American journal of infection control
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Am J Infect Control · May 2008
Comparative StudyPilot study of directional airflow and containment of airborne particles in the size of Mycobacterium tuberculosis in an operating room.
Containment of airborne microorganisms to prevent transmission in a positively pressured operating room (OR) is challenging. Occupational transmission of Mycobacterium tuberculosis (M tuberculosis) to perioperative personnel has occurred, but protection of the surgical site is of equal importance. High-efficiency particulate air (HEPA) filters can mitigate occupational exposure and improve air quality. Smoke plumes and submicron particulates were released to simulate aerobiology of M tuberculosis and assess impact and efficacy of particle removal in an OR suite using different HEPA filtration units and configurations. ⋯ This pilot study clearly indicates that avoiding the use of freestanding HEPA filters inside an OR during a surgical procedure is prudent and consistent with Centers for Disease Control and Prevention guidelines. A PAS-HEPA unit is effective in removing submicron particles and will enhance safety of care of a patient with an airborne infection requiring surgery.
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Am J Infect Control · May 2008
Review Practice GuidelineAntimicrobial resistance in major pathogens of hospital-acquired pneumonia in Asian countries.
Antimicrobial resistance is a worldwide problem. For patients with hospital-acquired or ventilator-associated pneumonia, resistant pathogens pose a significant challenge to successful treatment outcomes and to the cost-effective delivery of health care. ⋯ The emergence of these strains has provided a major impetus toward development of the present consensus treatment recommendations of the Asian HAP Working Group. The following review provides summary data regarding the incidence and prevalence of antibiotic-resistant pathogens in 10 Asian countries.
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Am J Infect Control · May 2008
Appraisal of recommended respiratory infection control practices in primary care and emergency department settings.
The severe acute respiratory syndrome (SARS) epidemic and concern about pandemic influenza prompted the Centers for Disease Control and Prevention (CDC) to develop guidelines to prevent the transmission of all respiratory infections in health care settings during first contact with a potentially infected person. The extent to which health care workers and institutions use these CDC recommended practices is uncertain. ⋯ This study found significant gaps in adherence to CDC recommendations for the control of respiratory infections in ambulatory care clinical settings. Practical strategies are needed to identify and reduce barriers to implementation of recommended practices for control of respiratory infections.
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Am J Infect Control · May 2008
Role of the infectious diseases specialist consultant on the appropriateness of antimicrobial therapy prescription in an intensive care unit.
Use of routine microbiologic surveillance, antibiotic practice guidelines, and infectious diseases (ID) specialist consultation might contribute to achieve an early diagnosis and an appropriate antibiotic treatment of infections, particularly in an intensive care unit (ICU) setting. ⋯ The introduction of an ID specialist consultation program may improve the appropriateness of the antimicrobial therapy prescription in ICU and the adherence to the local antibiotic therapy guidelines. Furthermore, appropriate antibiotic therapy is associated with a reduction in both ICU and in-hospital mortality.