Infection
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Review Case Reports
Isolated bacterial meningitis as the key syndrome of infective endocarditis.
Bacterial meningitis is an unusual first manifestation but a major complication of infective endocarditis. ⋯ An extensive search for endocarditis is recommended in every case of an unusual isolate in bacterial meningitis whether it is isolated from blood or CSF.
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Multicenter Study Comparative Study
Phlebitis rate and time kinetics of short peripheral intravenous catheters.
An observational prospective cohort study was carried out on complication rates and time kinetics of phlebitis caused by short peripheral intravenous catheters (PIVCs) in inpatients on 15 hospital wards in four hospitals in Cologne, Germany. ⋯ Linear time kinetics of PIVC phlebitis do not support CDC recommendations for an elective PIVC change after 72 hours, provided daily monitoring of the insertion site occurs.
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Multicenter Study
Prevalence and patterns of antibiotic prescribing in Italian hospitals.
Use of antimicrobial drugs is associated with the emergence of resistant bacteria, increasing hospital expenditures and requires an assessment of appropriateness. The aim of this study was to investigate prevalence and patterns of antibiotic prescribing and expenditures in Italian hospitals. A prevalence survey was performed in 15 Italian hospitals. ⋯ High rates of antibiotic usage were observed in Italian hospitals. Areas for improvement, both for the use of diagnostic resources and the prescribing habits, were identified. The 1-day prevalence survey of antimicrobial use may be a tool of feedback to prescribers for more appropriate drug selection.
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Healthcare-associated infections are a major cause of morbidity and mortality at hospitals in the United States. Surveillance of these infections identifies secular trends and provides data upon which prevention interventions can be based in order to improve patient safety. National surveillance of healthcare-associated infections was initiated in the United States in 1970. ⋯ These methods have resulted in a significant reduction in bloodstream infections, urinary tract infections and pneumonia in intensive care unit (ICU) patients and surgical site infections in surgical patients. The NNIS data show that national surveillance of healthcare-associated infections combined with an intervention prevention program can reduce infection rates, reduce morbidity and mortality and improve patient safety. Establishment of such healthcare-associated infection surveillance and prevention systems in countries throughout the world should be a priority.
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The etiology of fever of unknown origin (FUO) includes primarily infectious, collagen-vascular and neoplastic diseases. The distribution of the disorders causing FUO may differ according to the geographic area and the socioeconomical status of the country. Moreover, the developments in radiographic and microbiologic methods have changed the spectrum of diseases causing FUO. ⋯ Although the relative rate of infectious disease as etiologic category is less commonly encountered, infectious disease, especially tuberculosis, remains a common cause of FUO. Although several diseases may lead to FUO, lymphomas, adult-onset Still's disease and particularly tuberculosis should be considered in the differential diagnosis of a patient admitted with FUO.