Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Jun 2006
Risk factors for nosocomial primary bloodstream infection in pediatric intensive care unit patients: a 2-year prospective cohort study.
The primary objective was to determine the rate of and risk factors for nosocomial primary bloodstream infection (BSI) in pediatric intensive care unit (PICU) patients in order to determine the validity of our previously published findings. The secondary objective was to analyze whether risk factors for primary BSI differed by organism type, particularly whether device use was more strongly associated with BSI due to gram-positive organisms. ⋯ Arterial catheter use and packed red blood cell transfusion are potentially modifiable risk factors for nosocomial primary BSI in PICU patients. Genetic syndromes may be markers for unrecognized immune defects that impair host defense against microorganisms.
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Infect Control Hosp Epidemiol · Jun 2006
Measures to control an outbreak of pertussis in a neonatal intermediate care nursery after exposure to a healthcare worker.
Hospitalized premature infants are particularly vulnerable to morbidity and mortality from pertussis. Effective prevention and investigative and control measures are not well described. ⋯ HCWs or patients may serve as the source of pertussis in nosocomial outbreaks, which can result in substantial morbidity and outlay of resources for control measures. Our review suggested that a diagnosis of pertussis should be an early consideration for HCWs with cough illness. Targeted pertussis immunization of HCWs, employee health policies that provide for testing and furlough of HCWs with prolonged cough, and monitoring of HCWs for compliance with infection control measures could reduce the morbidity and costs associated with pertussis outbreaks. These measures will require evaluation of their effectiveness.
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Infect Control Hosp Epidemiol · Jun 2006
Survey on use of and attitudes toward influenza vaccination among emergency department staff in a New York metropolitan hospital.
Recognizing that the potential transmission of influenza virus would be concentrated at a hospital's primary point of entry, we determined rates of staff compliance with the influenza vaccination recommendations of the Advisory Committee on Immunization Practices (ACIP) in the Emergency Department (ED). We describe the basic knowledge concerning influenza transmission and factors influencing vaccination decisions among ED staff. ⋯ Despite ACIP recommendations, 50% of respondents did not receive an influenza vaccination. Misconceptions regarding influenza vaccine efficacy, concerns about adverse effects, and fear of contracting illness were significantly associated with noncompliance with vaccination. Variables that were important contributors to compliance with vaccination were prior influenza illness and services rendered by the FVP.
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Infect Control Hosp Epidemiol · Jun 2006
Risk factors for candidemia in pediatric patients with congenital heart disease.
To identify the main risk factors for the acquisition of candidemia in children with congenital heart disease (CHD) in order to improve the clinical management of these patients. ⋯ Patients with CHD who have a high TISS score 1 week after PICU admission and patients who have received prolonged antibiotic therapy should be considered at high risk for candidemia. Our results suggest that shorter courses of antibiotic therapy, routine surveillance culture for Candida species, and initiation of preemptive or empirical antifungal treatment could help in the clinical management of these patients.