The Journal of hospital infection
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The use of transmission precautions such as contact isolation in patients known to be colonised or infected with multidrug-resistant organisms is recommended in healthcare institutions. Although essential for infection control, contact isolation has recently been associated with adverse effects in patients. We undertook a systematic review to determine whether contact isolation leads to psychological or physical problems for patients. ⋯ Well-validated tools are necessary to investigate these results further. Large studies examining a number of safety indicators to assess the adverse effects of isolation are needed. Patient education may be an important step to mitigate the adverse psychological effects of isolation and is recommended.
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Defervescence of sepsis after removal of culture-positive central venous catheters (CVCs) has been advocated for diagnosis of catheter-related bloodstream infection (CRBSI) even without positive blood culture. However, most studies report CRBSI incidence only when blood cultures, and CVC tip, are positive (standard definition). We examined the effect of inclusion of defervescence criteria on CRBSI incidence in a total parenteral nutrition (TPN) population. ⋯ This increased to 13+/-6.4 per 1000 CVC-days when defervescence criteria were included. Inclusion of defervescence criteria increased CRBSI incidence by a mean of 2.5+/-1.4 episodes per 1000 days or 27% (95% CI: 1.61-3.339; P<0.001). This study implies that the scale of CRBSI may be higher than is currently recognised and that the blood culture positivity rate for CRBSI is 79% (152/192).