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楼主: 潮水

文摘翻译有奖(2010年国外医院感染相关杂志)

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 楼主| 发表于 2010-4-13 19:43 | 显示全部楼层
本帖最后由 潮水 于 2010-4-15 18:39 编辑

英国医院感染杂志2010年第5期
40、Impact of hospital-wide infection rate, invasive procedures use and antimicrobial consumption on bacterial resistance inside an intensive care unit 全院感染率、侵入操作和抗生素使用对ICU细菌耐药的影响
  Journal of Hospital Infection
Volume 75, Issue 1, May 2010, Pages 23-27
Summary
We performed a 30-month ecological study to determine the impact of hospital-wide antibiotic consumption, invasive procedure use and hospital-acquired infections (HAIs) on antibiotic resistance in an intensive care unit (ICU). Microbiological isolates from ICU patients with established diagnosis of hospital infection were monitored throughout the study. Overall hospital consumption per 100 patient-days of piperacillin-tazobactam, fluoroquinolones and cephalosporins increased from 1.9 to 2.3 defined daily doses (DDD) (P < 0.01), from 4.7 to 10.3 DDD (P < 0.01) and from 12.1 to 16.4 DDD (P < 0.01), respectively. Bacterial multiresistance in ICU was identified in 31.3% (N = 466) of isolates, with increasing resistance demonstrated for meropenem-resistant Klebsiella spp. (P = 0.01) and meropenem-resistant Acinetobacter spp. (P = 0.02). There was a positive correlation between multiresistance rate and DDD of cephalosporins (P < 0.01) and fluoroquinolones (P = 0.03). The rate of ceftazidime-resistant Klebsiella spp. correlated with DDD of fluoroquinolones and cephalosporins; the rate of ceftazidime-resistant Pseudomonas spp. correlated with consumption of cephalosporins, and rate of meticillin-resistant Staphylococcus aureus (MRSA) correlated with fluoroquinolone use. During the studied period, 36.9% (P < 0.001) and 34.5% (P < 0.01) of the changing multiresistance rate in ICU was associated with use of invasive procedures and overall HAI rate, respectively. Multiresistance rates in ICU are influenced by the variation in overall HAI rate, hospital-wide invasive procedures and antibiotic consumption outside the ICU.

Keywords: Antimicrobial use; Drug resistance; Hospital infection; Microbial resistance
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发表于 2010-4-13 21:50 | 显示全部楼层
本帖最后由 gemao 于 2010-4-13 21:52 编辑

39、Deposits on the intraluminal surface and bacterial growth in central venous catheters 中心静脉导管的表明沉积物及微生物生长
Journal of Hospital Infection
Volume 75, Issue 1, May 2010, Pages 19-22
Summary
Central venous catheter (CVC) tip and blood cultures are generally used to diagnose a catheter-related infection. Such methodology does not confirm the presence of bacterial colonisation on parts of CVCs other than the CVC tip. In order to assess the extent of bacterial colonisation, 10 catheters were examined in detail from patients admitted to intensive care unit. Swabs from the lumen at several sites (hub, indwelling and non-indwelling) were cultured and the intraluminal surface of the device subjected to scanning electron microscopy (SEM). Bacteria were detected on five out of 10 catheters (50%), and bacterial contamination of CVCs was common in the hub area of the device. Deposits (crystallisation) that differed from bacterial colonisation or biofilm were observed on the intraluminal surface of used CVCs. SEM showed bacteria firmly anchored to the deposits. Experimental flow studies demonstrated that deposits were more likely to appear after exposure to solutions such as total parenteral nutrition rather than distilled water. These deposits facilitated bacterial colonisation 30 times more than CVCs free from deposits.
Keywords: Bacteria; Central venous catheterisation; Infection; Scanning electron microscopy

中心静脉导管头部(尖端)和血培养通常用于导管相关性感染的诊断,这种方法学不能确定中心静脉导管头部以外的其他部位是否存在细菌。为了评估细菌定植的程度,研究选择ICU病人,详细检查了10根中心静脉导管。擦拭导管的若干部分(接口,体内段,体外段)进行培养,腔内表面用扫描电镜(SEM)检查。在10根导管中有5个发现细菌(50%),中心静脉导管的细菌污染常鉴于接口区域。不同于细菌的定植或生物膜的沉积物结晶见于使用过的中心静脉导管腔内表面。SEM显示细菌牢固地固定在沉积物上。实验性流量研究证明沉积物最可能出现在使用诸如TPN全肠道外营养溶液而非蒸馏水之后。这些带有沉积物的导管出现细菌定植是没有沉积物的中心静脉导管的30倍。
关键词:细菌  中心静脉导管  感染 扫描电子显微镜

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 楼主| 发表于 2010-4-18 12:21 | 显示全部楼层
本帖最后由 潮水 于 2010-5-2 16:20 编辑

英国医院感染杂志2010年第5期
(已翻译)41、Impact of a hospital-wide programme of heterogeneous antibiotic use on the development of antibiotic-resistant Gram-negative bacteria 异质性抗生素使用项目对革兰氏阴性菌耐药菌的影响
  Journal of Hospital Infection
Volume 75, Issue 1, May 2010, Pages 28-32
Summary
Although antibiotic heterogeneity has been proposed as a strategy to limit the emergence of antibiotic resistance, few clinical studies have been conducted to validate the concept. This paper evaluates a hospital-wide strategy of heterogeneous antibiotic use intended to reduce infections caused by resistant Gram-negative rods (GNR). A strategy termed ‘periodic antimicrobial monitoring and supervision’ (PAMS) was implemented between September 2006 and February 2008. The 18 month intervention period was compared with the preceding 18 months (12 months pre-establishment and 6 months preparation). During PAMS, recommended, restricted and off-supervised classes of antibiotics active against more resistant GNR were changed every 3 months according to the antimicrobial usage density and rates of resistance to those antibiotics in Pseudomonas aeruginosa during the preceding term. Usage of five categories of antibiotics was supervised by four full-time staff. Antibiotic heterogeneity was estimated using the Peterson index (AHI). AHI estimates were 0.66 and 0.74 during the observation period but rose after the introduction of PAMS (period 1: 0.84; period 2: 0.94; period 3: 0.88). The incidence of patients from whom resistant GNR were isolated decreased significantly (P < 0.001), whereas isolation of multidrug-resistant (MDR) GNR decreased from 1.7% to 0.5% (P < 0.001). There was no significant difference in the incidence of extended spectrum β-lactamase-producing organisms. Rates of imipenem resistance among Pseudomonas aeruginosa improved during PAMS2. PAMS facilitated hospital-wide heterogeneous antibiotic usage which was associated with reduced rates of resistant GNR.

Keywords: Antibiotic resistance; Antimicrobial stewardship; Carbapenems; Heterogeneous antibiotic use; Multidrug resistant Gram-negative rods; Pseudomonas aeruginosa
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 楼主| 发表于 2010-4-18 12:24 | 显示全部楼层
英国医院感染杂志2010年第5期
42、Extended-spectrum β-lactamase-producing Enterobacter cloacae in mobile dialysis units in the medical and surgical departments of a university hospital: a case–control study 医院内外科移动血液透析机中产广谱β-内酰胺酶阴沟肠杆菌的病例对照研究
  Journal of Hospital Infection
Volume 75, Issue 1, May 2010, Pages 33-36
outbreak of extended-spectrum β-lactamase (ESBL)-producing Enterobacter cloacae in the University Medical Center Freiburg. A risk factor analysis was performed on 23 patients with ESBL-producing E. cloacae in the medical and surgical departments by comparing them with 46 non-colonised controls, who were matched for ward and length of hospital stay. For these, a risk factor analysis was conducted. Suspected sources for transmission of ESBL were examined and staff received training in infection control measures. The higher risk in colonised patients was attributed to dialysis with mobile units [odds ratio (OR): 4.00; 95% confidence interval (CI): 1.05–15.234; P = 0.04]. Dialysis units were examined, but no contamination was found. Improvement in dialysis procedures, additional staff training and renewed training in standard precautions led to a substantial fall in case numbers. Risk factor analysis showed that colonised patients carried more invasive devices than controls (central venous catheter: OR: 2.50; 95% CI: 0.74–8.45; P = 0.14; Foley catheter: 5.08; 0.61–42.23; P = 0.13) and were given a greater number of different antibiotics (penicillins: 2.52; 0.71–8.89; P = 0.15; fluoroquinolones: 2.37; 0.77–7.28; P = 0.13). The differences in mobile dialysis frequency and antibiotic use between cases and controls were relevant, although the latter was not statistically significant. It was possible to contain the high frequency of ESBL colonisation or infection by reinforcing infection control measures and training the staff involved.

Keywords: Case–control study; Enterobacter cloacae; Extended-spectrum β-lactamase; Mobile dialysis unit; Outbreak
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 楼主| 发表于 2010-4-18 12:29 | 显示全部楼层
本帖最后由 潮水 于 2010-5-2 16:20 编辑

英国医院感染杂志2010年第5期
(已翻译)43、High-throughput whole-genome sequencing to dissect the epidemiology of Acinetobacter baumannii isolates from a hospital outbreak 医院感染爆发中鲍曼不动杆菌全通量基因测序
  Journal of Hospital Infection
Volume 75, Issue 1, May 2010, Pages 37-41
Summary
Shared care of military and civilian patients has resulted in transmission of multidrug-resistant Acinetobacter baumannii (MDR-Aci) from military casualties to civilians. Current typing technologies have been useful in revealing relationships between isolates of A. baumannii but they are unable to resolve differences between closely related isolates from small-scale outbreaks, where chains of transmission are often unclear. In a recent hospital outbreak in Birmingham, six patients were colonised with MDR-Aci isolates indistinguishable using standard techniques. We used whole-genome sequencing to identify single nucleotide polymorphisms in these isolates, allowing us to discriminate between alternative epidemiological hypotheses in this setting.

Keywords: Acinetobacter baumannii; Epidemiology; Multidrug resistance; Single nucleotide polymorphism; Whole-genome sequencing; 454 pyrosequencing
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 楼主| 发表于 2010-4-18 12:34 | 显示全部楼层
英国医院感染杂志2010年第5期
44、Duration of norovirus excretion and the longitudinal course of viral load in norovirus-infected elderly patients 感染诺如病毒老年病人病毒排出期限和载量纵向观察
  Journal of Hospital Infection
Volume 75, Issue 1, May 2010, Pages 42-46
Summary
To prevent dissemination of norovirus in semiclosed environments such as aged-care facilities, it is important to know the period of infectivity in norovirus-infected individuals. We recruited 13 elderly patients aged 60–98 years with norovirus gastroenteritis (11 residents in aged-care facilities and two healthy adults) for this study, and measured the viral loads for norovirus in a total of 63 follow-up faecal samples using a real-time quantitative polymerase chain reaction assay. The average period of norovirus excretion was 14.3 days (range: 9–32 days; median: 13 days). All of the follow-up samples collected between 7 and 10 days after the onset of symptoms tested positive. Viral loads in samples collected between 14 and 18 days after the onset of symptoms were divided into three groups: those testing negative, those with <104 copies/g stool, and those with >104 copies/g stool. Stools from the group with <104 copies/g stool were found to be negative for norovirus up to 21–24 days after the onset of symptoms; however, the group with >104 copies/g stool showed prolonged norovirus excretion (up to 32 days) in stools. Although the period of infectivity of excreted viruses has not yet been clarified, these results suggest that careful attention should be taken for at least 14 days after the onset of symptoms and that the measurement of viral load in stools around 16 days after onset might be a useful method for following the course of viral shedding for each patient infected with norovirus.

Keywords: Elderly; Excretion; Norovirus; Viral load; Viral shedding
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 楼主| 发表于 2010-4-18 12:36 | 显示全部楼层
本帖最后由 潮水 于 2010-5-2 16:19 编辑

英国医院感染杂志2010年第5期
(已翻译)45、Educational intervention for preventing bloodborne infection among medical students in China 中国医学生预防血液传播疾病的教育干预
Journal of Hospital Infection
Volume 75, Issue 1, May 2010, Pages 47-51
Summary
Although medical students are known to be at risk for bloodborne infections, there have been no systematic studies, effective intervention programmes, or guidelines for them in China. We developed prevention guidelines, implemented an intervention, and evaluated the effectiveness of knowledge among medical students. This study was designed as a cluster randomised controlled trial. All those who completed a consent form were randomly assigned either to an intervention or to a control group. The intervention group underwent an educational intervention programme consisting of a series of lectures and videos following a baseline survey. The control group completed the same intervention programme after the study was completed. A questionnaire of 25 items was sent to participants three months and nine months after the initial intervention programme. Outcomes measured before and after intervention included knowledge of transmission route, first-aid care, and post-exposure prophylaxis. Pearson's χ2-test was used, and the efficacy of students was analysed to control for bias. Intervention in the form of a one-time bloodborne pathogen educational prevention programme for Chinese medical students had little effect on knowledge.

Keywords: Bloodborne infection; Chinese medical students; Educational intervention; Intervention programme
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 楼主| 发表于 2010-4-19 20:33 | 显示全部楼层
英国医院感染杂志2010年第5期
46、Adsorption of active ingredients of surface disinfectants depends on the type of fabric used for surface treatment 表面消毒效果取决于织物类型
Journal of Hospital Infection

Volume 75, Issue 1, May 2010, Pages 56-61
Summary
The disinfection of surfaces in the immediate surrounding of a hospitalised patient is considered to be an important element for prevention of nosocomial infection. The type of fabric in a mop, however, has to our knowledge never been regarded as relevant for an effective disinfection of surfaces. We have therefore studied the adsorption of benzalkonium chloride (BAC), glutardialdehyde and propan-1-ol from working solutions of three surface disinfectants to four different types of fabric (A: white pulp and polyester; B: viscose rayon; C: polyester; D: mixture of viscose, cellulose and polyester). The working solutions of each disinfectant were exposed to each fabric for up to 24 h. Before and after exposure, tissues were removed and squeezed in a standardised way. The eluate was used for determination of the concentration of the active ingredient in quadruplicate. The analysis of glutardialdehyde and BAC was performed using high performance liquid chromatography; the analysis of propan-1-ol was done using gas chromatography. BAC was strongly adsorbed to the tissues based on white pulp (up to 61% after 30 min), followed by the viscose rayon tissues (up to 70% after 30 min) and the mixed tissues (up to 54% after 7 h). The polyester fibre tissue adsorbed the smallest amounts of BAC with up to 17% after 15 min. Only with the polyester fibre tissue were BAC concentrations found in the range of the calculated BAC concentrations. Glutardialdehyde and propan-1-ol did not adsorb to any of the fibres. Effective surface disinfection also includes selection of an appropriate fabric.

Keywords: Adsorption; Benzalkonium chloride; Fabric; Surface disinfection
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发表于 2010-4-19 20:41 | 显示全部楼层
41.Impact of hospital-wide infection rate, invasive procedures use and antimicrobial consumption on bacterial resistance inside an intensive care unit 全院感染率、侵入操作和抗生素使用对ICU细菌耐药的影响
我们进行了30个月关注生态环境的研究,测算医院范围内抗生素使用、侵入性操作使用和医院获得性感染对ICU中抗生素耐药的冲击。本研究对ICU中已经诊断为院内感染的病人中分离出来的微生物进行监测。整个医院使用每100人天的氧哌嗪青霉素-他唑巴坦,氟喹诺酮 和头孢菌素规定每日计量(DDD) 分别从1.9增加到2.3 (P < 0.01) ,从4.7增加到 10.3 (P < 0.01),从 12.1 增加到 16.4 (P < 0.01)。ICU中分离的细菌标本(N = 466)中有31.3%多药耐药,其中耐美罗培南克雷伯菌属 (P = 0.01)和耐美罗培南不动杆菌属 (P = 0.02) 耐药性增加。多药耐药率和头孢霉素的规定每日剂量 (P < 0.01)&#8226;和氟喹诺酮的规定每日剂量有正性相关(P = 0.03) 。克雷伯菌属的耐药率与氟喹诺酮和头孢霉素的规定每日剂量有相互关系;不动杆菌属的耐药率与头孢霉素的使用有关,耐甲氧西林金黄色葡萄球菌的比例与氟喹诺酮使用有关。在研究期间ICU中的不断变换的多药耐药率分别与侵入性操作的使用【36.9% (P < 0.001)】和整体医院获得性感染率有关【34.5% (P < 0.01))。ICU 的多药耐药率受整体医院获得性感染率变化和医院范围内ICU 范围外创伤性操作的抗生素使用的影响。

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发表于 2010-4-19 21:00 | 显示全部楼层
45、Educational intervention for preventing bloodborne infection among medical students in China 中国医学生预防血液传播疾病的教育干预
Journal of Hospital Infection   Volume 75, Issue 1, May 2010, Pages 47-51
Summary
尽管已知医学生存在血源性感染的风险,但在中国没有系统的研究、有效的干预计划或指南。我们在医学生中建立的预防指南,贯彻干预和评价知识的有效性。本研究采用群组随机对照研究。所有完成知情同意书的人随机分为干预组和对照组。干预组在进行基线调查后进行教育干预计划,包括一系列讲座和视频。对照组在研究完成后完成同样干预计划。在干预项目开始后3个月和9个月给参与者25项的调查表。在干预前后进行测量包括传播途径、紧急处理和暴露后预防等知识的结果。使用Pearson's χ2-test,分析学生的效力,控制偏倚。以前的血源性致病因素教育干预计划这种干预形式对中国医学生的知识作用有限。

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发表于 2010-4-19 21:11 | 显示全部楼层
英国医院感染杂志2010年第5期
43、High-throughput whole-genome sequencing to dissect the epidemiology of Acinetobacter baumannii isolates from a hospital outbreak 医院感染爆发中鲍曼不动杆菌全通量基因测序
  Journal of Hospital Infection   Volume 75, Issue 1, May 2010, Pages 37-41
Summary
军队和平民病人共同分享护理造成多药耐药鲍曼不动杆菌从军队受害者向平民传播。目前分类技术有助于显示鲍曼不动杆菌分离标本之间的联系,但是它们不能解决从小规模爆发中密切相关分离标本之间的不同,因为传播链通常不清楚。 在最近伯明翰爆发的医院中,6个病人定植多耐药鲍曼不动杆菌的病人使用标准技术不能分辨分离标本。我们使用全基因序列发现在这些分离标本中仅有1个核苷酸具有多态性,使得我们分辨(认识)这种情况下的不寻常的流行病假设。

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发表于 2010-4-23 16:32 | 显示全部楼层
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26、医院流行病学研究:艰难梭菌应对策略
《医院感染杂志》第74卷,第4期,2010年4月,319-325页
摘要
艰难梭菌相关性腹泻(CDAD)仍然是一个重要的感染控制难题。用于查明病例起源的诊断方法和定义尚无定论。为了更好地确定一家英国大型教学医院诊断(全科医生诊所和医院首诊)的新发275例CDAD的流行病学特征,我们开展了前瞻性流行病学研究。研究发现在小于65岁的住院病例中血液病房和重症监护病房的比例最高,达29%。55例患者在入院后48小时内得到诊断,其中按照不同的有关获得性腹泻发病定义有9至25例可被确定为社区获得性病例。在48例社区发病的病例中,这一数字在19至25之间,这些数据与国家卫生局(NHS)认可的数据相比较可能会有差异。所有病例在诊断后被追访了90天并得到了全部归因死亡率数据。在医院诊断的227例病例中,56例(25%)在30天内死亡,其中29%年龄小于65岁。这些死亡病例中86%有死亡鉴定资料。48例社区发病病例中有15例(31%)检出难辨梭菌,有8例(17%)是首要病因(1a或1b)。我们的研究显示出当地流行病学资料对于根据国家卫生局(NHS)认可数据制定艰难梭菌相关性腹泻(CDAD)预防控制措施的应用价值,并可为国家性目标和政策制订提供证据基础。
关键词:抗生素相关性腹泻;艰难梭菌;流行病学;医院获得性感染

纰漏之处敬请斧正啊!

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 楼主| 发表于 2010-4-28 18:51 | 显示全部楼层
美国感染控制杂志2010年第4期
47、Management of a multidrug-resistant Acinetobacter baumannii outbreak in an intensive care unit using novel environmental disinfection: A 38-month report ICU鲍曼不动杆菌爆发处置
American Journal of Infection Control
Volume 38, Issue 4, May 2010, Pages 259-263
Background
Between June 1, 2004, and March 14, 2005, 16 patients in the surgical/medical intensive care unit (ICU) were infected and another 2 were colonized with multidrug-resistant (MDR) Acinetobacter baumannii. We describe the systematic investigation initiated to discover an environmental reservoir and a novel measure taken to terminate the outbreak.

Methods
Cultures were taken from moist areas in the ICU, including sink traps, sink and counter surfaces, drains, and faucets. Strains were characterized using restriction endonuclease analysis. A weekly full drainpipe chase cleansing protocol with sodium hypochlorite (bleach) solution for all 24 ICU and waiting room area sinks connected by common plumbing was initiated in March 2005.

Results
Eleven of 16 infected patients (69%) had a clonal MDR strain, 1 patient (6%) was infected with an unrelated strain, and in 4 patients (25%) strains were not available for typing. The reservoir for the A baumannii clone was detected in a sink trap within one of the ICU patient rooms that likely represented contamination of the entire horizontal drainage system. The bleaching protocol initiated in March 2005 successfully decontaminated the reservoir and eliminated the MDR A baumannii infections.

Conclusion
A systematic search for an environmental reservoir followed by decontamination significantly reduced (P < .01) the incidence of MDR A baumannii infection.

Key Words: Acinetobacter baumannii; environmental disinfection; health care-associated infection; multidrug resistance
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 楼主| 发表于 2010-4-28 18:58 | 显示全部楼层
美国感染控制杂志2010年第4期
48、Survey of employee knowledge and attitudes before and after a multicenter Veterans' Administration quality improvement initiative to reduce nosocomial methicillin-resistant Staphylococcus aureus infections 降低MRSA感染采取质量改进措施后雇员的知识和态度调查

Background
Although guidelines currently recommend prevention practices to decrease in-hospital transmission of infections, increasing adherence to the practices remains a challenge. This study assessed the effect of a multicenter methicillin-resistant Staphylococcus aureus (MRSA) prevention initiative on changes in employees' knowledge, attitudes, and practices.

Methods
Two cross-sectional surveys were distributed at baseline (October 2006) and follow-up (July 2007) at 17 medical centers participating in the Veterans' Administration (VA) MRSA initiative.

Results
Surveys were completed by 1362 employees at baseline and 952 employees at follow-up (representing 57% and 56% of eligible respondents, respectively). Respondents included physicians (9%), nurses (38%), allied health professionals (30%), and other support staff (24%). Of the 5 knowledge items, the mean proportion answered correctly increased slightly from baseline to follow-up (from 71% to 73%; P = .07). The percentage of respondents who believed that MRSA was a problem on their unit increased over time (from 56% to 65%; P < .001). Respondents also reported increased comfort with reminding other staff about proper hand hygiene (from 61% to 70%; P < .001) and contact precautions (from 63% to 70%; P < .002). The percentage of respondents reporting at least one barrier to proper hand hygiene decreased over time (from 25% to 20%; P = .003).

Conclusions
In this multicenter study of VA employees, implementation of a MRSA quality improvement initiative was associated with temporal improvements in knowledge and perceptions regarding MRSA prevention.

Key Words: Methicillin-resistant Staphylococcus aureus; quality improvement; prevention; employee survey; knowledge; attitudes; practices
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 楼主| 发表于 2010-4-28 19:01 | 显示全部楼层
本帖最后由 潮水 于 2010-5-2 16:18 编辑

美国感染控制杂志2010年第4期
(已翻译)49、Outbreak of late-onset group B Streptococcus in a neonatal intensive care unit 新生儿ICU迟发型B族链球菌感染爆发
Background
In September 2007, the Tennessee Department of Health was notified of a cluster of late-onset group B streptococcal (GBS) infections in a neonatal intensive care unit (NICU). Outbreaks of late-onset GBS are rare.

Methods
A case was defined as culture-confirmed invasive GBS infection in a neonate aged ≥7 days, identified in hospital A during August 23 to September 6, 2007. We reviewed medical records; examined NICU microbiology reports; and performed serotyping, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST) on invasive isolates. Maternal GBS screening, prophylaxis, and infection control policies were reviewed and staff practices observed.

Results
Five cases of late-onset GBS were identified. None of the mothers of the infants received optimal GBS prophylaxis. Patient isolates were of 2 serotypes, 3 PFGE patterns, and 2 MLST patterns. Three isolates were indistinguishable on subtyping. These 3 cases were clustered in time. No common health care providers were identified. Infection control deviations in the NICU were observed.

Conclusion
We identified a multiclonal cluster of 5 late-onset GBS cases. Multiple factors likely contributed to the outbreak, including nosocomial transmission of GBS. Further efforts to prevent late-onset GBS disease are necessary.

Key Words: Outbreak; late-onset group B Streptococcus; neonatal intensive care unit
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 楼主| 发表于 2010-4-29 21:55 | 显示全部楼层
美国感染控制杂志2010年第4期
50、Evaluation of the decontamination efficacy of new and reprocessed microfiber cleaning cloth compared with other commonly used cleaning cloths in the hospital超细纤维布与普通抹布去污效果评估
Background
The aim of this study was to investigate the decontamination capacity of 4 different types of cleaning cloths (microfiber cleaning cloth, cotton cloth, sponge cloth, and disposable paper towels) commonly used in hospital in their ability to reduce microbial loads from a surface used dry or wet in new condition. All of the cloths except disposable paper towels were also compared after 10 and 20 times of reprocessing, respectively, at 90°C for 5minutes in a washing machine.

Methods
Stappylococcus aureus (ATCC 6538) and Escherichia coli (ATCC 8739) were used as test organisms. Test organisms were then added to a test soil (6% bovine serum albumin and 0.6% sheep erythrocytes) resulting in a controlled concentration of 5×107 colony-forming units per milliliter in the final test suspension. Standardized tiles measuring 5×5cm were used as test surface.

Results
Microfiber cloths showed the best results when being used in new condition. However, after multiple reprocessing, cotton cloth showed the best overall efficacy.

Conclusion
We therefore suggest that the choice of the cleaning utilities should be based on their decontamination efficacy after several reprocessings and recommend the establishment of strict and well-defined cleaning and disinfection protocols.

Key Words: Microfiber, decontamination, reprocessing, cloth, cleaning
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 楼主| 发表于 2010-4-29 22:01 | 显示全部楼层
美国感染控制杂志2010年第4期
51、Control of methicillin-resistant Staphylococcus aureus in planktonic form and biofilms: A biocidal efficacy study of nonthermal dielectric-barrier discharge plasma生物膜MRSA控制
Background
Bacterial contamination of surfaces with methicillin-resistant Staphylococcus aureus (MRSA) is a serious problem in the hospital environment and is responsible for significant nosocomial infections. The pathogenic contaminants form biofilms, which are difficult to treat with routine biocides. Thus, a continuous search for novel disinfection methods is essential for effective infection control measures. This demonstration of a novel technique for the control of virulent pathogens in planktonic form as well as in established biofilms may provide a progressive alternative to standard methodology.

Methods
We evaluated a novel technique of normal atmospheric nonthermal plasma known as floating-electrode dielectric-barrier discharge (FE-DBD) plasma against a control of planktonic and biofilm forms of Escherichia coli, S aureus, multidrug-resistant methicillin-resistant S aureus (MRSA) -95 (clinical isolate), -USA300, and -USA400, using widely accepted techniques such as colony count assay, LIVE/DEAD BacLight Bacterial Viability assay, and XTT (2,3-Bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) assay.

Results
Exposure of free living planktonic forms of E coli, S aureus, and MRSA were rapidly inactivated by DBD plasma. Approximately 107 bacterial cells were completely (100%) killed, whereas 108 and 109 were reduced by approximately 90% to 95% and 40% to 45%, respectively, in less than 60 seconds (7.8 J/cm2) and completely disinfected in ≤120 seconds. In established biofilms, the susceptibility of MRSA USA400 was comparable with USA300 but less susceptible than MRSA95 (clinical isolate), S aureus, and E coli (P < .05) to FE-DBD plasma, and plasma was able to kill MRSA more than 60% within 15 seconds (1.95 J/cm2). The killing responses were plasma exposure-time dependent, and cell density dependent. The plasma was able disinfect surfaces in a less than 120 seconds.

Conclusion
Application of DBD plasma can be a valuable decontamination technique for the removal of planktonic and biofilm-embedded bacteria such as MRSA -USA 300, -USA 400, methicillin-sensitive S aureus (MSSA), and E coli, the more common hospital contaminants. Of interest, E coli was more resistant than S aureus phenotypes.

Key Words: Dielectric-Barrier Discharge plasma, dielectric barrier discharge, nonthermal plasma, Escherichia coli, Staphylococcus aureus, methicillin-resistant S aureus, MRSA, infection control
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 楼主| 发表于 2010-4-29 22:06 | 显示全部楼层
美国感染控制杂志2010年第4期
52、Lessons learned from the anti-SARS quarantine experience in a hospital-based fever screening station in Taiwan SARS检疫经验教训
Background
Severe acute respiratory syndrome (SARS) was the first major novel infectious disease to hit the international community in the 21st century. While SARS was sweeping over almost 30 countries, most hospitals in Taiwan instituted mandatory quarantine measures, one of the most effective public health strategies for preventing disease transmission. We explored the anti-SARS quarantine experience of patients in a hospital-based fever screening station.

Methods
We conducted a phenomenologic, qualitative study using semistructured telephone interviews during the SARS outbreak in Taiwan. Seventeen patients with fever who were quarantined in the fever screening station of a hospital emergency department for at least 2hours were recruited into this study.

Results
Data analysis using Collaizi's 9 steps revealed 2 categories—external burden and internal struggle—and 6 themes regarding patients' quarantine experience. External burden included 3 themes: (1) bearing the uncomfortable surroundings, (2) facing discrimination, and (3) lacking in-person family support. Internal struggle consisted of 3 themes: (1) struggle with being quarantined, (2) struggle with emotional turmoil, and (3) struggle with possible SARS diagnosis.

Conclusion
These results will contribute to sensitizing health care professionals to empathize with quarantined persons while providing quality quarantine care and other infection control measures.

Key Words: Severe acute respiratory syndrome (SARS), quarantine, phenomenologic inquiry
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 楼主| 发表于 2010-4-29 22:06 | 显示全部楼层
本帖最后由 潮水 于 2010-4-29 22:13 编辑

美国感染控制杂志2010年第4期
52、Lessons learned from the anti-SARS quarantine experience in a hospital-based fever screening station in Taiwan SARS检疫经验教训
Background
Severe acute respiratory syndrome (SARS) was the first major novel infectious disease to hit the international community in the 21st century. While SARS was sweeping over almost 30 countries, most hospitals in Taiwan instituted mandatory quarantine measures, one of the most effective public health strategies for preventing disease transmission. We explored the anti-SARS quarantine experience of patients in a hospital-based fever screening station.

Methods
We conducted a phenomenologic, qualitative study using semistructured telephone interviews during the SARS outbreak in Taiwan. Seventeen patients with fever who were quarantined in the fever screening station of a hospital emergency department for at least 2hours were recruited into this study.

Results
Data analysis using Collaizi's 9 steps revealed 2 categories—external burden and internal struggle—and 6 themes regarding patients' quarantine experience. External burden included 3 themes: (1) bearing the uncomfortable surroundings, (2) facing discrimination, and (3) lacking in-person family support. Internal struggle consisted of 3 themes: (1) struggle with being quarantined, (2) struggle with emotional turmoil, and (3) struggle with possible SARS diagnosis.

Conclusion
These results will contribute to sensitizing health care professionals to empathize with quarantined persons while providing quality quarantine care and other infection control measures.

Key Words: Severe acute respiratory syndrome (SARS), quarantine, phenomenologic inquiry
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 楼主| 发表于 2010-4-29 22:13 | 显示全部楼层
本帖最后由 潮水 于 2010-5-2 16:18 编辑

美国感染控制杂志2010年第4期
(已翻译)53、Nosocomial infections caused by community-associated methicillin-resistant Staphylococcus aureus in Colombia社区相关MRSA引起的医院感染
Background
Community-associated methicillin-resistant Staphylococcus aureus strains (CA-MRSA) have emerged as the causative agent of health care-associated infections.

Methods
An observational and prospective study was carried out in 5 hospitals in Bogotá, Colombia; severe MRSA infections were identified, and their origin led to classification as health care-associated (HA-MRSA), community-associated, or nosocomial infections. MRSA isolates were analyzed by SCCmec, pulsed-field gel electrophoresis, multilocus sequence typing, and virulence factors.

Results
Twenty-six (10.4%) CA-MRSA nosocomial infection-causing strains (eg, USA300) were detected in 250 MRSA infection isolates in mainly primary bacteremia and surgical site infections. The mortality related to nosocomial infection by CA-MRSA was 27%.

Conclusion
The presence of nosocomial infection by CA-MRSA in Colombia was confirmed.

Key Words: Methicillin-resistant Staphylococcus aureus, Colombia, nosocomial infections
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