文摘翻译有奖（2010年国外医院感染相关杂志）

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美国感染控制杂志2010年第2期
20、Bloodborne pathogen risk reduction activities in the body piercing and tattooing industry在人体穿刺和纹身行业降低血源性疾病传播危险
Background
This study examines how well regulations for bloodborne pathogens (BBPs), established primarily to reduce exposure risk for health care workers, are being followed by workers and employers in the tattooing and body piercing industry.

Method
Twelve shops performing tattooing and/or body piercing (body art) in Pennsylvania and Texas were assessed for compliance with 5 administrative and 10 infection control standards for reducing exposure to BBPs.

Results
All shops demonstrated compliance with infection control standards, but not with administrative standards, such as maintaining an exposure control plan, offering hepatitis B vaccine, and training staff. Shops staffed with members of professional body art organizations demonstrated higher compliance with the administrative standards. Shops in locations where the body art industry was regulated and shops in nonregulated locations demonstrated similar compliance, as did contractor- and employee-staffed shops.

Conclusions
Regulations to control occupational exposure to BBPs have been in place since 1991. This study corroborates noncompliance with some standards within the body art industry reported by previous studies. Without notable enforcement, regulation at national, state, or local levels does not affect compliance. In this study, the factor most closely associated with compliance with administrative regulations was the artist's membership in a professional body art association.

Key Words: Bloodborne pathogens, OSHA standards, infection control, body art, tattoo, body piercing

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美国感染控制杂志2010年第2期
21、Effect of exclusion policy on the control of outbreaks of suspected viral gastroenteritis: Analysis of outbreak investigations in care homes关闭政策在疑似肠道病毒感染爆发控制中效果：养老院爆发调查分析。

Norovirus is an important cause of gastroenteritis outbreaks in care homes. Differences exist in the recommended duration of exclusion for affected staff during an outbreak.

Methods
We conducted a retrospective analysis of outbreak reports in 2006 and 2007 managed by health protection staff in 2 counties with differing exclusion policies, one advising exclusion of affected staff and isolation of residents for 72hours and the other for 48hours after the resolution of symptoms. We compared attack rates and average numbers of cases in residents and staff, adjusting for type of care home and staffing rate.

Results
A total of 96 outbreaks were managed, 63 with a 72-hour exclusion policy and 33 with a 48-hour exclusion policy. The longer exclusion policy resulted in lower mean number of cases among staff (6.5 vs 9.6; P=.044) and a lower overall attack rate (32.6% vs 35.1%; P=.05). No differences in the mean number of cases or the attack rate among residents were seen.

Conclusion
This brief study suggests that a longer exclusion policy reduces the number of cases among staff affected with viral gastroenteritis, possibly resulting in less staff absences. This could have potential benefits, particularly when resources are limited.

Key Words: Norovirus, outbreak control, exclusion policy, health care, infection control

lindahawk729

回复 1# 潮水
认领第12号。锻炼一下，呵呵。

lindahawk729

12、Contamination of laryngoscope handles喉镜手柄的污染
Journal of Hospital Infection  Volume 74, Issue 2, February 2010, Pages 123-128
医院感染杂志，第74卷，第二期，2010年2月，第123-128页
Summary
Despite use of sterile or disposable laryngoscope blades for each patient, disinfection of laryngoscope handles does not routinely occur, and these devices present a potential route of transmission of pathogens between patients and staff. A total of 192 specimens from 64 laryngoscope handles deemed ‘ready for patient use’ in the anaesthetic rooms of 32 operating theatres were semiquantitatively assessed for bacterial contamination. A further 116 specimens from 58 of the handles were tested for occult blood contamination. One or more species of bacteria were isolated from 55 (86%) of the handles, and included organisms such as enterococci, meticillin-susceptible Staphylococcus aureus, Klebsiella and acinetobacter. Cultures did not yield any anaerobes, fungi, meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci or multiply-resistant Gram-negative bacilli. No occult blood contamination was demonstrated. Although the majority of organisms isolated were not pathogenic, their presence indicates the potential for transmission of pathogens from laryngoscope handles. Strategies to address contamination of handles include revision of procedures for disinfection and storage prior to use, introduction of disposable handles or sheaths, and re-design of handles to eliminate knurled surfaces and contact points.

Keywords: Anaesthesia; Decontamination; Equipment; Infection; Laryngoscope


摘要
    尽管每个病人已使用灭菌的或一次性喉镜刀片，喉镜手柄的消毒却尚未纳入操作常规，这些器具存在着将病原体在医患之间传播的隐患。于32间手术室麻醉间64支呈备用状态的喉镜手柄采集192例标本进行细菌半定量检测，进而于58支手柄采集116例标本进行潜血试验。占样本量86%的55支手柄中分离出1种以上菌株，其中包括肠球菌、对甲氧西林敏感的金黄色葡萄球菌、克雷伯菌和不动菌属等生物体。未培养出厌氧菌、真菌、耐甲氧西林金黄色葡萄球菌、耐万古霉素肠球菌以及多重耐药的革兰氏阴性杆菌。隐血试验全部呈阴性。虽然分离出的生物体大多数不致病，但它们的存在指示了病原体通过喉镜手柄传播的隐患。应对手柄污染的策略包括修订使用前消毒与贮存的操作规程，采用一次性手柄或手柄套以及重新设计手柄，去除消毒，储存，使用前程序的修订，采用一次性处理或鞘，以及重新设计手柄，减少表面凸出及接触点。

关键词：麻醉；去污；设备；感染；喉镜

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英国医院感染杂志2010年第3期
22、Impact of the amount of hand rub applied in hygienic hand disinfection on the reduction of microbial counts on hands 搓手面积对卫生手消毒中降低手部微生物的影响
  Journal of Hospital Infection
Volume 74, Issue 3, March 2010, Pages 212-218
Summary
Two different hand rubs were tested in order to investigate the minimum volume required for microbicidal efficacy according to the European Norm EN 1500; we also sought to determine whether there is a correlation with hand size. Eight male volunteers with big hands (mean 184 cm2) and eight female volunteers with significantly smaller hands (mean 148 cm2; P < 0.001) participated in our study. Application of 2 mL of both products (P) provided mean log10 reductions significantly smaller than those of the reference disinfectant (R) (product A: P = 3.34, R = 4.00, P = 0.001; product B: P = 3.37, R = 3.75, P = 0.022). Higher volumes (product A: 3 and 4 mL; product B: 2.5, 3 and 4 mL) ensured that the pass criteria of the European Norm (EN) 1500 were fulfilled. For both products log10 reductions increased with increasing product volume until a plateau was reached. For the smaller female hands, this plateau level was reached after applying 3 mL of product A and 2.5 mL of product B. The plateau level on male hands was observed after treating the hands with ≥4 mL of product A and 3 mL of product B. The increase in product volume also correlated with the decrease in the number of volunteers considering the product volume applied as insufficient. In conclusion, the applied volume for hygienic hand rub should not fall below 3 mL in order to achieve maximum benefit.

Keywords: Application volume; EN 1500; Hand rub; Hygienic hand disinfection

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英国医院感染杂志2010年第3期
（已翻译）23、Antimicrobial efficacy of alcohol-based hand gels 酒精凝胶的抗菌效果  Journal of Hospital Infection
Volume 74, Issue 3, March 2010, Pages 219-224
Summary
In recent years, several commercial alcohol-based hand gels have appeared on the market to improve the hand-cleansing compliance of healthcare workers. Although the antimicrobial efficacy of these products has been reported in different countries, few studies have investigated this subject in Brazil. In this study, we assessed the antimicrobial efficacy of 12 alcohol-based hand gels produced in Brazil, containing 70% w/w or v/v ethyl alcohol as the active ingredient, according to the European Standard EN 1500 (EN 1500). The following alcohol gels were tested: Hand Gel, Voga Gel, Solumax Solugel, Doctor Clean, Rio Gel, Clear Gel, Sevengel, Hand CHC, Gel Bac, WBL-50 Gel, Sanigel and Soft Care Gel. In addition, 70% w/w ethyl alcohol and three alcohol-based hand rubs (Sterillium, Sterillium Gel, and Spitaderm), commonly used in Europe and effective according to EN 1500, were also tested. All the products tested, except for two, were approved by the EN 1500 test protocol with a 60 s application. The results confirmed the antimicrobial efficacy of the majority of the alcohol gels produced in Brazil for hand hygiene of healthcare workers.

Keywords: Alcohol-based hand gels; Alcohol-based hand rinses; EN 1500; Hand hygiene

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英国医院感染杂志2010年第3期
24、Clean Hands for Life&#8482;: results of a large, multicentre, multifaceted, social marketing hand-hygiene campaign 干净的手拯救生命：一个大型的多层面、多中心的社会手卫生运动的效果
  Journal of Hospital Infection
Volume 74, Issue 3, March 2010, Pages 225-231
Summary
A year-long multifaceted hand-hygiene campaign entitled Clean Hands for Life&#8482; targeting individual, environmental and organisational factors that influence healthcare worker (HCW) hand-hygiene behaviour was implemented in 36 acute and long-term care facilities in Vancouver Coastal Health region. The campaign involved rotation of ten novel posters, two poster contests, and distribution of multiple promotional items. A social marketing approach was used to implement and monitor the effectiveness of the campaign. Evaluation included quality assurance surveys, staff surveys (baseline, mid- and post-campaign), and focus groups. A total of 141 poster contest submissions was received, 5452 staff surveys completed and 14 focus groups conducted. Overall knowledge of the importance of hand-hygiene and intention to clean hands was high at baseline. No significant differences were observed when mid- and post-campaign scores were compared to baseline. The majority (89.5%) of HCWs reported that they preferred soap and water over alcohol hand gel. A significant increase in the self-reported use of hand-hygiene products was observed particularly among HCWs not providing direct patient care. Barriers to hand-hygiene included inappropriate placement of sinks, traffic flow issues, inadequately stocked washrooms, workload and time constraints. Organisational support was visible throughout the campaign. The results showed that social marketing is an effective approach in engaging HCWs. Hand-hygiene campaigns that focus almost exclusively on increasing awareness among HCWs may not be as successful as multifaceted campaigns or campaigns that target identified barriers to hand-hygiene.

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英国医院感染杂志2010年第3期
（已翻译）25、Impact of active surveillance on meticillin-resistant Staphylococcus aureus transmission and hospital resource utilisation 主动监测对MRSA传播和医疗资源的影响
  Journal of Hospital Infection
Volume 74, Issue 3, March 2010, Pages 232-237
Summary
The utility of active surveillance cultures (ASCs) for meticillin-resistant Staphylococcus aureus (MRSA) has been a controversial aspect of infection prevention. This prospective cohort study analyses the effect of ASCs for MRSA on hospital-acquired infections in a tertiary care hospital (hospital 1) and a community-based hospital (hospital 2). Both hospitals have high MRSA prevalence and are part of a large healthcare system in southeastern Michigan. Hospital-acquired infections in the intensive care unit (ICU) and in the rest of the hospital were compared before and after the implementation of ASCs in the ICUs. Patients in hospital 1 with evidence of MRSA colonisation from ASCs were placed in contact isolation during their stay in the ICU; patients from hospital 2 remained in contact isolation throughout their hospital stay. Prevalence of MRSA colonisation on admission to the ICU was 23% and 13% in hospitals 1 and 2, respectively. Average incidence of new colonisation during the study period was 1.85 per 1000 patient-days and 3.47 per 1000 patient-days in hospitals 1 and 2, respectively. A decrease in ventilator-associated pneumonia (VAP) occurred in both hospitals, whereas decrease in hospital-wide nosocomial MRSA infection was demonstrated only in hospital 2. We conclude that, in addition to standard infection prevention initiatives, ASC with contact precautions can be effective in reducing the incidence of VAP and nosocomial MRSA infection in healthcare communities with endemic MRSA.

Keywords: Active surveillance cultures; Hospital-acquired infections; Meticillin-resistant Staphylococcus aureus; Surveillance; Ventilator-associated pneumonia

lindahawk729

这个模块很不错，促进我们学英语。有时间还会参与的。有类似任务通知我。

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回复 29# lindahawk729
欢迎大家参加本版的文摘有奖翻译活动！

ygzs

刚看到这个帖子，楼主很好的创意！！！能帮助大家提高英语水平啊！
一定积极参与！但最近忙于准备我院月底院感防控宣传周诸多事宜，实在抽不出足够时间，等有时间一定参加！

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英国医院感染杂志2010年第4期
（已翻译）26、Hospital-based epidemiology: a strategy for ‘dealing with Clostridium difficile’ 艰难梭菌应对策略医院流行病学研究
Journal of Hospital Infection
Volume 74, Issue 4, April 2010, Pages 319-325
Summary
Clostridium difficile-associated diarrhoea (CDAD) remains a major infection control problem. Uncertainty remains over methods of diagnosis and definitions for ascertaining provenance of cases. We undertook a prospective epidemiological study to better ascertain local epidemiology of 275 new cases (general practitioner and hospital) diagnosed in a large teaching hospital in the UK. The highest incidence of cases was found in haematology and critical care and a surprisingly high proportion, 29%, of hospital cases occurred in those aged <65 years. Fifty-five cases were diagnosed within 48 h of admission. Of these, those defined as ‘community-acquired’ varied between 9 and 25 according to various proposed definitions relating to acquisition and onset of diarrhoea. Of 48 community-onset cases, this number varied between 19 and 25, the variability making comparisons between National Health Service (NHS) trusts potentially inaccurate. Cases were followed for 90 days after diagnosis and all cause mortality data obtained. Of 227 cases diagnosed in hospital, 56 (25%) died within 30 days, 29% of whom were aged <65 years. Death certification data were available in 86% of these cases. C. difficile was recorded on 15 (31%) certificates and as a primary cause (1a or 1b) in 8 (17%) cases. Our study shows the value of local epidemiology for planning infection prevention and control strategies within an NHS trust and for contributing to the evidence base for national targets and policies.

Keywords: Antibiotic-associated diarrhoea; Clostridium difficile; Epidemiology; Hospital-acquired infection

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英国医院感染杂志2010年第4期
27、Routine antibiotic use in preterm neonates: a randomised controlled trial 早产儿常规使用抗生素的随机对照试验
Journal of Hospital Infection
Volume 74, Issue 4, April 2010, Pages 332-336
Summary
The immature immune system of preterm neonates puts them at higher risk of neonatal sepsis. We conducted a part-blinded randomised controlled trial to compare the effect of routine antibiotic treatment on the incidence of clinical sepsis in preterm neonates. Preterm neonates without other risk factors for infection admitted in the first 12 h of life were randomised to receive routine antibiotics or to a control group (no antibiotics unless clinically indicated). The primary outcome variable was the incidence of clinical sepsis. Secondary outcomes were the incidence of positive blood cultures, necrotising enterocolitis (NEC) stage II or III, or death, and the duration of hospital stay. The incidence of clinical sepsis was comparable in both groups (intervention 31.9%, control 25.4%; P = 0.392). Mortality was equivalent in both groups. The control group had significantly more positive blood cultures (P = 0.002). The incidence of NEC and the duration of hospital stay were comparable in both groups. In low risk preterm neonates we found no evidence that routine antibiotic use has a protective effect.

keywords: Antibiotics; Preterm; Routine; Sepsis

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英国医院感染杂志2010年第4期
28、Carriage rate of carbapenem-resistant Klebsiella pneumoniae in hospitalised patients during a national outbreak 爆发期间住院病人碳青霉烯类耐药肺炎克雷伯菌携带率
Journal of Hospital Infection
Volume 74, Issue 4, April 2010, Pages 344-349
Summary
During a national outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) in Israel, we conducted a point prevalence survey to determine the extent of asymptomatic carriage. Subsequently, a retrospective case–control study was done, comparing carriers of CRKP with non-carriers, in order to detect risk factors for carriage. Oral, perianal and rectal swabs were obtained from all hospitalised eligible and consenting patients. Selective media for carbapenem-resistant Gram-negative bacteria were used and pulsed-field gel electrophoresis (PFGE) helped to determine clonal source. Culture was obtained from 298 patients. Sixteen (5.4%) were carriers of CRKP, with a higher carriage rate in medical and surgical wards. Only 18% of carriers were treated with any carbapenem prior to the survey. Five of the 16 carriers had a positive clinical specimen for CRKP, hence a clinical infection versus asymptomatic carriage ratio of 1:3. The rectum was the most sensitive site sampled, detecting 15/16 carriers, and the overall sensitivity of the method was 94% with a negative predictive value of 99.6%. In a multivariate analysis of risk factors for CRKP carriage, three variables were significantly related to carriage state: diaper use, longer duration of hospital stay and vancomycin use. PFGE demonstrated that all 16 isolates were identical, confirming clonal origin. A point prevalence survey performed at a single medical centre during an outbreak of CRKP demonstrated a carriage rate of 5.4%. The clonal origin of these isolates suggests that strict adherence to isolation procedure may contain this outbreak.

Keywords: Antibiotic resistance; Carbapenemase; Carriage; Prevalence; Screening

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英国医院感染杂志2010年第4期
29、Outbreak of carbapenem-resistant Pseudomonas aeruginosa infection in a surgical intensive care unit 外科重症监护病房碳青霉烯类耐药铜绿假单胞菌感染爆发
Journal of Hospital Infection
Volume 74, Issue 4, April 2010, Pages 350-357
Summary
Infection control personnel performing surveillance activities noticed a cluster of patients with isolates of carbapenem-resistant Pseudomonas aeruginosa (CRPA) in the surgical intensive care unit (SICU) of a German University Hospital. An outbreak investigation including a descriptive analysis, a case–control study comparing 15 CRPA case patients with 18 patients with carbapenem-susceptible P. aeruginosa, environmental sampling and pulsed-field gel electrophoresis (PFGE) typing of P. aeruginosa isolates was carried out. Fifteen patients acquired CRPA in the SICU during the outbreak period between 1 July 2006 and 31 October 2006 and PFGE typing of 11 available patient isolates revealed two outbreak strains as well as sporadic CRPA isolates. Both outbreak strains were resistant to penicillins, cephalosporins, carbapenems, aminoglycosides and quinolones, and remained susceptible only to colistin. The most likely mode of transmission was cross-transmission between patients during postoperative wound care with abdominal and/or thoracic drains (odds ratio: 64.33; 95% confidence interval: 5.32–999) and therapy with quinolones (48.37; 3.71–999) being independent risk factors for acquisition of CRPA. No further clusters of CRPA cases were observed after implementation of contact isolation precautions and after healthcare workers were made aware of the likely mode of transmission. This study shows the complex epidemiology of CRPA in a SICU including cross-transmission of two CRPA strains related to postoperative wound care.

Keywords: Case–control study; Carbapenem resistance; Nosocomial outbreak; Pseudomonas aeruginosa

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英国医院感染杂志2010年第4期
（已翻译）30、Epidemiology and clonality of multidrug-resistant Acinetobacter baumannii from a healthcare region in Hong Kong 香港多重耐药鲍曼不动杆菌流行病学及病原学
Journal of Hospital Infection
Volume 74, Issue 4, April 2010, Pages 358-364
Summary
We assessed the risk factors and molecular epidemiology of multidrug-resistant Acinetobacter baumannii (MDR-AB) in Hong Kong. The patients were treated in five hospitals in a healthcare region during 2005–2006. We performed genomic identification by amplified rRNA gene restriction analysis (ARDRA) and investigated the existence of metallo-β-lactamases and the clonality of representative MDR-AB strains by phenotypic and molecular methods. Forty-five subjects with MDR-AB were compared with 135 controls (patients with no MDR-AB). In the logistic regression, chronic wound (odds ratio: 29.5, 95% confidence interval: 8.1–107.2; P < 0.001) was the only factor independently associated with MDR-AB colonisation or infection. ARDRA identified all 45 MDR-AB as genomic species 2TU. Pulsed-field gel electrophoresis clustered all except two isolates into two clonal types, designated HKU1 and HKU2 with 24 and 19 isolates, respectively. The main features of HKU1 strains were ST26, adeB type XII, positivity for blaOxA-23-like and blaOxA-51-like genes and high level resistance to carbapenems. Most HKU1 strains retained susceptibility to gentamicin, cotrimoxazole and minocycline. By contrast, HKU2 strains exhibited ST22, adeB type II, and were usually positive only for the blaOxA-51-like gene and resistant to gentamicin, cotrimoxazole and minocycline. Both clones were found to have disseminated widely. In conclusion, clonal expansion is playing major roles in the increase of MDR-AB in these hospitals in Hong Kong. The findings highlight the need to enhance infection control measures.

Keywords: Acinetobacter baumannii; Molecular epidemiology; Multilocus sequence typing; Risk factors

gemao

小试牛刀
25. 主动监测对MRSA传播和医疗资源的影响
对MRSA进行主动监测培养在防止感染方面仍有争议的。本项前瞻性cohort研究分析了主动性监测住院获得性MRSA感染在三级护理医院 (hospital 1) 和社区医院 (hospital 2)的效果。这2家医院是密西根东南部大型卫生系统的一部分，有很高的MRSA流行性。本研究将ICU中医院获得性感染与医院的其他部分进行比较，以及在ICU引入ASCs前后。医院1中，通过ASCs，对有MRSA 定植证据的患者，在其进入ICU之中进行接触隔离；医院2中的病人在整个住院过程中进行完全的接触隔离。进入ICU时MRSA的患病率，在2家医院中分别是23%和13% 。在研究期间，2家医院每1000病人-天的平均新定植发生率分别是 1.85，和3.47。2家医院中呼吸机相关肺炎的发生也减少，而仅在第2家医院证明全院范围的非社区MRSA感染减少。我们得出结论：在MRSA流行的卫生保健社区，除了主动的标准感染预防，ASC和接触隔离可以有效地减少VAP和非社区MRSA感染。
关键词: 主动监测培养；医院获得性感染；耐甲氧西林金黄色葡萄球菌；监测；呼吸机相关肺炎

gemao

Keywords: Anaesthesia; Decontamination; Equipment; Infection; Laryngoscope
英国医院感染杂志2010年第3期
23、Antimicrobial efficacy of alcohol-based hand gels 酒精凝胶的抗菌效果  
Journal of Hospital Infection  Volume 74, Issue 3, March 2010, Pages 219-224
Summary
In recent years, several commercial alcohol-based hand gels have appeared on the market to improve the hand-cleansing compliance of healthcare workers. Although the antimicrobial efficacy of these products has been reported in different countries, few studies have investigated this subject in Brazil. In this study, we assessed the antimicrobial efficacy of 12 alcohol-based hand gels produced in Brazil, containing 70% w/w or v/v ethyl alcohol as the active ingredient, according to the European Standard EN 1500 (EN 1500). The following alcohol gels were tested: Hand Gel, Voga Gel, Solumax Solugel, Doctor Clean, Rio Gel, Clear Gel, Sevengel, Hand CHC, Gel Bac, WBL-50 Gel, Sanigel and Soft Care Gel. In addition, 70% w/w ethyl alcohol and three alcohol-based hand rubs (Sterillium, Sterillium Gel, and Spitaderm), commonly used in Europe and effective according to EN 1500, were also tested. All the products tested, except for two, were approved by the EN 1500 test protocol with a 60 s application. The results confirmed the antimicrobial efficacy of the majority of the alcohol gels produced in Brazil for hand hygiene of healthcare workers.

近年，若干商用酒精凝胶洗手液出现在市场上，改善了健康工作者手卫生的依从性。尽管这些产品的抗菌有效性在不同的国家报告不同，但在巴西，已经对这一课题进行一些研究。在此研究中，我们评估了12种巴西根据欧洲标准EN 1500生产的酒精消毒凝胶，含有70% w/w 或 v/v乙醇作为活性物质。以下产品进行检测：Hand Gel, Voga Gel, Solumax Solugel, Doctor Clean, Rio Gel, Clear Gel, Sevengel, Hand CHC, Gel Bac, WBL-50 Gel, Sanigel和 Soft Care Gel. 另外，3种通常在欧洲使用的含70%w/w 乙醇的酒精消毒凝胶，有效性符合EN1500，也一同被检测。所有检测产品，除2种外，按照EN1500检测指南推荐使用60秒。结果显示：大部分巴西生产的酒精消毒凝胶可以满足健康工作者手卫生的抗菌效果。
关键词：酒精消毒凝胶 EN 1500  手卫生

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回复 37# gemao
在研究期间中，新定植的平均发生率分别是每1000病人-天 1.85，和3.47。2家医院中呼吸机相关肺炎的发生减少，而仅在第2家医院证明全院范围的非社区MRSA感染减少。
部分词句再整理一下可能会更好！

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英国医院感染杂志2010年第4期
31、Higher arterial catheter-related infection rates in femoral than in dorsalis pedis access 股动脉比足背动脉进入发生动脉导管相关的感染率要高Journal of Hospital Infection
Volume 74, Issue 4, April 2010, Pages 365-369
Summary
Although there are many studies on arterial catheter-related infection (ACRI) there is little information on the relative risks associated with different catheter access sites. In previous studies we have shown a higher incidence of ACRI in femoral than in radial access sites. This prospective observational study was designed to compare the incidence of ACRI in patients on an intensive care unit with femoral versus dorsalis pedis access sites. We compared 1085 femoral arterial catheters inserted for a cumulative 6497 days with 174 dorsalis pedis catheters inserted for a cumulative 1050 days. We detected 33 cases of ACRI in the femoral access group (11 with bacteraemia and 22 with line site infection; 5.08 infections per 1000 catheter-days) but none in the dorsalis pedis access group. There were no significant differences between the two groups regarding age, sex, Acute Physiological Assessment and Chronic Health Evaluation (APACHE) II, diagnosis, previous arterial catheter insertion, use of mechanical ventilation, use of antimicrobials or catheter duration. Regression analysis showed a higher incidence of ACRI for femoral than for dorsalis pedis access sites (odds ratio: 7.6; 95% confidence interval: 1.37–infinite; P = 0.01). These results suggest that dorsalis pedis arterial access should be used in preference to femoral arterial access in order to reduce the risk of ACRI.

Keywords: Arterial catheter; Bacteraemia; Catheter infection; Dorsalis pedis; Femoral