Abstract:
OBJECTIVE:In colorectal surgery, the composition of the most effective bundle for prevention of surgical site infections (SSI) remains uncertain. We performed a meta-analysis to identify bundle interventions most associated with SSI reduction. METHODS:We systematically reviewed 4 databases for studies that assessed bundles with ≥3 elements recommended by clinical practice guidelines for adult colorectal surgery. The main outcome was 30-day postoperative SSI rate (overall, superficial, deep, and/or organ-space). RESULTS:We included 40 studies in the qualitative review, and 35 studies (54,221 patients) in the quantitative review. Only 3 studies were randomized controlled trials. On meta-analyses, bundles were associated with overall SSI reductions of 44% (RR, 0.57; 95% CI, 0.48-0.65); superficial SSI reductions of 44% (RR, 0.56; 95% CI, 0.42-0.75); deep SSI reductions of 33% (RR, 0.67; 95% CI, 0.46-0.98); and organ-space SSI reductions of 37% (RR, 0.63; 95% CI, 0.50-0.81). Bundle composition was heterogeneous. In our meta-regression analysis, bundles containing ≥11 elements, consisting of both standard of care and new interventions, demonstrated the greatest SSI reduction. Separate instrument trays, gloves with and without gown change for wound closure, and standardized postoperative dressing change at 48 hours correlated with the highest reductions in superficial SSIs. Mechanical bowel preparation combined with oral antibiotics, and preoperative chlorhexidine showers correlated with highest organ-space SSI reductions. CONCLUSIONS:Preventive bundles emphasizing guideline-recommended elements from both standard of care as well as new interventions were most effective for SSI reduction following colorectal surgery. High clinical-bundle heterogeneity and low quality for most observational studies significantly limit our conclusion.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Pop-Vicas AE,Abad C,Baubie K,Osman F,Heise C,Safdar Ndoi
10.1017/ice.2020.112subject
Has Abstractpub_date
2020-07-01 00:00:00pages
805-812issue
7eissn
0899-823Xissn
1559-6834pii
S0899823X20001129journal_volume
41pub_type
杂志文章abstract::The hospital-wide attack rate for Clostridium difficile-associated diarrhea at our tertiary-care university hospital was 0.02 per 100 patient discharges (0.02%) in 1982, but 0.41% and 1.47% in 1986 and 1987, respectively, with a peak incidence of 2.25% in the fourth quarter of 1987. Hospital antibiotic usage patterns ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646173
更新日期:1990-06-01 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
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abstract:OBJECTIVE:To integrate electronic clinical decision support tools into clinical practice and to evaluate the impact on indwelling urinary catheter (IUC) use and catheter-associated urinary tract infections (CAUTIs).Design, Setting, and ParticipantsThis 4-phase observational study included all inpatients at a multicampu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2018.114
更新日期:2018-08-01 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::Definitions of ventilator-associated pneumonia do not note a preferred daily time for obtaining denominator data. We examined collecting data on the number of ventilator-days at different times of day in 7 intensive care units. Rates of ventilator-associated pneumonia did not significantly differ when denominator data...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/652450
更新日期:2010-05-01 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:OBJECTIVES:To investigate and control an outbreak of epidemic keratoconjunctivitis (EKC) occurring in a neonatal intensive care unit (NICU) and to determine signs specific for EKC in newborns. DESIGN:Outbreak investigation and case-control study. SETTING:NICU of a 1,600-bed university hospital in Heidelberg, Germany....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502247
更新日期:2003-07-01 00:00:00
abstract::We report on COVID-19 risk among HCWs exposed to a patient diagnosed with COVID-19 on day 13 of hospitalization. There were 44 HCWs exposed to the patient before contact and droplet precautions were implemented: of these, 2 of 44 (5%) developed COVID-19 potentially attributable to the exposure. ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.256
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) may contaminate their immediate environment with this organism. However, the extent to which gastrointestinal colonization with MRSA affects environmental contamination is not known. We investigated the frequency of environmental conta...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/520737
更新日期:2007-10-01 00:00:00
abstract::Thorough counseling with emphasis on the importance of mosquito bite avoidance, as well as on compliance with prophylactic antimalarial regimens, remains an important task for the physician preparing a patient for international travel. Chloroquine continues to be the drug of choice for prophylaxis in areas not reporti...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/646703
更新日期:1993-03-01 00:00:00
abstract::Antimicrobial agents are among the most frequently prescribed medications in long-term-care facilities (LTCFs). Therefore, it is not surprising that Clostridium difficile colonization and C. difficile-associated diarrhea (CDAD) occur commonly in elderly LTCF residents. C. difficile has been identified as the most comm...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/501997
更新日期:2002-11-01 00:00:00
abstract::OBJECTIVE To analyze influential infectious diseases, antimicrobial stewardship, infection control, or medical microbiology blogs and bloggers SETTING World wide web DESIGN We conducted a systematic search for blogs in accordance with the PRISMA guidelines in September 2015. METHODS A snowball sampling approach was ap...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.69
更新日期:2017-07-01 00:00:00
abstract::We report the case of a pediatrician who developed meningococcal meningitis after performing endotracheal intubation without protection on a child who was suspected of having meningoencephalitis. This case emphasizes the necessity for healthcare workers who perform high-risk procedures to use personal protection devic...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501672
更新日期:1999-08-01 00:00:00
abstract::OBJECTIVETo evaluate probiotics for the primary prevention of Clostridium difficile infection (CDI) among hospital inpatients.DESIGNA before-and-after quality improvement intervention comparing 12-month baseline and intervention periods.SETTINGA 694-bed teaching hospital.INTERVENTIONWe administered a multispecies prob...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.76
更新日期:2018-07-01 00:00:00
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 (...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.41
更新日期:2017-06-01 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
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.37
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:The present study investigated regional variations in antibiotic use for the treatment of hospital-acquired infections (HAIs) in France by means of a multilevel analysis, to identify targets for quality improvement. METHODS:Data were obtained from the 2001 and 2006 French national point-prevalence surveys of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/657909
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:To determine whether hepatitis B virus (HBV) transmission occurred among patients visiting a physician's office and to evaluate potential transmission mechanisms. DESIGN:Serologic survey, retrospective cohort study, and observation of infection control practices. SETTING:Private medical office. PATIENTS:T...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502612
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To investigate whether rhinovirus infection leads to increased airborne dispersal of coagulase-negative staphylococci (CoNS). DESIGN:Prospective nonrandomized intervention trial. SETTING:Wake Forest University School of Medicine, Winston-Salem, North Carolina. PARTICIPANTS:Twelve nasal Staphylococcus aureu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502430
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:To compare the number of surgical site infections (SSIs) registered after hospital discharge with respect to various surgical procedures and to identify the procedures for which postdischarge surveillance (PDS) is most important. DESIGN:Prospective SSI surveillance with voluntary PDS. Recommended methods for...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/506403
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:The device standardized infection ratio (SIR) is used to compare unit and hospital performance for different publicly reported infections. Interventions to reduce unnecessary device use may select a higher-risk population, leading to a paradoxical increase in SIR for some high-performing facilities. The stan...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.175
更新日期:2019-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591861
更新日期:2008-11-01 00:00:00
abstract::An outbreak of invasive Mycobacterium chimaera infections associated with heater-cooler devices (HCDs) has now affected patients in several countries on different continents. Clinical infections are characterized by delayed diagnosis, inadequate treatment response to antimicrobial agents, and poor prognosis. Outbreak ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2016.283
更新日期:2017-01-01 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::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::Following large declines in tuberculosis transmission the United States, large-scale screening programs targeting low-risk healthcare workers are increasingly a source of false-positive results. We report a large cluster of presumed false-positive tuberculin skin test results in healthcare workers following a change t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.59
更新日期:2018-06-01 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::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:OBJECTIVE:Ertapenem exposure has been reported to select for cross-resistance to other carbapenems in Pseudomonas aeruginosa in vitro. Single-center investigations report conflicting results. We evaluated ertapenem use and antipseudomonal carbapenem susceptibility for 6 years spanning the time of ertapenem adoption at ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/652154
更新日期:2010-05-01 00:00:00