Abstract:
:OBJECTIVE To elicit expert consensus on the likelihood of infectious outcomes (patient colonization or infection) following a broad range of infectious risk moments (IRMs) from observations in acute care. DESIGN Expert consensus study using modified Delphi technique. PARTICIPANTS Panel of 40 international experts including nurses, physicians and microbiologists specialized in infectious diseases and infection prevention and control (IPC). METHODS The modified Delphi process consisted of 3 online survey rounds, with feedback of mean ratings and expert comments between rounds. The Delphi survey comprised 52 care scenarios representing observed IRMs organized into 6 sections: hands, gloves, medical devices, mobile objects, invasive procedures, and additional moments. For each scenario, experts indicated the likelihood of both patient colonization and infection on a scale from 0 to 5 (high). Expert ratings were plotted against frequencies of IRMs observed during actual patient care resulting in a risk index. RESULTS Following 3 rounds, consensus was achieved for 92 of 104 items (88.5%). The mean ratings across all scenarios for likelihood of colonization and infection were 2.68 and 2.02, respectively. The likelihood of colonization was rated higher than infection for 48 of 52 scenarios. Ratings were significantly higher for colonization (P=.001) and infection (P<.0005) when the scenario involved transfer of pathogens to critical patient sites. CONCLUSIONS The design of effective IPC strategies requires the selection of behaviors according to their impact on patient outcomes. The IRM index reported here provides a basis for standardizing and prioritizing targets for quality improvement initiatives, training, and future research in acute health care. Infect Control Hosp Epidemiol 2018;39:280-289.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Clack L,Passerini S,Manser T,Sax Hdoi
10.1017/ice.2017.327subject
Has Abstractpub_date
2018-03-01 00:00:00pages
280-289issue
3eissn
0899-823Xissn
1559-6834pii
S0899823X17003270journal_volume
39pub_type
杂志文章abstract::Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. CRE colonization at unit admission was infrequent (3.9%). Most CRE...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.236
更新日期:2018-12-01 00:00:00
abstract::If you have calculated a confidence interval for an infection rate and found the interval extending into meaningless negative numbers, chances are the error is due to use of approximation formulae. Many of us unknowingly were taught to use the Wald approximation, which does not always approximate the exact binomial di...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501701
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:To determine the predictors of 7-day mortality in older adult patients with Staphylococcus aureus bacteremia after controlling for comorbidity using the Charlson weighted index of comorbidity (WIC) and to identify the risk factors associated with bacteremia due to methicillin-resistant S. aureus (MRSA). DES...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507924
更新日期:2006-11-01 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::During the last quarter century, numerous reports have indicated that antimicrobial resistance commonly is encountered in long-term-care facilities (LTCFs). Gram-negative uropathogens resistant to penicillin, cephalosporin, aminoglycoside, or fluoroquinolone antibiotics and methicillin-resistant Staphylococcus aureus ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647257
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:To study the cost-effectiveness of vaccination for hepatitis A. SETTING:Hypothetical analysis of students currently enrolled in medical school in the United States. METHOD:A Markov-based model was developed using data from the literature, actual hospital costs, and an annual discount rate of 5%. The inciden...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647513
更新日期:1997-10-01 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::Hospital antibiotic use in Argentina has not been described. We present results of point prevalence surveys on antibiotic use conducted in 109 Argentinian hospitals in November 2018 and submitted to the National Program of Epidemiology and Control of Hospital-Acquired Infections, and we discuss potential areas for imp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.243
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To investigate a possible nosocomial outbreak of tuberculosis (TB). DESIGN:Retrospective cohort study. SETTING:Community hospital. METHODS:We reviewed medical records, hospital infection control measures, and potential locations of nosocomial exposure. We examined the results of acid-fast bacilli (AFB) sme...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502144
更新日期:2003-11-01 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:OBJECTIVE:Despite evidence to the contrary, many practitioners continue to inappropriately screen for and treat bacteria in the urine of clinically asymptomatic patients. The purpose of this study was to evaluate the impact of a new order set on the number of urine culture performed, antibiotic days of therapy (DOT), c...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.37
更新日期:2020-05-01 00:00:00
abstract::We describe an outbreak of Pseudomonas aeruginosa respiratory tract infections related to intrinsically contaminated ultrasound gel used for intraoperative transesophageal echocardiograms in cardiovascular surgery patients. This investigation led to a product safety alert by the Food and Drug Administration and the de...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671268
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To estimate the incidence of methicillin-resistant Staphylococcus aureus (MRSA) in patients hospitalized in French public hospitals. DESIGN:A 2-month survey that included 163,573 patients and 140,114 admissions. SETTING AND PATIENTS:Forty-three public or public-affiliated hospitals throughout France, includ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501656
更新日期:1999-07-01 00:00:00
abstract::New studies have been published regarding the epidemiology of Clostridium difficile in topics such as asymptomatic C. difficile colonization, community-associated C. difficile infection, environmental contamination outside healthcare settings, animal colonization, and the interactions between C. difficile and the gut ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2018.36
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Although many catheter-related bloodstream infections (CRBSIs) are preventable, measures to reduce these infections are not uniformly implemented. OBJECTIVE:To update an existing evidenced-based guideline that promotes strategies to prevent CRBSIs. DATA SOURCES:The MEDLINE database, conference proceedings,...
journal_title:Infection control and hospital epidemiology
pub_type: 指南,杂志文章
doi:10.1086/502007
更新日期:2002-12-01 00:00:00
abstract::We assessed the rate of recovery of fluoroquinolone-resistant and fluoroquinolone-susceptible Escherichia coli isolates from culture of frozen perirectal swab samples compared with the results for culture of the same specimen before freezing. Recovery rates for these 2 classes of E. coli were 91% and 83%, respectively...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/529590
更新日期:2008-04-01 00:00:00
abstract::A series of handwashing experiments using a pigskin substrate and Serratia marcescens as the contaminant compared the residual activity of a chlorhexidine detergent handwash product alone and in combination with anionic and nonionic-based moisturizing products and surfactant systems. The anionic based moisturizing pro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646124
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:To elucidate behavioral determinants of handwashing among nurses. DESIGN:Statistical modeling using the Theory of Planned Behavior and relevant components to handwashing behavior by nurses that were derived from focus-group discussions and literature review. SETTING:The community and 3 tertiary care hospita...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503335
更新日期:2006-05-01 00:00:00
abstract::Differences in reported hand hygiene compliance rates were assessed on the basis of the unit affiliation of observers. In 2 hospitals, unit-based observers more often reported higher compliance rates than did non-unit-based observers (79% vs 58.6%; difference, 20.4%; P<.001). Nonstandardized data collection methods co...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/655441
更新日期:2010-08-01 00:00:00
abstract::The geriatric population represents the largest reservoir of Mycobacterium tuberculosis infection in developed nations, including the United States. Tuberculosis (TB) case rates in the United States are highest for this age group compared with other age categories. The subtle clinical manifestations of TB in the elder...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501816
更新日期:2000-09-01 00:00:00
abstract::A 19-item survey instrument was designed and mailed by the Infectious Diseases Society of America to its membership to determine the media preferred by infectious diseases physicians for continuing medical education on general topics and on antimicrobial resistance. The objective of the survey was to offer the develop...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/505922
更新日期:2006-08-01 00:00:00
abstract::We analyzed antibiotic use data from 29 southeastern US hospitals over a 5-year period to determine changes in antibiotic use after the fluoroquinolone US Food and Drug Administration (FDA) advisory update in 2016. Fluoroquinolone use declined both before and after the FDA announcement, and the use of select, alternat...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.247
更新日期:2019-11-01 00:00:00
abstract::A retrospective, propensity-matched cohort study was conducted to determine the mortality rate in patients with healthcare-associated infection (HAI) due to multidrug-resistant (MDR) Acinetobacter baumannii. The 28-day mortality rate for patients with MDR A. baumannii HAI was not significantly different than that for ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591456
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that antibiotic use could be controlled or improved in a community teaching hospital, with improvement defined as reductions in overall use, overall cost, and antimicrobial resistance. DESIGN:Interventional study with historical comparison. SETTING:A not-for-profit, 900-bed community ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/500419
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVES:To trace the routes of transmission and sources of Staphylococcus aureus found in the surgical wound during cardiothoracic surgery and to investigate the possibility of reducing wound contamination, with regard to total counts of bacteria and S. aureus, by wearing special scrub suits. METHODS:A total of 65 ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501910
更新日期:2001-06-01 00:00:00
abstract::The annual cost of a screening program to detect methicillin-resistant Staphylococcus aureus (MRSA) in a teaching hospital in Spain was 10,261 Euro. The average cost per MRSA infection was 2,730 Euro; therefore, the cost of the program would be covered if it only prevented 4 infections per year (11% of the total numbe...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507968
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To describe the identification, management, and clinical characteristics of hospitalized patients with influenza-like illness (ILI) during the peak period of activity of the 2009 pandemic strain of influenza A virus subtype H1N1 (2009 H1N1). DESIGN:Retrospective review of electronic medical records. PATIENT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/661912
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To curtail the prevalence and cross-transmission of methicillin-resistant Staphylococcus aureus (MRSA) in a rural healthcare setting. DESIGN:Before-after, quasi-experimental quality improvement study. SETTING:A regional-referral hospital, 5 affiliated nursing homes, and an outpatient MRSA clinic. INTERVENT...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/650445
更新日期:2010-03-01 00:00:00
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 descr...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2015.312
更新日期:2016-04-01 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