Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Dec 2009
Multidrug-resistant gram-negative bacteria at a long-term care facility: assessment of residents, healthcare workers, and inanimate surfaces.
To characterize the clinical and molecular epidemiology of multidrug-resistant (MDR) organisms in residents, in healthcare workers (HCWs), and on inanimate surfaces at a long-term care facility (LTCF). ⋯ The prevalence of MDR gram-negative bacteria is high among LTCF residents and exceeds that of vancomycin-resistant enterococci and methicillin-resistant S. aureus. Common areas in LTCFs may provide a unique opportunity for person-to-person transmission of MDR gram-negative bacteria.
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Infect Control Hosp Epidemiol · Dec 2009
Epidemiology and outcomes of hospitalizations with complicated skin and skin-structure infections: implications of healthcare-associated infection risk factors.
Healthcare-associated infections are likely to be caused by drug-resistant and possibly mixed organisms and to be treated with inappropriate antibiotics. Because prompt appropriate treatment is associated with better outcomes, we studied the epidemiology of healthcare-associated complicated skin and skin-structure infections (cSSSIs). ⋯ Healthcare-associated cSSSIs are common and are likely to be caused by gram-negative organisms. Mixed infections carry a >2-fold greater risk of inappropriate treatment. Healthcare-associated cSSSIs are associated with increased mortality and prolonged length of hospital stay, compared with community-acquired cSSSIs.
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Infect Control Hosp Epidemiol · Nov 2009
Between community and hospital: healthcare-associated gram-negative bacteremia among hospitalized patients.
Healthcare-associated, community-acquired bacteremia is a subcategory of community-acquired bacteremia distinguished by recent exposure of the patient to the healthcare system before hospital admission. Our objective was to apply this category to a prospective cohort of hospitalized patients with gram-negative bacteremia to determine differences in the epidemiological characteristics, treatment, and outcome of community-acquired bacteremia; healthcare-associated, community-acquired bacteremia; and hospital-acquired bacteremia. ⋯ Many cases of gram-negative bacteremia that occurred in hospitalized patients were healthcare associated. The patients differed in some aspects from patients with community-acquired bacteremia and from those with hospital-acquired bacteremia, but not in mortality.
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Infect Control Hosp Epidemiol · Nov 2009
Comparative StudyUse of International Classification of Diseases, Ninth Revision, Clinical Modification codes and medication use data to identify nosocomial Clostridium difficile infection.
The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for Clostridium difficile infection (CDI) is used for surveillance of CDI. However, the ICD-9-CM code alone cannot separate nosocomial cases from cases acquired outside the institution. The purpose of this study was to determine whether combining the ICD-9-CM code with medication treatment data for CDI in hospitalized patients could enable us to distinguish between patients with nosocomial CDI and patients who were admitted with CDI. The primary objective was to compare the sensitivity, specificity, and predictive value of using the combination of ICD-9-CM code for CDI and CDI treatment records to identify cases of nosocomial CDI with the sensitivity, specificity, and predictive value of using the ICD-9-CM code alone. ⋯ Combining the ICD-9-CM code for CDI with drug therapy information increased the positive predictive value for nosocomial CDI but decreased the sensitivity.
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Infect Control Hosp Epidemiol · Nov 2009
Usefulness of weekly methicillin-resistant Staphylococcus aureus screening.
We evaluated the usefulness of adding weekly methicillin-resistant Staphylococcus aureus (MRSA) screening to our established admission screening and clinical sampling in 4 acute care units of a university hospital. Our results suggest that weekly MRSA screening allows the detection of 56.1% of all cases of hospital-acquired MRSA carriage. These cases would have remained undetected had admission screening and clinical sampling been the only types of surveillance in place.