Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Apr 2007
Pathogens in early-onset and late-onset intensive care unit-acquired pneumonia.
To compare the type of pathogens isolated from patients with early-onset intensive care unit (ICU)-acquired pneumonia with those isolated from patients with late-onset ICU-acquired pneumonia and to study risk factors for the isolation of pathogens that are potentially resistant to multiple drugs. ⋯ Pathogens potentially resistant to multiple drugs were isolated in 52% of cases of early-onset ICU-acquired pneumonia. Previous antibiotic use (both prophylactic and therapeutic) is the main risk factor for the isolation of these pathogens.
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Infect Control Hosp Epidemiol · Apr 2007
Multicenter StudyRisk factors for death due to nosocomial infection in intensive care unit patients: findings from the Krankenhaus Infektions Surveillance System.
To determine risk factors for death among patients with nosocomial pneumonia and patients with primary bloodstream infections (BSI) in intensive care units (ICUs). ⋯ The study results underline the need for further investigations of the role of antimicrobial resistance in the outcome of patients with nosocomial pneumonia and patients with primary BSI.
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Infect Control Hosp Epidemiol · Apr 2007
Risk adjustment for surgical site infection after median sternotomy in children.
To determine whether the National Nosocomial Infections Surveillance (NNIS) System risk index adequately stratified a population of pediatric patients undergoing cardiac surgery according to the risk of developing surgical site infection (SSI). ⋯ The NNIS risk index did not adequately stratify pediatric patients undergoing median sternotomy according to their risk of developing an SSI. Various modifications to the risk index yielded only slightly higher AUC values.
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Infect Control Hosp Epidemiol · Apr 2007
Nosocomial bacteremia in children: a 15-year experience at a general hospital in Mexico.
To describe the incidence and etiology of nosocomial bloodstream infections in children at a general hospital. ⋯ There were 868 nosocomial bloodstream infections detected in 29,273 subjects (overall rate, 2.94 episodes per 100 discharges). Infection rates were greatest among children admitted to the neonatal intensive care unit and lowest for those admitted to the school-age ward and the infectious diseases ward. There was a significant decrease in rates of nosocomial bacteremia in all of the wards. The organisms isolated most commonly were Klebsiella pneumoniae, Candida species, and coagulase-negative staphylococci. Mortality rates were higher for children with a gram-negative bacterial bloodstream infection (45.2%) and lower for children with a gram-positive bacterial infection (19.2%).Conclusions. Rates of nosocomial bloodstream infection decreased over the past 15 years at our hospital but continue to cause significant mortality. Continuing efforts to decrease the frequency of and mortality due to bloodstream infection are warranted.
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Infect Control Hosp Epidemiol · Apr 2007
Usefulness of severity-of-illness scores based on admission data only in nosocomial infection surveillance systems.
Surveillance of nosocomial infection (NI) and the use of reference data for comparison is recommended to improve the quality of patient care. In addition to standardization according to device use, another stratification of reference data according to patients' severity-of-illness scores is often required for benchmarking in intensive care units (ICUs). ⋯ The APACHE II and TISS scores on admission are not useful predictors for NI in ICUs.