Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Oct 2014
Substantial shifts in ranking of California hospitals by hospital-associated methicillin-resistant Staphylococcus aureus infection following adjustment for hospital characteristics and case mix.
States have established public reporting of hospital-associated (HA) infections-including those of methicillin-resistant Staphylococcus aureus (MRSA)-but do not account for hospital case mix or postdischarge events. ⋯ When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.
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Infect Control Hosp Epidemiol · Oct 2014
Observational StudyDo peer effects improve hand hygiene adherence among healthcare workers?
To determine whether hand hygiene adherence is influenced by peer effects and, specifically, whether the presence and proximity of other healthcare workers has a positive effect on hand hygiene adherence. ⋯ The presence and proximity of other healthcare workers is associated with higher hand hygiene rates. Furthermore, our results also indicate that rates increase as the social environment becomes more crowded, but with diminishing marginal returns.
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Infect Control Hosp Epidemiol · Oct 2014
Effect of standardized surveillance of intensive care unit-acquired infections on ventilator-associated pneumonia incidence.
In a multicenter surveillance of intensive care unit (ICU)-acquired infections, adjusted ventilator-associated pneumonia (VAP) incidence diminished by -1.0% per year (95% confidence interval [CI], -1.8 to -0.2; P = .02) in ICUs with continuous surveillance but increased by +16.1% (95% CI, 0.5%-34.1%; P = .04) in the year following surveillance disruption, suggesting a preventive effect of surveillance on VAP.
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Infect Control Hosp Epidemiol · Oct 2014
Observational StudyPrevalence of nasal colonization and strain concordance in patients with community-associated Staphylococcus aureus skin and soft-tissue infections.
Determine the prevalence and relatedness of Staphylococcus aureus anterior nares colonization in individuals with community-associated staphylococcal skin and soft-tissue infection (SSTI). ⋯ On the phenotypic level, concordant anterior nares colonization with incident staphylococcal SSTI is more common in MSSA than MRSA; however, the opposite is observed when accounting for molecular typing, and MRSA SSTI displays greater concordance. USA300 was responsible for strain concordance with MRSA SSTI. Studies are needed to examine the roles of nasal and extra-nasal carriage, colonization preceding infection, and increased virulence in the pathogenesis of MRSA SSTI.