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 2014
Randomized Controlled Trial Pragmatic Clinical TrialDoes chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
To determine rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization. ⋯ In this large cluster-randomized trial, we demonstrated that universal decolonization with CHG bathing resulted in a significant reduction in blood culture contamination.
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Infect Control Hosp Epidemiol · Oct 2014
Effect of standardized surveillance of intensive care unit-acquired infections on ventilator-associated pneumonia incidence.
In a multicenter surveillance of intensive care unit (ICU)-acquired infections, adjusted ventilator-associated pneumonia (VAP) incidence diminished by -1.0% per year (95% confidence interval [CI], -1.8 to -0.2; P = .02) in ICUs with continuous surveillance but increased by +16.1% (95% CI, 0.5%-34.1%; P = .04) in the year following surveillance disruption, suggesting a preventive effect of surveillance on VAP.
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Infect Control Hosp Epidemiol · Oct 2014
Observational StudyPrevalence of nasal colonization and strain concordance in patients with community-associated Staphylococcus aureus skin and soft-tissue infections.
Determine the prevalence and relatedness of Staphylococcus aureus anterior nares colonization in individuals with community-associated staphylococcal skin and soft-tissue infection (SSTI). ⋯ On the phenotypic level, concordant anterior nares colonization with incident staphylococcal SSTI is more common in MSSA than MRSA; however, the opposite is observed when accounting for molecular typing, and MRSA SSTI displays greater concordance. USA300 was responsible for strain concordance with MRSA SSTI. Studies are needed to examine the roles of nasal and extra-nasal carriage, colonization preceding infection, and increased virulence in the pathogenesis of MRSA SSTI.
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Infect Control Hosp Epidemiol · Oct 2014
Improving compliance with timely intraoperative redosing of antimicrobials in surgical prophylaxis.
Appropriate use of antimicrobials for surgical prophylaxis is an important patient safety issue. Antimicrobial levels should be present during the duration of the surgical procedure until incision site closure. For prolonged surgical procedures in which the tissue concentration of the prophylactic antimicrobial may decrease to below the necessary minimum inhibitory concentration, intraoperative redosing of antimicrobials may be crucial. ⋯ Compliance with redosing of intraoperative antimicrobials was improved with the combined approach of guidelines, education to healthcare providers, and real-time automated paging system.