American journal of infection control
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Am J Infect Control · Nov 2010
Effectiveness of a simple intervention for prevention of catheter-associated urinary tract infections in a community teaching hospital.
Catheter-associated urinary tract infection (CA-UTI) is the most common health care-associated infection. Instrumentation of the urinary tract, mainly urinary catheterization, is the most important risk factor for CA-UTI. It is believed that proper catheter management can reduce the incidence of CA-UTI. ⋯ A simple intervention using a sticker placed on patients' medical record binder to remind physicians to remove unnecessary urinary catheters can significantly increase the appropriate utilization of urinary catheters and decrease the rate of CA-UTI in community teaching hospitals.
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Am J Infect Control · Nov 2010
Comparative StudyStopcock lumen contamination does not reflect the full burden of bacterial intravenous tubing contamination: analysis using a novel injection port.
Prior clinical studies have used injection port lumen culture as a marker of intravenous (IV) fluid system contamination. We hypothesized that culturing injected saline (effluent) is a more sensitive method of detecting IV fluid system bacterial contamination than lumen culture. To test this hypothesis, we compared the incidence of lumen contamination with effluent contamination in a simulated setting. We also measured the effect of a novel injection port protective device (Port Guide; Matrix Tooling, Inc, Wood Dale, IL) on contamination. ⋯ Effluent culture is a more sensitive marker of IV fluid system contamination than injection port lumen culture. A novel protective device on the stopcock (Port Guide) significantly reduced IV fluid system bacterial contamination.
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Am J Infect Control · Nov 2010
Lower arterial catheter-related infection in brachial than in femoral access.
Recent guidelines do not establish a recommendation about the arterial catheter site to minimize the arterial catheter-related infection risk. In this prospective and observational study, we found a higher arterial catheter-related infection in 1085 arterial femoral sites than in 141 arterial brachial sites (5.08 vs 0 per 1000 catheter-days, respectively; odds ratio, 6.18; 95% confidence interval: 1.11-infinite; P = .02). Thus, arterial brachial access should be used in preference to femoral access.
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Am J Infect Control · Nov 2010
Prospective study of colonization and infection because of Pseudomonas aeruginosa in mechanically ventilated patients at a neonatal intensive care unit in China.
Ventilator-associated pneumonia (VAP) is an important nosocomial infection at neonatal intensive care units (NICU), frequently caused by Pseudomonas aeruginosa. A 6-month prospective study from January 2009 through June 2009 was performed to investigate the respective contribution of endogenous and exogenous transmission of P aeruginosa in the respiratory colonization or/and infection in the mechanically ventilated patients at a NICU to identify routes of lung infection with P aeruginosa and to assess risk factors for colonization or respiratory infection with P aeruginosa. ⋯ Our results confirm that the upper respiratory tract acts as an important reservoir of P aeruginosa colonization and infection in the mechanically ventilated patients and emphasize the importance of exogenous acquisition of P aeruginosa. A combination of early identification and eradication of airways colonization by P aeruginosa plus infection control measures may be the basis to prevent pulmonary infection.
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Am J Infect Control · Nov 2010
Urinary catheters in the emergency department: very elderly women are at high risk for unnecessary utilization.
Many of the urinary catheters (UCs) placed in the emergency department (ED) might not be necessary. We evaluated compliance with our institutional UC utilization guidelines and assessed factors influencing utilization. ⋯ Very elderly women are at high risk for inappropriate UC utilization in the ED. Interventions are needed to address this vulnerable population.