Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · May 1999
An outbreak of acute gastroenteritis in a geriatric long-term-care facility: combined application of epidemiological and molecular diagnostic methods.
To assess possible transmission modes of, and risk factors for, gastroenteritis associated with Norwalk-like viruses (NLVs) in a geriatric long-term-care facility. ⋯ In the absence of evidence for food-borne or waterborne transmission, NLVs likely spread among residents and employees of a long-term-care facility through person-to-person or airborne droplet transmission. Rapid notification of local health officials, collection of clinical specimens, and institution of infection control measures are necessary if viral gastroenteritis transmission is to be limited in institutional settings.
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Infect Control Hosp Epidemiol · Apr 1999
Bloodstream infections in a neonatal intensive-care unit: 12 years' experience with an antibiotic control program.
To assess the prevalence of gram-positive coccal (GPC), gram-negative bacillary (GNB), and fungal blood-stream infections (BSIs) during a 12-year period in which a consistent antibiotic treatment protocol was in place; to evaluate the efficacy of these antibiotic policies in relation to treatment, to the emergence of bacterial or fungal resistance, and to the occurrence of infection outbreaks or epidemics. ⋯ We observed a decrease in the prevalence of early-onset BSIs due to GBS and an increase in late-onset BSIs due to GPC, GNB, and fungi. The combination of ampicillin and gentamicin for suspected early-onset BSIs and vancomycin and gentamicin for late-onset BSIs has been successful for treatment of individual patients without the occurrence of infection outbreaks or the emergence of resistance. Controlled antibiotic programs and periodic evaluations based on individual unit and not on hospitalwide antibiograms are advisable.
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Infect Control Hosp Epidemiol · Mar 1999
Surgical-site complications associated with a morphine nerve paste used for postoperative pain control after laminectomy.
To identify risk factors that might explain a sudden increase in the rate of surgical-site complications following laminectomy. ⋯ The intraoperative use of morphine nerve paste may delay wound healing and increase postoperative morbidity. When new products are introduced, standardized protocols should be developed for their use, and systematic surveillance should be done to monitor for potential adverse outcomes.
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Infect Control Hosp Epidemiol · Feb 1999
Use of personal protective equipment and operating room behaviors in four surgical subspecialties: personal protective equipment and behaviors in surgery.
To evaluate Universal Precautions (UP) compliance in the operating room (OR). ⋯ OR personnel had poor compliance with UP. Although there was significant variation in use of personal protective equipment between groups, the total exposure rate was high (22%), indicating the need for further training and reinforcement of UP to reduce occupational exposures.
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Infect Control Hosp Epidemiol · Nov 1998
Risk of infection due to central venous catheters: effect of site of placement and catheter type.
To determine the influence of catheter site and type (single- vs triple-lumen) on infection rates associated with central venous catheterization. ⋯ Our data support an association between intravenous catheter contamination and insertion at a femoral site.