American journal of infection control
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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.
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Am J Infect Control · Apr 2008
Comparative StudySurvey of infection control policies for patients with cystic fibrosis in the United States.
Written infection control policies used at cystic fibrosis (CF) care sites in the United States were compared with recently published guidelines. Most policies recommended contact precautions for hospitalized patients infected with Burkholderia cepacia complex (73%), multidrug-resistant organisms (63%), and methicillin-resistant Staphylococcus aureus (64%). ⋯ Although routine mask use by patients remains an unresolved issue, many policies advocated this practice. Future studies should address barriers to implementation of these evidence-based guidelines and continue to monitor implementation.
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Am J Infect Control · Apr 2008
Hyperglycemia as a risk factor for surgical site infections in patients undergoing mastectomy.
The aim of this study was to evaluate the association between perioperative hyperglycemia and surgical site infections (SSIs) in patients undergoing mastectomy. ⋯ Postoperative SSI was a very frequent complication in this cohort. Our data indicate that higher blood glucose values are an independent risk factor for postoperative SSI. Preoperative concomitant chemoradiation and age > 50 years were also risk factors for developing an SSI in patients undergoing mastectomy.
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Am J Infect Control · Apr 2008
Control of a hospital-wide vancomycin-resistant Enterococci outbreak.
To analyze control measures used to eradicate a large vancomycin-resistant Enterococci (VRE) outbreak in a nonendemic 1600-bed tertiary care institution. ⋯ A multipronged strategy orchestrated by a central task force curbed but could not eradicate VRE. Control measures were confounded by hospital infrastructure and high MRSA endemicity.
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Am J Infect Control · Mar 2008
ReviewEvaluation of the rationale for concurrent use of N95 filtering facepiece respirators with loose-fitting powered air-purifying respirators during aerosol-generating medical procedures.
The concurrent use of N95 filtering facepiece respirators with powered air-purifying respirators during aerosol-generating medical procedures in patients with severe respiratory pathogens has been promoted as offering additional protection against infectious agents. The purpose of this article is to examine the impact of this additional respiratory equipment upon protection and personal performance. ⋯ The burden imposed by additional respiratory protective equipment should not be discounted, and the potentially minor contribution to protection may be offset by the negative impact on personal performance. Novel uses of protective equipment occasionally are spawned during crisis situations, but their generalized applicability to healthcare workers should ultimately be evidence-based.