initiated with a povidone-iodine antiseptic solution that was intrinsically contaminated with Pseudomonas cepacia. These investigations were helpful in understanding the microbicidal and chemical properties of iodophor solutions and the mechanism by which P cepacia can survive i...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646342
更新日期:1991-05-01 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::Monsel's solution is a common topically applied hemostatic agent used in minor dermatologic and gynecologic surgery. Clinically, because it is often stored for long periods and dispensed from a common source for multiple patients, Monsel's solution is a potential vector for transmission of infection. However, microbio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502180
更新日期:2003-02-01 00:00:00
abstract::OBJECTIVE To describe the investigation and control of a cluster of Serratia marcescens bacteremia in a 505-bed tertiary-care center. METHODS Cluster cases were defined as all patients with S. marcescens bacteremia between March 2 and April 7, 2014, who were found to have identical or related blood isolates determined...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.137
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:Evaluate changes in antimicrobial use during COVID-19 and after implementation of a multispecialty COVID-19 clinical guidance team compared to pre-COVID-19 antimicrobial use. DESIGN:Retrospective observational study. SETTING:Tertiary-care academic medical center. PARTICIPANTS:Internal medicine and medical ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.1291
更新日期:2020-10-26 00:00:00
abstract:OBJECTIVE:To identify variables contributing to interfacility differences in mortality among residents of long-term care facilities who have lower respiratory tract infection. DESIGN:Multicenter, prospective, 1-year observational study. SETTING:Twenty-one long-term care facilities in 4 geographic areas of Canada. PA...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/590123
更新日期:2008-08-01 00:00:00
abstract::The effectiveness of five 30-second handwashes with a non-antiseptic lotion soap to remove nosocomial pathogens (10(8) CFU) applied to fingertips was studied. CFU for all species dropped rapidly after the first handwash; persistence (10 to 15 CFU) was maintained thereafter. Wiping hands with an antiseptic (70% isoprop...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502388
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE: To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC). DESIGN: Cohort prospective multinational multicenter surveillance study. SETTING: Eighty-two hospitals of 66 cities in 30 countries (Argentina, Br...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/670626
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Investigation of a program to eradicate amebiasis using consecutive intensive mass screenings followed by medication in a large institute for adults with mental retardation in Taiwan. DESIGN:Prospective cohort study, with 3 years of follow-up. SETTING:A large, 450-bed institution for adults with mental reta...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/518351
更新日期:2007-06-01 00:00:00
abstract::We found that a majority of hospitalized patients were aware of the importance of hand hygiene, but observations indicated that performance of hand hygiene was uncommon. An intervention in which healthcare personnel facilitated hand hygiene at specific moments significantly increased performance of hand hygiene by pat...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.78
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Surveillance of nosocomial infections (NIs) is well established in many countries but often does not include gastrointestinal infections. We sought to determine the proportion of NIs among all hospitalized cases for the 4 most prevalent types of gastrointestinal infections in Germany. METHODS:We analyzed all...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/657133
更新日期:2010-12-01 00:00:00
abstract::Water cultures were significantly more sensitive than concurrently collected swab cultures (n=2,147 each) in detecting Legionella pneumophila within a Veterans Affairs healthcare system. Sensitivity for water versus swab cultures was 90% versus 30% overall, 83% versus 48% during a nosocomial Legionnaires' disease outb...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.235
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:To describe the pattern of transmission of SARS-CoV-2 during 2 nosocomial outbreaks of COVID-19 with regard to the possibility of airborne transmission. DESIGN:Contact investigations with active case finding were used to assess the pattern of spread from 2 COVID-19 index patients. SETTING:A community hospit...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.321
更新日期:2020-07-03 00:00:00