American journal of infection control
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Am J Infect Control · Nov 2007
Initial inappropriate urinary catheters use in a tertiary-care center: incidence, risk factors, and outcomes.
To evaluate the epidemiology and outcomes for initiation of inappropriate urinary catheterization (IUC) among hospitalized patients. ⋯ UC were inappropriately used more commonly among female, nonambulatory, and medical ICU patients. Careful attention to this aspect of medical care may reduce the incidence CA-UTI with subsequent decreases in length of stay, cost of hospitalization, and cost for treatment of CA-UTI.
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Am J Infect Control · Nov 2007
Epidemiology of hospital-acquired bloodstream infections in a Tunisian pediatric intensive care unit: a 2-year prospective study.
There are few data providing rates of nosocomial bloodstream infections (NBI) in pediatric intensive care patients from developing regions of the world. ⋯ Considering the high incidence of NBI resulted from multiple drug-resistant gram-negative rods in our center, implementation of improved infection control practices is required.
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Am J Infect Control · Nov 2007
Clinical TrialImplementation of chlorhexidine gluconate for central venous catheter site care at Siriraj Hospital, Bangkok, Thailand.
A meta-analysis and cost-effectiveness analysis of randomized controlled trials comparing chlorhexidine gluconate with povidone-iodine solutions for venous catheter site care found that the use of chlorhexidine gluconate significantly reduced the risk for catheter-related bloodstream infections and that it was cost-effective. The objective of the study was to implement locally formulated chlorhexidine gluconate for central venous catheter (CVC) site care in intensive care units (ICUs) at Siriraj Hospital. ⋯ The locally formulated 2% chlorhexidine gluconate in 70% alcohol was safe, effective, and efficient for CVC site care in ICUs at Siriraj Hospital.
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Am J Infect Control · Nov 2007
Emergency room staff education and use of a urinary catheter indication sheet improves appropriate use of foley catheters.
Inappropriate use of indwelling urinary tract catheters (IUTCs) in the hospital setting is widespread and associated with nosocomial urinary tract infections. In a prior observational study, we found less than half of IUTCs placed in hospitalized elderly patients had appropriate indications. We tested an emergency department (ED) intervention to increase appropriate use of IUTCs. ⋯ Education and use of an indication sheet produced a dramatic reduction in total number of catheters used and had a smaller impact on appropriateness of use and documentation.
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Am J Infect Control · Nov 2007
Clinical and molecular epidemiology of community-onset, extended-spectrum beta-lactamase-producing Escherichia coli infections in Thailand: a case-case-control study.
Extended-spectrum beta-lactamase (ESBL)-producing organisms, first identified in Germany in 1983, are now widely recognized as clinically relevant causes of infections in community. ⋯ CO-ESBL-producing E coli is an emerging multidrug-resistant microorganism in Thailand. Patients with prior ESBL colonization and recent antibiotic exposures, especially to third-generation cephalosporins and fluoroquinolones, were at risk for CO-ESBL-producing E coli infection.