American journal of infection control
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Am J Infect Control · Nov 2012
The results of a 6-year epidemiologic surveillance for ventilator-associated pneumonia at a tertiary care intensive care unit in Saudi Arabia.
Ventilator-associated pneumonia (VAP) prevention is an important patient safety initiative. We describe the impact of a multidisciplinary surveillance program on VAP rates in a tertiary medical-surgical-trauma intensive care unit (ICU). ⋯ The study showed a reduction in VAP rates with active surveillance, reporting and evidence-based preventive strategies and identified several modifiable risk factors, which should be the focus of additional interventions.
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Am J Infect Control · Nov 2012
Epidemiology and outcomes associated with surgical site infection following bariatric surgery.
Surgical site infection (SSI) is a frequent problem complicating bariatric surgery. However, the potential risk factors, risk stratification, and outcomes of SSIs in this patient population remain poorly defined. The aim of this prospective case-control study was to characterize better the risk factors and to improve risk stratification for SSIs following bariatric surgery. ⋯ SSI following bariatric surgery was associated with receipt of antibiotic prophylaxis other than cefazolin and comorbid conditions including sleep apnea and bipolar disorder. The BULCS score performed favorably as a predictor and risk adjuster for SSI following bariatric surgery. SSI was associated with increased health care resource utilization.
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Am J Infect Control · Nov 2012
A negative nares screen in combination with absence of clinical risk factors can be used to identify patients with very low likelihood of methicillin-resistant Staphylococcus aureus infection in a Veterans Affairs hospital.
Screening for nares carriage of methicillin-resistant Staphylococcus aureus (MRSA) could be used to identify patients at reduced risk for MRSA infection. However, recent studies suggest that negative results of nares surveillance testing are not reliable to predict a low risk for MRSA infection. ⋯ Negative nares screening results in combination with absence of certain clinical risk factors or syndromes could provide a useful strategy to predict patients with low likelihood of MRSA infection.
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Am J Infect Control · Nov 2012
"Swimming in resistance": Co-colonization with carbapenem-resistant Enterobacteriaceae and Acinetobacter baumannii or Pseudomonas aeruginosa.
Co-colonization of patients with carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (AB) or Pseudomonas aeruginosa (PA) is reported to be associated with increased antibiotic resistance and mortality. ⋯ Co-colonization is found in patients with the greatest disease burden in the hospital and occurs due to the dissemination of multiple CRE strains. This finding calls into question the practice of cohorting patients with CRE in close proximity to patients with AB or PA.
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Am J Infect Control · Nov 2012
Decreasing ventilator-associated pneumonia in the intensive care unit: a sustainable comprehensive quality improvement program.
An intensive care unit implemented an oral care bundle to decrease ventilator-associated pneumonia (VAP). A retrospective analysis comparing like time periods revealed the VAP rate per 1,000 ventilator-days dropped significantly from 10.5 to 0 (P = .016). The oral care bundle remains in place as of end of May 2011 and has proven to be a sustainable method for VAP prevention.