A simple method for quantifying nosocomial infection and colonization with multidrug-resistant organisms is described. This method is applied to the intensive care unit of an academic medical center where longitudinal surveillance data have been used to assess the impact of infection control interventions and antibiotic use.

A total of 2,725 healthcare workers in 8 Mediterranean countries replied to a self-assessment questionnaire that assessed their perceptions on hand hygiene. Responses revealed that rates of hand hygiene compliance before patient contact were significantly less than rates after patient contact (P < .001) and that use of soap and water was preferred over use of alcohol-based hand rub. These findings suggest that self-protection could be a major subliminal driver for performance of hand hygiene.

To develop measures to prevent neonatal rotavirus infection, we carried out rotavirus surveillance testing on all the newborns who were admitted to a newborn nursery in Korea during 1 year. We investigated the characteristics of neonatal rotavirus infection and found that it occurred throughout the year with the G4P[6] strain exclusively. Most newborns were infected nosocomially and showed no symptoms. We concluded that rotavirus might be transmitted from asymptomatic infected newborns who were born outside the hospital. We recommend isolation and rotavirus surveillance testing for all transfer patients.

This prospective observational study was designed to assess the incidence of, risk factors for, and outcome of catheter-related bloodstream infection in children undergoing cardiac surgery. A staff specifically trained to handle the central venous catheters with proper aseptic techniques and an appropriate patient to medical staff ratio remain the most effective measures to prevent this infection.

A large norovirus outbreak affecting hospital patients and staff occurred during the winter of 2007. We administered a survey to affected staff to evaluate adherence to social distancing recommendations. Of the 102 survey respondents, 74 (73%) completed self-quarantine. Staff adherence was similar regardless of job responsibility. Incomplete adherence to recommendations could potentially accelerate and prolong infectious disease outbreaks.

The prevalence of latent tuberculosis infection in a cohort of nurses new to a London hospital was 7.6% (13 of 171), using an interferon-γ(IFN-γ) release assay, and 16.2% (24 of 148), using the tuberculin skin test. On multivariate analysis, birth in a country with tuberculosis prevalence of more than 40 cases per 100,000 population was associated with positive results of both the IFN-γ release assay and the tuberculin skin test.

We reviewed the frequency and duration of vancomycin use during 93 left ventricular assist device placements. Vancomycin prophylaxis was administered for a mean duration (± standard deviation) of 10.5 ± 11 days. Empirical vancomycin use was frequent, with a mean duration (± standard deviation) of therapy of 9.8 ± 9 days (median, 8 days) given during 81 (87%) of the implantations. The most common indications for empirical vancomycin treatment were isolated leukocytosis or driveline drainage. Strategies to improve vancomycin use during left ventricular assist device support should be considered.

We investigated the association between the amount of alcohol-based hand rub (hereafter, “hand rub”) used and the incidence of healthcare-acquired bloodstream infection (HCR-BSI) from 2004 through early 2008. The amount of hand rub used increased significandy, and the incidence of HCR-BSI remained stable. There was no significant association between the amount of hand rub used and the incidence of HCR-BSI.

We assessed the in vitro antimicrobial activity and the in vivo efficacy of dipping ventricular assist devices in a combination of N-acetylcysteine, gentamicin, and amphotericin B (NAC/G/A). Ventricular assist devices dipped in NAC/G/A exhibited broad-spectrum antimicrobial activity in vitro and were less likely than undipped devices to become colonized with Staphylococcus aureus in a rabbit model.

We identified 1,805 gram-negative organisms in cultures of urine samples obtained over a 10-month period from residents of 63 long-term care facilities. The prevalence of fluoroquinolone resistance in Escherichia coli was 51% (446 of 874 isolates), whereas the preva¬lences of ceftazidime and imipenem resistance in Klebsiella species were 26% and 6% (84 and 19 of 323 isolates), respectively. The prevalence of resistance varied significantly by facility type, size, and geographic location.

We investigated a cluster of methicillin-resistant Staphylococcus aureus soft-tissue infections in 5 security guards employed in a hospital emergency department. An epidemiologic investigation and molecular subtyping of isolates revealed that the source was a patient and that a community-acquired methicillin-resistant S. aureus strain (USA-300) was transmitted to healthcare workers through physical contact.

In a national surveillance system study, the infection rate following cerebrospinal fluid shunt surgery was 4.1% (95% confidence interval, 3.36%-4.92%). Cases of infection were more common in children than in adults (4.85% vs 3.24%; P = .04) and occurred sooner after surgery in children than in adults. A wide variation in compliance with antimicrobial prophylaxis was observed between 21 participating medical centers.

We evaluated the usefulness of adding weekly methicillin-resistant Staphylococcus aureus (MRSA) screening to our established admission screening and clinical sampling in 4 acute care units of a university hospital. Our results suggest that weekly MRSA screening allows the detection of 56.1% of all cases of hospital-acquired MRSA carriage. These cases would have remained undetected had admission screening and clinical sampling been the only types of surveillance in place.

Healthcare workers who received the tetanus-diphtheria–acellular pertussis (Tdap) vaccine were surveyed about adverse events. Local adverse events were more common among women and among those who received the Tdap vaccine less than 5 years after they had received the tetanus-diphtheria vaccine. Systemic adverse events were more common among healthcare workers aged less than 30 years. These findings provide guidance for counseling of healthcare workers who receive Tdap vaccine.

In our study of nursing home residents with clinically suspected urinary tract infection who did not require the use of an indwelling catheter, we identified bacteria isolated from urine samples, the resistance patterns of these isolated bacteria, and the antibiotic therapy prescribed to the residents. Escherichia coli, the predominant organism isolated, frequently was resistant to commonly prescribed oral antibiotics. Trimethoprim-sulfamethoxazole remains the best empiric antimicrobial therapy for a urinary tract infection, but nitrofurantoin should be considered if E. coli is identified.

We sought to evaluate the indirect impact of ertapenem use for the treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae infections in our hospital on the susceptibility of Pseudomonas aeruginosa to imipenem. The use of ertapenem was mandated for treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae infections in the absence of nonfermenting gram-negative bacilli for 1 year. The use of imipenem was restricted. Imipenem consumption decreased 64.5%. Ertapenem consumption was 42.57 defined daily doses per 1,000 patient-days. None of the 18 P. aeruginosa isolates recovered after ertapenem introduction were imipenem-resistant, compared with 4 of the 20 P. aeruginosa isolates recovered in the previous year.

Our study assessed the factors that influence the resistance of blood residues on dental surgical instruments to washer-disinfector-based cleaning procedures in a clinical setting. The use of 2 additional cleaning methods—presoaking and scrubbing by hand—and the use of newer and/or less structurally complex instruments significantly increased the efficacy of washer-disinfector cleaning.