Over the last decade, substantial scientific evidence has accumulated that indicates contamination of environmental surfaces in hospital rooms plays an important role in the transmission of key ...health care–associated pathogens (eg, methicillin-resistant Staphylococcus aureus , vancomycin-resistant enterococci, Clostridium difficile , Acinetobacter spp). For example, a patient admitted to a room previously occupied by a patient colonized or infected with one of these pathogens has a higher risk for acquiring one of these pathogens than a patient admitted to a room whose previous occupant was not colonized or infected. This risk is not surprising because multiple studies have demonstrated that surfaces in hospital rooms are poorly cleaned during terminal cleaning. To reduce surface contamination after terminal cleaning, no touch methods of room disinfection have been developed. This article will review the no touch methods, ultraviolet light devices, and hydrogen peroxide systems, with a focus on clinical trials which have used patient colonization or infection as an outcome. Multiple studies have demonstrated that ultraviolet light devices and hydrogen peroxide systems have been shown to inactivate microbes experimentally plated on carrier materials and placed in hospital rooms and to decontaminate surfaces in hospital rooms naturally contaminated with multidrug-resistant pathogens. A growing number of clinical studies have demonstrated that ultraviolet devices and hydrogen peroxide systems when used for terminal disinfection can reduce colonization or health care–associated infections in patients admitted to these hospital rooms.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Recent data demonstrate that the contaminated hospital surface environment plays a key role in the transmission of Clostridium difficile . Enhanced environmental cleaning of rooms housing Clostridium ...difficile -infected patients is warranted, and, if additional studies demonstrate a benefit of “no-touch” methods (eg, ultraviolet irradiation, hydrogen peroxide systems), their routine use should be considered.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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Surgical site infections Anderson, Deverick J
Infectious disease clinics of North America,
03/2011, Volume:
25, Issue:
1
Journal Article
Peer reviewed
Surgical site infections (SSIs) lead to adverse patient outcomes, including prolonged hospitalization and death. Wound contamination occurs with each incision, but proven strategies exist to decrease ...the risk of SSIs. In particular, improved adherence to evidence-based preventative measures related to appropriate antimicrobial prophylaxis can decrease the rate of SSI. Aggressive surgical debridement and effective antimicrobial therapy are needed to optimize the treatment of SSIs.
Background State-specific, health care-associated infection (HAI) cost estimates have not been calculated to guide Department of Public Health efforts and investments. Methods We completed a cost ...identification study by conducting a survey of 117 acute care hospitals in NC to collect surveillance data on patient-days, device-days, and surgical procedures during 1 year. We then calculated expected rates and direct hospital costs of surgical site infections (SSI), Clostridium difficile infection, and 3 selected device-related HAIs for hospitals and the entire state using reference data sets such as the National Healthcare Safety Network. Results In total, 67 (53%) hospitals responded to the survey. The median bed size of respondent hospitals was 140 (interquartile range, 66-350). A “standard” NC hospital diagnosed approximately 100 HAI each year with estimated costs of $985,000 to $2.7 million. The most common HAI was SSI (73%). Costs related to SSI accounted for 87% to 91% of overall costs. In total, the overall direct annual cost of these 5 selected HAIs was estimated to be between $124.1 and $347.8 million in 2009 for the state of NC. Conclusion Using conservative estimates, HAI led to costs of more than $100 million in acute care hospitals in the state of NC in 2009. The majority of costs were due to SSI.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Staphylococcal surgical site infections Anderson, Deverick J; Kaye, Keith S
Infectious disease clinics of North America,
03/2009, Volume:
23, Issue:
1
Journal Article
Peer reviewed
Staphylococcus aureus is the leading cause of surgical site infections (SSI) in the United States. In particular, SSI caused by methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a ...devastating complication, leading to increased mortality rates, increased length of hospitalization, and increased costs. Proven strategies for prevention of SSI caused by S aureus include addressing modifiable risk factors and correct choice and timing of antimicrobial prophylaxis. Other strategies, including decolonization and the use of vancomycin, remain controversial.
Since the publication of “A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals” in 2008, prevention of healthcare-associated infections (HAIs) has become a ...national priority. Despite improvements, preventable HAIs continue to occur. The 2014 updates to the Compendium were created to provide acute care hospitals with up-to-date, practical, expert guidance to assist in prioritizing and implementing their HAI prevention efforts. They are the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Institute for Healthcare Improvement (IHI), the Pediatric Infectious Diseases Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), and the Surgical Infection Society (SIS).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
We have developed an automated surveillance system to detect bloodstream infection (BSI) occurring after endoscopic retrograde cholangiopancreatography (ERCP). We retrospectively applied this ...automated surveillance tool to all patients who underwent ERCP at out institution between July 2004 and April 2006 to determine the baseline rates of BSI after ERCP and identify the epidemiology of the pathogens. A total of 2052 ERCPs were performed during the study period; 46 BSIs occurred within 30 days after ERCP (overall rate of post-ERCP BSI, 2.24/100 procedures). The most commonly isolated organisms were Enterobacteriaceae (n = 18; 29%) and enterococci (n = 14; 22%). Because invasive procedures are performed in various outpatient and inpatient settings, novel methods are needed to conduct effective surveillance for infection.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Most evidence-based methods to control the spread of antimicrobial resistance have been developed and applied to the hospital setting. Strategies to control the emergence and spread of antimicrobial ...resistance in hospitals can be categorized as either infection control or antibiotic stewardship strategies. Infection control is the discipline focused on preventing the spread of infections within the health care setting; antibiotic stewardship can help minimize the emergence of multidrug-resistant organisms by promoting prudent use of antibiotics. This article describes different infection control and antibiotic management strategies that can be used to control antimicrobial resistance in hospital settings.
Most hospitals have achieved great successes in improving adherence to the basic quality measures recommended by SCIP. Yet, patients continue to have SSIs. Evidence-based strategiesdoptimizing ...antimicrobial prophylaxis dosing, preparing the colon with mechanical bowel preparation andoral antibiotics, optimizing tissue oxygenation, and using a surgical safety checklistdcan help high-performing hospitals and health care providers move beyond SCIP to ensure that they provide the best care possible to their surgical patients and decrease the rate of SSIs.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
Background There is currently no accepted standard denominator to calculate and to report the incidence of occupational exposures to bloodborne pathogens (OEBBPs) in health care. Methods We performed ...a multicenter study of OEBBP injuries reported from 31 community hospitals in the southeastern United States from January 2003 to December 2006. A qualitative design was used to assess 4 commonly used denominators to calculate the incidence of OEBBP: patient-days; staffed beds; occupied beds and full-time employee equivalents (FTEs). Six criteria were used to assess the quality and suitability of each denominator as a standard method to calculate incidence of OEBBP. We also analyzed the correlation of hospital rankings produced by these 4 denominators. Results During 4 years of study, a total of 3375 occupational exposures were reported. Patient-days outperformed others as a denominator to calculate rates of OEBBP when judged by 6 predefined criteria. Data for staffed beds, occupied beds, and FTE were manually collected, infrequently reported, and often subject to missing data. Furthermore, FTE and staffed beds data also captured unoccupied beds and non-clinical employee data that were not associated with risk of OEBBP. Conclusion Patient-days may be the most suitable and readily available denominator for standard reporting and benchmarking of incidence of OEBBP. Patient-days may be used as a standard method for comparing rates of OEBBP.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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