Articles: intensive-care-units.
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Infection control : IC · Jan 1981
Surveillance in a surgical intensive care unit: patient and environment.
Microbiologic surveillance of both the patients and the ambient environment of a surgical intensive care unit allowed us to relate the incidence of nosocomial respiratory tract infection to levels of airborne bacteria. Over the study period respiratory tract nosocomial infection rates varied from 0.7% to 17.0%, and nonrespiratory infection rates varied from 1.0% to 25.0%. Airborne bacteria counts during that time varied from 1.0 +/- 0.8 S. ⋯ If the bacteria traveled from the air to the patients, there appear to be at least three possible explanations for this significant relationship: (1) direct inoculation of the airway by the airborne bacteria; (2) inoculation of the airway by direct contact, which is related to the degree of "cleanliness" of the environment; and (3) an increased incidence of contaminated respiratory equipment and airway inoculation because of high counts of airborne bacteria. It is also possible that high bacterial air counts represent contamination of the air from patients with respiratory infections. Regardless of the pathway(s), surveillance of the ambient environment may prove to be a useful epidemiologic tool in the study and control of nosocomial respiratory tract infections in certain high-risk patient care areas.
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We prospectively studied all patients admitted to a multidisciplinary intensive care unit to determine how many of their diseases were iatrogenic and, of these, what number were potentially avoidable. Of 325 patients admitted in the course of one year, 41 (12.6%) were hospitalized because of iatrogenic disease. ⋯ Nevertheless, 19 patients (46.3%) were admitted with iatrogenic disease resulting from therapeutic or technical errors that were potentially avoidable. Iatrogenic disease was fatal in eight cases, life-threatening in 13, moderate in 20.