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At least 865 records · Page 48Linked to original sources

PubMed2004

Norovirus outbreaks in a hospital setting: the role of infection control.

AIMS: Noroviruses (NV) (until recently known as Norwalk-like viruses) are a common cause of outbreaks of viral gastroenteritis and can result in significant hospital disruption. We report our experience of two outbreaks that occurred in a geriatric rehabilitation hospital and the role of infection control in limiting their spread. METHODS: The outbreaks occurred in two separate rehabilitation wards for older people. A case definition was developed and a register kept to record patient and staff sickness. The NV was identified from faecal specimens by reverse transcriptase polymerase chain reaction. RESULTS: There were 41 cases in the first outbreak, with an attack rate of 57.1% for patients and 41% for staff. The outbreak lasted 14 days and closed the ward for 11 days. During this outbreak one patient died, with gastroenteritis the precipitating event of his final illness. There were 24 cases in the second outbreak, with an attack rate of 56.5% for patients and 18% for staff. The outbreak lasted 16 days with the ward closed for six days. The mean duration of staff sickness was 3.5 days in the second outbreak compared with only 1.2 days in the first outbreak. In both outbreaks infection was contained within a single ward. CONCLUSIONS: NV infections can significantly disrupt hospitals through their rapid spread to patients and staff as well as the associated high attack rate. Early recognition of an outbreak and prompt implementation of infection control measures, staffing restrictions and ward closure can limit the spread of infection.

Aged↗

PubMed1994

Infection control in Mississippi dental practices: a comparison of Mississippi Dental Association members and non-members.

In conclusion, the results of the survey were reassuring in many ways. The data indicate that the dental profession in Mississippi seems to have taken advantage of continuing education opportunities, paid increased attention to infection control, and in general, were using appropriate techniques before the OSHA mandate of 1992. Furthermore, members of the MDA not only demonstrated a greater understanding of infections diseases, but were also 20 percent more likely to report behavior known to reduce the risk of cross infection. It will be important to continue to identify the "gaps" and provide information, additional training, and encouragement to the dental profession and to dental auxiliaries to improve infection control procedures where improvement appears to be needed.

Data Collection↗

PubMedDate not supplied

Awareness about biomedical waste management and infection control among dentists of a teaching hospital in New Delhi, India.

All 64 dentists working in a teaching hospital of New Delhi participated in a survey. A pre-tested self-administered questionnaire was used to assess knowledge and practices of biomedical waste management and infection control among these dentists. The results show that not all dentists were aware of the risks they were exposed to and only half of them observed infection control practices. In addition to this, majority of them were not aware of proper hospital waste management. The dentists need to be educated on Biomedical Waste (Management & Handling) Rules, 1998 through extensive training programme.

Adult↗

PubMed1999

Infection control in gene therapy.

Gene therapy is now being studied for the treatment of a wide variety of acquired and inherited diseases. Viruses used as vectors for gene transfer include retroviruses, adenoviruses, vaccinia viruses, adeno-associated viruses, and herpesviruses. These vectors, developed in the laboratory and in animal studies, are now being introduced into the clinical arena Infection control practitioners will be involved invariably in reviewing the use of these agents in their clinics and hospitals. This review summarizes key aspects of the more common vectors and makes recommendations for infection control.

Cross Infection↗

PubMed1997

Hospital infection control practices for tuberculosis.

Although completely eliminating the risk for transmission of M. tuberculosis in all health-care facilities may not be possible, adherence to the principles outlined in the CDC guidelines should reduce the risk to persons in such settings. The guidelines are designed to help health-care facilities develop an infection-control plan tailored to the individual circumstances and risk in each facility. The key to maintaining an effective TB infection control plan is periodic evaluation of the plan, with reassessment of risk and revision of the plan accordingly.

AIDS-Related Opportunistic Infections↗

PubMed2005

A systematic review of quasi-experimental study designs in the fields of infection control and antibiotic resistance.

We performed a systematic review of articles published during a 2-year period in 4 journals in the field of infectious diseases to determine the extent to which the quasi-experimental study design is used to evaluate infection control and antibiotic resistance. We evaluated studies on the basis of the following criteria: type of quasi-experimental study design used, justification of the use of the design, use of correct nomenclature to describe the design, and recognition of potential limitations of the design. A total of 73 articles featured a quasi-experimental study design. Twelve (16%) were associated with a quasi-experimental design involving a control group. Three (4%) provided justification for the use of the quasi-experimental study design. Sixteen (22%) used correct nomenclature to describe the study. Seventeen (23%) mentioned at least 1 of the potential limitations of the use of a quasi-experimental study design. The quasi-experimental study is used frequently in studies of infection control and antibiotic resistance. Efforts to improve the conduct and presentation of quasi-experimental studies are urgently needed to more rigorously evaluate interventions.

Drug Resistance, Microbial↗

PubMed2006

[Nursing auxiliaries and technicians and hospital infection control in surgical centers: myths and truths].

This analytical and descriptive study is aimed at detecting concepts that translate myths and truths on hospital infection among nursing auxiliaries and technicians at the surgical centers of three hospitals. The data collection instrument consisted of 28 affirmative statements (15 true and 13 false) encompassing factors related to the patient, the surgical team, the environment, and procedures. The statements contain a three-point scale (I agree, I am in doubt, I disagree). We received 72% of adequate answers and 28% of non-adequate, which indicates that perioperative nursing professionals have satisfactory knowledge of hospital infection control. In the items use of safety footwear, rings and other objects, hair as a pathogen, hand scrubbing, use of humid gown and surgical area, infected surgery and cleaning routine, occupational diseases, hospital infection, surgical site infection and surgery time we were able to detect myths and rituals about infection control, which are mainly related to the culture of those who practice them, thus perpetuating resistance to change.

Cross Infection↗

PubMed1993

Infection control in hospitals: has its quality-enhancing and cost-effective role been appreciated?

A review of data from surveys worldwide, including the United Kingdom and the United States, or morbidity and mortality and costs incurred as direct consequences of hospital-acquired infection is presented. These data testify to the role of hitherto somewhat undervalued Infection Control in hospitals as a key factor in the quality of medical care and also establish its contribution towards cost-effectiveness in various health care systems, including the National Health Service in the UK (NHS). It is appropriate, therefore, for Infection Control to be accorded proper appreciation and adequate funding. The achievement of these aims is likely to be helped by the recent changes in the NHS management system and supported by the requirements of Medical Audit and Hospital Accreditation Schemes.

Cost-Benefit Analysis↗

PubMed2002

Infection control: avoiding the inevitable.

Infection, while a major cause of morbidity, should not be considered an inevitable consequence of injury. Good aseptic technique, compulsive attention to detail, and thorough understanding of the points addressed in the following list of critical points are the best guarantee that infection will not add avoidable morbidity to misfortune. Critical points regarding infectious problems in care of the injured child: 1. Polymicrobial infection is the rule with 50% of isolates being mixed aerobic and anaerobic bacteria. 2. It is a misnomer to consider antibiotic use in a pediatric trauma victim as prophylactic. Antimicrobials used in this setting are best considered adjunctive. 3. The major indication for anti-infective therapy in pediatric trauma is an injury with a high probability of infection. 4. Antibiotics do not sterilize the wound or body cavity; they limit bacterial proliferation, thereby supplementing effective immune control. 5. Available studies suggest that 24 hours is as efficacious as a longer treatment duration in a purely adjunctive mode. 6. In bites inflicted by dogs and cats, Pasturella species are frequent. 7. Human bites may result in infection by Eikenella corrodens. 8. Based on this bacteriology, adjunctive intravenous ampicillin sulbactam or oral amoxicillin clavulanate are recommended for human and animal bites. 9. Tetanus prophylaxis is indicated in all significant soft tissue injuries. 10. Risk of osteomyelitis correlates directly with the extent of the associated soft tissue injury and vascular compromise. 11. The majority of infectious complications in the injured child are not a consequence of the injury itself, but rather in the treatment thereof. 12. In the injured child the most common nosocomial infection is lower respiratory followed by primary blood stream and the urinary tract. 13. The management of nosocomial pneumonia in the injured child is based on the time of diagnoses. Early evidence of pulmonary infection requires treatment with a third generation cephalosporin with or without an antistaphylococcal penicillin. Late pneumonia is treated with an aminoglycoside with or without an antipseudomonal added. 14. Catheter related infection is, in the injured child, overwhelmingly gram positive with coagulase negative staphlococcal species accounting for 30-60% of isolates. Staphlococcus aureus is responsible for an additional 15-20%. 15. The role of antibiotics in the prevention of catheter related meningitis is controversial. Recent adult studies suggest no advantage to their routine use. If utilized, they should only be employed prophylactically and not continued throughout the monitoring period. 16. Lack of response to treatment of sepsis may represent an inappropriate antimicrobial agent, improper dosage, inability to achieve adequate levels at the site of infection. (eg, CSF) fungal pathogen, and/or ongoing contamination or undrained purulent focus.

Antibiotic Prophylaxis↗

PubMed2004

Impact of surveillance rounds on adherence to infection control policies and procedures at a children's hospital.

Adherence to written infection control policies and procedures was studied and on-site education was provided for 1 year at a children's hospital. There was significant improvement in sharp objects disposal, hazardous waste handling, availability of personal protective equipment, isolation precautions, and staff knowledge regarding location of the exposure control plan.

Child↗

PubMed1992

A review of traditional resistance surveillance methodologies and infection control.

The hospital affords an excellent environment for the proliferation of pathogenic bacteria and for the selection of antimicrobial-resistant strains. This article traces the evolution of microbiologic surveillance techniques and highlights some of the more effective means of infection control. Traditional surveillance methods relied on nationwide antimicrobial susceptibility data for practical information regarding the nature of infectious disease trends in order to guide the selection of appropriate empiric antibiotic therapy. The application of nationwide antibiograms to the local hospital setting may mask the local emergence of rapidly developing resistances, such as chromosomally mediated type-I beta-lactamase resistance, which has been associated with increased use of certain cephalosporins. "Focused surveillance" techniques yield improved detection of emerging localized resistances within specific hospital units. In addition to unit-specific surveillance, many hospitals are now observing the advantages of an infection site-specific monitoring program. Judicious use of newer antimicrobials and implementation of detailed hospitalwide surveillance procedures will help to minimize the spread of epidemic and resistant infections. It remains the responsibility of the infection control and antibiotic utilization or advisory committees to make appropriate recommendations concerning the selection, restriction, and proper use of the newer extended-spectrum antibiotics. The clinical microbiology laboratory as a source of information remains a key participant in a quality program.

Bacteriological Techniques↗

PubMed1976

Infection control in small hospitals. Prevalence surveys in 18 institutions.

In prevalance surveys of 18 small hospitals in the intermountain region, 20.4% of the patients had community-acquired infections and 7.2% had infections acquired in the hospital. The types of nosocomial infections and patterns of antibiotic usage were similar to those encountered in large hospitals. In the small hospitals, 49% of the suspected bacterial infection were cultured, whereas at a nearby large hospital 77% were cultured. Seventeen of these small hospitals had an infection-control committee but these committees were unable to assess adequately the extent of their nosocomial infection problems. Monitoring of the environment with bacterial cultures was a frequent practice; overall, a ratio of one environmental culture was performed to each three diagnostic cultures. These results indicate the need to develop and evaluate nosocomial infection control programs in small hospitals.

Anti-Bacterial Agents↗

PubMed2006

[Application of sequential noninvasive following invasive mechanical ventilation in COPD patients with severe respiratory failure by investigating the appearance of pulmonary-infection-control-window].

OBJECTIVE: To evaluate the application of sequential noninvasive following invasive mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients with severe respiratory failure by investigating the appearance of pulmonary-infection-control-window. METHODS: From November 2001 to October 2004, 76 case of COPD patients with severe respiratory failure due to pulmonary infection were intubated and recruited in the study. When the pulmonary infection was significantly controlled (the time of pulmonary infection control was called PIC window) by the antibiotic and comprehensive therapy, all cases were randomized into noninvasive veatiation group (NIV) and control group. The early extubation was conducted and followed by noninvasive mechanical ventilation via facial mask with bilevel positive airway pressure mode immediately in the NIV group. Conventional invasive synchronized intermittent mandatory ventilation (SIMV) plus pressure support ventilation (PSV) was used as the weaning technique in the control group. RESULTS: Thirty eight cases among 76 patients were in the NIV group, and the rest in the control group. The NIV group and the control group had similar age, sex, APACHE scores, RR, HR, MAP, PaO2 and PaCO2 at the time of commencement and PIC window (P > 0.05). The time of PIC window was (7.5 +/- 1.9) d in the NIV group, and (8.0 +/- 2.5) d in the control group (P > 0.05). In the NIV group, the durations of invasive mechanical ventilation (MV) and total MV were (7.5 +/- 1.9) d and (12.5 +/- 4.0) d respectively, while the durations were (23.5 +/- 9.5) d in the control group (P < 0.05). The durations of RICU stay and hospital stay were shorter than that in the control group. The incidence of ventilation associated pneumonia (VAP) was 18.4% (7/38) in the NIV group, 39.5% (15/38) in the control group respectively (P < 0.05). The incidence of reintubation was 13.2% (5/38) in the NIV group, 34.2% (13/38) in the control group respectively (P < 0.05). Hospital mortality was 7.9% (3/38) in the NIV group, and 28.9% (11/38) in the control group (P < 0.05). CONCLUSION: In those COPD patients requiring intubation and mechanical ventilantion who have severe respiratory failure due to pulmonary infection, sequential noninvasive following invasive mechanical ventilation at the appearance of PIC window can significantly reduce the MV duration, the length of RICU stay and hospital stay, and decrease the occurrence of VAP, reintubation and hospital mortality as well. So it is an efficient strategy to be generalized.

Aged↗

PubMed2006

Infection control in pediatric extended care facilities.

Pediatric extended care facilities provide for the biopsychosocial needs of patients younger than 21 years of age who have sustained self-care deficits. These facilities include long-term and residential care facilities, chronic disease and specialty hospitals, and residential schools. Infection control policies and procedures developed for adult long-term care facilities, primarily nursing homes for elderly people, are not applicable to long-term care facilities that serve pediatric patients. This article reviews the characteristics of pediatric extended care facilities and their residents, and the epidemic and endemic nosocomial infections, infection control programs, and antimicrobial resistance profiles found in pediatric extended care facilities.

Bacterial Infections↗

PubMed2006

Diploma in Hospital Infection Control--important changes to the accreditation of prior experiental learning and update.

The Diploma in Hospital Infection Control (DipHIC) was established by the Hospital Infection Society, London School of Hygiene and Tropical Medicine and the Public Health Laboratory Service (now the Health Protection Agency) in 1997. We outline important changes to the assessment of eligibility for the DipHIC by accreditation of prior experiental learning, provide a web link to examples of reflections, and list all those who have been awarded the DipHIC by the various routes.

Accreditation↗

PubMed2003

SARS: hospital infection control and admission strategies.

Nosocomial clustering with transmission to health care workers, patients and visitors is a prominent feature of severe acute respiratory syndrome (SARS). Hospital outbreaks of SARS typically occurred within the first week after admission of the very first SARS cases when the disease was not recognized and before isolation measures were implemented. In the majority of nosocomial infections, there was a history of close contact with a SARS patient, and transmission occurred via large droplets, direct contact with infectious material or by contact with fomites contaminated by infectious material. In a few instances, potential airborne transmission was reported in association with endotracheal intubation, nebulised medications and non-invasive positive pressure ventilation of SARS patients. In all SARS-affected countries, nosocomial transmission of the disease was effectively halted by enforcement of routine standard, contact and droplet precautions in all clinical areas and additional airborne precautions in the high-risk areas. In Hong Kong, where there are few private rooms for patient isolation, some hospitals have obtained good outcome by having designated SARS teams and separate wards for patient triage, confirmed SARS cases and step-down of patients in whom SARS had been ruled out. In conclusion, SARS represents one of the new challenges for those who are involved in hospital infection control. As SARS might re-emerge, all hospitals should take advantage of the current SARS-free interval to review their infection control programmes, alert mechanisms, response capability and to repair any identified inadequacies.

Algorithms↗

PubMed1991

The role of barrier precautions in infection control.

Barrier precautions are a fundamental component of any infection control strategy and a critical aspect of all isolation systems. Because many infections are transmitted from patient-to-patient via the hands of personnel, gloves and gowns are widely recommended to provide an extra measure of protection against cross-infection. It is not clear whether gloves are superior to handwashing (if performed obsessionally) in this respect, and there is little evidence that gowns confer additional benefit. These concerns notwithstanding, barrier precautions can substantially reduce the risk of some infections, such as respiratory syncytial virus disease. On the other hand, the modes of transmission of many infections are complex (e.g. with rotavirus) or controversial (e.g. with rhinovirus), and, even though hands are involved in transmission, barrier precautions alone may not suffice to prevent spread. Moreover, neither gloves nor gowns can prevent nosocomial infections caused by endogenous microbial flora; perhaps this explains the limited efficacy of barrier precautions in reducing the endemic rate of infection due to bacteria such as Pseudomonas aeruginosa in intensive care units. Barrier precautions may also fail if colonized patients are not identified promptly. One potential solution to this problem is 'body substance isolation' (BSI), in which all patients are considered to be potential carriers of nosocomial pathogens whether or not they have been cultured or have developed a clinical infection. In BSI barrier techniques are used when any potentially contaminated patient material is handled. BSI also provides barrier protection from bloodborne pathogens for personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross Infection↗

PubMed1995

Infection control in long-term care.

Elderly residents of long-term care facilities are especially vulnerable to certain infectious diseases such as pneumonia, urinary tract infection, and skin or soft tissue infections. As part of quality of care, the detection, control, and prevention of infections in long-term care facilities through an organized infection control program is a requirement of federal, state, and professional regulatory agencies. Implementation of the major components of an infection control program requires a cooperative interdisciplinary effort among the facility administration, medical director, infection control committee, infection control practitioner, staff, and local health department.

Aged↗