American journal of infection control
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Am J Infect Control · Nov 2007
Epidemiology of hospital-acquired bloodstream infections in a Tunisian pediatric intensive care unit: a 2-year prospective study.
There are few data providing rates of nosocomial bloodstream infections (NBI) in pediatric intensive care patients from developing regions of the world. ⋯ Considering the high incidence of NBI resulted from multiple drug-resistant gram-negative rods in our center, implementation of improved infection control practices is required.
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Am J Infect Control · Nov 2007
Clinical TrialImplementation of chlorhexidine gluconate for central venous catheter site care at Siriraj Hospital, Bangkok, Thailand.
A meta-analysis and cost-effectiveness analysis of randomized controlled trials comparing chlorhexidine gluconate with povidone-iodine solutions for venous catheter site care found that the use of chlorhexidine gluconate significantly reduced the risk for catheter-related bloodstream infections and that it was cost-effective. The objective of the study was to implement locally formulated chlorhexidine gluconate for central venous catheter (CVC) site care in intensive care units (ICUs) at Siriraj Hospital. ⋯ The locally formulated 2% chlorhexidine gluconate in 70% alcohol was safe, effective, and efficient for CVC site care in ICUs at Siriraj Hospital.
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Am J Infect Control · Nov 2007
Emergency room staff education and use of a urinary catheter indication sheet improves appropriate use of foley catheters.
Inappropriate use of indwelling urinary tract catheters (IUTCs) in the hospital setting is widespread and associated with nosocomial urinary tract infections. In a prior observational study, we found less than half of IUTCs placed in hospitalized elderly patients had appropriate indications. We tested an emergency department (ED) intervention to increase appropriate use of IUTCs. ⋯ Education and use of an indication sheet produced a dramatic reduction in total number of catheters used and had a smaller impact on appropriateness of use and documentation.
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Am J Infect Control · Nov 2007
Clinical and molecular epidemiology of community-onset, extended-spectrum beta-lactamase-producing Escherichia coli infections in Thailand: a case-case-control study.
Extended-spectrum beta-lactamase (ESBL)-producing organisms, first identified in Germany in 1983, are now widely recognized as clinically relevant causes of infections in community. ⋯ CO-ESBL-producing E coli is an emerging multidrug-resistant microorganism in Thailand. Patients with prior ESBL colonization and recent antibiotic exposures, especially to third-generation cephalosporins and fluoroquinolones, were at risk for CO-ESBL-producing E coli infection.
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Am J Infect Control · Oct 2007
ReviewPrevention of disease transmission during flexible laryngoscopy.
The medical literature was reviewed to evaluate the risk of disease transmission and nosocomial infection associated with flexible laryngoscopes. These instruments have been reported to be contaminated with blood, body fluids, organic debris, and potentially pathogenic microorganisms during routine clinical use. Failure to reprocess properly a flexible laryngoscope may, therefore, result in patient-to-patient disease transmission. ⋯ Whereas 70% isopropyl alcohol, quaternary ammonium compounds, and other products that achieve intermediate-level or low-level disinfection are contraindicated for reprocessing flexible laryngoscopes, 2% glutaraldehyde and other products that achieve high-level disinfection (or sterilization) are recommended for reprocessing these instruments to prevent nosocomial infection. A formal set of step-by-step guidelines for reprocessing flexible laryngoscopes is provided. Use of a disposable sheath to cover and protect the flexible laryngoscope from contamination during clinical use is discussed.