大卫版主帮助我查找几篇英文文献，先谢了！
1、How outbreaks can contribute to prevention of nosocomial infection: analysis of 1,022 outbreaks.
To describe the epidemiology of nosocomial outbreaks published in the scientific literature. DESIGN: Descriptive information was obtained from a sample of 1,022 published nosocomial outbreaks from 1966 to 2002. METHODS: Published nosocomial outbreaks of the most important nosocomial pathogens were included in the database. A structured questionnaire was devised to extract information in a systematic manner on nosocomial outbreaks published in the literature. The following items were used: the reference, type of study (case reports or studies applying epidemiologic or fingerprinting methods), type of microorganism, setting, patients and personnel involved, type of infection, source of infection, mode of transmission, risk factors identified, and preventive measures applied. RESULTS: Bloodstream infection was the most frequently identified type of infection (37.0%), followed by gastrointestinal infection (28.5%) and pneumonia (22.9%). In 37% of the outbreaks, the authors were not able to identify the sources. The most frequent sources were patients (25.7%), followed by medical equipment or devices (11.9%), the environment (11.6%), and the staff (10.9%). The mode of transmission remained unclear in 28.3% of the outbreaks. Transmission was by contact in 45.3%, by invasive technique in 16.1%, and through the air in 15.0%. The percentage of outbreaks investigated by case-control studies or cohort studies over the years was small (21% and 9%, respectively, for the whole time period). CONCLUSION: Outbreak reports in the literature are a valuable resource and should be used for educational purposes as well as for preparing outbreak investigations.
——Infect Control Hosp Epidemiol. 2005 Apr;26(4):357-61.
2、Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review.
There have been few recent studies demonstrating a definitive association between the transmission of airborne infections and the ventilation of buildings. The severe acute respiratory syndrome (SARS) epidemic in 2003 and current concerns about the risk of an avian influenza (H5N1) pandemic, have made a review of this area timely. We searched the major literature databases between 1960 and 2005, and then screened titles and abstracts, and finally selected 40 original studies based on a set of criteria. We established a review panel comprising medical and engineering experts in the fields of microbiology, medicine, epidemiology, indoor air quality, building ventilation, etc. Most panel members had experience with research into the 2003 SARS epidemic. The panel systematically assessed 40 original studies through both individual assessment and a 2-day face-to-face consensus meeting. Ten of 40 studies reviewed were considered to be conclusive with regard to the association between building ventilation and the transmission of airborne infection. There is strong and sufficient evidence to demonstrate the association between ventilation, air movements in buildings and the transmission/spread of infectious diseases such as measles, tuberculosis, chickenpox, influenza, smallpox and SARS. There is insufficient data to specify and quantify the minimum ventilation requirements in hospitals, schools, offices, homes and isolation rooms in relation to spread of infectious diseases via the airborne route. PRACTICAL IMPLICATION: The strong and sufficient evidence of the association between ventilation, the control of airflow direction in buildings, and the transmission and spread of infectious diseases supports the use of negatively pressurized isolation rooms for patients with these diseases in hospitals, in addition to the use of other engineering control methods. However, the lack of sufficient data on the specification and quantification of the minimum ventilation requirements in hospitals, schools and offices in relation to the spread of airborne infectious diseases, suggest the existence of a knowledge gap. Our study reveals a strong need for a multidisciplinary study in investigating disease outbreaks, and the impact of indoor air environments on the spread of airborne infectious diseases.
——Indoor Air. 2007 Feb;17(1):2-18
3、A cover up? Potential risks of wearing theatre clothing outside theatre.
A report from the Hospital Infection Society Working Group (2002) examined ritualistic practices in theatre and evidence was sought to establish which practices could be supported with clear scientific evidence. The report stated that there is little or no research to show that wearing theatre attire outside the theatre and returning without changing into clean theatre attire increases wound infection rates. It is difficult to implement infection control practices on a scientific basis as there is often a lack of evidence to support the practice. Moreover, many practices are grounded in 'this is the way things are done around here' (Ward 2000).
——J Perioper Pract. 2006 Jan;16(1):30-3, 35-41 .
4、Preventing ventilator-associated pneumonia: an evidence-based approach of modifiable risk factors.
5、Infection control and the prevention of nosocomial infections in the intensive care unit.
6、Disposable surgical face masks: a systematic review.
Surgical face masks were originally developed to contain and filter droplets of microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound. Surgical face masks have recently been advocated as a protective barrier between the surgical team and the patient, but the role of the surgical face mask as an effective measure in preventing surgical wound infections is questionable. The aim of the systematic review is to identify and review all randomised controlled trials evaluating disposable surgical face masks worn by the surgical team during clean surgery to prevent postoperative surgical wound infection. All relevant publications about disposable surgical face masks were sought through the Specialised Trials Register of the Cochrane Wounds Group (March 2001). Manufacturers and distributors of disposable surgical masks as well as professional organisations including the National Association of Theatre Nurses and the Association of Operating Room Nurses were contacted for details of unpublished and ongoing studies. Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing the use of disposable surgical masks with the use of no mask were included. Main results: Two randomised controlled trials were included involving a total of 1453 patients. In a small trial there was a trend towards masks being associated with fewer infections, whereas in a large trial there was no difference in infection rates between the masked and unmasked group. Neither trial accounted for cluster randomisation in the analysis. Reviewers' conclusions: From the limited results it is unclear whether wearing surgical face masks results in any harm or benefit to the patient undergoing clean surgery.
——Can Oper Room Nurs J. 2005 Sep;23(3):20-1, 24-5, 33-8.
7、Evidence of control and prevention of surgical site infection by shoe covers and private shoes: a systematic literature review
The study is about shoe cover and private shoe usage and aimed to find scientific evidence on their direct relation in the control of surgical site contamination and/or infection transmitted by floor microorganisms. A systematic review of basic research on shoe covers and private shoes usage was carried out, covering the period from 1950 to 2003, by means of a search in electronic sources, bibliographies of relevant studies and proceedings of scientific events. The analysis was supported by two researchers, both of whom were experienced in this theme and one of them in research methodology. The research methods revealed a diverse range and various problems. Only 4 studies obtained a dispersion of floor microorganisms to the air environment, although not significant, and none of them was directly related to surgical site contamination and/or infection. Results do not suggest direct evidence on their efficacy but there is evidence, nonetheless, that barrier and microorganisms transfer from one specific area to another depend on the type of shoe cover, with lower transfer rates when private shoes and shoe covers are employed. Occupational contamination risk during shoe cover attire and removal is also evident and the decision about continuity of their usage needs to be technically and administratively controlled.
——Rev Lat Am Enfermagem. 2005 Jan-Feb;13(1):86-92. Epub 2005 Mar 3.
8、Theatre over-shoes do not reduce operating theatre floor bacterial counts.
Occasional staff or visitors to operating theatres are usually requested to don over-shoes as this is perceived to reduce bacterial floor colony counts. However, this entails some expense and considerable inconvenience. Using disposable surface contact plates floor bacterial counts were measured four times a day at five different sites during the 5 normal working days of one 2-week period in a general operating theatre when over-shoes were worn and one 2-week period when over-shoes were not worn. There was no significant difference in the mean bacterial floor colony counts between the two periods according to sampling times or sites. As in Intensive Therapy units, over-shoes should no longer be used in general operating theatres.
——J Hosp Infect. 1991 Feb;17(2):117-23.
有点贪婪:P 谢谢了:lol |
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