American journal of infection control
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Am J Infect Control · Jun 2001
Randomized Controlled Trial Clinical TrialClinical assay of N-duopropenide alcohol solution on hand application in newborn and pediatric intensive care units: control of an outbreak of multiresistant Klebsiella pneumoniae in a newborn intensive care unit with this measure.
Outbreaks of gram-negative colonization (generally by antibiotic-resistant enterobacteria) are common in newborn intensive care units (NICUs), and control methods are not always effective. We studied the effectiveness of an alcohol solution of N-duopropenide (NDP) in vivo (germicidal effect on flora of teams in the NICU and the pediatric intensive care unit vs handwashing with nonantiseptic soap) and its effect on the control of a multiresistant (MR) Klebsiella pneumoniae outbreak in our NICU that had persisted for 13 months, despite the use of classic control measures. For educational purposes, we also performed 4 prevalence studies of microbial hand flora in NICU staff (two before and two after introducing NDP). ⋯ Four prevalence studies of hand microbial contamination, before and after NDP introduction in the NICU, showed a significant reduction of enterobacteriaceae, mainly MR K pneumoniae, in health care workers. In conclusion, NDP in alcohol was very effective in vivo. It proved to be a useful complementary measure to handwashing and reduced exogenous microorganism transmission in a unit with a heavy patient-care workload.
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Am J Infect Control · Jun 2001
Comparative StudyA new hydrogen peroxide--based medical-device detergent with germicidal properties: comparison with enzymatic cleaners.
The objective of this study was to evaluate the efficacy of the cleaning and bacterial killing ability of a new non-enzyme-based formulation (killing detergent solution [KDS]) compared with commercially available enzymatic detergents that included Metrizyme (Metrex Research Division of Sybron Canada Ltd. Morrisburg, Ontario) and Gzyme (Germiphene Corp, Brantford, Ontario). KDS is a hydrogen peroxide-based detergent formulation that combines cleaning efficacy with the ability to kill microorganisms. The KDS formulation helps ensure the protection of the health care worker from infectious risk during the soaking and cleaning stages of medical device reprocessing and reduces the bioburden on devices before sterilization/disinfection. ⋯ In summary the KDS has excellent microbial-killing ability in 3-minute exposures at room temperature and cleans as well as the existing enzymatic detergent formulations that were tested.
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Am J Infect Control · Jun 2001
Infectious waste surveys in a Saudi Arabian hospital: an important quality improvement tool.
To analyze the composition by weight of the infectious waste stream, better segregate waste, reduce disposal costs, reduce the load on the hospital incinerator, identify inappropriate items having significant cost or safety implications, and provide a safer work environment for housekeepers. ⋯ We believe this is the first report of such an extensive analysis of a hospital's infectious waste. Many hospitals do not have the resources to conduct such detailed surveys of their waste streams. However, regardless of the method of treatment and disposal, such surveys are valuable quality improvement tools because all health care facilities want to reduce disposal costs, identify high-value items mistakenly discarded, and improve safety.
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Am J Infect Control · Jun 2001
Multicenter StudyNosocomial infection rates in US children's hospitals' neonatal and pediatric intensive care units.
Few data are available on nosocomial infections (NIs) in US children's hospitals' neonatal or pediatric intensive care units. The Pediatric Prevention Network (PPN) was established to improve characterization of NIs in pediatric patients and to develop and test interventions to decrease NI. ⋯ The number of months that NICU or PICU NI surveillance was conducted varied among hospitals. Reported NICU and PICU NI rates varied by hospital; some reported overall NI rates, and others focused on one or more particular sites of infection (eg, BSI or pneumonia). Many did not provide NICU device-associated rates stratified by birth-weight group. Denominators used to calculate device-associated infection rates also varied, with hospitals reporting either patient-days or device-days. These findings suggest the need to determine reasons for variations and to identify optimal NI surveillance methods at children's hospitals so that valid interhospital NI rate comparisons can be made.