Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Jul 2016
Multicenter Study Clinical Trial Pragmatic Clinical TrialA Multicenter Pragmatic Interrupted Time Series Analysis of Chlorhexidine Gluconate Bathing in Community Hospital Intensive Care Units.
OBJECTIVE To determine whether daily chlorhexidine gluconate (CHG) bathing of intensive care unit (ICU) patients leads to a decrease in hospital-acquired infections (HAIs), particularly infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). DESIGN Interrupted time series analysis. SETTING The study included 33 community hospitals participating in the Duke Infection Control Outreach Network from January 2008 through December 2013. ⋯ CHG bathing did not affect rates of specific or overall infections due to MRSA. Our findings support daily CHG bathing of ICU patients. Infect Control Hosp Epidemiol 2016;37:791-797.
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Infect Control Hosp Epidemiol · Jul 2016
The Role of Nursing Homes in the Spread of Antimicrobial Resistance Over the Healthcare Network.
OBJECTIVE Recerntly, the role of the healthcare network, defined as a set of hospitals linked by patient transfers, has been increasingly considered in the control of antimicrobial resistance. Here, we investigate the potential impact of nursing homes on the spread of antimicrobial-resistant pathogens across the healthcare network and its importance for control strategies. METHODS Based on patient transfer data, we designed a network model representing the Dutch healthcare system of hospitals and nursing homes. ⋯ CONCLUSIONS If an antimicrobial-resistant pathogen emerges that spreads easily within nursing homes, control efforts aimed at hospitals may no longer be effective in preventing nationwide outbreaks. It is important to consider nursing homes in planning regional and national infection control and in implementing surveillance systems that monitor the spread of antimicrobial resistance. Infect Control Hosp Epidemiol 2016;37:761-767.
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Infect Control Hosp Epidemiol · Jul 2016
Costs of Antimicrobial Stewardship Programs at US Children's Hospitals.
The costs of antimicrobial stewardship programs (ASPs) in children's hospitals have not been described previously. We assessed ASP costs using an online survey administered to ASP leaders at U. ⋯ Overall costs were not correlated with hospital size. Infect Control Hosp Epidemiol 2016;37:852-854.
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Infect Control Hosp Epidemiol · Jul 2016
Choosing Wisely in Healthcare Epidemiology and Antimicrobial Stewardship.
OBJECTIVE To identify Choosing Wisely items for the American Board of Internal Medicine Foundation. METHODS The Society for Healthcare Epidemiology of America (SHEA) elicited potential items from a hospital epidemiology listserv, SHEA committee members, and a SHEA-Infectious Diseases Society of America compendium with SHEA Research Network members ranking items by Delphi method voting. The SHEA Guidelines Committee reviewed the top 10 items for appropriateness for Choosing Wisely. ⋯ Five runner-up recommendations are included. CONCLUSIONS These 5 SHEA Choosing Wisely and 5 runner-up items limit medical overuse. Infect Control Hosp Epidemiol 2016;37:755-760.