Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
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J. Infect. Chemother. · Dec 2006
Clinical characteristics and outcomes of bacteremia caused by Acinetobacter species other than A. baumannii: comparison with A. baumannii bacteremia.
Previous reports have suggested that bacteremia caused by Acinetobacter species other than A. baumannii is frequently associated with intravascular catheters, and that A. baumannii is less virulent than non-baumannii Acinetobacter. To validate these observations, 28 patients with bacteremia caused by Acinetobacter species other than A. baumannii (cases) were compared with 112 randomly selected patients with A. baumannii bacteremia (controls). ⋯ No significant differences between cases and controls were noted in crude mortality (17.9% vs 32.4%; P = 0.131) or bacteremia-related mortality (14.3% vs 12.6%; P = 0.760). In conclusion, we found that the portals of entry and the mortality of bacteremia associated with Acinetobacter species other than A. baumannii and with A. baumannii were similar.
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J. Infect. Chemother. · Dec 2006
To reduce catheter-related bloodstream infections: is the subclavian route better than the jugular route for central venous catheterization?
The most important targets of hospital-acquired infection control are to reduce the incidence of surgical-site, catheter-related, and ventilator-associated infections. In this report, we address previously presented infection-control strategies for central venous (CV) line catheterization, using a CV catheter-related infection surveillance system. Data concerning CV catheter insertion were collected from all facilities in our 650-bed hospital, excluding the operating and hemodialysis wards. ⋯ Infection rates were 3.8 per 1000 catheter-days in subclavian, 6.1 in jugular, and 15.7 in femoral vein catheterization. In high-risk departments (intensive care unit [ICU] and emergency departments) the infection rate was 5.4 for subclavian and 10.2 for jugular catheterization, whereas it was 3.6 for subclavian and 4.6 for jugular catheterization in noncritical-care departments. Considering complications such as pneumothorax, CV catheterization of the jugular vein is recommended in certain situations.
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J. Infect. Chemother. · Dec 2006
Etiology and clinical study of community-acquired pneumonia in 157 hospitalized children.
We tried to verify whether the currently employed diagnosis and treatment of community-acquired pneumonia in children were appropriate. For this purpose, we created tentative criteria for the classification of pediatric community-acquired pneumonia. We classified the community-acquired pneumonia into ten categories: (1) bacterial, (2) concomitant viral-bacterial, (3) viral, (4) mycoplasmal, (5) concomitant mycoplasmal-bacterial, (6) concomitant mycoplasmal-viral, (7) chlamydial, (8) concomitant chlamydial-bacterial, (9) concomitant chlamydial-viral, and (10) unknown. ⋯ We chose the initial treatment according to clinical and laboratory findings on admission (i.e., patients' age, clinical course, chest X-ray, and laboratory findings). In 68 of the 71 patients with bacterial (without mycoplasmal) pneumonia, an appropriate antibacterial-agent was prescribed. In 25 of the 27 patients with mycoplasmal pneumonia, clindamycin and minocycline were prescribed.