文摘翻译有奖（2010年国外医院感染相关杂志）

gemao

英国医院感染杂志2010年第6期
72、Can ‘search and destroy’ reduce nosocomial meticillin-resistant Staphylococcus aureus in an Irish hospital? 搜索并摧毁计划能减少MRSA医院感染吗
在爱尔兰，健康和儿童机构推荐在入院时对MRSA的高危病人进行筛选，隔离这些病人直到证明MRSA阴性，清除任何发现的MRSA。这些措施根据一项称为“搜索、摧毁”计划，据说在斯堪的纳维亚使用此计划成功减少了MRSA。但是在爱尔兰很少有关于“搜索摧毁”计划的报告。本研究为一项采用干预队列研究进行设计的定量准实验研究。在医院中已经使用减少MRSA报告时间（2007）和先发隔离措施（2008），并制定住院MRSA筛选计划。监测干预后的MRSA感染率和定植率，并与干预前的基线比率进行对比。在2007年和2008年，院内MRSA感染率和定植率均有下降。但是由于研究是准实验设计和医院内MRSA流行低，因此没有建立因果联系。

gemao

英国医院感染杂志2010年第6期
69、Speed of molecular detection techniques for meticillin-resistant Staphylococcus aureus admission screening in an acute care hospital MRSA入院筛查分子生物学快速检测Summary
对MRSA携带者的主动筛选是紧急医护医院控制策略的基本组成部分。最近推荐MRSA的分子分析筛选技术、定时分析模式可以明显减少标本的处理时间，我们调查使用分子分析技术的时间并与传统培养技术的时间进行对比。在为期4个月的研究时间中，所有高危病人（n=44）和已知MRSA阳性的再入院病人（N=41），在入院时进行MRSA筛选。每组都有较长的分析前时间间隔，自入院到采集标本，再到实验室，是全部过程的关键因素。样本处理时间上，与传统培养技术相比，使用分子分析可以减少样本处理时间的一个重要因素。由于分析前的时间较长，除了与PCR技术相关的高额费用外，不推荐使用分子技术进行入院筛选。但是在再入院病人，快速的检测结果可以节省不必要的隔离天数，对医院的经济有益。PCR检测可能对再入院筛选有用。总之，在使用昂贵的PCR技术之前，应调查当地MRSA筛选的政策。

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美国临床感染病杂志2010年第4期
75、Rates of Hospital-Acquired Respiratory Illness in Bangladeshi Tertiary Care Hospitals: Results from a Low-Cost Pilot Surveillance Strategy医院获得性呼吸道感染率
Background.Patients hospitalized in resource-poor health care settings are at increased risk for hospital-acquired respiratory infections due to inadequate infrastructure.

Methods.From 1 April 2007 through 31 March 2008, we used a low-cost surveillance strategy to identify new onset of respiratory symptoms in patients hospitalized for >72 h and in health care workers in medicine and pediatric wards at 3 public tertiary care hospitals in Bangladesh.

Results.During 46,273 patient-days of observation, we recorded 136 episodes of hospital-acquired respiratory disease, representing 1.7% of all patient hospital admissions; rates by ward ranged from 0.8 to 15.8 cases per 1000 patient-days at risk. We identified 22 clusters of respiratory disease, 3 of which included both patients and health care workers. Of 226 of heath care workers who worked on our surveillance wards, 61 (27%) experienced a respiratory illness during the study period. The cost of surveillance was US$43 per month per ward plus 30 min per day in data collection.

Conclusions.Patients on these study wards frequently experienced hospital-acquired respiratory infections, including 1 in every 20 patients hospitalized for >72 h on 1 ward. The surveillance method was useful in calculating rates of hospital-acquired respiratory illness and could be used to enhance capacity to quickly detect outbreaks of respiratory disease in health care facilities where systems for outbreak detection are currently limited and to test interventions to reduce transmission of respiratory pathogens in resource-poor settings.

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美国临床感染病杂志2010年第4期
76、Prospective Surveillance for Invasive Fungal Infections in Hematopoietic Stem Cell Transplant Recipients, 2001–2006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database造血干细胞移植受者侵入性真菌感染监测
Background.The incidence and epidemiology of invasive fungal infections (IFIs), a leading cause of death among hematopoeitic stem cell transplant (HSCT) recipients, are derived mainly from single-institution retrospective studies.

Methods.The Transplant Associated Infections Surveillance Network, a network of 23 US transplant centers, prospectively enrolled HSCT recipients with proven and probable IFIs occurring between March 2001 and March 2006. We collected denominator data on all HSCTs preformed at each site and clinical, diagnostic, and outcome information for each IFI case. To estimate trends in IFI, we calculated the 12-month cumulative incidence among 9 sequential subcohorts.

Results.We identified 983 IFIs among 875 HSCT recipients. The median age of the patients was 49 years; 60% were male. Invasive aspergillosis (43%), invasive candidiasis (28%), and zygomycosis (8%) were the most common IFIs. Fifty-nine percent and 61% of IFIs were recognized within 60 days of neutropenia and graft-versus-host disease, respectively. Median onset of candidiasis and aspergillosis after HSCT was 61 days and 99 days, respectively. Within a cohort of 16,200 HSCT recipients who received their first transplants between March 2001 and September 2005 and were followed up through March 2006, we identified 718 IFIs in 639 persons. Twelve-month cumulative incidences, based on the first IFI, were 7.7 cases per 100 transplants for matched unrelated allogeneic, 8.1 cases per 100 transplants for mismatched-related allogeneic, 5.8 cases per 100 transplants for matched-related allogeneic, and 1.2 cases per 100 transplants for autologous HSCT.

Conclusions.In this national prospective surveillance study of IFIs in HSCT recipients, the cumulative incidence was highest for aspergillosis, followed by candidiasis. Understanding the epidemiologic trends and burden of IFIs may lead to improved management strategies and study design.

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美国临床感染病杂志2010年第4期
77、Invasive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET)器官移植受者侵入性真菌感染
Background.Invasive fungal infections (IFIs) are a major cause of morbidity and mortality among organ transplant recipients. Multicenter prospective surveillance data to determine disease burden and secular trends are lacking.

Methods.The Transplant-Associated Infection Surveillance Network (TRANSNET) is a consortium of 23 US transplant centers, including 15 that contributed to the organ transplant recipient dataset. We prospectively identified IFIs among organ transplant recipients from March, 2001 through March, 2006 at these sites. To explore trends, we calculated the 12-month cumulative incidence among 9 sequential cohorts.

Results.During the surveillance period, 1208 IFIs were identified among 1063 organ transplant recipients. The most common IFIs were invasive candidiasis (53%), invasive aspergillosis (19%), cryptococcosis (8%), non-Aspergillus molds (8%), endemic fungi (5%), and zygomycosis (2%). Median time to onset of candidiasis, aspergillosis, and cryptococcosis was 103, 184, and 575 days, respectively. Among a cohort of 16,808 patients who underwent transplantation between March 2001 and September 2005 and were followed through March 2006, a total of 729 IFIs were reported among 633 persons. One-year cumulative incidences of the first IFI were 11.6%, 8.6%, 4.7%, 4.0%, 3.4%, and 1.3% for small bowel, lung, liver, heart, pancreas, and kidney transplant recipients, respectively. One-year incidence was highest for invasive candidiasis (1.95%) and aspergillosis (0.65%). Trend analysis showed a slight increase in cumulative incidence from 2002 to 2005.

Conclusions.We detected a slight increase in IFIs during the surveillance period. These data provide important insights into the timing and incidence of IFIs among organ transplant recipients, which can help to focus effective prevention and treatment strategies.

gemao

美国临床感染病杂志2010年第4期75、Rates of Hospital-Acquired Respiratory Illness in Bangladeshi Tertiary Care Hospitals: Results from a Low-Cost Pilot Surveillance Strategy
医院获得性呼吸道感染率Background.Patients hospitalized in resource-poor health care settings are at increased risk for hospital-acquired respiratory infections due to inadequate infrastructure.背景：居住在健康环境差的病人由于基础设施不足发生医院感染的风险升高。方法：从2007年4月1日至2008年3月31日，我们在Bangladesh的3家地区公共医院内科和儿科工作人员中使用低成本检测策略发现在住院超过72小时病人新发生的呼吸症状，结果：在观察的46273个病人住院日中，出现136次院内感染，占所有住院病人的1.7%，不同的病房发生率从每1000人日0.8-15.8个病例不等。22个呼吸道疾病菌株，其中3个涉及病人和医务工作者。在我们研究期间监控的病房中，226个健康工作用者中61例经历过呼吸道疾病，在收集数据中检测成本是每月每间病房43美元。我们发现结论 在这些研究病房中的病人院内感染率，在住院在一间病房超过72小时的病人中，每20人就有1例。此监测系统用于提供医院感染呼吸道感染发生率，增加在健康工作人群中发现快速爆发的能力，在爆发监测系统中目前受限，在资源较差的环境下，检查减少呼吸道病原菌传播的干预措施。

天鹅城

这翻译也能得分？上面的那篇翻译很多句子都读不通

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回复 126# 天鹅城
欢迎对译文进行编译，也有加分哦！

chengdw116

我英语水平不好,
但在这儿可以对照学习一下医学英语
感谢!

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回复 128# chengdw116
欢迎参加有奖文摘编译！

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英国医院感染杂志2010年第7期
78、Hospital-acquired, laboratory-confirmed bloodstream infections: linking national surveillance data to clinical and financial hospital data to estimate increased length of stay and healthcare costs 医院获得性血流感染监测
Summary
This matched cohort study estimates the effect of hospital-acquired bloodstream infection (HA-BSI) on length of stay (LOS) and costs during hospitalisation of 1839 patients (age range <1 to >80 years) gathered from 19 acute hospitals in Belgium. A second objective was to evaluate the impact of the choice of matching criteria. Data from national surveillance of HA-BSI were linked to hospital administrative discharge data, with respect for the patients' right to confidentiality of their health record. Controls were identified based on a set of matching factors: hospital, All-Patient Refined Diagnosis Related Groups, age, principal diagnosis, Charlson Comorbidity Index and time to infection. The results showed that, depending on the choice of matching factors, the estimation of additional LOS decreased from 26 to 10 days, with the most critical factor being the time to infection. The additional LOS attributable to HA-BSI was 9.9 days [95% confidence interval (CI): 7.8, 11.9]. The additional cost per infection was

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英国医院感染杂志2010年第7期
79、The 2007 Belgian national prevalence survey for hospital-acquired infections 比利时2007年医院感染调查
Summary
Despite ongoing targeted surveillance efforts, no overall in-hospital prevalence data for hospital-acquired infections (HAIs) have been published for Belgium. Sixty-three Belgian acute hospitals participated in a point-prevalence study among either all patients admitted in their institution or 50% of the patients in each ward. HAIs were registered bed-site at a single day per ward during the period October–November 2007. The diagnosis was made according to the Centers for Disease Control and Prevention (CDC) criteria implemented in a custom-made rule-based software expert system available on a portable computer. The total number of patients surveyed nationally was 17 343, from 543 distinct hospital wards. The overall prevalence of HAIs was 7.1% (95% confidence interval: 6.7–7.4%); 6.2% (5.9–6.5%) of the patients suffered from at least one HAI. Prevalence of HAIs on adult intensive care was 31.3%. The major proportion of HAIs was observed among patients admitted on non-intensive care unit (non-ICU) wards, mainly on the wards of internal medicine, surgery, geriatrics and rehabilitation. Urinary tract infections were the most common type of HAI at geriatric and rehabilitation wards. This study demonstrates that the use of a portable computer system with a designated expert system for diagnosing HAIs according to the CDC criteria in a large point prevalence study is feasible and may reduce the within-subject variation. In Belgium, the prevalence of HAIs in acute hospitals thus identified is similar to that of neighbouring countries. As more than 80% of all HAIs occur on non-ICU wards, preventive efforts need to extend beyond the ICU.

Keywords: Computer assisted registration; Hospital-acquired infection; Point prevalence study; National surveillance system

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英国医院感染杂志2010年第7期
80、Prevalence of nosocomial infections in The Netherlands, 2007–2008: results of the first four national studies 荷兰2007-2008年医院感染流行Summary
The PREZIES national network for the surveillance of nosocomial infections (NI) in The Netherlands has organised a national prevalence study twice a year since 2007. This paper presents the results of the first four surveys. Of 95 hospitals in The Netherlands, 41 participated in 92 surveys and 26 937 patients were included. On the survey day 6.2% had an NI (prevalence of infections 7.2%). The prevalence of infections varied from 1.4% to 16.5% between hospitals. The prevalence of surgical site infections was 4.8%, pneumonia 1.1%, primary bloodstream infection 0.5% and symptomatic urinary tract infection 1.7%. On admission to hospital, 3.3% of patients had an NI. On the day of the survey, 30.9% of the patients were receiving antibiotics. The use of antibiotics as well as medical devices differed considerably between hospitals. Both the prevalence of NI in The Netherlands and the use of antibiotics and devices were comparable to other European countries.

Keywords: Antibiotic use; Device use; Hospital-acquired infection; National survey; Nosocomial infection; Prevalence survey

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英国医院感染杂志2010年第7期
81、Clinical relevance of surgical site infection as defined by the criteria of the Centers for Disease Control and Prevention 按美国CDC标准诊断的临床相关手术部位感染
Summary
Surgical site infection (SSI) is a common complication after abdominal surgery and the Centers for Disease Control and Prevention (CDC) criteria are commonly used for diagnosis and surveillance. The aim of this study was to evaluate whether SSI diagnosed according to CDC is clinically relevant (CRSSI) and whether there is agreement between evaluations according to the CDC criteria, the ASEPSIS score (Additional treatment, presence of Serous discharge, Erythema, Purulent exudate, Separation of the deep tissues, Isolation of bacteria and duration of Stay) and CRSSI. We included 54 patients diagnosed with SSI and a matched control group (N = 46) without SSI according to the CDC criteria after laparotomy. Two blinded experienced surgeons evaluated the hospital records and determined whether patients had CRSSI, based on the following criteria: antibiotic treatment, surgical intervention, prolonged hospital stay or referral to an intensive care unit for SSI. The rate of CRSSI was 38 of 54 (70%) in patients with CDC-diagnosed SSI and none in patients without a CDC-diagnosed SSI. Sixty-one percent of the CDC-diagnosed SSIs were superficial, of which 48% were considered clinically relevant. There was substantial agreement between the CDC criteria and CRSSI [kappa = 0.69; 95% confidence interval (CI): 0.55–0.83] and fair agreement between the ASEPSIS score and the CDC criteria (kappa = 0.23; 95% CI: 0–0.49) and between the ASEPSIS score and CRSSI (kappa = 0.39; 95% CI: 0.17–0.61). The CDC criteria represent a suitable standard definition for monitoring and identifying SSI, even if some cases of less clinically significant superficial SSI are included.

Keywords: Surgical site infection; CDC criteria; ASEPSIS score; Clinical monitoring

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英国医院感染杂志2010年第7期
82、Discharge after discharge: predicting surgical site infections after patients leave hospital 病人出院后手术部位感染判定
Summary
In this population-based retrospective cohort study, we examined the frequency, severity, and prediction of post-discharge surgical site infections (SSIs). We evaluated all patients admitted for their first elective surgical procedure in Ontario, Canada, between 1 April 2002 and 31 March 2008. Procedure and patient characteristics were derived from linked hospital, emergency room and physician claims databases within Canada's universal healthcare system. The 30 day risk of SSI was derived from the initial hospital admission, outpatient consultations, return emergency room visits and readmissions. The cohort included 622 683 patients, of whom 84 081 (13.5%) were diagnosed with SSI, and more than half (48 725) were diagnosed post-discharge. Post-discharge infections were associated with an increased risk of reoperation (odds ratio: 2.28; 95% confidence interval: 2.11–2.48), return emergency room visit (9.08; 8.89–9.27), and readmission (6.16; 5.98–6.35). The most common risk index predicted incremental increases in the risk of in-hospital SSI, but did not predict increases in the risk of post-discharge infection. Patients with post-discharge infections had baseline characteristics more akin to uninfected patients than patients with in-hospital infections. Predictors of post-discharge infection included shorter procedure duration, shorter length of stay, rural residence, alcoholism, diabetes and obesity. Post-discharge SSIs are frequent, severe, scattered over time and location, and hard to predict using common risk indices. They represent an important hidden burden in our healthcare system.

Keywords: Elective surgery; Post-discharge infection; Risk; Surgical site infection

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英国医院感染杂志2010年第7期
83、Risk factors for device-associated infection related to organisational characteristics of intensive care units: findings from the Korean Nosocomial Infections Surveillance System 设备相关感染的危险因素
Summary
Device-associated infections (DAIs) have been the major causes of morbidity and mortality of patients in intensive care units (ICUs). This study evaluated the risk factors for DAIs in ICUs. Ninety-six medical or surgical ICUs of 56 hospitals participated in the Korean Nosocomial Infections Surveillance System between July 2007 and June 2008. The occurrence of catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CABSI), and ventilator-associated pneumonia (VAP) were monitored and DAI rates were calculated. Data associated with ICU characteristics were collected and Poisson regression was used for statistical analysis. Rates of CAUTI, CABSI, and VAP were 3.87 per 1000 urinary catheter days, 2.23 per 1000 central line days, and 1.89 per 1000 mechanical ventilator days, respectively. Rates of CAUTI were higher in ICUs in Seoul (P = 0.032) and ICUs of major teaching hospitals (P = 0.010). The ICUs of university-affiliated hospitals showed lower CAUTI rates (P = 0.013). CABSI rates were higher in Seoul (P = 0.001) and in medical ICUs (P = 0.026). VAP rates were lower in ICUs of hospitals with more than 900 beds compared with hospitals with 400–699 beds (P = 0.026). VAP rates were higher in surgical ICUs (P < 0.0001) and increased 1.13-fold with each 100-unit increase in beds per infection control professional (P = 0.003). The organisational and institutional characteristics of ICUs may influence DAI rates and there is a need for improvement in the incidence of VAP, CAUTI or CABSI.

Keywords: Device-associated infection; Intensive care unit; Nosocomial infection; Surveillance; Ventilator-associated pneumonia

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英国医院感染杂志2010年第7期
84、Surveillance of selected post-caesarean infections based on electronic registries: validation study including post-discharge infections 剖腹产后感染监测
Summary
The importance of surveillance of post-discharge infections has increased as a consequence of shorter hospital stay after surgical procedures. This study examined the ability of a computer-based surveillance system to identify urinary tract infections (UTIs) and postoperative wound infections (PWIs) within 30 days after caesarean section. We assessed the use of data from various electronic registries to identify patients with post-caesarean UTI and PWI classified according to a reference standard. The standard was based on information from medical records and self-reported data (questionnaire) using modified Centers for Disease Control and Prevention definitions. The sensitivity of the computer system in detecting UTI diagnosed during hospital stay, readmission or at visits to hospital outpatient clinics was 80.0%; the specificity was 99.9%. For post-discharge UTIs diagnosed outside the hospital, sensitivity and specificity were 76.3% and 99.9%, respectively. For PWIs diagnosed in hospital and post-discharge outside hospital, sensitivities were 77.1% and 68.9%, and the specificities 99.5% and 98.2%. We conclude that a computer-based surveillance system may identify in-hospital infections and post-discharge infections with a relatively high sensitivity and excellent specificity.

Keywords: Electronic surveillance; Post-caesarean infections; Post-discharge infections; Validation study

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英国医院感染杂志2010年第7期
85、 Surveillance and endemic vancomycin-resistant enterococci: some success in control is possible VRE流行与监测
Summary
Vancomycin-resistant enterococci (VRE) are prevalent in many Irish hospitals. We analysed surveillance data from 2001 to 2008 in a centre where VRE is endemic. All clinically significant enterococci were tested for susceptibility to vancomycin. All intensive care unit admissions were screened on admission and weekly thereafter. Interventions included isolating/cohorting VRE patients, monthly prevalence surveys of VRE patients, the introduction of an electronic alert system, programmes to improve hand and environmental hygiene, and the appointment of an antibiotic pharmacist. There was a significant increase in the number of positive VRE screening samples from 2001 (1.96 patients with positive VRE screens per 10 000 bed-days) to 2006 (4.98 per 10 000 bed-days) (P ≤ 0.001) with a decrease in 2007 (3.18 per 10 000 bed-days) (P ≤ 0.01). The number of VRE bloodstream infections (BSI) increased from 0.09 BSI per 10 000 bed-days in 2001 to 0.78 per 10 000 bed-days in 2005 (P ≤ 0.001) but decreased subsequently. Linear regression analysis indicated a significant association between new cases of VRE and non-isolated VRE patients, especially between May 2005 and December 2006 [P = 0.009; 95% confidence interval (CI): 0.08–0.46] and between May 2005 and December 2008 (P = 0.008; 95% CI: 0.06–0.46). Routine surveillance for VRE together with other measures can control VRE BSI and colonisation, even where VRE is endemic, and where facilities are constrained.

Keywords: Bloodstream infection; Isolation; Surveillance; Vancomycin; Vancomycin-resistant enterococci

gemao

Summary
摘要：耐万古霉素肠球菌已经在爱尔兰医院中开始流行，我们分析了一家VRE流行地区的医疗中心2001年至2008年的监测数据。所有临床表现肠球菌都进行万古霉素易感性检测。所有ICU住院病人在住院时接受筛选，此后每周进行筛选检查。干预措施包括隔离/分组VRE病人，每月进行VRE病人患病率的调查，引入电子警告系统，改善手卫生和环境卫生的计划，任命抗菌素药师。从2001年至2006年，VRE筛选阳性的数量明显增加(2001年每10000床日数有1.96个VRE阳性病人，2006年每10000床日数有4.98个VRE阳性病人) (P ≤ 0.001) ，到2007年出现下降（每10000床日数有3.18个VRE阳性病人）(P ≤ 0.01)。VRE血流感染的（BSI）数量从2001年的每10000床日数0.09BSI 增加到2005年的每10000床日数0.78BSI (P ≤ 0.001)，但随后出现下降。线性回归分析显示在新的VRE病例与非隔离VRE病人之间存在明显联系，特别是在2005年5月至2006年12月之间[P = 0.009; 95% confidence interval (CI): 0.08–0.46]和2005年5月至2008年12月之间(P = 0.008; 95% CI: 0.06–0.46)。即使在VRE流行、医疗设施受限的地区，VRE的常规监测也可以与其他方法一起控制VRE BSI和定植。

gemao

Summary
在以人口为基数的回顾性队列研究中，我们检查了出院后手术部位感染（SSI）的发生频率、严重性和预见性。我们评价了2002年4月1日至2008年3月31日在加拿大奥兰多市，所有首次选择性手术病人。手术方式和病人特点来自加拿大全民健康系统中相关医院、急诊室和医师索赔数据库。SSI 30天风险来自初次住院、门诊咨询、再次急诊就诊和再入院。队列包括622683名病人，其中84 081 (13.5%)诊断为SSI，超过一半(48 725)诊断为出院后感染，出院后感染有增加的再手术风险(odds ratio: 2.28; 95% confidence interval: 2.11–2.48)，再次急诊就诊风险(9.08; 8.89–9.27)和再入院风险(6.16; 5.98–6.35)。最常见的风险指数可以预计住院SSI风险增加，但不能预计出院后感染风险增加。出院后感染病人的基线特征与住院内感染病人相比，与非感染病人更相似（类似）。出院后感染的预测因素包括手术操作时间短，住院时间短，居住在农村、酗酒者，糖尿病和肥胖，出院后SSI时常发生，严重，随时间和地区分散，用常规风险指数难以预测。他们成为我们健康系统中重要的隐藏负担。