American journal of infection control
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Am J Infect Control · Apr 1997
Cost analysis and clinical impact of weekly ventilator circuit changes in patients in intensive care unit.
The introduction of heated circuits and sealed, single-use humidifiers has prompted some investigators to question the traditional recommendations for changing ventilator circuits. We studied the clinical and cost impact of extending the circuit change interval from 72 hours to 7 days in our two intensive care units with 17 beds. ⋯ Weekly circuited changes in patients undergoing ventilation therapy in the intensive care unit are cost-effective and do not contribute to increased rates of nosocomial pneumonia.
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Am J Infect Control · Dec 1996
Surgical wound infections diagnosed after discharge from hospital: epidemiologic differences with in-hospital infections.
The purpose of this study was to study postoperative infections detected in hospital and after discharge and to identify risk factors for such infections. ⋯ There were important epidemiologic differences between in-hospital SWI and postdischarge SWI; most risk factors for in-hospital SWI are not predictors for postdischarge SWI.
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Am J Infect Control · Oct 1995
Multicenter Study Clinical Trial Controlled Clinical TrialMupirocin ointment with and without chlorhexidine baths in the eradication of Staphylococcus aureus nasal carriage in nursing home residents.
Mupirocin ointment has been shown to be effective in eradicating Staphylococcus aureus nasal carriage in residents of a long-term care facility. Antiseptic soaps have been used as adjunct to this therapy. We compared the efficacy of short-term intranasal mupirocin ointment with and without chlorhexidine baths in the eradication of S. aureus nasal carriage with follow-up for 12 weeks. ⋯ A short course of mupirocin ointment was effective in eradicating nasal carriage of S. aureus in nursing home residents. There were no statistical differences in efficacy between the two regimens with respect to the eradication of nasal carriage and prevention of recolonization with S. aureus.
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Am J Infect Control · Jun 1995
Comparative StudyAssociation between severity of illness and mortality from nosocomial infection.
For the years 1987 through 1992, a study was undertaken to analyze nosocomial infection mortality data and to stratify risk according to severity of underlying illness to compare with published data from the Centers for Disease Control and Prevention. ⋯ In published reports from the Centers for Disease Control and Prevention, a rate of 13% is given for nosocomial pneumonia and bloodstream infections contributing to or causing death; however, there is no stratification for severity of illness in these reports. The presence of life-threatening illness before the onset of nosocomial pneumonia or bloodstream infection accounts for most deaths among our patients. For valid comparisons, mortality outcome data for nosocomial infections should be stratified for risk according to severity of underlying illness.
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Am J Infect Control · Jun 1995
Comparative StudyThe challenge of vancomycin-resistant enterococci: a clinical and epidemiologic study.
Vancomycin-resistant enterococci have been recovered with increasing frequency from hospitalized patients. Risk factors, mode of nosocomial transmission, extent of colonization in hospitalized patients, and treatment options for these organisms have not been completely delineated. ⋯ Multidrug-resistant and vancomycin-resistant enterococci have become important nosocomial pathogens that are difficult to treat. Vancomycin-resistant enterococcal bacteremia was associated with a poor prognosis. We found a high rate of colonization in patients with suspected C. difficile toxin colitis. Judicious use of vancomycin and broad-spectrum antibiotics is recommended, and strict infection control measures must be implemented to prevent nosocomial transmission of these organisms.