American journal of infection control
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Am J Infect Control · Jun 2001
Randomized Controlled Trial Clinical TrialClinical assay of N-duopropenide alcohol solution on hand application in newborn and pediatric intensive care units: control of an outbreak of multiresistant Klebsiella pneumoniae in a newborn intensive care unit with this measure.
Outbreaks of gram-negative colonization (generally by antibiotic-resistant enterobacteria) are common in newborn intensive care units (NICUs), and control methods are not always effective. We studied the effectiveness of an alcohol solution of N-duopropenide (NDP) in vivo (germicidal effect on flora of teams in the NICU and the pediatric intensive care unit vs handwashing with nonantiseptic soap) and its effect on the control of a multiresistant (MR) Klebsiella pneumoniae outbreak in our NICU that had persisted for 13 months, despite the use of classic control measures. For educational purposes, we also performed 4 prevalence studies of microbial hand flora in NICU staff (two before and two after introducing NDP). ⋯ Four prevalence studies of hand microbial contamination, before and after NDP introduction in the NICU, showed a significant reduction of enterobacteriaceae, mainly MR K pneumoniae, in health care workers. In conclusion, NDP in alcohol was very effective in vivo. It proved to be a useful complementary measure to handwashing and reduced exogenous microorganism transmission in a unit with a heavy patient-care workload.
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Am J Infect Control · Dec 1999
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized, controlled trial comparing transparent polyurethane and hydrocolloid dressings for central venous catheters.
This study was undertaken to determine the frequency of skin colonization, hub colonization, and central venous catheter colonization in transparent hydrocolloid versus standard polyurethane dressings. ⋯ The results of this study suggest that an increased risk of catheter colonization is associated with the use of hydrocolloid dressings, despite previous research suggesting that they significantly reduce microbial growth compared with standard polyurethane. The clinical significance of increased numbers of positive blood cultures in the polyurethane group requires further examination, although distinguishing between contamination and true infection in intensive care settings continues to be methodologically challenging. Further studies are required to determine whether these findings are generalizable across different study settings and whether similar outcomes are obtained when different brands of hydrocolloid dressing are used.
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Am J Infect Control · Aug 1998
Randomized Controlled Trial Comparative Study Clinical TrialClinical efficacy of a chlorous acid preoperative skin antiseptic.
Among the ways to reduce the incidence of iatrogenic infectious disease is the use of efficacious preoperative antiseptics. Iodophors and chlorhexidines, the chief presurgical disinfectants today, have various problems with practicality. A new preoperative skin antiseptic has been developed (Alcide Corporation, Redmond, Wash) that involves the mixture of a 0.1% sodium chlorite formulation and an activating preparation of 0.5% mandelic acid to produce chlorous acid and other antimicrobial degradation products. ⋯ An activated chlorous acid product statistically matched the performance of chlorhexidine gluconate in reducing populations of resident flora on treated skin sites. With an easier and shorter application procedure and strong, long-term antimicrobial activity, the new halogenated antiseptic seems to be a useful and possible efficacious preoperative skin disinfectant.
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Am J Infect Control · Jun 1988
Randomized Controlled Trial Comparative Study Clinical TrialBacterial colonization and phlebitis-associated risk with transparent polyurethane film for peripheral intravenous site dressings.
Previous studies of various brands of polyurethane dressings have noted differences in the rates of catheter colonization. We compared Bioclusive transparent polyurethane (TP) dressing with a cotton gauze (CG) dressing on peripheral intravenous (IV) access sites for the incidence of phlebitis, catheter tip colonization, skin colonization, and catheter-related bacteremia. The study, involving 598 ward patients, was case controlled, prospective, and randomized for a period of 4 months. ⋯ Cultures of specimens from the skin and catheter tips of the majority of patients (91%) showed no growth. An association was found between those patients with greater than 15 CFU isolated from catheter tips and those with phlebitis (p = 0.022). No documented catheter-related bacteremia occurred in either study group.