The Journal of hospital infection
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A survey of operating theatres in Great Britain and Ireland by postal questionnaire was undertaken to determine the number of non-ventilated theatres in use, the number of designated theatres for specialist surgery and how and when bacterial sampling is conducted. Replies were received from 147 centres covering 438 operating theatre suites. Eighty-seven (59%) centres contained three or fewer suites and only 32% did not have a designated theatre for any specialist surgery. ⋯ Four percent of plenum and 9% of ultraclean theatres are never monitored bacteriologically and settle plates are used in 72 (49%) centres. This survey suggests there is some confusion over the indications for bacteriological monitoring and what constitutes acceptable standards. The use of non-ventilated theatres, except for the most minor of procedures, is of some concern and should be phased out.
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Serious infections are often treated by paediatricians with parenteral antibiotics. Traditionally, patients receiving parenteral treatment are hospitalized. ⋯ The present article discusses the potential benefits of outpatient treatment of serious paediatric infections, together with the logistic approach for such treatment. Outpatient treatment for serious paediatric infections may provide an excellent medical treatment that both reduces costs and increases the patient's quality of life.
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Because of the increasing numbers of immunosuppressed patients and the general resurgence of mycobacterial infection, diagnostic bronchoalveolar lavage (BAL) using a fibreoptic bronchoscope is an important and frequent procedure. A contaminated bronchoscope may introduce spurious mycobacteria into specimens causing diagnostic confusion, infect the patient with mycobacteria, or be a vehicle for cross-infection. ⋯ Future solutions to prevent contamination include the regular maintenance of bronchoscopes and washers, having adequate cleaning and disinfection protocols and ensuring that they are adhered to, improving bronchoscope and washer design, and developing alternative disinfectants or new ways of using current ones. All these will probably have considerable cost implications for hospitals.
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Comparative Study
Nasal carriage of Staphylococcus aureus and cross-contamination in a surgical intensive care unit: efficacy of mupirocin ointment.
A six month prospective study was carried out in a surgical intensive care unit (SICU) of a university hospital to assess the incidence and routes of exogenous colonization by Staphylococcus aureus. A total of 157 patients were included in the study. One thousand one hundred and eleven specimens (nasal, surgical wound swabs, tracheal secretions obtained on admission and once a week thereafter, and all clinical specimens) were collected over a four month period from patients without nasal decontamination (A). ⋯ The bronchopulmonary tract infection rate was reduced in group B (P = 0.032). In conclusion, in an SICU, nasal carriage of S. aureus appeared to be the source of endogenous and cross-colonization. The use of nasal mupirocin ointment reduced the incidence of Bp and Sw colonization, as well as the MRSA infection rate.