Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Aug 2007
Case ReportsRalstonia pickettii bacteremia associated with pediatric extracorporeal membrane oxygenation therapy in a Canadian hospital.
We describe 2 pediatric patients with Ralstonia pickettii bacteremia associated with extracorporeal membrane oxygenation (ECMO) therapy. Investigation revealed a common environmental source--the ECMO temperature-control units. We created guidelines for disinfecting these units that do not void the manufacturer's warranty and have prevented additional cases of bacteremia due to this organism.
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To describe the rate of infection, associated organisms, and potential risk factors for ventilator-associated pneumonia (VAP) in patients receiving mechanical ventilation at home. ⋯ Although the organisms associated with VAP in the home setting are similar to those associated with hospital-acquired VAP, the incidence and mortality is much lower in the home care setting. Interventions to reduce the risk of VAP among patients receiving home care should be focused on patients who require ventilation for longer daily durations or who are new to receiving mechanical ventilation at home.
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Infect Control Hosp Epidemiol · Jul 2007
Microbiology of ventilator-associated pneumonia compared with that of hospital-acquired pneumonia.
Nosocomial pneumonia is the leading cause of mortality attributed to nosocomial infection. Appropriate empirical therapy has been associated with improved survival, but data are limited regarding the etiologic agents of hospital-acquired pneumonia in nonventilated patients (HAP). This evaluation assessed whether the currently recommended empirical therapy is appropriate for both ventilator-associated pneumonia (VAP) and HAP by evaluating the infecting flora. ⋯ Our data demonstrated that patients with HAP, compared with those with VAP, had a similar frequency of infection with ORSA but less commonly had infections due to P. aeruginosa, Acinetobacter species, and S. maltophilia. However, the overall frequency of infection with these pathogens was sufficiently high to warrant the use of empirical therapy likely to be active against them. Our data supports using the currently recommended empirical therapy for both HAP and VAP.
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Infect Control Hosp Epidemiol · Jul 2007
Effectiveness of multifaceted hospitalwide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand.
To evaluate the efficacy of a multifaceted hospitalwide quality improvement program that featured an intervention to remind physicians to remove unnecessary urinary catheters. ⋯ This study suggests that a multifaceted intervention to remind physicians to remove unnecessary urinary catheters can significantly reduced the duration of urinary catheterization and the CA-UTI rate in a hospital in a developing country.
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Infect Control Hosp Epidemiol · Jun 2007
Clinical and economic impact of multidrug resistance in nosocomial Acinetobacter baumannii bacteremia.
To investigate the impact of antimicrobial resistance on clinical and economic outcomes among hospitalized patients with multidrug-resistant (MDR) Acinetobacter baumannii bacteremia. ⋯ Patients with MDR A. baumannii bacteremia had a higher mortality rate and incurred greater medical costs than patients with non-MDR A. baumannii bacteremia.