We examined a cluster of 5 hemodialysis patients who contracted gram-negative bacteremia. A nurse who used an artificial fingernail to open a vial of heparin that was mixed to make a flush solution had a culture of an artificial fingernail specimen positive for Serratia marcescens. The typing of the S. marcescens strains isolated from the 5 patients and the nurse showed them to be identical. This finding provides strong support for policies prohibiting artificial nails for healthcare workers in all hemodialysis units.

We investigated the source of infection in a patient who developed acute hepatitis C virus infection after cardiothoracic surgery. A healthcare worker was found to be infected with hepatitis C virus, and molecular analysis indicated the strain was similar to that found in the patient. The exact mode of transmission was not identified; however, atopic eczema on the healthcare worker's hands may have contributed to the transmission.

The ability to recover bacteria from frozen culture specimens has important implications. The purpose of this study was to validate the utility of frozen specimens for recovery of several gram-positive and gram-negative bacterial species by culture. Results demonstrate that 98% of 250 bacterial isolates identified on initial culture were subsequently recovered by culture of frozen specimens after a median storage period of 564 days.

A positive linear trend (P<.001) between the National Noscomial Infection Surveillance system (NNIS) risk index and mortality was observed in 2,848 general surgery patients followed up 6 years after discharge. In stratified analyses, the NNIS risk index predicted mortality in patients with chronic disease (P = .007, by test for trend) but not in the remaining patients.

Chryseobacterium indologenes was isolated from blood samples from a 5-month-old infant with bloodstream infection. Environmental sampling was performed. Molecular typing with arbitrarily primed polymerase chain reaction demonstrated the cross-contamination of commercial distillate water. The infant was infected by this water as a result of medical assistance received during hospitalization.

We assessed the efficacy of 2 alcohol-based gels and 1 alcohol-based rinse for surgical hand disinfection, using European standard EN 12791. Volunteers performed surgical hand disinfection with a reference product and each of the 3 study products, with 1-week intervals between disinfection episodes. The immediate and sustained antimicrobial activities of each study product were not significantly less than those of the reference product. The study products passed the efficacy requirements of the EN 12791 standard, and they are considered suitable for surgical hand disinfection.

We describe 2 pediatric patients with Ralstonia pickettii bacteremia associated with extracorporeal membrane oxygenation (ECMO) therapy. Investigation revealed a common environmental source—the ECMO temperature-control units. We created guidelines for disinfecting these units that do not void the manufacturer's warranty and have prevented additional cases of bacteremia due to this organism.

We assessed the quality of hand hygiene among healthcare workers at a pediatrics hospital in Rio de Janeiro, Brazil. Hand hygiene was performed in 491 (34%) of 1,455 opportunities. Of these hand hygiene events, correct performance was observed in only 173 (35%). Multivariate analysis revealed that correct performance of hand hygiene was associated with the use of an alcohol-based product and a lack of jewelry (for all events) and employment in an infirmary with a comparatively higher ratio of nurses to patients (for events involving nurses).

To determine the effectiveness of infection control strategies to reduce transmission of vancomycin-resistant enterococci (VRE), a cohort study was performed in a university hospital. Contact precautions alone were not effective in reducing transmission of VRE. Strict isolation of affected patients in private rooms, in addition to use of contact precautions, showed a significantly improved reduction in the transmission of VRE.

Fire incidents in German hospitals related to the use of alcohol-based hand rubs were analyzed. Seven nonsevere fire incidents were identified, occurring during 25,038 hospital-years, which were caused by individual human actions and not by technical failure. The results underline the safety of using alcohol-based hand rubs in hospitals.

Among 101 nursing home residents with suspected urinary tract infection (UTI), we determined the negative predictive value of dipstick testing for leukocyte esterase and nitrite to be 100% (95% confidence interval, 74%-100%), compared with laboratory evidence of UTI (greater than 10 white blood cells/mm3 on urinalysis and greater than 100,000 colony forming units/mL on urine culture). Nursing home dipstick testing effectively excluded the possibility of UTI.

This study evaluates the association between the degree of fear of human immunodeficiency virus (HIV) infection and support for different HIV testing policies. A strong fear of acquiring HIV infection at work was widespread among a sample of 601 Polish surgical and emergency nurses. Most favored inappropriate HIV testing of all surgical patients and inpatients. Previous training about HIV and acquired immunodeficiency syndrome (AIDS) and experience caring for HIV-positive patients had a significant impact on reducing support for testing of all inpatients but not for testing of surgical patients.

The spectrum and antimicrobial susceptibilities of pathogens causing acute nosocomial urinary tract infection in hospitalized pediatric patients were revealed to be heterogeneous. Therefore, to avoid the failure of empirical antimicrobial therapy in these patients, underlying disease and previous antimicrobial treatment have to be considered.