Prognostic indicators for early mortality after tracheostomy in the intensive care unit.

Background: Tracheostomy is indicated for patients requiring prolonged mechanical ventilation. The aim of this study is to identify prognostic indicators for early mortality after tracheostomy to potentially avoid futility in the intensive care unit.

Methods: Patients who underwent tracheostomy and died within 30 d of admission (futile group) were compared with patients who underwent tracheostomy and survived more than 30 d after admission (nonfutile group).

Differential impact of infection control strategies on rates of resistant hospital-acquired pathogens in critically ill surgical patients.

Background: There were two major outbreaks of multi-drug resistant Acinetobacter baumannii (MDRA) in our general surgery and trauma intensive care units (ICUs) in 2004 and 2011. Both required aggressive multi-faceted interventions to control. We hypothesized that the infection control response may have had a secondary benefit of reducing rates of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile (C.

Hand-hygiene compliance does not predict rates of resistant infections in critically ill surgical patients.

Background: Our institution had a major outbreak of multi-drug-resistant Acinetobacter (MDRA) in its general surgical and trauma intensive care units (ICUs) in 2011, requiring implementation of an aggressive infection-control response. We hypothesized that poor hand-hygiene compliance (HHC) may have contributed to the outbreak of MDRA. A response to the outbreak including aggressive environmental cleaning, cohorting, and increased hand hygiene compliance monitoring may have led to an increase in HHC after the outbreak and to a consequent decrease in the rates of infection by the nosocomial pathogens methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile.