Abstract:
OBJECTIVE:To assess the accuracy of nosocomial infections data reported on patients in the intensive-care unit by nine hospitals participating in the National Nosocomial Infections Surveillance (NNIS) System. DESIGN:A pilot study was done in two phases to review the charts of selected intensive-care-unit patients who had nosocomial infections reported to the NNIS System. The charts of selected high- and low-risk patients in the same cohort who had no infections reported to the NNIS System also were included. In phase I, trained data collectors reviewed a sample of charts for nosocomial infections. Retrospectively detected infections that matched with previously reported infections were deemed to be true infections. In phase II, two Centers for Disease Control and Prevention (CDC) epidemiologists reexamined a sample of charts for which a discrepancy existed. Each sampled infection either was confirmed or disallowed by the epidemiologists. Confirmed infections also were deemed to be true infections. True infections from both phases were used to estimate the accuracy of reported NNIS data by calculating the predictive value positive, sensitivity, and specificity at each major infection site and the "other sites." RESULTS:The data collectors examined a total of 1,136 patients' charts in phase I. Among these charts were 611 infections that the study hospitals had reported to the CDC. The data collectors retrospectively matched 474 (78%) of the prospectively identified infections, but also detected 790 infections that were not reported prospectively. Phase II focused on the discrepant infections: the 137 infections that were identified prospectively and reported but not detected retrospectively, and the 790 infections that were detected retrospectively but not reported previously. The CDC epidemiologists examined a sample of 113 of the discrepant reported infections and 369 of the discrepant detected infections, and estimated that 37% of all discrepant reported infections and 43% of all discrepant detected infections were true infections. The predictive value positive for reported bloodstream infections, pneumonia, surgical-site infection, urinary tract infection, and other sites was 87%, 89%, 72%, 92%, and 80%, respectively; the sensitivity was 85%, 68%, 67%, 59%, and 30%, respectively; and the specificity was 98.3%, 97.8%, 97.7%, 98.7%, and 98.6%, respectively. CONCLUSIONS:When the NNIS hospitals in the study reported a nosocomial infection, the infection most likely was a true infection, and they infrequently reported conditions that were not infections. The hospitals also identified and reported most of the nosocomial infections that occurred in the patients they monitored, but accuracy varied by infection site. Primary bloodstream infection was the most accurately identified and reported site. Measures that will be taken to improve the quality of the infection data reported to the NNIS System include reviewing the criteria for definitions of infections and other data fields, enhancing communication between the CDC and NNIS hospitals, and improving the training of surveillance personnel in NNIS hospitals.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Emori TG,Edwards JR,Culver DH,Sartor C,Stroud LA,Gaunt EE,Horan TC,Gaynes RPdoi
10.1086/647820subject
Has Abstractpub_date
1998-05-01 00:00:00pages
308-16issue
5eissn
0899-823Xissn
1559-6834journal_volume
19pub_type
杂志文章,多中心研究abstract::Water samples taken from extracorporeal membrane oxygenator (ECMO) devices used at University Hospitals Birmingham yielded high total viable counts (TVCs) containing a variety of microorganisms, including M. chimaera. Disinfection resulted in the reduction of TVCs and eradication of Mycobacterium chimaera. Weekly disi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.163
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To identify environmentally safe, rapidly acting agents for killing spores of Clostridium difficile in the hospital environment. DESIGN:Three classic disinfectants (2% glutaraldehyde, 1.6% peracetyl ions, and 70% isopropanol) and acidified nitrite were compared for activity against C. difficile spores. Four ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502129
更新日期:2003-10-01 00:00:00
abstract::We report on healthcare worker use of a safe zone (outside a 3-foot perimeter around the patient's bed) and personal protective equipment in 2 inpatient spinal cord injury/disorder units. Workers remained within the safe zone during 22% of observations but were less compliant with personal protective equipment inside ...
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: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:OBJECTIVE:To evaluate the efficacy of Centers for Disease Control and Prevention (CDC)-recommended infection control measures implemented in response to an outbreak of multidrug-resistant (MDR) tuberculosis (TB). DESIGN:Retrospective cohort studies of acquired immunodeficiency syndrome (AIDS) patients and healthcare w...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647075
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:Carbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging multidrug-resistant pathogen associated with higher mortality, longer hospital stays, and increased costs. CRKP was thought to be sporadic in Los Angeles County (LAC); however, the actual incidence is unknown. To address this, LAC declared CRKP ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/669087
更新日期:2013-02-01 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:UNLABELLED:OBJECTIVE. To determine the impact of known observers on hand hygiene performance in inpatient care units with differing baseline levels of hand hygiene compliance. DESIGN:Observational study. SETTING:Three inpatient care units, selected on the basis of past hand hygiene performance, in a hospital where ha...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/595692
更新日期:2009-03-01 00:00:00
abstract::The prevalence of latent tuberculosis infection in a cohort of nurses new to a London hospital was 7.6% (13 of 171), using an interferon-gamma (IFN-gamma) release assay, and 16.2% (24 of 148), using the tuberculin skin test. On multivariate analysis, birth in a country with tuberculosis prevalence of more than 40 case...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/597546
更新日期:2009-06-01 00:00:00
abstract::More than 90% of Thai hospitals surveyed reported implementing environmental cleaning and disinfection (ECD) protocols. Hospital epidemiologist presence was associated with the existence of an ECD checklist (P=.01) and of ECD auditing (P=.001), while good and excellent hospital administrative support were associated w...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.171
更新日期:2017-10-01 00:00:00
abstract::In a hospital in Lima, Peru, a review of 103 Staphylococcus aureus infections was conducted during 2002. The prevalence of oxacillin-resistant S. aureus strains was 68%; 25% of strains were resistant to multiple drugs. Previous use of antibiotics and undergoing a surgical procedure during the current hospital stay wer...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/500650
更新日期:2006-02-01 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:OBJECTIVE:To determine knowledge and attitudes about pertussis and pertussis vaccination among healthcare workers (HCWs). DESIGN:Self-administered, Web-based survey. SETTING:Tertiary-care academic medical center. PARTICIPANTS:Medical center employees who participated in direct patient care were recruited to complete...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/521654
更新日期:2007-11-01 00:00:00
abstract::Five of 18 samples of working dilutions of disinfectants used in the University of Ilorin Teaching Hospital, the University Clinic, and three other urban medical centers were found to be contaminated with bacteria. The results confirmed that disinfectants in storage support the growth of infectious agents, underlining...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646986
更新日期:1994-09-01 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:To determine whether empiric isolation of patients with acute respiratory virus infection symptoms could be discontinued when preliminary shell vial cultures were negative, and the impact of this approach on hospital resources. DESIGN:In 1993, we retrospectively reviewed respiratory virus test results from 1...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647389
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:To investigate and determine the cause of an outbreak of Mycobacterium mucogenicum bacteremias in bone marrow transplant (BMT) and oncology patients. DESIGN:Case-control study and culturing of hospital water sources. Isolates were typed using molecular methods. SETTING:University-affiliated, tertiary-care m...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502341
更新日期:2004-12-01 00:00:00
abstract::To understand the feasibility of implementing a standardized performance measure for collecting and reporting influenza vaccination rates among healthcare personnel, qualitative, semistructured interviews were conducted with key informants in 32 healthcare facilities. Despite practical and logistical challenges to imp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/667375
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:Two pilot studies were conducted to produce efficacy data on an observational tool designed to assess the use of Universal Precautions (UP) in patient care settings. The instrument addresses barrier precautions, hand-washing, handling of sharps, and avoidance of unprotected mouth to mouth resuscitation. DES...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646248
更新日期:1991-10-01 00:00:00
abstract::OBJECTIVE National hospital performance measures for C. difficile infection (CD) are available; comparing antibacterial use among performance levels can aid in identifying effective antimicrobial stewardship strategies to reduce CDI rates. DESIGN Hospital-level, cross-sectional analysis. METHODS Hospital characteristi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.87
更新日期:2016-08-01 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::Benchmarks for antimicrobial consumption measured in antimicrobial days are beginning to emerge. The relationship between the traditional measure of days of therapy and antimicrobial days is unclear. We observed a high intermethod correlation (R2=0.99): antimicrobial days were 1.9-fold lower than days of therapy acros...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.109
更新日期:2016-08-01 00:00:00
abstract::The rate of purified protein derivative (PPD) conversion in workers at our hospital increased to 1.7% in 1991. After implementation of mandatory respiratory isolation of patients with community-acquired pneumonia, the rate dropped to 0.6%. This policy may protect workers in institutions where the majority of patients ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647675
更新日期:1997-08-01 00:00:00
abstract::The effectiveness of five 30-second handwashes with a non-antiseptic lotion soap to remove nosocomial pathogens (10(8) CFU) applied to fingertips was studied. CFU for all species dropped rapidly after the first handwash; persistence (10 to 15 CFU) was maintained thereafter. Wiping hands with an antiseptic (70% isoprop...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502388
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Of the 13 US vancomycin-resistant Staphylococcus aureus (VRSA) cases, 8 were identified in southeastern Michigan, primarily in patients with chronic lower-extremity wounds. VRSA infections develop when the vanA gene from vancomycin-resistant enterococcus (VRE) transfers to S. aureus. Inc18-like plasmids in V...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671735
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The incidence of extended-spectrum beta-lactamase (ESbetaL)-mediated resistance has increased markedly during the past decade. Risk factors for colonization with ESbetaL-producing Escherichia coli and Klebsiella species (ESbetaL-EK) remain unclear, as do methods to control their further emergence. DESIGN:Cas...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502045
更新日期:2002-05-01 00:00:00
abstract::The technology of intravenous catheter access ports has evolved from open ports covered by removable caps to more-sophisticated, closed versions containing mechanical valves. We report a significant increase in catheter-related bloodstream infections after the introduction of a new needle-free positive-pressure mechan...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/499166
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure. METHODS:Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phl...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1086/674398
更新日期:2014-01-01 00:00:00
abstract::Pediatric extended care facilities provide for the biopsychosocial needs of patients younger than 21 years of age who have sustained self-care deficits. These facilities include long-term and residential care facilities, chronic disease and specialty hospitals, and residential schools. Infection control policies and p...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/504937
更新日期:2006-06-01 00:00:00
abstract::Micrococcus bacteria are frequently isolated from blood cultures and could represent a cause of infections associated with medical devices, particularly in immunocompromised patients; however, there is a lack of information on the management of micrococcal bacteremia. We report what is, to our knowledge, the largest s...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592705
更新日期:2009-01-01 00:00:00