Abstract:
OBJECTIVE:Evaluate the clinical impact of the implementation of VERIGENE gram-positive blood culture testing (BC-GP) coupled with antimicrobial stewardship result notification for children with positive blood cultures. DESIGN:Quasi-experimental study. SETTING:Quaternary children's hospital. PATIENTS:Hospitalized children aged 0-21 years with positive blood culture events 1 year before and 1 year after implementation of BC-GP testing. METHODS:The primary outcome was time to optimal antibiotic therapy for positive blood cultures, defined as receiving definitive therapy without unnecessary antibiotics (pathogens) or no antibiotics (contaminants). Secondary outcomes were time to effective therapy, time to definitive therapy, and time to stopping vancomycin, length of stay, and 30-day mortality. Time-to-therapy outcomes before and after the intervention were compared using Cox regression models and interrupted time series analyses, adjusting for patient characteristics and trends over time. Gram-negative events were included as a nonequivalent dependent variable. RESULTS:We included 264 preintervention events (191 gram-positive, 73 gram-negative) and 257 postintervention events (168 gram-positive, 89 gram-negative). The median age was 2.9 years (interquartile range, 0.3-10.1), and 418 pediatric patients (80.2%) had ≥1 complex chronic condition. For gram-positive isolates, implementation of BC-GP testing was associated with an immediate reduction in time to optimal therapy and time to stopping vancomycin for both analyses. BC-GP testing was associated with decreased time to definitive therapy in interrupted time series analysis but not Cox modeling. No such changes were observed for gram-negative isolates. No changes in time to effective therapy, length of stay, or mortality were associated with BC-GP. CONCLUSIONS:The implementation of BC-GP testing coupled with antimicrobial stewardship result notification was associated with decreased time to optimal therapy and time to stopping vancomycin for hospitalized children with gram-positive blood culture isolates.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Tribble AC,Gerber JS,Bilker WB,Lautenbach Edoi
10.1017/ice.2020.191subject
Has Abstractpub_date
2020-08-01 00:00:00pages
883-890issue
8eissn
0899-823Xissn
1559-6834pii
S0899823X20001919journal_volume
41pub_type
杂志文章abstract::OBJECTIVE To compare central line use and central line-associated bloodstream infection in newborn infants before and after the introduction of a central line infection prevention bundle in order to determine the effectiveness of the bundle and to identify areas for further improvement. DESIGN Retrospective cohort ana...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.127
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To assess the safety, sustainability, and effectiveness of a laboratory intervention to reduce processing of midstream urine (MSU) cultures. DESIGN:Prospective observational cohort. SETTING:Medical and surgical inpatients in a tertiary-care hospital. PARTICIPANTS:The study included 1,678 adult inpatients w...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.385
更新日期:2021-01-01 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 the frequency of, and risk factors for, infections associated with intra-arterial catheters used for cancer chemotherapy. METHODS:Between September 1992 and September 1995, we conducted a surveillance study of all 807 intra-arterial catheters placed for chemotherapy at our center. The insertion ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647890
更新日期:1998-09-01 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::We evaluated the impact of reflex urine culture screen results on antibiotic initiation. More patients with positive urine screen but negative culture received antibiotics than those with a negative screen (30.5 vs 7.1%). Urine screen results may inappropriately influence antibiotic initiation in patients with a low l...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.230
更新日期:2020-09-01 00:00:00
abstract::How the media communicate and how the scientific community influences the media are important factors to consider in the public health response to emerging pathogens, including methicillin-resistant Staphylococcus aureus. Social representation theory suggests that the media link "the threatening" to commonplace "ancho...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/656000
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To evaluate a method to identify hospitals contributing to Clostridioides difficile infections (CDI) at subsequent hospitalizations. DESIGN:Retrospective cohort study. METHODS:We merged 2014-2015 National Healthcare Safety Network (NHSN) inpatient CDI laboratory-identified events with hospital patient disch...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.447
更新日期:2020-09-30 00:00:00
abstract:OBJECTIVE:To investigate the relationship between contact precautions and delirium among inpatients, adjusting for other factors. DESIGN:Retrospective cohort study. SETTING:A 662-bed tertiary care center. PATIENTS:All nonpyschiatric adult patients admitted to a tertiary care center from 2007 through 2009. METHODS:G...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/663340
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The role of coagulase-negative staphylococci (CNS) in bacteremias continues to be controversial. Until the 1970s, CNS were mostly recognized as contaminants, being part of the cutaneous flora. Since then, several studies have reported increasing incidence and severity of infections due to CNS. PURPOSE:To re...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/647878
更新日期:1998-08-01 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::We quantified the time burden of alcohol-based handrub accompanying nonsterile-glove use among emergency physicians, through observation in controlled and clinical settings. We report gloving episodes per hour, gloving times with and without handrub, and handrub recommendations compliance. Handrub adds 46 seconds to e...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
doi:10.1086/668781
更新日期:2013-01-01 00:00:00
abstract::Annual surveillance data (2007-2015), collected continuously in 132 German hospitals, was evaluated for development of alcohol-based hand-rub consumption (AHC) as a surrogate parameter for hand hygiene adherence. Overall, the median increase in AHC was 94%. The increases over 9 years were significant in all units and ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.71
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of an educational program for the prevention of catheter colonization. DESIGN:Two cross-sectional studies were carried out in a 500-bed randomly selected area of the hospital, separated by an educational program on the care of intravenous lines based on the Centers for Disease Contro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1994-04-01 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
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/646954
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVE:To compare the impacts of different methicillin-resistant Staphylococcus aureus (MRSA) screening test options (eg, polymerase chain reaction [PCR], rapid culture) and program characteristics on the clinical outcomes and budget of a typical US hospital. METHODS:We developed an Excel-based decision-analytic mo...
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::We assessed hand hygiene adherence in 2 infectious disease units. In one unit, adherence declined slightly from year 1 (84.2%) to year 4 (71.0%) after a multimodal intervention but remained much higher than before intervention. Adherence dropped in the second unit after a loss of leadership (from 50.7% to 5.7%). Stron...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/675296
更新日期:2014-03-01 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
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更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To determine trends, patient characteristics, and outcome of patients with healthcare-associated influenza in Canadian hospitals. DESIGN:Prospective surveillance of laboratory-confirmed influenza among hospitalized adults was conducted from 2006 to 2012. Adults with positive test results at or after admissio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/674858
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the incidence of nosocomial bacteremias related to the use of non-impregnated central venous catheters (CVCs) when only non-technologic strategies were used to prevent them. DESIGN:This was a prospective study of infectious complications of CVCs placed in intensive care unit (ICU) patients from A...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502461
更新日期:2004-08-01 00:00:00
abstract::A case-control study was conducted on an epidemic of bacteremia and meningitis caused by Serratia marcescens in the neonatal intensive care unit and special care nursery of a general hospital in Mexico City, Mexico. A 19.9% incidence of bacteremia and meningitis was recorded in contrast to 1.4% and 3.7% during preepid...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645909
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To screen copper and noncopper paints for their bactericidal effectiveness in rendering surfaces self-disinfecting. DESIGN:Tested paints were applied to glass coverslips, cured, inoculated with test organisms (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis), and dr...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/648361
更新日期:1995-08-01 00:00:00
abstract::Monsel's solution is a common topically applied hemostatic agent used in minor dermatologic and gynecologic surgery. Clinically, because it is often stored for long periods and dispensed from a common source for multiple patients, Monsel's solution is a potential vector for transmission of infection. However, microbio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502180
更新日期:2003-02-01 00:00:00
abstract::We investigated alternative measurement methodology for infrared body thermometry to increase accuracy for outdoor fever screening during the 2003 SARS epidemic. Our results indicate that the auditory meatus temperature is a superior alternative compared with the forehead body surface temperature due to its close appr...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
doi:10.1086/502351
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:Ambulatory healthcare-associated infections (HAIs) occur frequently in children and are associated with morbidity. Less is known about ambulatory HAI costs. This study estimated additional costs associated with pediatric ambulatory central-line-associated bloodstream infections (CLABSIs), catheter-associated ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.305
更新日期:2020-11-01 00:00:00
abstract::The purpose of this study was to determine whether any waste was labeled incorrectly as infectious or contained material that could be recycled. Waste generated in preparation for surgery was separated and weighed. Of 530 lbs of operating room waste, 40 lbs were noninfectious, largely plastic and paper. The results of...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647693
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To investigate prospectively the clinical course and risk factors for ventilator-associated tracheobronchitis (VAT) and the impact of VAT on intensive care unit (ICU) morbidity and mortality. DESIGN:Prospective cohort study. SETTING:University Hospital Larissa, Larissa, Greece. PATIENTS:Critical care patie...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671274
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:Few data are available on methicillin-resistant Staphylococcus aureus (MRSA) colonization in day care. We performed a study in a medical university child care center to study the epidemiology of MRSA in this population. DESIGN:Survey. SETTING:A child care center on the campus of a university medical center....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/605721
更新日期:2009-10-01 00:00:00
abstract::Of 49 long-term care facility residents, 21 (43%) were colonized with 2 or more distinct strains of Escherichia coli. There were no significant risk factors for colonization with multiple strains of E. coli. These results suggest that future efforts to efficiently identify the diversity of colonizing strains will be c...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/597234
更新日期:2009-05-01 00:00:00