American journal of infection control
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Am J Infect Control · Jun 2002
Comparative StudyUse of silver-hydrogel urinary catheters on the incidence of catheter-associated urinary tract infections in hospitalized patients.
Urinary tract infections (UTIs) account for 40% of all nosocomial infections, and about 80% of these are associated with the use of urinary catheters. They not only contribute to excess morbidity and mortality, but they also significantly add to the cost of hospitalization. Clinical trials with silver-coated urinary catheters have shown conflicting results. However, recent trials with silver-hydrogel urinary catheters have shown a reduction in nosocomial UTIs, and these catheters appear to offer cost savings. ⋯ The use of silver-hydrogel urinary catheters resulted in a nonsignificant reduction in catheter-associated UTIs and a modest cost-saving.
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Am J Infect Control · Jun 2002
The impact of alcohol hand sanitizer use on infection rates in an extended care facility.
Nosocomial infections are a major problem in health care facilities, resulting in extended durations of care and substantial morbidity. Since alcohol gel hand sanitizers combine high immediate antimicrobial efficacy with ease of use, this study was carried out to determine the effect of the use of alcohol gel hand sanitizer by caregivers on infection types and rates in an extended care facility. ⋯ This study indicates that use of an alcohol gel hand sanitizer can decrease infection rates and provide an additional tool for an effective infection control program.
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Am J Infect Control · May 2002
Severity-of-illness markers as predictors of nosocomial infection in adult intensive care unit patients.
Patients admitted to intensive care units (ICUs) are at high risk for acquiring nosocomial infections. We examined the association between markers of severity of illness at ICU admission and the development of ICU-attributable nosocomial infections. ⋯ The need for mechanical ventilation on ICU day 1 and transfer to the ICU from another unit are independent predictors of ICU-attributable nosocomial infections. Up to 50% of ICU patients who develop nosocomial infections could be easily identified at ICU admission, allowing for targeted use of preventive strategies to reduce the risk of nosocomial infections.
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Am J Infect Control · Feb 2002
Comparative StudySurveillance of ventilator-associated pneumonia in very-low-birth-weight infants.
Surveillance of ventilator-associated pneumonia (VAP) is an essential part of quality patient care. Very-low-birth-weight (VLBW) infants, many with tracheal microbial colonization and bronchopulmonary dysplasia (BPD), comprise a difficult group in whom to make a diagnosis of pneumonia with the Centers for Disease Control and Prevention (CDC) criteria for infants younger than 1 year. ⋯ Surveillance diagnosis of VAP in VLBW infants is difficult because current CDC definitions are not specific for this population. Isolated positive tracheal culture alone does not distinguish between bacterial colonization and respiratory infection. Clinical and laboratory signs of VAP, mostly nonspecific, can be found in other conditions such as bronchopulmonary dysplasia and nosocomial BSI. Routine radiologic reports suggestive of pneumonia in airway-colonized infants without definitive clinical and laboratory evidence of infection could be misleading. To improve accuracy, surveillance diagnosis of VAP in special populations such as VLBW infants should be reformulated; meanwhile, ICPs should seek consultation with experienced clinicians for interpretation of data.