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 (CLABSI) outcomes. METHODS We compared CAUTI and CLABSI NHSN-defined outcomes for calendar years 2014 and 2015 in the adult intensive care units (ICUs) of a single large health system. Changes in the event rates, the associated organisms, and the standardized infection ratio (SIR) were evaluated. RESULTS The study included 137 adult ICUs from 65 hospitals. The CAUTI SIR dropped from 1.04 in 2014 to 0.58 in 2015 (-44.2%), while the CLABSI SIR increased from 0.36 in 2014 to 0.47 in 2015 (+30.6%). CAUTI rates dropped 44.8% from 2.09 to 1.15 events per 1,000 device days (P<.001). Gram-positive-associated CAUTI rates dropped 36.7% from 0.34 to 0.22 per 1,000 device days (P=.007). CLABSI rates increased 27.1% from 0.71 to 0.90 per 1,000 device days (P=.027). Candida-associated CLABSI increased by 91.1% from 0.104 to 0.198 per 1,000 device days (P=.012), and Enterococcus-associated CLABSI increased by 121.6% from 0.071 to 0.16 per 1,000 device days (P=.008). CONCLUSIONS The revised CAUTI definition led to a large reduction in CAUTI rates and, in turn, an increase in candidemia and enterococcemia cases classified as CLABSI events. These findings have important implications on the perceived successes or failures to eliminate both infections. Infect Control Hosp Epidemiol 2017;38:685-689.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Fakih MG,Groves C,Bufalino A,Sturm LK,Hendrich ALdoi
10.1017/ice.2017.41subject
Has Abstractpub_date
2017-06-01 00:00:00pages
685-689issue
6eissn
0899-823Xissn
1559-6834pii
S0899823X17000411journal_volume
38pub_type
杂志文章abstract::The usefulness of routine annual tuberculin skin testing (purified protein derivative [PPD]) of hospital employees has been questioned. Between 1984 and the end of 1987 the PPD conversion rates of hospital employees at a university and psychiatric hospital in North Florida were compared. The number of employees in bot...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645922
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:To assess the ability of a protective isolation room ventilation system to reduce patient exposure to airborne infectious agents, using a small-scale model that permits cost-effective and unobtrusive study of relevant indices of performance. DESIGN:A one-half scale model of a protective isolation room at the...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647181
更新日期:1996-01-01 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::Group A streptococci account for less than 1% of all surgical wound infections but are an important cause of nosocomial outbreaks. We report here a cluster of four group A streptococcal infections that occurred within an 11-day period on a single surgical service. The index case presented with toxic shock-like syndrom...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646732
更新日期:1993-05-01 00:00:00
abstract::Infection control in the long-term-care facility has expanded substantially since "Topics in Long-Term Care" debuted in this journal in 1989. This section has been on hiatus, but now, after a 4-year lag, resumes its exploration of these topics. In the first article, endemic and epidemic infections in long-term care ar...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647831
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:To investigate the possibility that contaminated commercial activated charcoal may serve as a source for fungal colonization or infection of the lower respiratory tract. DESIGN:The clinical course of a patient who aspirated commercial activated charcoal was reviewed. Fungal cultures were performed for 2 samp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646281
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:To determine the impact of the introduction of a plastic shield-shaped device (Needleguard, Biosafe, Auckland, New Zealand) and education program designed to allow safer recapping, on recorded rates of needlestick injury. DESIGN:A before-after trial with a two-year duration of follow-up. SETTING:Tertiary re...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646328
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:To establish a new, rapid, and reliable genotypic fingerprinting technique for methicillin-resistant Staphylococcus aureus (MRSA) typing in routine epidemiological surveillance. DESIGN:The method is based on polymerase chain reaction (PCR) restriction fragment-length polymorphism (RFLP) following HaeII diges...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501903
更新日期:2001-05-01 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:OBJECTIVE:To determine whether hydrogen peroxide vapor (HPV) decontamination can reduce environmental contamination with and nosocomial transmission of Clostridium difficile. DESIGN:A prospective before-after intervention study. SETTING:A hospital affected by an epidemic strain of C. difficile. INTERVENTION:Intensiv...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/589906
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:Central line-associated bloodstream infection (BSI) rates are a key quality metric for comparing hospital quality and safety. Traditional BSI surveillance may be limited by interrater variability. We assessed whether a computer-automated method of central line-associated BSI detection can improve the validity...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/678602
更新日期:2014-12-01 00:00:00
abstract::This study reports an investigation of outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization involving 17 newborns in the neonatal unit of a teaching hospital. A neonatal specialist colonized with MRSA that eventually became mupirocin-resistant was implicated as a recurrent source ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/513616
更新日期:2007-05-01 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::We aimed to determine the association between the presence of Acinetobacter baumannii in patient rooms and the carrier status of the occupants. Fifty-six (39%) of 143 rooms with A. baumannii-positive patients had results positive for A. baumannii. Only 49 (10%) of 485 rooms with A. baumannii-negative patients were pos...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/670209
更新日期:2013-05-01 00:00:00
abstract::An intensive care nurse with eczema was repeatedly treated for methicillin-resistant Staphylococcus aureus (MRSA) carriage. Because cultures remained positive for MRSA, her house was investigated. Thirty-four percent of environmental samples yielded MRSA. Her children and cat were free of MRSA. The house was decontami...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507966
更新日期:2006-10-01 00:00:00
abstract::Antibiotic prescribing practices across the Veterans' Health Administration (VA) experienced significant shifts during the coronavirus disease 2019 (COVID-19) pandemic. From 2015 to 2019, antibiotic use between January and May decreased from 638 to 602 days of therapy (DOT) per 1,000 days present (DP), while the corre...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.1277
更新日期:2020-10-20 00:00:00
abstract::Three different sequentially applied post-varicella zoster virus (VZV) exposure management strategies were employed over a 43-month period. We began by using a standard post-exposure protocol in which 50 susceptible healthcare workers (HCW) involved in hospital exposures were furloughed from work at a loss to the hosp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646176
更新日期:1990-06-01 00:00:00
abstract::We evaluated vancomycin use in a hospital with endemic vancomycin-resistant enterococci and a vancomycin restriction program. Only 68% of vancomycin was prescribed appropriately. Inappropriate use was due primarily to empirical therapy. In the patients with a microbiological diagnosis following empirical therapy, 83% ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501548
更新日期:1999-01-01 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::A previously published study recommended the daily use of visible smoke to test for negative air pressure in isolation rooms occupied by potentially infectious tuberculosis cases. Continuous monitoring devices were found to have poor reliability. Findings from our survey of engineering controls in acute-care hospitals...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501943
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Patients in the neonatal intensive care unit (NICU) are at high risk for healthcare-associated infections. Variability in reported infection rates among NICUs exists, possibly related to differences in prevention strategies. A better understanding of current prevention practices may help identify prevention ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/677636
更新日期:2014-09-01 00:00:00
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::A surgeon-specific computer-generated monthly questionnaire was used to improve surveillance of surgical wound infections in outpatients as well as inpatients following discharge. From July 1988 through June 1989, 20,536 surgical procedures were performed at our medical center, of which 53% were for outpatients. The t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646084
更新日期:1990-10-01 00:00:00
abstract::The mite Dermanyssus gallinae may cause pruritic dermatitis in humans. We describe a case of nosocomial infestation with D. gallinae from an abandoned pigeon nest suspended on the front wall of the Hôpital Henri Mondor near a window. Close surveillance and regular destruction of pigeon nests could prevent these incide...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/528815
更新日期:2008-03-01 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 determine the extent to which evidence-based practices for the prevention of central venous catheter (CVC)-associated bloodstream infections are incorporated into the policies and practices of academic intensive care units (ICUs) in the United States and to determine variations in the policies on CVC inser...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/499151
更新日期:2006-01-01 00:00:00
abstract::The Quality Indicator Study Group was created by the governing boards of three national professional organizations that have interest and experience in epidemiology, nosocomial infection control and prevention, and quality of care improvement. The Study Group has reviewed the existing literature concerning quality ind...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647112
更新日期:1995-05-01 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::From 2000 to 2009, rates of multidrug-resistant Acinetobacter baumanii increased 10-fold to 0.2 per 1,000 patient days. From 2010 to 2015, however, rates markedly declined and have stayed below 0.05 per 1,000 patient days. Herein, we present a 15-year trend analysis and discuss interventions that may have led to the d...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.52
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Carbapenem-resistant Enterobacteriaceae (CRE) are rapidly emerging worldwide. Control group selection is critically important when analyzing predictors of antimicrobial resistance. Focusing on modifiable risk factors can optimize prevention and resource expenditures. To identify specific predictors of CRE, p...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/666642
更新日期:2012-08-01 00:00:00