The Journal of hospital infection
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Review Meta Analysis
Preoperative hair removal and surgical site infections: network meta-analysis of randomized controlled trials.
Preoperative hair removal has been used to prevent surgical site infections (SSIs) or to prevent hair from interfering with the incision site. We aimed to update the meta-analysis of published randomized controlled trials about hair removal for the prevention of SSIs, and conduct network meta-analyses to combine direct and indirect evidence and to compare chemical depilation with clipping. The PubMed, ScienceDirect and Cochrane databases were searched for randomized controlled trials analysing different hair removal techniques and no hair removal in similar groups. ⋯ This meta-analysis of 19 randomized controlled trials confirmed the absence of any benefit of depilation to prevent surgical site infection, and the higher risk of surgical site infection when shaving is used for depilation. Chemical depilation and clipping were compared for the first time. The risk of SSI seems to be similar with both methods.
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The outbreak of Ebola virus disease (EVD) in West Africa and the concomitant implications for healthcare services have resulted in unique and complex challenges for infection prevention and control teams (IPCTs) worldwide. A substantial weight of responsibility was placed on IPCTs to adequately protect both patients and colleagues in the face of sometimes discrepant and often rapidly evolving national and international guidance. We reflect on our local experiences and describe some of the barriers that we faced when preparing our organization for EVD.
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Review
The stethoscope and healthcare-associated infection: a snake in the grass or innocent bystander?
There is a concern that stethoscopes may transmit infectious agents which could result in healthcare-associated infection (HCAI). The aim of this review was to evaluate the available literature as to the role of the stethoscope in the development of HCAI. A literature search was conducted across several databases for relevant studies and reports. ⋯ The optimum method for stethoscope cleaning has not been defined, although alcohol-based disinfectants are effective in reducing bacterial contamination. In conclusion, a link between contaminated stethoscopes and HCAI has not yet been confirmed, but transfer of bacteria between skin and stethoscope has been shown. The available information would suggest that stethoscopes should be decontaminated between patients.
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Alkane vapocoolant sprays evaporate rapidly, lower skin temperature and result in a temporary interruption in pain sensation. They reduce the pain of intravenous cannulation. However, concern exists that they may recontaminate the sterile cannulation site. ⋯ Alkane vapocoolant spray does not recontaminate the skin after disinfection, and should pose no increased risk of infection when used as an anaesthetic agent prior to intravenous cannulation following disinfection. While it does have inherent bactericidal activity, this is not sufficient for it to be used as the sole disinfectant.
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Extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are Gram-negative, multi-drug-resistant organisms that are of major clinical significance among immunocompromised patients in high-risk areas in hospital settings. In Ireland, the number of ESBL-E bloodstream infections is increasing. ⋯ A significant proportion of the patients screened were found to be colonized with ESBL-E. Typing revealed three incidents of potential cross-infection. Therefore, timely detection of ESBL-E among patients in high-risk wards is critical for treatment and infection control.