Variable performance of models for predicting methicillin-resistant Staphylococcus aureus carriage in European surgical wards.

Background: Predictive models to identify unknown methicillin-resistant Staphylococcus aureus (MRSA) carriage on admission may optimise targeted MRSA screening and efficient use of resources. However, common approaches to model selection can result in overconfident estimates and poor predictive performance. We aimed to compare the performance of various models to predict previously unknown MRSA carriage on admission to surgical wards.

Interventions to reduce colonisation and transmission of antimicrobial-resistant bacteria in intensive care units: an interrupted time series study and cluster randomised trial.

Background: Intensive care units (ICUs) are high-risk areas for transmission of antimicrobial-resistant bacteria, but no controlled study has tested the effect of rapid screening and isolation of carriers on transmission in settings with best-standard precautions. We assessed interventions to reduce colonisation and transmission of antimicrobial-resistant bacteria in European ICUs.

Methods: We did this study in three phases at 13 ICUs.

Comparison of strategies to reduce meticillin-resistant Staphylococcus aureus rates in surgical patients: a controlled multicentre intervention trial.

Objective: To compare the effect of two strategies (enhanced hand hygiene vs meticillin-resistant Staphylococcus aureus (MRSA) screening and decolonisation) alone and in combination on MRSA rates in surgical wards.

Design: Prospective, controlled, interventional cohort study, with 6-month baseline, 12-month intervention and 6-month washout phases.

Setting: 33 surgical wards of 10 hospitals in nine countries in Europe and Israel.

Ten-year decrease of acquired methicillin-resistant Staphylococcus aureus (MRSA) bacteremia at a single institution: the result of a multifaceted program combining cross-transmission prevention and antimicrobial stewardship.

Background: In France, the proportion of MRSA has been over 25% since 2000. Prevention of hospital-acquired (HA) MRSA spread is based on isolation precautions and antibiotic stewardship. At our institution, before 2000, the Infection Disease and the Infection Control teams had failed to reduce HA-MRSA rates.

Hand hygiene practices and adherence determinants in surgical wards across Europe and Israel: a multicenter observational study.

We examined hand hygiene practices in surgical wards in 9 countries in Europe and Israel through direct practice observation. There was marked interhospital variation in hand hygiene compliance (range, 14%-76%), as well as glove and alcohol-based handrub use. After multivariable analysis, surgical subspecialty, professional category, type of care activity, and workload were independently associated with compliance.

Supplemental treatment of air in airborne infection isolation rooms using high-throughput in-room air decontamination units.

Background: Evidence has recently emerged indicating that in addition to large airborne droplets, fine aerosol particles can be an important mode of influenza transmission that may have been hitherto underestimated. Furthermore, recent performance studies evaluating airborne infection isolation (AII) rooms designed to house infectious patients have revealed major discrepancies between what is prescribed and what is actually measured.

Methods: We conducted an experimental study to investigate the use of high-throughput in-room air decontamination units for supplemental protection against airborne contamination in areas that host infectious patients.

Highly sensitive and efficient computer-assisted system for routine surveillance for surgical site infection.

Objectives: Surveillance of surgical site infections (SSIs) is effective in reducing the rates of these complications, but it is extremely time-consuming and, consequently, underused. We determined the sensitivity and specificity of a computer-assisted surveillance system, compared with a conventional method involving review of medical records, and the time saved with the computer-assisted system.

Method: A prospective study was conducted from January 1 to December 31, 2001.

Epidemiology and control of antibiotic resistance in the intensive care unit.

Purpose Of Review: Resistance to antibiotics is very high in the intensive care units of many countries, although there are several exceptions. Some infections are becoming extremely difficult to treat. The risk of cross-transmission of those strains is very high.

Clinical and therapeutic features of nonpostoperative nosocomial intra-abdominal infections.

Objective: To compare the clinical, microbiological, and therapeutic features of nonpostoperative nosocomial intra-abdominal infections (non-PostopNAI) with community-acquired intra-abdominal infections (CAI).

Summary Background Data: Prospective (June 2000 through January 2001) consecutive case series analysis of patients operated for secondary nonpostoperative intra-abdominal infections collected in 176 study centers (surgical wards and intensive care units).

Patients And Methods: Clinical, microbiological, and therapeutic characteristics of CAI and non-PostopNAI infections were collected.

A continuous quality-improvement program reduces nosocomial infection rates in the ICU.

Objective: To assess the impact of a continuous quality-improvement program on nosocomial infection rates.

Design And Setting: Prospective single-center study in the medical-surgical ICU of a tertiary care center. PATIENTS.