The Journal of hospital infection
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Multicenter Study Observational Study
Nationwide study on peripheral-venous-catheter-associated-bloodstream infections in internal medicine departments.
The use of peripheral venous catheters (PVCs) has increased outside intensive care units, as has the rate of PVC-associated-bloodstream infection (PVC-BSI). PVCs are widely used in internal medicine departments (IMDs), but data on the incidence of PVC-BSI and its characteristics in IMDs are scarce. ⋯ PVCs carry a significant risk for bacteraemia in Spanish IMDs. Phlebitis is not always clinically evident in patients with bacteraemia in this population. The study findings support the need for educational and interventional preventive measures in both IMDs and emergency departments to reduce the rate of PVC-BSI and associated comorbidities, and costs.
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Antimicrobial stewardship programmes (ASPs) have been effective in optimizing antibiotic use for inpatients. However, an emergency department's fast-paced clinical setting can be challenging for a successful ASP. ⋯ The implementation of an ASP markedly decreased the number of unnecessary antimicrobial prescriptions, but had little impact on most other aspects of inappropriate prescribing.
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To review studies of systemic antibiotic prophylaxis in burn patients. ⋯ The available evidence does not support the role of systemic antibiotic prophylaxis in the management of the majority of burn patients. Nevertheless, it may be useful in patients with severe burns who require mechanical ventilation, and in selected split-thickness skin grafting procedures.
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Comparative Study
Comparison of two whole-room ultraviolet irradiation systems for enhanced disinfection of contaminated hospital patient rooms.
Ultraviolet (UV) light decontamination systems are being used increasingly to supplement terminal disinfection of patient rooms. However, efficacy may not be consistent in the presence of soil, especially against Clostridium difficile spores. ⋯ Terminal disinfection should be performed on all surfaces prior to UV decontamination. In-house validation studies should be considered to ensure optimal positioning in each room layout and sufficient cycle duration to eliminate target pathogens.
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Randomized Controlled Trial
Chlorhexidine gluconate or polyhexamethylene biguanide disc dressing to reduce the incidence of central-line-associated bloodstream infection: a feasibility randomized controlled trial (the CLABSI trial).
A number of antimicrobial-impregnated discs to prevent central-line-associated bloodstream infection (CLABSI) are marketed but it is unclear which disc is most effective. ⋯ Disc dressings containing PHMB are safe to use for infection prevention at catheter insertion sites. An adequately powered trial to compare PHMB and CHG discs is feasible.