Abstract：
BACKGROUND:Although antimicrobial stewardship programs (ASPs) are uniquely positioned to improve treatment of Clostridium difficile infection (CDI) through targeted interventions, studies to date have not rigorously evaluated the influence of ASP involvement on clinical outcomes attributed to CDI. METHODS:We performed a quasiexperimental study of adult patients with CDI before (n = 307) and after (n = 285) a real-time ASP review was initiated. In the intervention group, an ASP pharmacist was notified of positive CDI results and consulted with the care team to initiate optimal therapy, minimize concomitant antibiotic and acid-suppressive therapy, and recommend surgical/infectious diseases consultation in complicated cases. The primary outcome was a composite of attributable 30-day mortality, intensive care unit admission, colectomy/ileostomy, and recurrence. RESULTS:A higher percentage of patients in the ASP intervention group had acid-suppressive therapy discontinued (30% vs 13%; P < .01). Among patients with severe CDI, more patients in the intervention group received an infectious diseases consultation (17% vs 10%; P = .04), received appropriate therapy with oral vancomycin (87% vs 59%; P <.01), and vancomycin was initiated earlier (mean, 1.1 vs 1.7 days; P <.01). Incidence of the composite outcome was not significantly different between the 2 groups (12.3% vs 14.7%; P = .40). CONCLUSIONS:ASP review and intervention improved CDI process measures. A decrease in composite outcomes was not found, which may be due to low baseline rates of attributable complications in our institution.
journal_name
Am J Infect Controljournal_title
American journal of infection controlauthors
Welch HK,Nagel JL,Patel TS,Gandhi TN,Chen B,De Leon J,Chenoweth CE,Washer LL,Rao K,Eschenauer GAdoi
10.1016/j.ajic.2016.05.027subject
Has Abstractpub_date
2016-12-01 00:00:00pages
1539-1543issue
12eissn
0196-6553issn
1527-3296pii
S0196-6553(16)30625-3journal_volume
44pub_type
杂志文章abstract：INTRODUCTION:Reverse osmosis (RO), a major advance in hemodialysis (HD) safety, effectively clears most water organisms. Delftia acidovorans is an environmental water-borne pathogen that is rarely reported to cause human infections. We report a pseudo outbreak caused by colonization of RO machines with D acidovorans wi...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2019.11.027
更新日期：2020-03-01 00:00:00
abstract：:Literature suggests that cancer patients can become colonized or infected with a variety of opportunistic and health care-associated pathogens, putting them at higher risk for nonventilator health care-associated pneumonia. This section will review the epidemiology of nonventilator health care-associated pneumonia and...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.03.005
更新日期：2020-05-01 00:00:00
abstract：BACKGROUND:The prevalence of healthcare associated infection (HAI) is generally higher in countries with limited resources than developed countries. To address the high prevalence of HAI, Turkish Ministry of Health introduced a national infection control program in 2005. METHODS:Device associated (DA)-HAIs routinely s...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.12.013
更新日期：2020-12-25 00:00:00
abstract：:Hand dermatitis as a result of frequent exposure to water and cleansing agents is a significant problem in the health care industry. In developing prevention efforts to address this problem, it is necessary to make appropriate recommendations for moisturizers that are compatible with latex gloves and/or handwashing ag...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1067/mic.2001.117298
更新日期：2001-12-01 00:00:00
abstract：BACKGROUND:Contamination of bronchoalveolar lavage fluid is a major problem in the world. Although 2% glutaraldehyde (GA) is widely used as a disinfectant for bronchoscope cleaning, recently, GA-tolerant mycobacteria have been isolated, which makes this problem more complicated. METHODS:We studied the susceptibility t...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2003.07.007
更新日期：2004-06-01 00:00:00
abstract：:In a study conducted in 11 health care settings for elderly patients, we demonstrated a significant negative correlation between the proportion of glove use outside any risk of exposure to body fluids and compliance with hand hygiene (P < .02). This result underscores a major limitation of strategies for controlling t...
journal_title：American journal of infection control
pub_type： 杂志文章,多中心研究
doi：10.1016/j.ajic.2011.05.008
更新日期：2012-05-01 00:00:00
abstract：:Urinary tract infections are one of the most common hospital-acquired infections, with 70%-80% resulting from catheter-associated urinary tract infections (CAUTIs). We undertook a qualitative study to assess patient perspectives of indwelling urinary catheters using a semistructured interview. We found that patient aw...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2015.10.011
更新日期：2016-03-01 00:00:00
abstract：:Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of health care facilities with home and everyday life settings barely addressed. As seen with the recent global SARS-CoV...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.04.011
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:Patient and visitor hand hygiene has the potential to prevent health care-associated infections, but there are few data on the efficacy of interventions to improve patient/visitor hand hygiene. OBJECTIVE:To determine whether conventional and front-line ownership (FLO) patient/visitor hand hygiene interventi...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2019.09.026
更新日期：2020-05-01 00:00:00
abstract：BACKGROUND:Previous studies have drawn different conclusions about the impact of Candida airway colonization on clinical outcomes in patients with ventilator-associated pneumonia (VAP). METHODS:We searched PubMed, the Cochrane Library, Embase (via OVID), and Web of Science database. We included both retrospective and ...
journal_title：American journal of infection control
pub_type： 杂志文章,评审
doi：10.1016/j.ajic.2019.11.002
更新日期：2020-06-01 00:00:00
abstract：OBJECTIVE:To describe successful termination of an outbreak of vancomycin-resistant Enterococcus faecium (VREfm) colonization within a neonatal service. SETTING:Multisite neonatal intensive care unit and special care nurseries within a single health care service. PARTICIPANTS:Forty-four cases of VREfm-colonized neona...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2015.05.047
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Asymptomatic bacteriuria is often treated with antimicrobials despite no benefit to patients, contributing to antimicrobial resistance and costs. Identifying knowledge deficits may improve physician training and antimicrobial stewardship efforts. We surveyed internal medicine and medicine-pediatrics resident...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2013.01.020
更新日期：2013-10-01 00:00:00
abstract：:A nurse-to-patient transmission of HIV type 1 was recently documented in a French hospital. The origin of the transmission remained unclear. To inform patients who may have been exposed to the nurse while they had received care, a lookback investigation that included mailings and a viral screening was conducted for 75...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1067/mic.2002.119926
更新日期：2002-06-01 00:00:00
abstract：:The Association for Practitioners in Infection Control, Inc. (APIC) is a multidisciplinary organization of over 9000 health care professionals who practice institutional epidemiology in the form of infection control and quality improvement within a variety of settings. As a national leader in prevention and control of...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(93)90230-2
更新日期：1993-04-01 00:00:00
abstract：BACKGROUND:This study was conducted to evaluate the ongoing transmission of methicillin-resistant Staphylococcus aureus (MRSA) in a 10-bed trauma intensive care unit (TICU) in a large teaching hospital. METHODS:Surveillance cultures for MRSA were obtained on admission to the TICU. Colonized or infected patients were p...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2007.05.013
更新日期：2008-03-01 00:00:00
abstract：BACKGROUND:Surgical site infections (SSIs) following hip fracture surgeries have profound clinical and economic implications. The study aims to analyze the effect of an integrative SSI prevention care bundle on the SSI incidence among surgical hip patients. The study also aims to examine the association between SSI and...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2018.10.011
更新日期：2019-05-01 00:00:00
abstract：:Infection control professionals have traditionally relied on didacticism to promote behavior change among health care workers, but this approach yields disappointing results in a postmodern era of social fragmentation and intellectual ambiguity. We define a socioethical approach to behavior change and propose its impl...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2005.09.004
更新日期：2006-03-01 00:00:00
abstract：:We report a historic nosocomial outbreak of Salmonella enteritidis affecting 4 inpatients who underwent endoscopic retrograde cholangiopancreatography. The cause was attributed to inadequate decontamination of an on-loan endoscope used over a weekend. This report highlights the risks of using on-loan endoscopes, parti...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2016.11.024
更新日期：2017-04-01 00:00:00
abstract：:Candida auris presents a unique challenge to practitioners and infection control teams worldwide because of its virulence, alarming resistance profile, environmental fitness, and risk of nosocomial transmission. We describe 2 cases of Candida auris infection managed with the CDC recommendations with no evidence of in-...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.08.027
更新日期：2020-08-20 00:00:00
abstract：BACKGROUND:The best strategy for active surveillance for methicillin-resistant Staphylococcus aureus (MRSA) remains unclear. We attempted to identify a risk factor score to predict MRSA colonization at hospital admission. METHODS:Data on 9 variables reported as risk factors for MRSA colonization were analyzed, and a r...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2013.02.013
更新日期：2013-11-01 00:00:00
abstract：:Bacteria can develop resistance to antibiotics, but little is known about their ability to increase resistance to chemical disinfectants. This study randomly sampled 3 automated endoscope reprocessors in the United States using aldehydes for endoscope disinfection. Bacterial contamination was found after disinfection ...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2011.11.004
更新日期：2012-11-01 00:00:00
abstract：BACKGROUND:Insufficient use of behavioral theory to understand health care workers' (HCWs) hand hygiene compliance may result in suboptimal design of hand hygiene interventions and limit effectiveness. Previous studies examined HCWs' intended, rather than directly observed, compliance and/or focused on just 1 behaviora...
journal_title：American journal of infection control
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.ajic.2013.07.019
更新日期：2014-02-01 00:00:00
abstract：:Six hundred twenty-two isolates from 554 samples taken from hands of 103 hospital personnel and 50 controls were obtained over a mean period of 35 days. Eighty-five were obtained immediately before and after handwashing (HW), the remainder after HW only. The relationship of HW agent used, clinical area and job, and fr...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(84)90020-8
更新日期：1984-04-01 00:00:00
abstract：BACKGROUND:Scabies is a dermatologic infestation caused by Sarcoptes scabiei. In industrialized countries, hospitals and other health structures can sometimes be hit. The optimal management of scabies outbreaks still has to be established, mass prophylaxis being one possible option. METHODS:To identify the optimal app...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2013.10.006
更新日期：2014-03-01 00:00:00
abstract：:The antibacterial efficacy of 4% chlorhexidine gluconate (CHG) and 1% triclosan as handwash antiseptics is well established. Few published studies have identified hand bacteria found in glove juice samples, and most studies have used nonclinical study subjects. We report a longitudinal comparative study to determine t...
journal_title：American journal of infection control
pub_type： 临床试验,杂志文章
doi：10.1016/s0196-6553(99)70051-9
更新日期：1999-08-01 00:00:00
abstract：OBJECTIVE:This systematic review had two aims. First to identify the incidence of urinary tract infection (UTI) and bacteriuria in people undertaking intermittent catheterisation (IC), second to determine the effectiveness of antiseptic cleaning of the meatal area prior to IC in reducing the incidence of UTI and bacter...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2021.01.009
更新日期：2021-01-21 00:00:00
abstract：BACKGROUND:A cross-sectional study was conducted in a large university hospital in Belo Horizonte, Minas Gerais, Brazil to evaluate surgical glove integrity after use during surgery. METHODS:This 6-month study was conducted by a gastroenterological, cardiovascular, and pediatric surgical team consisting of surgeons (m...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2014.06.021
更新日期：2014-10-01 00:00:00
abstract：:Sample-size determination is a crucial component of study design. Estimates of sample size are influenced by the amount of change that must occur between study groups and the degree of risk that the investigator is willing to accept in evaluating the null hypothesis. A complete understanding of the impact of sample si...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(93)90007-q
更新日期：1993-06-01 00:00:00
abstract：BACKGROUND:Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens in many hospitals. The true prevalence of VRE in pediatric hospitals is not known. METHODS:A surveillance study was performed at a pediatric tertiary care medical center by using vancomycin-containing screening media. RESULTS:Six chi...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1053/ic.1998.v26.a93115
更新日期：1998-12-01 00:00:00
abstract：:During a 17-month period (01/11/85-05/31/86) 225 cases of nosocomial diarrhea were identified in a children's hospital. Diarrhea was considered to be nosocomial if it began at least 72 hours after the patient's hospital admission or within 3 days after discharge. One or more routine diagnostic studies for identificati...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(89)90021-7
更新日期：1989-04-01 00:00:00
