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Prevalence of nosocomial infections in neonatal intensive care unit patients: Results from the first national point-prevalence survey

Abstract

OBJECTIVES: Patients admitted to neonatal intensive care units (NICUs) are at high risk of nosocomial infection. We conducted a national multicenter assessment of nosocomial infections in NICUs to determine the prevalence of infections, describe associated risk factors, and help focus prevention efforts.… Read more

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Evaluation of a reporting system for bacterial contamination of blood components in the United States

Abstract

BACKGROUND: The transfusion of blood components contaminated with bacteria may have serious clinical consequences, but few data are available on the incidence of these events. A national effort to assess the frequency of blood component bacterial contamination associated with transfusion reaction (the BaCon Study) was initiated to better estimate their occurrence.… Read more

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Transfusion-transmitted bacterial infection in the United States, 1998 through 2000

Abstract

BACKGROUND: Bacterial contamination of blood components can result in transfusion-transmitted infection, but the risk is not established.

STUDY DESIGN AND METHODS: Suspected cases of transfusion-transmitted bacteremia were reported to the CDC by participating blood collection facilities and transfusion services affiliated with the American Red Cross, AABB, or Department of Defense blood programs from 1998 through 2000.… Read more

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Nosocomial infections in a children’s hospital in Argentina: impact of a unique infection control intervention program

Abstract

OBJECTIVE: To assess the efficacy of parental education and use of parents as nursing assistants on reducing nosocomial infections.

DESIGN: Prospective study.

METHODS: Active surveillance for nosocomial infections was performed on two wards. On ward A, parents were educated about infection control practices and assisted nursing staff with routine tasks, so that nursing personnel could focus their efforts on procedures with higher risk of infection.… Read more

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The effects of iron deficiency on lymphocyte cytokine production and activation: preservation of hepatic iron but not at all cost

Abstract

Worldwide, over 40% of children have iron deficiency anaemia, frequently associated with infections. Certain cytokines are involved in both immune activation/response to infection and iron transport/metabolism. We therefore assessed the relations among iron deficiency, cytokine production and lymphocyte activation markers in 142 hospitalized Malawian children.… Read more

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Computerized pharmacy databases as source of data on antimicrobial prescriptions in children’s hospitals

Abstract

Harbarth S, Levine GL, Jarvis WR, Goldmann DA, Huskins WC

Am J Health Syst Pharm 2001 Nov;58(21):2069-71

PMID: 11715830

Computerized pharmacy databases as source of data on antimicrobial prescriptions in children’s hospitals was last modified: November 1st, 2001 by Harbarth S, Levine GL, Jarvis WR, Goldmann DA, Huskins WC… Read more
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Comparison of serum and cell-specific cytokines in humans

Abstract

Cytokines function at the cellular, microenvironmental level, but human cytokine assessment is most commonly done at the macro level, by measuring serum cytokines. The relationships between serum and cellular cytokines, if there are any, are undefined. In a study of hospitalized patients in Malawi, we compared cytometrically assessed, cell-specific cytokine data to serum interleukin 2 (IL-2), IL-4, IL-6, IL-8, IL-10, gamma interferon (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) levels in 16 children and 71 (IL-2, -4, -6, -10) or 159 (IL-8, IFN-gamma, and TNF-alpha) adults, using Wilcoxon rank sum tests and Pearson’s (r(p)) and Spearman’s (r(s)) rank correlations.… Read more

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Vancomycin-resistant enterococci colonization in patients at seven hemodialysis centers

Abstract

BACKGROUND: Vancomycin-resistant enterococci (VRE) are increasing in prevalence at many institutions, and are often reported in dialysis patients. We studied the prevalence of and risk factors for VRE at seven outpatient hemodialysis centers (three in Baltimore, MD, USA, and four in Richmond, VA, USA).… Read more

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Physician preferences for continuing medical education with a focus on the topic of antimicrobial resistance: Society for Healthcare Epidemiology of America

Abstract

OBJECTIVE: To determine the type of media preferred for continuing medical education (CME) and to assess the factors that affect physician preferences for CME in general and on the special topic of antimicrobial resistance.

DESIGN: A voluntary survey of the membership of the Society for Healthcare Epidemiology of America, Inc.… Read more

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Nosocomial outbreak of Microbacterium species bacteremia among cancer patients

Abstract

To date, only 6 sporadic Microbacterium species (formerly coryneform Centers for Disease Control and Prevention [CDC] groups A-4 and A-5) infections have been reported. The source, mode of transmission, morbidity, mortality, and potential for nosocomial transmission of Microbacterium species remain unknown.… Read more

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Occupational transmission of Mycobacterium tuberculosis to health care workers in a university hospital in Lima, Peru

Abstract

From November 1996 through March 1997, presumptive active pulmonary tuberculosis (TB) was detected in 44 health care workers (HCWs) at a university hospital in Lima, Peru. To further assess the magnitude of the outbreak and determine risk factors for occupational Mycobacterium tuberculosis transmission, we identified HCWs in whom active pulmonary TB was diagnosed from January 1994 through January 1998, calculated rates by year and hospital work area, and conducted a tuberculin skin test (TST) survey.… Read more

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Intracellular cytokines in the acute response to highly active antiretroviral therapy

Abstract

OBJECTIVES: Successful highly active antiretroviral therapy (HAART) is usually associated with a rapid decline in HIV plasma RNA levels and a gradual increase in CD4 T cells. We examined whether changes in cytokine production and profile precede other immunological changes and whether these might occur in temporal association with plasma HIV RNA changes.… Read more

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Cytokines and malaria parasitemia

Abstract

The balance between pro- and antiinflammatory cytokines may be important in malaria presentation and outcome. Malaria tends to be more severe in children than in adults, presumably because partial immunity develops with age. However, the full nature of, and age-related differences in, anti-malarial immunity are unknown.… Read more

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Risk factors for candidal bloodstream infections in surgical intensive care unit patients: the NEMIS prospective multicenter study. The National Epidemiology of Mycosis Survey

Abstract

To assess risk factors for development of candidal blood stream infections (CBSIs), a prospective cohort study was performed at 6 sites that involved all patients admitted to the surgical intensive care unit (SICU) for 48 h over a 2-year period.… Read more

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Costs and savings associated with infection control measures that reduced transmission of vancomycin-resistant enterococci in an endemic setting

Abstract

OBJECTIVE: To determine the costs and savings of a 15-component infection control program that reduced transmission of vancomycin-resistant enterococci (VRE) in an endemic setting.

DESIGN: Evaluation of costs and savings, using historical control data.

SETTING: Adult oncology unit of a 650-bed hospital.… Read more

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Use and efficacy of tuberculosis infection control practices at hospitals with previous outbreaks of multidrug-resistant tuberculosis

Abstract

OBJECTIVE: To evaluate the implementation and efficacy of selected Centers for Disease Control and Prevention guidelines for preventing spread of Mycobacterium tuberculosis.

DESIGN: Analysis of prospective observational data.

SETTING: Two medical centers where outbreaks of multidrug-resistant tuberculosis (TB) had occurred.… Read more

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A prospective study of vascular access infections at seven outpatient hemodialysis centers

Abstract

Vascular access infections are a major cause of morbidity and mortality in hemodialysis patients, and the use of antimicrobials to treat such infections contributes to the emergence and spread of antimicrobial-resistant bacteria. To determine the incidence of and risk factors for vascular access infections, we studied hemodialysis patients at 7 outpatient dialysis centers (4 in Richmond, VA, and 3 in Baltimore, MD) during December 1997 to July 1998.… Read more

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Nosocomial infection rates in US children’s hospitals’ neonatal and pediatric intensive care units

Abstract

BACKGROUND: Few data are available on nosocomial infections (NIs) in US children’s hospitals’ neonatal or pediatric intensive care units. The Pediatric Prevention Network (PPN) was established to improve characterization of NIs in pediatric patients and to develop and test interventions to decrease NI.… Read more

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Observational study of the use of infection control interventions for Mycobacterium tuberculosis in pediatric facilities

Abstract

INTRODUCTION: Hospital transmission of Mycobacterium tuberculosis (TB) is a problem in US facilities where adults are treated. However, specific guidelines for facilities in which pediatric patients are cared for have never been defined, nor has any study attempted to assess pediatric health care worker (HCW) compliance with TB infection control (IC) guidelines.… Read more

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Anesthesia-associated carbon monoxide exposures among surgical patients

Abstract

OBJECTIVE: To estimate the extent of, and evaluate risk factors for, elevated carboxyhemoglobin levels among patients undergoing general anesthesia and to identify the source of carbon monoxide.

DESIGN: Matched case-control study to measure carboxyhemoglobin levels.

SETTING: Large academic medical center.… Read more

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Serratia liquefaciens bloodstream infections from contamination of epoetin alfa at a hemodialysis center

Abstract

BACKGROUND: In a one month period, 10 Serratia liquefaciens bloodstream infections and 6 pyrogenic reactions occurred in outpatients at a hemodialysis center.

METHODS: We performed a cohort study of all hemodialysis sessions on days that staff members reported S. liquefaciens bloodstream infections or pyrogenic reactions.… Read more

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Control of vancomycin-resistant enterococcus in health care facilities in a region

Abstract

BACKGROUND: In late 1996, vancomycin-resistant enterococci were first detected in the Siouxland region of Iowa, Nebraska, and South Dakota. A task force was created, and in 1997 the assistance of the Centers for Disease Control and Prevention was sought in assessing the prevalence of vancomycin-resistant enterococci in the region’s facilities and implementing recommendations for screening, infection control, and education at all 32 health care facilities in the region.… Read more

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Utility of paired BACTEC MYCO/F LYTIC blood culture vials for detection of bacteremia, mycobacteremia, and fungemia

Abstract

In previous bloodstream infection studies in Malawi, we inoculated blood from a single venesection into a single BACTEC MYCO/F LYTIC (MFL) vial. Inoculation of one vial, however, would be expected to reduce the sensitivity of bloodstream pathogen detection with MFL vials.… Read more

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Serratia marcescens transmission in a pediatric intensive care unit: a multifactorial occurrence

Abstract

BACKGROUND: Fourteen patients in the pediatric cardiac intensive care unit (CICU) had or =1 positive culture for a single strain of Serratia marcescens from April through December 1995 (study period).

OBJECTIVES: To identify risk factors for S marcescens infection or colonization in a pediatric CICU.… Read more

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Infection control dogma: top 10 suspects

Abstract

As infection control evolved into an art and science through the years, many infection control practices have become infection control dogmas (principles, beliefs, ideas, or opinions). In this “Reality Check” session of the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections, we assessed participants’ perceptions of prevalent infection control dogmas.… Read more

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Infection control and changing health-care delivery systems

Abstract

In the past, health care was delivered mainly in acute-care facilities. Today, health care is delivered in hospital, outpatient, transitional care, long-term care, rehabilitative care, home, and private office settings. Measures to reduce health-care costs include decreasing the number of hospitals and the length of patient stays, increasing outpatient and home care, and increasing long-term care for the elderly.… Read more

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Building communication networks: international network for the study and prevention of emerging antimicrobial resistance

Abstract

The global nature of antimicrobial resistance and the failure to control the emergence of resistant organisms demand the implementation of a global surveillance program involving both developed and developing countries. Because of the urgent need for infection control interventions and for rapid distribution of information about emerging organisms, we initiated the International Network for the Study and Prevention of Emerging Antimicrobial Resistance (INSPEAR).… Read more

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Colonization of skilled-care facility residents with antimicrobial-resistant pathogens

Abstract

OBJECTIVES: To determine the frequency of and risk factors for colonization of skilled-care unit residents by several antimicrobial-resistant bacterial species, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), or extended-spectrum-beta-lactamase-producing (ESBL-producing) (ceftazidime resistant) Klebsiella pneumoniae or Escherichia coli.

DESIGN: Point-prevalence survey and medical record review.… Read more

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Reality check: should we use vancomycin for the prophylaxis of intravascular catheter-associated infections?

Abstract

The use of intravascular catheters is associated with increased risk of bloodstream infections, principally caused by coagulase-negative staphylococci. This “Reality Check” session, held at the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections, focused on the question of whether, and in what manner, vancomycin should be used for the prophylaxis of these infections

Grohskopf LA, Maki DG, Sohn AH, Sinkowitz-Cochran RL, Jarvis WR, Goldmann DA

Infect Control Hosp Epidemiol 2001 Mar;22(3):176-9

PMID: 11310698

Reality check: should we use vancomycin for the prophylaxis of intravascular catheter-associated infections?… Read more
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Modulation of CD8 and CD3 by HIV or HIV antigens

Abstract

To investigate whether human immunodeficiency virus (HIV)-1 and HIV-1 antigens modulate surface and cytoplasmic CD8 or CD3, as well as CD4, we used cell permeabilization reagents, surface/cytoplasmic fluorescent staining, multiparameter flow cytometric techniques and an in vitro culture system in which relatively few lymphocytes are actively infected with HIV.… Read more

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Emerging healthcare-associated problem pathogens in the United States

Abstract

Healthcare-associated infections are a major cause of morbidity and mortality. Dramatic changes in the delivery of healthcare during the past decade have changed the definition of healthcare-associated infections. Healthcare delivery changes include a reduction in the number of general hospital beds, an increase in the proportion of patients who are in intensive care units, a larger proportion of surgical procedures performed as outpatient procedures, a marked increase in patients cared for in outpatient settings, and an increase in the delivery of healthcare in the home setting.… Read more

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Evaluation of a successful vancomycin-resistant Enterococcus prevention intervention in a community of health care facilities

Abstract

BACKGROUND: In April 1997, vancomycin-resistant enterococci (VRE) emerged in several health care facilities in the Siouxland region and a VRE Task Force was formed. From 1997 through 1999, an evaluation of VRE prevalence at 30 facilities was performed.

METHODS: In 1999, we conducted a survey and focus groups of health care workers to address initial reactions to VRE, feasibility of the Task Force recommendations, and lessons learned.… Read more

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Reality check: should we try to detect and isolate vancomycin-resistant enterococci patients?

Abstract

Antimicrobial resistance, including vancomycin resistance in enterococci (VRE), is a growing problem in healthcare facilities. This “Reality Check” session focused on the question of whether we should try to detect and isolate patients colonized or infected with VRE.

Ostrowsky B, Steinberg JT, Farr B, Sohn AH, Sinkowitz-Cochran RL, Jarvis WR

Infect Control Hosp Epidemiol 2001 Feb;22(2):116-9

PMID: 11232874

Reality check: should we try to detect and isolate vancomycin-resistant enterococci patients?… Read more
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Invasive aspergillosis outbreak on a hematology-oncology ward

Abstract

An outbreak of invasive aspergillosis occurred in a community hospital in temporal association with construction activity. Epidemiological investigation showed that patients who are at highest risk comprise a small group and are readily identifiable. Clinicians should strive to protect these patients, following guidelines published by the Centers for Disease Control and Prevention.… Read more

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Management of occupational exposures to hepatitis C virus: current practice and controversies

Abstract

Unlike hepatitis B virus and human immunodeficiency virus, there currently are no immunization or chemoprophylactic interventions available to prevent infection after an occupational exposure to hepatitis C virus (HCV). A “Reality Check” session was held at the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections to gather information on current practices related to management of occupational exposures to HCV, generate discussion on controversial issues, and identify areas for future research.… Read more

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Seasonal variation in the etiology of bloodstream infections in a febrile inpatient population in a developing country

Abstract

OBJECTIVES: Published data suggest that Streptococcus pneumoniae, non-typhi Salmonella species, and Mycobacterium tuberculosis are the predominant causes of bloodstream infection (BSI) in hospitalized populations in sub-Saharan Africa. This study was conducted during the wet season to ascertain the etiology and prevalence of BSI among febrile inpatients in a hospital where the dry season BSI profile in a similar study population had already been documented.… Read more