Mar 262014
 
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Empathy dolls: are they a source of cross-contamination between patients?

J Hosp Infect. 2014 Mar 6;

Authors: Subramanian B, Parsons H, Finner P, Townsend R

Abstract
Following a cluster of two patients with identical strains of Clostridium perfringens prosthetic joint infections on an ortho-geriatric ward in a teaching hospital in England, investigations were conducted into infection control practices. It emerged that empathy dolls were being used to help alleviate agitation in dementia patients; this had been introduced without consultation with the infection prevention and control team. Environmental testing of the doll pre and post laundry at different temperatures helped to establish the types and numbers of organisms present. This testing enabled our unit to provide guidance on the optimum strategy for decontamination and safe use of these dolls.

PMID: 24661788 [PubMed - as supplied by publisher]

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Mar 132014
 
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Point prevalence surveys of healthcare-associated infections and use of indwelling devices and antimicrobials over three years in a tertiary care hospital in India.

J Hosp Infect. 2014 Feb 18;

Authors: Kumar A, Biswal M, Dhaliwal N, Mahesh R, Appannanavar SB, Gautam V, Ray P, Gupta AK, Taneja N

Abstract
Few hospitals in India perform regular surveillance for healthcare-associated infections (HAIs) and use of indwelling devices and antimicrobials. The aim of this study was to conduct two one-day point prevalence surveys of HAIs and use of indwelling devices and antimicrobials in a large 1800-bed tertiary care hospital in India. The overall prevalence of HAIs was 7%, and surgical site infections were the most common (33%). Indwelling devices were present in 497 (27%) patients, and 915 (50%) patients were receiving antimicrobials. This study helped to generate robust baseline data on the prevalence of HAIs and use of indwelling devices and antimicrobials in the study hospital.

PMID: 24613563 [PubMed - as supplied by publisher]

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Mar 042014
 
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Can influenza vaccination coverage among healthcare workers influence the risk of nosocomial influenza-like illness in hospitalized patients?

J Hosp Infect. 2014 Feb 6;

Authors: Amodio E, Restivo V, Firenze A, Mammina C, Tramuto F, Vitale F

Abstract
BACKGROUND: Approximately 20% of healthcare workers are infected with influenza each year, causing nosocomial outbreaks and staff shortages. Despite influenza vaccination of healthcare workers representing the most effective preventive strategy, coverage remains low.
AIM: To analyse the risk of nosocomial influenza-like illness (NILI) among patients admitted to an acute care hospital in relation to influenza vaccination coverage among healthcare workers.
METHODS: Data collected over seven consecutive influenza seasons (2005-2012) in an Italian acute care hospital were analysed retrospectively. Three different sources of data were used: hospital discharge records; influenza vaccination coverage among healthcare workers; and incidence of ILI in the general population. Clinical modification codes from the International Classification of Diseases, 9(th) Revision were used to define NILI.
FINDINGS: Overall, 62,343 hospitalized patients were included in the study, 185 (0.03%) of whom were identified as NILI cases. Over the study period, influenza vaccination coverage among healthcare workers decreased from 13.2% to 3.1% (P < 0.001), whereas the frequency of NILI in hospitalized patients increased from 1.1‰ to 5.7‰ (P < 0.001). A significant inverse association was observed between influenza vaccination coverage among healthcare workers and rate of NILI among patients (adjusted odds ratio 0.97, 95% confidence interval 0.94-0.99).
CONCLUSION: Increasing influenza vaccination coverage among healthcare workers could reduce the risk of NILI in patients hospitalized in acute hospitals. This study offers a reliable and cost-saving methodology that could help hospital management to assess and make known the benefits of influenza vaccination among healthcare workers.

PMID: 24581755 [PubMed - as supplied by publisher]

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Feb 252014
 
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Contamination of liquid soap for hospital use with Raoultella planticola.

J Hosp Infect. 2014 Jan 22;

Authors: García-San Miguel L, Sáez-Nieto JA, Medina MJ, López Hernández S, Sánchez-Romero I, Ganga B, Asensio A

Abstract
This article reports the contamination of a batch of liquid soap for hospital use with Raoultella planticola. The micro-organism was first identified as Klebsiella pneumoniae due to the inability of automated systems to characterize this species. There is a need to strengthen the inspection of cosmetic products to be used in the hospital setting. It is recommended that hospitalized patients at the highest risk of infection should use antimicrobial soaps for personal hygiene. The incidence of infections due to R. planticola is unknown as it is usually misclassified as Klebsiella spp. by automated systems.

PMID: 24559578 [PubMed - as supplied by publisher]

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Feb 252014
 
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Do active safety-needle devices cause spatter contamination?

J Hosp Infect. 2014 Feb 5;

Authors: Roff M, Basu S, Adisesh A

Abstract
Exposure to blood and body fluids is an occupational hazard in healthcare. Although the potential for blood-borne virus transmission through needlestick injury has been widely studied, the risk of this occurring through spatter contamination from safety-needle syringes is not well understood. This report examines this risk from three commonly used safety needles and suggests that this presents a new and significant hazard. Further work should be commissioned to quantify this hazard and determine which type of safety needle would minimize spatter contamination following syringe discharge and safety activation.

PMID: 24560976 [PubMed - as supplied by publisher]

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Jan 012014
 
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Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study.

J Hosp Infect. 2013 Dec 1;

Authors: González López JL, Arribi Vilela A, Fernández Del Palacio E, Olivares Corral J, Benedicto Martí C, Herrera Portal P

Abstract
BACKGROUND: Catheter-related infections (CRIs) caused by peripheral intravenous catheters (PIVCs) are an increasingly common iatrogenic complication. To prevent this, recommended timelines for routine replacement of PIVCs have increased from 48h to 72h and subsequently to 96h, despite a lack of supporting scientific evidence.
AIM: To compare closed-system (COS) PIVCs with open-system (MOS) PIVCs.
METHODS: This prospective, randomized controlled trial compared the indwell time of COS PIVCs without complications with that of MOS PIVCs, removed only by clinical indication. In total, 1199 PIVCs (642 inpatients) were randomized and 283 PIVCs were cultured. Sixteen catheters (11 patients) were lost to the study after randomization.
FINDINGS: In total, 104,469 catheter-hours (54,173h in 584 COS and 50,296h in 599 MOS) were recorded. The median dwell time was 137.1h for COS PIVCs and 96h for MOS PIVCs (P = 0.001). Among PIVCs in place for ≥24h, the median dwell time was 144.5h for COS PIVCs [95% confidence interval (CI) 123.4-165.6] and 99h for MOS PIVCs (95% CI 87.2-110.8). Use of COS PIVCs reduced phlebitis rates by 29% (31 vs 45 cases/1000 catheter-days; P = 0.004). The probability that a MOS PIVC would last for 96h was 79.9%, and the probability that a COS PIVC would last for 144h was 80.4%. There were no significant differences in rates of bacterial colonization per 1000 catheter-days (51.1 COS vs 54.1 MOS) or CRI (5.76 COS vs 6.65 MOS). Nevertheless, there was a 20% relative risk reduction in CRI.
CONCLUSION: Use of COS PIVCs reduced episodes of phlebitis and risk of infection at a cost of only €0.09/day. When PIVCs are replaced based on clinical indication, COS PIVCs last for up to 144h and MOS PIVCs last for up to 96h without increased risk and with significant cost savings (€786,257/year/1000 beds).

PMID: 24373830 [PubMed - as supplied by publisher]

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