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 baseline (October 2011-August 2013) and 2 intervention periods, September 2013-June 2015 and July 2015-June 2016, including 1,525 oncology hospitalizations and 301 HSCT hospitalizations. INTERVENTION In phase 1, we completed an update of the institutional febrile neutropenia (FN) guideline for the pediatric oncology service, recommending first-line β-lactam monotherapy rather than routine use of 2 gram-negative agents. Phase 2 included updating the HSCT service FN guideline and engagement with a new pediatric antimicrobial stewardship program. The use of target antibiotics (tobramycin and ciprofloxacin) was measured in days of therapy per 1,000 patient days collected from administrative data. Intervention effects were evaluated using interrupted time series with segmented regression. RESULTS Phase 1 had mixed effects-long-term reduction in tobramycin use (97% below projected at 18 months) but rebound with increasing slope in ciprofloxacin use (+18% per month). Following phase 2, tobramycin and ciprofloxacin use on the oncology service were both 99% below projected levels at 12 months. On the HSCT service, tobramycin use was 99% below the projected level and ciprofloxacin use was 96% below the projected level at 12 months. CONCLUSIONS Locally adapted guidelines can facilitate practice changes in oncology and HSCT settings. More comprehensive and ongoing interventions, including follow-up education, feedback, and engagement of companion services may be needed to sustain changes. Infect Control Hosp Epidemiol 2017;38:1039-1047.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Wattier RL,Levy ER,Sabnis AJ,Dvorak CC,Auerbach ADdoi
10.1017/ice.2017.118subject
Has Abstractpub_date
2017-09-01 00:00:00pages
1039-1047issue
9eissn
0899-823Xissn
1559-6834pii
S0899823X17001180journal_volume
38pub_type
杂志文章abstract:OBJECTIVE:To develop new evaluation indices of infection control and to use them to evaluate Korean infection surveillance and control programs (ISCPs). DESIGN:We performed a questionnaire-based survey to 164 acute care general hospitals throughout the Republic of Korea that had more than 300 beds. Study methods were ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/512632
更新日期:2007-04-01 00:00:00
abstract::We compared cleaning rates associated with use of a white ultraviolet (UV) powder versus a transparent UV gel among units with various degrees of previous experience with UV powder. The study outcome was the presence of discordant cleaning (removal of powder without the removal of gel, or vice versa). We found higher ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/663713
更新日期:2012-02-01 00:00:00
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 admissio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/678069
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Surgical site infections (SSIs) are common surgical complications that lead to increased costs. Depending on payer type, however, they do not necessarily translate into deficits for every hospital. OBJECTIVE:We investigated how surgical site infections (SSIs) influence the contribution margin in 2 reimburse...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1017/ice.2019.273
更新日期:2019-12-01 00:00:00
abstract::OBJECTIVE To compare 6 airway-management devices in 3 isolation scenarios regarding their effect on airway management: portable isolation unit (PIU), personal protective equipment (PPE), and standard protection measures METHODS In total, 30 anesthesiologists working in emergency medical services performed airway manag...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/ice.2017.287
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To determine the safety and cost-effectiveness of replacing the intravenous (IV) tubing sets in hospitalized patients at 4- to 7-day intervals instead of every 72 hours. DESIGN:Prospective, randomized study of infusion-related contamination associated with changing IV tubing sets within 3 days versus within ...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/501879
更新日期:2001-03-01 00:00:00
abstract::We describe the clinical, microbiologic, and molecular features of the first series of qacA/B-containing strains of methicillin-resistant Staphylococcus aureus from infected US patients. All qac-carrying strains were clonally diverse, and qacA strains exhibited increased tolerance to chlorhexidine as measured by minim...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/662380
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:To study the epidemiology of Yersinia enterocolitica infections in hospitalized patients and to determine the frequency of hospital-acquired infection and the modes of transmission within the hospital. DESIGN:Descriptive study in which the clinical microbiology laboratory reported all positive Yersinia cultu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646496
更新日期:1992-03-01 00:00:00
abstract::We propose the use of a machine learning algorithm to improve possible COVID-19 case identification more quickly using a mobile phone-based web survey. This method could reduce the spread of the virus in susceptible populations under quarantine. ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.61
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:Describe the epidemiology of central line-associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) participating in a standardized and mandatory CLABSI surveillance program. DESIGN:Retrospective cohort. Setting. We included patients admitted (April 2007-March 2011) to 7 level II/I...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673464
更新日期:2013-11-01 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::Aerobic gram-negative bacillus (AGNB) groin skin carriage was prospectively studied in ambulatory geriatric outpatients: 42 from three nursing homes and 44 from private homes. Initially, 12 (28.6%) Proteeae carriers were in the former group and 3 (6.8%) were in the latter (P = 0.01). At one year, 6 of 7 surviving nurs...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645990
更新日期:1989-04-01 00:00:00
abstract::Timely identification of outbreaks of hospital-associated infections is needed to implement control measures and minimize impact. Survey results from 33 hospitals indicated that most hospitals lacked a formal cluster definition and all targeted a very limited group of prespecified pathogens. Standardized, statisticall...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2015.325
更新日期:2016-04-01 00:00:00
abstract::During an insidious outbreak of salmonellosis in a long-term care facility, residents who were treated with acid-suppressing medications were 8 times more likely than other residents to develop Salmonella infection. Among vulnerable populations, the risks and benefits of acid-suppressing medications should be consider...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/520736
更新日期:2007-10-01 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::In 2001, New York State health officials were notified about 2 patients with Creutzfeldt-Jakob disease who had undergone neurosurgical procedures at the same hospital within 43 days of each other. One patient had Creutzfeldt-Jakob disease at the time of surgery; the other patient developed Creutzfeldt-Jakob disease 6....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503017
更新日期:2006-03-01 00:00:00
abstract::Vancomycin is a commonly prescribed empiric antibiotic used when methicillin-resistant Staphylococcus aureus (MRSA) infection is suspected. In this study, we aimed to determine the rate of culture-positive infection requiring vancomycin therapy. ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.123
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:Better understand the incidence, risk factors, and outcomes of peripheral venous catheter (PVC)-related Staphylococcus aureus bacteremia. DESIGN:Retrospective study of PVC-related S. aureus bacteremias in adult patients from July 2005 through March 2008. A point-prevalence survey was performed January 9, 200...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/660099
更新日期:2011-06-01 00:00:00
abstract::OBJECTIVE To assess the clinical effectiveness of a universal screening program compared with a risk factor-based program in reducing the rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) among admitted patients at the Ottawa Hospital. DESIGN Quasi-experimental study. SETTING Ottawa Hospital, a mu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.230
更新日期:2016-01-01 00:00:00
abstract::BACKGROUND Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) are emerging worldwide. Contact precautions are recommended for known ESBL-E carriers to control the spread of ESBL-E within hospitals. OBJECTIVE This study quantified the acquisition of ESBL-E rectal carriage among patients in Dutch hospit...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.241
更新日期:2018-01-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/658332
更新日期:2011-03-01 00:00:00
abstract::In patients with β-lactam allergies, administration of non-β-lactam surgical prophylaxis is associated with increased risk of infection. Although many patients self-report β-lactam allergies, most are unconfirmed or mislabeled. A quality improvement process, utilizing a structured β-lactam allergy tool, was implemente...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.274
更新日期:2019-12-01 00:00:00
abstract::Nine hundred seventy-two cultures taken from the external nares and the vaginal vestibules of 54 women for the isolation of Staphylococcus aureus were studied. The swabs were plated directly to a trypticase soy agar plate containing 5% sheep blood and were then placed into a selective staphylococcal broth. Both cultur...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645834
更新日期:1988-05-01 00:00:00
abstract::We report the effect of prospective audit and feedback (PAF) on inpatient fluoroquinolone (FQN) prescriptions. During the PAF period, FQN use decreased from 39.19 to 29.58 days of therapy per 1,000 patient days (P < .001) and appropriateness improved from 68% to 88% (P < .001). High-yield indications to target include...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.339
更新日期:2020-12-01 00:00:00
abstract::This study was designed to test the efficacy of a washer-disinfector in eliminating selected healthcare-associated pathogens from surgical instruments. Our results showed that a washer-disinfector was extremely effective in eliminating microorganisms (>7-log(10) reduction), including vegetative and spore-forming bacte...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/676867
更新日期:2014-07-01 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:OBJECTIVE:To characterize the probability and duration of viral shedding among adults given trivalent live attenuated influenza vaccine (LAIV). DESIGN:Prospective surveillance study. METHODS:Nasal wash samples were collected from adult volunteers at baseline and on days 3, 7, and 10 and between days 17 and 21 followi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502574
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of 1-week ventilator circuit change on ventilator-associated pneumonia and its cost-effectiveness compared with a 2-day change. DESIGN:An observational cohort study. SETTING:A tertiary level neonatal intensive care unit in a university-affiliated teaching hospital in Taiwan. Patien...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2014.48
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To investigate and control a nosocomial outbreak of Burkholderia cepacia lower respiratory tract infection. DESIGN:Outbreak investigation and case-control study. SETTING:A 260-bed community hospital. PATIENTS:Participants were mechanically ventilated intensive care patients without cystic fibrosis. A case ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501928
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:To investigate an outbreak in neonates of Enterobacter cloacae infection resistant to third-generation cephalosporins. DESIGN:A retrospective study of an outbreak in the neonatal intensive care unit (NICU) and review of E cloacae isolates in pediatric wards and other intensive care units from June 1992 throu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646998
更新日期:1995-01-01 00:00:00