Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Nov 2006
Staphylococcus aureus bacteremia in older adults: predictors of 7-day mortality and infection with a methicillin-resistant strain.
To determine the predictors of 7-day mortality in older adult patients with Staphylococcus aureus bacteremia after controlling for comorbidity using the Charlson weighted index of comorbidity (WIC) and to identify the risk factors associated with bacteremia due to methicillin-resistant S. aureus (MRSA). ⋯ The Charlson WIC is significantly associated with increased mortality of S. aureus bacteremia in older adults. Previous hospitalization in the past 3 months, residence in a long-term care facility, and altered mental status should be used as a guidance for empirical vancomycin therapy and application of infection control measures in older adults with suspected S. aureus bacteremia.
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Infect Control Hosp Epidemiol · Nov 2006
A cluster of nosocomial herpes simplex virus type 1 pneumonia in a medical intensive care unit.
We report a cluster of 3 cases of nosocomial herpes simplex virus type 1 (HSV-1) pneumonia occurring in close temporal and physical proximity during a 1-week period, which suggested a common source. HSV-1 nosocomial pneumonia occurs in immunocompetent intubated patients and presents as otherwise unexplained profound and/or prolonged hypoxemia (decreased F(IO2), increased P(O2), and decreased A-a gradient) and "failure to wean." The diagnosis of HSV-1 pneumonia is determined by demonstration of characteristic cytopathologic findings (Cowdry type A inclusion bodies) in distal respiratory epithelial cells from bronchoscopic specimens. Acyclovir therapy results in rapid improvement and ability to wean.
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Infect Control Hosp Epidemiol · Nov 2006
Screening for multidrug-resistant bacteria as a predictive test for subsequent onset of nosocomial infection.
To investigate whether carriage of multidrug-resistant bacteria is a risk factor for nosocomial infection and whether detection of carriage is predictive of subsequent onset of nosocomial infection. ⋯ Carriage proved to be a risk factor for subsequent nosocomial infection. However, the carriage test was useful as a predictive tool only for patients with a positive test result.
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Infect Control Hosp Epidemiol · Nov 2006
Duration of methicillin-resistant Staphylococcus aureus carriage, according to risk factors for acquisition.
To examine the duration of methicillin-resistant Staphylococcus aureus (MRSA) carriage and its determinants and the influence of eradication regimens. ⋯ Risk factors for MRSA acquisition should be carefully assessed in all MRSA carriers and should be included in infection control policies, such as the timing of decolonization treatment, the definition of MRSA clearance, and the decision of when to suspend isolation measures.