Abstract:
OBJECTIVE:To evaluate adherence to components of the Centers for Disease Control and Prevention (CDC) guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities. DESIGN:Multihospital study using direct observation and a standardized questionnaire. SETTING:Three urban hospitals (two county hospitals and one private community hospital) in counties in California with a high number and incidence rate of tuberculosis (TB) cases. MEASUREMENTS:The ventilation performance of treatment and TB-patient isolation rooms was assessed. Questionnaire data regarding TB control policy and procedures were obtained through interviews with the person(s) responsible for each program component; review of written TB control plans, training, and educational materials; and attendance at hospital TB control meetings and trainings. RESULTS:Twenty-eight percent of isolation rooms tested (7/25) were under positive pressure; 83% of rooms tested (20/24) had six or more nominal air changes per hour (ACH), but supply air did not mix rapidly with room air. Therefore, the nominal ACH likely overestimated the effective ACH and the subsequent protection provided. In virtually all rooms tested (26/27), air potentially containing M tuberculosis aerosol moved toward, rather than away from, likely worker locations. None of the hospitals regularly checked the performance of engineering controls. Only one hospital adhered to the CDC minimum requirements for respiratory protection. Training of healthcare workers generally was underutilized as a TB prevention measure. Hospitals did not provide comprehensive counseling regarding the need for healthcare workers to know their immune status and the risks associated with M tuberculosis infection in an immunocompromised individual. Employee representatives did not have a voice in TB-related decision making. CONCLUSIONS:Important aspects of day-to-day TB control practice did not conform to the written TB control policy. Subsequent to the identification of TB patients, healthcare workers at all three hospitals were potentially exposed to M tuberculosis aerosol due to breaches in negative-pressure isolation, the limitations of dilution ventilation, and the failure to maintain engineering controls and to implement respiratory protection controls fully. These findings lend support to the Occupational Safety and Health Administration's policy presumption that, absent clear evidence to the contrary, newly acquired healthcare-worker M tuberculosis infections are work-related.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Sutton PM,Nicas M,Reinisch F,Harrison RJdoi
10.1086/647851subject
Has Abstractpub_date
1998-07-01 00:00:00pages
487-93issue
7eissn
0899-823Xissn
1559-6834journal_volume
19pub_type
杂志文章abstract::Infection control in British nursing homes is different from that in U.S. nursing homes in seveal ways. Most British nursing homes, for example, do not have a designated on-site infection control nurse, and several agencies are responsible for regulatory oversight. This article discusses the state of infection control...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502198
更新日期:2003-04-01 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::The effectiveness and efficiency of 17 housekeepers in terminal cleaning 292 hospital rooms was evaluated through adenosine triphosphate detection. A subgroup of housekeepers was identified who were significantly more effective and efficient than their coworkers. These optimum outliers may be used in performance impro...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/676431
更新日期:2014-06-01 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::In 1997 the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in out-of-hospital settings....
journal_title:Infection control and hospital epidemiology
pub_type: 共识发展会议,指南,杂志文章,评审
doi:10.1086/501569
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Fluoroquinolones have not been frequently implicated as a cause of Clostridium difficile outbreaks. Nosocomial C. difficile infections increased from 2.7 to 6.8 cases per 1000 discharges (P < .001). During the first 2 years of the outbreak, there were 253 nosocomial C. difficile infections; of ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502539
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:In 2002, the Chicago Department of Public Health (CDPH; Chicago, Illinois) convened the Chicago-Area Neonatal MRSA Working Group (CANMWG) to discuss and compare approaches aimed at control of methicillin-resistant Staphylococcus aureus (MRSA) in neonatal intensive care units (NICUs). To better understand thes...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501216
更新日期:2006-02-01 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 devise a system for surveying the frequency of nosocomial infections in a tertiary care hospital in a developing country. DESIGN:Prospective selective surveillance by nurses of the charts of patients at high risk for nosocomial infections, as identified by a form completed by resident physicians. The sens...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646715
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:To assess the feasibility of electronic data capture of postdischarge durations and evaluate total durations of antimicrobial exposure related to inpatient hospital stays. DESIGN:Multicenter, retrospective cohort study. SETTING:Two community hospitals and 1 academic medical center. PATIENTS:Hospitalized pa...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1017/ice.2019.118
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To investigate trends in plasmid types of methicillin-resistant Staphylococcus aureus over a 3-year period and determine the clinical impact of plasmid typing. DESIGN:Restriction endonuclease analysis of plasmid DNA (REAP) was used to type 270 clinical isolates. SETTING:A Veterans Affairs Medical Center. R...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646627
更新日期:1993-01-01 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::The in vitro activities of bacitracin and mupirocin were compared for seven different strains of methicillin-resistant Staphylococcus aureus. Six of seven strains showed bacitracin minimum inhibitory concentrations (MICs) of 0.5 to 1.0 units/mL, and all seven had mupirocin MICs of 0.5 to 2 micrograms/mL. Time-kill stu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647270
更新日期:1996-03-01 00:00:00
abstract::A patient with no risk factors for malaria was hospitalized in New York City with Plasmodium falciparum infection. After investigating all potential sources of infection, we concluded the patient had been exposed to malaria while hospitalized less than 3 weeks earlier. Molecular genotyping implicated patient-to-patien...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.236
更新日期:2016-01-01 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::Healthcare-associated infection reporting validation is essential because this information is increasingly used in public healthcare quality assurances and care reimbursement. Washington State's validation of central line-associated bloodstream infection reporting applies credible quality sciences methods to ensure th...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.303
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Peripheral venous catheters (PVCs) can be associated with serious infectious complications. We evaluated the effect of education and feedback on process measures to improve PVC care and infectious complications. DESIGN:Quasi-experimental controlled crossover study with sampling before and aft...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1086/665322
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of asymptomatic carriage of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) among healthcare professionals (HCPs) who experience varying degrees of exposure to ambulatory patients and to genetically characterize isolates. METHODS:This single-center, cross-sectiona...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/652525
更新日期:2010-06-01 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::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:BACKGROUND:Understanding the extent of aerosol-based transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is important for tailoring interventions for control of the coronavirus disease 2019 (COVID-19) pandemic. Multiple studies have reported the detection of SARS-CoV-2 nucleic acid in air sampl...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2021.8
更新日期:2021-01-25 00:00:00
abstract:OBJECTIVE:To describe the epidemiology, interventions, and molecular typing methods used during the investigation and control of concurrent outbreaks of Serratia marcescens and methicillin-resistant Staphylococcus aureus (MRSA) infections in a neonatal intensive-care unit (NICU). SETTING:A 206-bed women's and infants'...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To determine differences in healthcare costs between cases of methicillin-susceptible Staphylococcus aureus (MSSA) infection and methicillin-resistant S. aureus (MRSA) infection in adults. DESIGN:Retrospective study of all cases of S. aureus infection. SETTING:Department of Veterans Affairs hospital and ass...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/651094
更新日期:2010-04-01 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: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: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:OBJECTIVE:Prevalence of multidrug-resistant (MDR) gram-negative (GN) bacteria is increasing globally and is complicated by patient movement between acute and long-term care facilities (LTCFs). In Asia, the contribution of LTCFs as a source of MDR GN infections is poorly described. We aimed to define the association bet...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/675823
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To determine the extent to which evidence-based practices for the prevention of central venous catheter (CVC)-associated bloodstream infections are incorporated into the policies and practices of academic intensive care units (ICUs) in the United States and to determine variations in the policies on CVC inser...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/499151
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To develop and field test an implementation assessment tool for assessing progress of hospital units in implementing improvements for the prevention of ventilator-associated pneumonia (VAP) in a two-state collaborative, including data on actions implemented by participating teams and contextual factors that m...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/677832
更新日期:2014-10-01 00:00:00
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 ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/647820
更新日期:1998-05-01 00:00:00