Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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Clin. Microbiol. Infect. · Dec 2012
Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards.
Improvement in hand hygiene (HH) compliance has been associated with a decrease in the incidence of hospital-acquired infection (HAI) and hospital-acquired methicillin-resistant Staphylococcus aureus (HA-MRSA) infection/colonization. We aimed to evaluate the impact of a multimodal intervention in medical wards on HH compliance, alcohol-based hand rub (AHR) consumption and incidence of HAI and HA-MRSA. A before-after intervention study and an assessment 1 year later were conducted in three internal medicine wards. ⋯ HA-MRSA incidence density was 0.92 in the PRE period vs. 0.25/1000 hospital-days in the POST period (p 0.2) and 0.15/1000 hospital-days (p 0.1) 1 year later. A sustained increase in AHR consumption was followed by an improvement in HH compliance after a multimodal campaign. A trend for lower incidence density of new hospital-acquired MRSA was detected in the POST intervention and follow-up periods.
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Clin. Microbiol. Infect. · Nov 2012
Pulmonary complications of pneumococcal community-acquired pneumonia: incidence, predictors, and outcomes.
The aim of this study was to evaluate the clinical characteristics, predictors and outcomes of pneumococcal pneumonia developing pulmonary complications and the distribution of pneumococcal serotypes. It was a prospective study including all adult patients admitted to the Hospital Clinic of Barcelona, Spain (2001-2009) with the diagnosis of pneumococcal pneumonia. Microbiological investigation was systematically performed, including antimicrobial susceptibility and serotype distribution (only invasive strains isolated during 2006-2009). ⋯ Resistance to antibiotics was lower in complicated cases. No significant differences were observed in the serotype distribution between complicated and uncomplicated pneumonia. In the multivariate analysis, COPD was a protective factor against pulmonary complications.
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Clin. Microbiol. Infect. · Nov 2012
MALDI-TOF MS Andromas strategy for the routine identification of bacteria, mycobacteria, yeasts, Aspergillus spp. and positive blood cultures.
All organisms usually isolated in our laboratory are now routinely identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) using the Andromas software. The aim of this study was to describe the use of this strategy in a routine clinical microbiology laboratory. The microorganisms identified included bacteria, mycobacteria, yeasts and Aspergillus spp. isolated on solid media or extracted directly from blood cultures. ⋯ For 96.3% and 92.2% of yeasts and Aspergillus spp., respectively, the identification was obtained with a single acquisition. After a second acquisition, the overall identification rate was 98.8% for yeasts (160/162) and 98.4% (63/64) for Aspergillus spp. In conclusion, the MALDI-TOF MS strategy used in this work allows a rapid and efficient identification of all microorganisms isolated routinely.
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Clin. Microbiol. Infect. · Oct 2012
Multicenter StudyMucormycosis after allogeneic haematopoietic stem cell transplantation: a French Multicentre Cohort Study (2003-2008).
We conducted a nationwide retrospective study to evaluate clinical characteristics and outcome of mucormycosis among allogeneic haematopoietic stem cell transplant recipients. Twenty-nine patients were diagnosed between 2003 and 2008. ⋯ Twenty-six patients received an antifungal treatment; surgery was performed in 12. Overall survival was 34% at 3 months and 17% at 1 year.
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Vaccination of immunocompromised patients is challenging both regarding efficacy and safety. True efficacy data are lacking so existing recommendations are based on immune responses and safety data. ⋯ However, vaccination against pneumococci, Haemophilus influenzae and influenza are generally recommended. Live vaccines must be used with care because the risk for vaccine-associated disease exists.