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T Eckmanns

Publications and source records attributed to T Eckmanns.

9 recordsLinked to original sources
PubMed2006

[On the 2007 edition of case definitions for the surveillance of notifiable infectious diseases in Germany].

The revised case definitions established by the Robert Koch Institute will become effective on 1 January 2007. The case definitions provide criteria for the reporting of mandatory notifiable infectious diseases according to the German infectious disease control act. The new case definitions take into account recent developments in laboratory methods. Furthermore in the new edition the criteria were updated and clarified if necessary. For each case definition a paragraph 'reference definition' is introduced and explained. If applicable additional information (e.g., vaccination history) to be reported was added. In this article, the major changes of the revised case definitions are described.

Communicable Disease Control↗
PubMed2006

Hand rub consumption and hand hygiene compliance are not indicators of pathogen transmission in intensive care units.

The objective of this study was to investigate whether nosocomial infection (NI) rates, hand hygiene compliance rates and the amount of alcohol-based hand rub used for hand disinfection are useful indicators of pathogen transmission in intensive care units (ICUs), and whether they could be helpful in identifying infection control problems. All isolates of 10 of the most frequent pathogens from patients who were hospitalized in an ICU for >48 h were genotyped to identify transmission episodes in five ICUs. The incidence of transmission was correlated with hand hygiene compliance, hand rub consumption and NI rates. The incidence of transmission episodes varied between 2.8 and 6.8 in the five ICUs. The NI rate was 8.6-22.5 per 1000 patient-days, hand hygiene compliance was 30-47% and hand rub consumption was 57-102 L per 1000 patient-days. There was no correlation between the incidence of transmission episodes and hand rub consumption or hand hygiene compliance. The correlation between transmission rates and NI rates was 0.4 (P = 0.5), and with the exclusion of one ICU, it was 1 (P < 0.01). The incidence of NI is a relatively good indicator for the identification of pathogen transmissions, but hand rub consumption and hand hygiene compliance, at least with the relatively low level of compliance found in this study, are not indicators of pathogen transmission.

Anti-Infective Agents, Local↗
PubMed2005

Reduction of orthopaedic wound infections in 21 hospitals.

INTRODUCTION: The German national nosocomial infections surveillance system (KISS) has been collecting surveillance data from hip and knee prosthesis operations since 1997. The purpose of this article is to investigate whether surveillance and feedback of surgical site infection (SSI) information to the physicians and nurses of participating hospitals lead to reduced SSI rates or not. MATERIALS AND METHODS: Only information from hospitals previously participating for at least 3 years was used for the analysis. Monthly SSI rates were pooled over the 36-month period, beginning in each clinic's case with its first month of participation, the rates then being compared for 12-month periods. Relative risks were calculated for comparison of the SSI rates in the first and third years of participation. A multiple logistic regression analysis with stepwise variable selection was performed to identify significant risk factors, including the year of surveillance after starting surveillance activities. RESULTS: The overall SSI rates were 1.4% for hip prosthesis and 1.0% for knee prosthesis. Fourteen clinics participated in KISS for at least 3 years continuously with HIP prostheses and 21 with knee prostheses. It was possible to include a total of 15,457 hip and 9,011 knee procedures for this analysis. A comparison of data from the first and the third years show a significant SSI reduction with hip procedures, with a relative risk of 0.54 (CI95 0.38-0.77), and a trend towards reduced SSI rates for knee procedures. The multiple logistic regression analysis confirmed that the SSI rate for hip prosthesis was significantly lower in the third year than in the first year of surveillance (OR = 0.57; CI95 0.42-0.78), though for knee prosthesis the level of significance was not achieved. CONCLUSION: A reduction of SSIs following hip and knee prosthesis operations through the introduction of ongoing surveillance and the possibility of using benchmark data for comparison does seem to be possible in many institutions.

Hip Prosthesis↗
PubMed2005

Use of terminal tap water filter systems for prevention of nosocomial legionellosis.

Hospital water supplies often contain Legionella spp. and represent a potential source of nosocomial infection, especially for immunocompromised patients or those in intensive care units. Therefore, pathogen-free water should be provided for such high-risk patients. Surveillance of splash water was performed in high-risk patient care areas at Berlin Charité-University Medicine (506 samples) and Medical School Hannover (767 samples) to investigate the ability to provide water that was free from Legionella spp. by the use of disposable, terminal tap water filter systems with non-impregnated, as well as impregnated, filters with prolonged usage intervals. Twenty (Berlin) and 32 (Hannover) water outlets were provided with disposable filters with a pore size of 0.2 microm. Testing of unfiltered tap water revealed growth of Legionella spp. in 53 of 210 (Berlin) and 30 of 32 (Hannover) samples. Non-impregnated, terminal, disposable water filters at taps used for high-risk patient care led to water free from Legionella spp. in 154 of 155 (99.4%) samples after three to four days and in 137 of 141 (97.2%) samples after six to seven days. When testing a new impregnated filter, 255 of 256 (99.6%) samples remained free from Legionella spp. after continuous use for seven days, as recommended by the manufacturers, and also after 10 days. Samples that were positive for Legionella spp. contained 1-4 cfu/mL. We believe that an impregnated filter system is suitable for the prevention of nosocomial Legionellosis in high-risk patient care areas.

Berlin↗
PubMed2001

[Compliance with hand hygiene in intensive care units].

INTRODUCTION: Nosocomial infections are an important problem in modern hospitals. The prevalence in German intensive care units is 15.3%. Hand washing or hand disinfection is believed to be the most important means of preventing nosocomial infections. We wished to answer the following questions: 1. How good is the compliance of hand hygiene on intensive care units? 2. Is compliance associated with the patient/nurse-ratio? METHOD: In a study of 8 intensive care units the compliance of hand hygiene was observed on two occasions, once in May 1996 and again in November 1997. The prime necessity for hand disinfection occurred when handling ventilation devices, intravascular catheters, urinary catheters and dressings. In addition the patient/nurse-ratio was calculated. RESULTS: A total of 1,879 infection-relevant handlings were observed. The compliance of hand hygiene ranged from 25.7 to 83.2% (mean 55.2%). The most commonly observed handlings were the manipulation of venous catheters (52.7%), the highest compliance was observed with the manipulation of ventilation equipment (91.8%). With a better patient nurse ratio the compliance did not improve but remained the same or was even reduced. DISCUSSION: The compliance of hand disinfection is similar to other study results, but on some intensive care units there was considerable room for improvement. In this study the compliance of hand hygiene is more of a constant factor in individual intensive care units than associated with the patient/nurse-ratio.

Attitude of Health Personnel↗
PubMed2001

Differential diagnosis of polyuric/polydipsic syndromes with the aid of urinary vasopressin measurement in adults.

OBJECTIVE: A water deprivation test or a hypertonic saline infusion test with the measurement of plasma osmolality and plasma vasopressin are the gold standard tests in the differential diagnosis of polyuric syndromes. Because commercially available vasopressin kits are too insensitive for this approach, and the concentration of vasopressin in urine is much higher than in plasma, urinary vasopressin measurements may be an alternative to the more difficult plasma vasopressin measurement. DESIGN: The diagnostic value of the measurement of urinary vasopressin with a rather insensitive commercially available vasopressin kit was compared with plasma vasopressin measurement by a highly sensitive radioimmunoassay (RIA). PATIENTS AND METHODS: Thirteen normal subjects and 27 patients with polyuria/polydipsia were examined by an 8-h fluid deprivation test. In all blood samples (0800 h, 1200 h, 1400 h and 1600 h) and in all urine collections (2-hourly fractions), osmolality as well as vasopressin were measured. RESULTS: Using plasma vasopressin measurement with a highly sensitive RIA as gold standard test, nine patients were classified as having primary polydipsia, whereas 18 had partial or complete cranial diabetes insipidus. Whereas the substitution of plasma vasopressin measurement by urinary vasopressin measurement alone did not provide 100% separation between both groups, the product of urinary vasopressin and urinary osmolality related to plasma osmolality completely separated the patients with primary polydipsia from those with diabetes insipidus. Urinary measurement of vasopressin and osmolality alone, which was recommended as a noninvasive diagnostic procedure in children, was too insensitive for exact differential diagnosis in our adult patients. CONCLUSIONS: The simultaneous measurement of plasma vasopressin and plasma osmolality in a dehydration test is the most powerful diagnostic tool in the differential diagnosis of polyuria/polydipsia. However, if highly sensitive assays for plasma vasopressin measurements are not available, the measurement of urinary vasopressin with commercially available, less sensitive RIAs may be a diagnostic alternative, which showed nearly the same sensitivity as plasma vasopressin measurement in our study population.

Adult↗