American journal of infection control
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Nosocomial bloodstream infections (BSI) create a serious health problem in hospitals all over the world. The objectives of our study were to explore putative disease markers and potential risk factors with nosocomial BSI in patients in intensive care units (ICU) and non-ICU patients and to determine risk factors associated with increased 28-day mortality rate in patients with nosocomial BSI acquired in combined medical-surgical ICU. However, the major purposes of this report were to identify epidemiologic differences between nosocomial BSI acquired in ICU and non-ICU, as well as analyses outcomes for patients with nosocomial BSI acquired in ICU. ⋯ Our results show epidemiologic differences between non-ICU and ICU BSI. Also, this study suggests that severity of underlying host conditions, mechanical ventilation, and microbial agents (Klebsiella species) affect the outcome of NBI in patients in ICU.
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Am J Infect Control · Jun 2005
ReviewHealth care-associated infections in the neonatal intensive care unit.
Neonates represent a unique and highly vulnerable patient population. Advances in medical technology that have occurred over the last few decades have improved the survival and quality of life for neonates, particularly those infants born with extreme prematurity or with congenital defects. ⋯ Rates of infections in neonatal intensive care units (NICUs) have varied from 6% to 40% of neonatal patients, with the highest rates in those facilities having larger proportions of very low-birth-weight infants (birthweight < or =1000 grams) or neonates requiring surgery. Efforts to protect the vulnerable NICU infants include the following: (1) optimal infection control practices, especially good hand hygiene and good nursery design; (2) prudent use of invasive interventions with particular attention to early removal of invasive devices after they are no longer essential; and (3) judicious use of antimicrobial agents, with an emphasis on targeted (narrow spectrum) rather than broad-spectrum antibiotics and appropriate indications (proven or suspected bacterial infections).
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Am J Infect Control · Apr 2005
The attributable cost and length of hospital stay because of nosocomial pneumonia in intensive care units in 3 hospitals in Argentina: a prospective, matched analysis.
No information is available on the financial impact of nosocomial pneumonia in Argentina. To calculate the cost of nosocomial pneumonia in intensive care units, a 5-year, matched cohort study was undertaken at 3 hospitals in Argentina. ⋯ Nosocomial pneumonia results in significant patient morbidity and consumes considerable resources. In the present study, patients with nosocomial pneumonia had significant prolongation of hospitalization, cost, and a high extra mortality. The present study illustrates the potential cost savings of introducing interventions to reduce nosocomial pneumonia. To our knowledge, this is the first study evaluating this issue in Argentina.
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The objective of this study was to assess the incidence of ventriculostomy-associated infections (VAI) and to examine the related risk factors. ⋯ The risk of VAI increases with increasing duration of catheterization and with repeated insertions. The use of local antibiotic irrigation or systemic antibiotics does not appear to reduce the risk of VAI. Routine surveillance cultures of CSF were no more likely to detect infection than cultures obtained when clinically indicated. These findings need to be considered in infection control policies addressing this important issue.
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Am J Infect Control · Mar 2005
Comparative StudyComparative efficacy of hand hygiene agents in the reduction of bacteria and viruses.
Health care-associated infections most commonly result from person-to-person transmission via the hands of health care workers. ⋯ Antimicrobial handwashing agents were the most efficacious in bacterial removal, whereas waterless agents showed variable efficacy. Alcohol-based handrubs compared with other products demonstrated better efficacy after a single episode of hand hygiene than after 10 episodes. Effective hand hygiene for high levels of viral contamination with a nonenveloped virus was best achieved by physical removal with a nonantimicrobial soap or tap water alone.