American journal of infection control
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Am J Infect Control · May 2011
Surveillance Provinciale des Infections Nosocomiales (SPIN) Program: implementation of a mandatory surveillance program for central line-associated bloodstream infections.
In 2003, the Surveillance Provinciale des Infections Nosocomiales (SPIN) program was launched to gather data on incidence rates of central line-associated bloodstream infections (CLABSIs) in intensive care units (ICUs) in the Province of Quebec. To improve the generalizability of SPIN benchmarks, in 2007 participation in SPIN became mandatory for all ICUs with ≥10 beds. ⋯ The implementation of mandatory participation was essential to increase the generalizability of SPIN CLABSI incidence rates, which also improved the quality of these data for use as provincial benchmarks.
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Am J Infect Control · May 2011
Forced-air warming blowers: An evaluation of filtration adequacy and airborne contamination emissions in the operating room.
Forced-air warming (FAW) is widely used to prevent hypothermia during surgical procedures. The airflow from these blowers is often vented near the operative site and should be free of contaminants to minimize the risk of surgical site infection. Popular FAW blowers contain a 0.2-μm rated intake filter to reduce these risks. However, there is little evidence that the efficiency of the intake filter is adequate to prevent airborne contamination emissions or protect the internal air path from microbial contamination buildup. ⋯ The design of popular FAW devices using the 200708C filter was found to be inadequate for preventing the internal buildup and emission of microbial contaminants into the operating room. Substandard intake filtration allowed airborne contaminants (both viable and nonviable) to penetrate the intake filter and reversibly attach to the internal surfaces within the FAW blowers. The reintroduction of these contaminants into the FAW blower air stream was detected and could contribute to the risk of cross-infection. Given the deficiencies identified with the 200708C intake filter, the introduction of a new filter (model 200708D) with substantially lower retention efficiency is of concern.
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Am J Infect Control · May 2011
Randomized Controlled TrialA prospective clinical trial on prevention of catheter contamination using the hub protection cap for needleless injection device.
Catheter hub contamination has been recognized as a source of catheter-related bloodstream infections. We have investigated the efficacy of a protection cap for a needleless injection device in preventing intraluminal catheter contamination, compared with a conventional 3-way stopcock. ⋯ The protection cap for needleless injection devices decreased microbial transfer from the injection port to the intraluminal fluid pathway and lowered the risk of catheter-related bloodstream infections.
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Am J Infect Control · Apr 2011
Clinical and cost ineffectiveness of preoperative screening for methicillin-resistant Staphylococcus aureus and intranasal mupirocin in preventing methicillin-resistant S aureus infections in cardiothoracic surgery.
In our recent experience with methicillin-resistant Staphylococcus aureus (MRSA) infections in 488 patients undergoing thoracic cardiovascular surgery, we found only 2 MRSA infections (one sternal and one graft site). Both patients received preoperative bacitracin and had a negative nares culture for MRSA before the initiation of bacitracin therapy. We conclude that preoperative MRSA screening cultures and bacitracin prophylaxis are neither clinically efficacious nor cost-effective in predicting or preventing MRSA in patients undergoing thoracic cardiovascular surgery.