The Journal of hospital infection
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In a retrospective study, population characteristics and outcome were investigated in intensive care unit (ICU) patients with hospital-acquired Pseudomonas aeruginosa bacteraemia admitted over a seven-year period (January 1992 through December 1998). A matched cohort study was performed in which all ICU patients with P. aeruginosa bacteraemia were defined as cases (N=53). Matching (1:2 ratio) of the controls (N=106) was based on the APACHE II classification: an equal APACHE II score (+/-1 point) and an equal diagnostic category. ⋯ In a multivariate survival analysis the APACHE II score was the only variable independently associated with mortality. In conclusion, P. aeruginosa bacteraemia is associated with a clinically relevant attributable mortality (15%). However, we could not find statistical evidence of P. aeruginosa being an independent predictor of mortality.
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The objective of this study is to describe infections in a specialized burns intensive care unit from 1993 to 1999. The criteria for admission to the unit are: children with burns involving at least 10% or adults with burns involving at least 20% of total body surface; burns affecting face, perineum or feet; suspected or proven airway injury; electric or chemical burns; age less than one year or above 50; or pre-existing disease with any extent of burns. Surveillance of hospital-acquired infection was prospective. ⋯ Gram-positive and Gram-negative organisms exhibited resistance to most antimicrobial agents used for therapy. During the first three days of hospitalization in the burns intensive care unit there were eight infections caused by S. aureus and three of these were resistant to oxacillin. These data provide background information regarding extensive burn patients on which decisions for control and prevention of hospital-acquired infections can be made.
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The objective of the present study was to determine risk factors for development of the most common hospital-acquired infections in paediatric burn patients in order to give recommendations for surveillance. The prospective cohort study in a paediatric burn centre was conducted over a period of two years using uni- and multivariate analysis for risk factor identification. In a group of 41 children with an mean total burn surface area (TBSA) of 18.9% 42 hospital-acquired infections were observed. ⋯ Duration of urinary catheter use and ventilation were identified as risk factors for the corresponding hospital-acquired infection. Surveillance of hospital-acquired infections in burn intensive care units should be performed in the same way as other intensive care unit types, as recommended by the National Nosocomial Infections Surveillance system, without consideration of the percentage of TBSA. In addition, burn wound infections should be recorded using the percentage of TBSA for stratification of burn wound infection rates.
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This work results from concerns that forced-air convection heaters applied to patients in the operating theatre might interfere with ultra-clean ventilation system and thus be a potential source of wound contamination. Air samples were taken in the operative field and the bacterial load calculated by estimating the number of colony forming units per cubic metre of air (cfu/m(3)). Six tests were carried out, two in empty theatres and four during standard orthopaedic operating lists. ⋯ A further small rise was seen after the convection heaters were turned on when applied to patients. This study showed that use of warm air convection heaters on patients produced a small increase in the number of colony forming units in ultra-clean air theatres but the levels were unlikely to have clinical significance. By far the greatest effect on numbers was movement and presence of the patient and theatre staff in the theatre.