Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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Clin. Microbiol. Infect. · Nov 2019
Observational StudyPrevalence of nasal carriage of methicillin-resistant Staphylococcus aureus in patients at hospital admission in The Netherlands, 2010-2017: an observational study.
We determined the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage upon hospital admission, among patients who were screened preoperatively for nasal S. aureus carriage between 2010 and 2017. We also aimed to evaluate the prevalence of MRSA carriers without the standard risk factors. ⋯ Our study revealed a sustained low prevalence of MRSA carriage upon hospital admission over 7 years. This supports the effectiveness of the Dutch Search and Destroy policy, in combination with a restrictive antibiotic prescription policy.
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Clin. Microbiol. Infect. · Nov 2019
Microbiological diagnostics of bloodstream infections in Europe-an ESGBIES survey.
High-quality diagnosis of bloodstream infections (BSI) is important for successful patient management. As knowledge on current practices of microbiological BSI diagnostics is limited, this project aimed to assess its current state in European microbiological laboratories. ⋯ Laboratories have started to implement novel technologies for rapid identification and AST for positive BC. However, progress is severely compromised by limited operating hours such that current practice of BC diagnostics in Europe complies only partly with the requirements for optimal BSI management.
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Clin. Microbiol. Infect. · Nov 2019
Meta AnalysisA systematic review and meta-analysis of patient data from the West Africa (2013-16) Ebola virus disease epidemic.
Over 28 000 individuals were infected with Ebola virus during the West Africa (2013-2016) epidemic, yet there has been criticism of the lack of robust clinical descriptions of Ebola virus disease (EVD) illness from that outbreak. ⋯ We have quantified a missed opportunity to generate reliable estimates of the clinical manifestations of EVD during the West Africa epidemic. Clinical data standards and data capture platforms are urgently needed.
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Clin. Microbiol. Infect. · Oct 2019
Barriers to the adoption of ventilator-associated events surveillance and prevention.
The CDC expanded the purview of safety surveillance for ventilated patients from ventilator-associated pneumonia (VAP) to ventilator-associated events (VAE) in 2013. CDC created VAE definitions to simplify surveillance, increase objectivity, and broaden prevention efforts. Many U. ⋯ Potential interventions to prevent VAEs include avoiding intubation, minimizing sedation, paired daily spontaneous awakening and breathing trials, conservative fluid management, conservative transfusion thresholds, low tidal volume ventilation, and early mobility. There are important limitations to all existing prevention studies, however, and no study has thus far has tested a VAE prevention bundle that includes all these interventions. Further work is needed to better define the clinical significance of VAPs missed by VAE surveillance, to rigorously evaluate the impact of an optimized VAE prevention bundle on VAEs and other outcomes, and to weigh whether these additional data provide adequate evidence to support mandating VAE surveillance and prevention.