Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Oct 2006
Comparative StudyCharacteristics of patients with healthcare-associated infection due to SCCmec type IV methicillin-resistant Staphylococcus aureus.
Methicillin-resistant Staphylococcus aureus (MRSA) with the staphylococcal cassette chromosome mec (SCCmec) type IV allele is most commonly associated with community-acquired MRSA (CA-MRSA) infection; however, such organisms have also been identified in the healthcare setting. The objective of the present study was to characterize the epidemiology of and clinical outcomes associated with SCCmec-IV MRSA infection acquired in the healthcare setting, compared with infection caused by MRSA of other SCCmec types. ⋯ SCCmec-IV MRSA appears to have become established in hospitals. The onset of infection caused by SCCmec-IV strains is earlier than the onset of infection with SCCmec-II/III strains; however, associated types of infection are similar. Infection with SCCmec-II/III MRSA is currently associated with an adverse impact on outcome, compared with infection with SCCmec-IV MRSA. Further research is warranted to determine the impact of SCCmec type IV strains in hospital settings.
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Infect Control Hosp Epidemiol · Sep 2006
Blood pressure cuff as a potential vector of pathogenic microorganisms: a prospective study in a teaching hospital.
To investigate the potential role of blood pressure (BP) cuffs in the spread of bacterial infections in hospitals. ⋯ The results of this survey highlight the importance of recognizing BP cuffs as potential vectors of pathogenic bacteria among patients and as a source of reinfection when dedicated to a single patient, emphasizing the urgent need for validated procedures for their use and maintenance.
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Infect Control Hosp Epidemiol · Aug 2006
Microbiology of surgical site infections and associated antimicrobial use among Vietnamese orthopedic and neurosurgical patients.
To determine the pathogens associated with surgical site infections (SSIs) and describe patterns of antimicrobial use and resistance in orthopedic and neurosurgical patients in a large university hospital in Vietnam. ⋯ Our data indicate that the incidence of SSI is high in our study population, that the main pathogens causing SSI are gram-negative bacteria and are often resistant to commonly used antimicrobials, that the use of broad-spectrum antimicrobials after surgery is widespread, and that implementation of interventions aimed at promoting appropriate and evidence-based use of antimicrobials are needed in Vietnam.
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Infect Control Hosp Epidemiol · Jul 2006
Inaccurate communications in telephone calls to an antimicrobial stewardship program.
Antimicrobial stewardship programs (ASPs) decrease unnecessary antimicrobial use, decrease antimicrobial resistance, and improve patient outcomes. The effectiveness of a prior approval system--that is, the requirement that approval be obtained from ASP practitioners before certain antimicrobials can be used--depends on the accuracy of the patient data communicated from the primary service. ⋯ A high proportion of ASP calls requesting prior approval included patient data inaccuracies, which have the potential to affect the prescribing of antimicrobials. Although risk factors were identified, these communication errors were common across the different types of ASP interactions. Inaccurate communications may compromise the utility of ASPs that use a prior approval system for optimizing antimicrobial use.
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Infect Control Hosp Epidemiol · Jul 2006
Antibiotic-stewardship practices at top academic centers throughout the United States and at hospitals throughout Massachusetts.
Improvements in antibiotic prescribing to reduce bacterial resistance and control hospital costs is a growing priority, but the way to accomplish this is poorly defined. Our goal was to determine whether certain antibiotic stewardship interventions were universally instituted and accepted at top US academic centers and to document what interventions, if any, are used at both teaching and community hospitals within a geographic area. ⋯ There was great variability among the approaches to the oversight of antibiotic prescribing at major academic hospitals. Antibiotic management interventions were lacking in more than half of the Massachusetts community hospitals surveyed. More research is needed to define the best antibiotic stewardship interventions for different hospital settings.