The Journal of hospital infection
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Multicenter Study
Plastic wound retractors as bacteriological barriers in gastrointestinal surgery: a prospective multi-institutional trial.
Surgical site infection remains a significant problem, and peri-operative strategies to reduce wound exposure to bacteria are needed urgently. Plastic ring wound retractors, used to gain access to the abdominal cavity, may shield the incision site from bacteria. ⋯ Plastic wound retractors reduce wound exposure to enteric bacteria in gastrointestinal surgery.
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Comparative Study
Differences in the compliance with hospital infection control practices during the 2009 influenza H1N1 pandemic in three countries.
In December 2009, the World Health Organization (WHO) issued updated guidelines on the prevention of H1N1 influenza virus in healthcare settings. In 2010, the WHO pandemic influenza alert level was still at phase 6. ⋯ Compliance with infection control measures for pandemic influenza appears to vary widely depending on the setting.
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Ventilator-associated pneumonia (VAP) is a significant problem in intensive care and there exists great demand for a suitable biomarker. Procalcitonin (PCT) has been proposed as a candidate marker. ⋯ No association was found between PCT concentration and the adequacy of antibiotic therapy or the aetiology of VAP. In logistic regression analysis, PCT was not significantly correlated with poor outcome. Although PCT levels were higher in non-survivors and those who developed septic shock, PCT is not a strong predictor of these outcomes.
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Ventilator-associated pneumonia (VAP) developed in 96 (60%) of 159 patients with 37.2 cases per 1000 ventilation-days in a medical intensive care unit (MICU). Median time for VAP development was 5.5 days (range: 2-25). ⋯ The daily cost for VAP patients was half that for non-VAP patients. The total costs for VAP patients were about three-fold higher than for non-VAP patients.
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Pre-operative skin preparation, aimed at reducing the endogenous microbial flora, is one of the main preventive measures employed to decrease the likelihood of surgical site infection. National recommendations on pre-operative management of infection risks were issued in France in 2004. ⋯ The essential content of the French guidelines seems to be understood, but reminders need to be issued. Some recommendations may need to be adapted for certain specialties.