American journal of infection control
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Am J Infect Control · Jun 2010
Active surveillance testing and decontamination strategies in intensive care units to reduce methicillin-resistant Staphylococcus aureus infections.
Active surveillance testing (AST) and decontamination strategies (DS) using a topical methicillin-resistant Staphylococcus aureus (MRSA) cleansing agent was introduced in July 2007 in a medical intensive care unit (MICU) and a surgical ICU (SICU) of a tertiary care hospital to reduce the incidence of MRSA infection. ⋯ In ICUs, AST detected 11 times more MRSA than clinical cultures. The lack of reduction in MRSA infection rates in the ICUs does not negate the roles of AST and DS, but does argue for better study design and outcome measures like MRSA transmission incidence, which perhaps would have demonstrated a true benefit of AST and DS.
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Am J Infect Control · Jun 2010
Exposure of emergency medical responders to methicillin-resistant Staphylococcus aureus.
Methicillin-resistant Staphylococcus aureus (MRSA) infections result in 19,000 deaths a year in the United States. Epidemiologic studies have shown that community-acquired infections are increasing dramatically, and strains typical of community infections are increasingly detected in hospital populations. Emergency medical responders (EMR) are exposed to both community and hospital MRSA patients, which, combined with their communal lifestyles in fire stations, results in higher risk of exposure. This study determined the occurrence and frequency of MRSA and other bacterial indicators on environmental surfaces in fire stations, training sites, and offices of EMR. ⋯ EMR have a high potential for exposure to MRSA, not only through patient and hospital contacts but also in the fire station environment. MRSA was isolated with the highest frequency on the couches and the class desks. Although the true health significance of these exposures is unknown, improved infection control practices, such as routine handwashing and surface disinfection, are warranted to reduce MRSA exposures.
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Am J Infect Control · May 2010
Low prevalence of Acinetobacter baumannii colonization on hospital admission.
We conducted a prospective cohort study of non-critically ill patients admitted to a tertiary care center between December 2003 and September 2004 and obtained perirectal samples at hospital admission to determine the prevalence of Acinetobacter baumannii. A baumannii was isolated from 1 of 555 cultures (0.18%); no multidrug-resistant A baumannii was identified. Interventions aimed at early identification of A baumannii-colonized patients may not benefit by widely targeting non-critically ill patients on hospital admission.
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Am J Infect Control · May 2010
The impact of portable high-efficiency particulate air filters on the incidence of invasive aspergillosis in a large acute tertiary-care hospital.
Worldwide, the frequency of invasive fungal infections has been increasing, with a corresponding increase in the numbers of high-risk patients. Exposure reduction through the use of high-efficiency particulate air (HEPA) filters has been the preferred primary preventive strategy for these high-risk patients. Although the efficiency and benefits of fixed HEPA filters is well proven, the benefits of portable HEPA filters are still inconclusive. ⋯ Portable HEPA filters are effective in the prevention of IA. The cost of widespread portable HEPA filtration in hospitals will be more than offset by the decreases in nosocomial infections in general and in IA in particular.