Shaping convex edges in borosilicate glass by single pass perforation with an Airy beam.

We demonstrate curved modifications with lengths of up to 2 mm within borosilicate glass produced by single 1030 nm picosecond laser shots with an Airy beam profile. Plasma ignition in the sidelobes of the beam as well as surface damage prove to be the crucial limitations for confined bulk energy deposition on a curved trajectory. A combined experimental and numerical analysis reveals optimum laser parameters for confined bulk energy deposition.

Time-series analysis to observe the impact of a centrally organized educational intervention on the prevention of central-line-associated bloodstream infections in 32 German intensive care units.

Background: Prevention measures reduce central-line-associated bloodstream infections (CLABSIs) but are not always implemented.

Aim: To investigate the effect of a central educational programme in German intensive care units (ICUs) on CLABSI rates.

Methods: Thirty-two German ICUs with CLABSI rates greater than or equal to the national average were compared with two control groups containing 277 and 67 ICUs.

Nosocomial infection and antibiotic use: a second national prevalence study in Germany.

Background: In 2011, seventeen years after the first national study on the prevalence of nosocomial infections and antibiotic use in German hospitals, a second national prevalence study was carried out according to the specifications of the European Centre for Disease Prevention and Control (ECDC).

Methods: The ECDC protocol, containing uniform surveillance definitions and ascertainment methods, was implemented. The only infections counted were those that were active or under treatment with antibiotics on the day of the study.

[Deficits in central venous catheter associated bloodstream infection].

Background And Objective: Intensive care units (ICUs) with high rates of central venous catheter (CVC) -associated bloodstream infections (BSI) were invited to implement a bundle on BSI prevention during an educational programme which was created by the German national reference center for surveillance of nosocomial infections (NRZ). Training of health care workers (HCWs) was the main component and will be presented in the following.

Methods: The intervention was realized by local infection control staff from April 2006 to March 2007.

Antibiotic usage in German hospitals: results of the second national prevalence study.

Objectives: Data on antibiotic usage (AU) are helpful for improvement of antibiotic stewardship. This study describes findings and targets for quality improvement in German hospitals identified in a national point prevalence survey of healthcare-associated infections and AU.

Methods: The survey was organized by the German National Reference Centre for Surveillance of Nosocomial Infections (NRZ) as part of a pan-European survey organized by the European Centre for Disease Prevention and Control (ECDC).

Attributable costs of ventilator-associated lower respiratory tract infection (LRTI) acquired on intensive care units: a retrospectively matched cohort study.

Background: Lower respiratory tract infections (LRTI) are the most common hospital-acquired infections on ICUs. They have not only an impact on each patient's individual health but also result in a considerable financial burden for the healthcare system. Our aim was to determine the costs and the length of stay of patients with ICU-acquired LRTI.

Concordance between European and US case definitions of healthcare-associated infections.

Background: Surveillance of healthcare-associated infections (HAI) is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN) while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE) project. In this study, we analyzed the concordance between US and European definitions of HAI.

Risk factors associated with surgical site infections following vascular surgery at a German university hospital.

Surgical site infection (SSI) after vascular surgery is a serious complication increasing morbidity, mortality, and costs for healthcare systems. A 4-year retrospective cohort study was performed in a university hospital with patients who had undergone arterial vascular surgery below the aortic arch. Investigated variables included demographics and clinical data.

Viremia after lung transplant: a cohort study on risk factors and symptoms associated with detection of Epstein-Barr virus.

Background-The frequency and impact of detection of Epstein-Barr virus in the blood of lung and heart-lung transplant recipients in the postoperative period is poorly characterized.Objective-To investigate the frequency of virus detection, associated clinical symptoms and risk factors, and influence of virus detection on outcome.Methods-A cohort of 98 lung transplant recipients were monitored for Epstein-Barr virus in blood before transplant and during their posttransplant hospital stay (median 4 weeks, range 1-21 weeks).

Laminar airflow ceiling size: no impact on infection rates following hip and knee prosthesis.

Objective: Laminar airflow (LAF) systems are widely used, at least in orthopedic surgery. However, there is still controversial discussion about the influence of LAF on surgical site infection (SSI) rates. The size of the LAF ceiling is also often a question of debate.

Impact of department volume on surgical site infections following arthroscopy, knee replacement or hip replacement.

Objective: To examine the association between surgical department volume and the risk of surgical site infections (SSI) after orthopaedic procedures.

Background: A minimum volume regulation of at least 50 knee replacements per year was implemented in 2006 in German surgical departments.

Methods: SSI rates were obtained from Krankenhaus-Infektions-Surveillance-System, the German national nosocomial infections surveillance system (January 2003-June 2008).

Five-years surveillance of invasive aspergillosis in a university hospital.

Background: As the most common invasive fungal infection, invasive aspergillosis (IA) remains a serious complication in immunocompromised patients, leading to increased mortality. Antifungal therapy is expensive and may result in severe adverse effects.The aim of this study was to determine the incidence of invasive aspergillosis (IA) cases in a tertiary care university hospital using a standardized surveillance method.

Prolonged duration of operation: an indicator of complicated surgery or of surgical (mis)management?

Purpose: The aim of this study was to investigate whether a prolonged operative time should be regarded as an indicator of quality problems in operating rooms or as patient-specific risk factors when analyzing surgical site infection (SSI) rates.

Method: Data from the SSI component of the German national nosocomial infection surveillance system (KISS) were used to address this question. Eight procedure categories tracked by at least 30 departments participating in KISS were included in the analysis, namely, hip (2 types) and knee prosthesis, breast surgery, hernia repair, C-section, cholecystectomy and colon operations.

The microbiological quality of air improves when using air conditioning systems in cars.

Background: Because of better comfort, air conditioning systems are a common feature in automobiles these days. However, its impact on the number of particles and microorganisms inside the vehicle--and by this its impact on the risk of an allergic reaction--is yet unknown.

Methods: Over a time period of 30 months, the quality of air was investigated in three different types of cars (VW Passat, VW Polo FSI, Seat Alhambra) that were all equipped with a automatic air conditioning system.

Outbreak of carbapenem-resistant Pseudomonas aeruginosa infection in a surgical intensive care unit.

Infection control personnel performing surveillance activities noticed a cluster of patients with isolates of carbapenem-resistant Pseudomonas aeruginosa (CRPA) in the surgical intensive care unit (SICU) of a German University Hospital. An outbreak investigation including a descriptive analysis, a case-control study comparing 15 CRPA case patients with 18 patients with carbapenem-susceptible P. aeruginosa, environmental sampling and pulsed-field gel electrophoresis (PFGE) typing of P.

Reproducibility of the surveillance effect to decrease nosocomial infection rates.

Objective: To investigate whether the reduction effect due to participation in a nosocomial infection surveillance system for laboratory-confirmed central venous catheter (CVC)-associated primary bloodstream infection (BSI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI) is reproducible for different time periods, independent of confounding factors that might occur during a specific time period.

Methods: Data from the German national nosocomial infection surveillance system from the period January 1997 through June 2008 were used. CVC-associated BSI data and SSI data were analyzed for 3 starting periods, and VAP data were analyzed for 2 starting periods.

New identification of outliers and ventilator-associated pneumonia rates from 2005 to 2007 within the German Nosocomial Infection Surveillance System.

This study presents data for ventilator use and ventilator-associated pneumonia (VAP) rates from the German hospital surveillance system for nosocomial infections (KISS: Krankenhaus Infektions Surveillance System). New Centers for Disease Control and Prevention (CDC) definitions became effective during 2005 and we describe the new method used by KISS to determine individual units with data at extreme ranges. The number of VAP cases per 1000 device-days was calculated and a new visual method, specifically funnel plots, was introduced to identify outliers.

Outbreak of carbapenem-resistant Acinetobacter baumannii carrying the carbapenemase OXA-23 in a German university medical centre.

A prolonged outbreak of carbapenem-resistant Acinetobacter baumannii in a German university medical centre in 2006 was investigated; the investigation included a descriptive epidemiological analysis, a case-control study, environmental sampling, molecular typing of A. baumannii isolates using PFGE and repetitive-sequence-based PCR (rep-PCR) typing, and detection of OXA-type carbapenemases by multiplex PCR. Thirty-two patients acquired the outbreak strain in five intensive care units (ICUs) and two regular wards at a tertiary care hospital within 10 months.

Decrease of deep sternal surgical site infection rates after cardiac surgery by a comprehensive infection control program.

When we noticed an increasing incidence of deep sternal surgical site infections (DSSI), a bundle of interdisciplinary infection control measures was initiated in order to prevent further cases of DSSI. Adherence to infection control measures was re-inforced, which included (1) methicillin-resistant Staphylococcus aureus (MRSA) screening, (2) bacterial decolonisation measures, (3) hair clipping instead of shaving, (4) education, (5) good stewardship for antibiotic prophylaxis, (6) change of surgical gloves after sternotomy and after sternal wiring, (7) new bandage techniques, (8) leaving the wound primarily covered for at least 48 h. We checked for potential risk factors in a case-control study (120 patients each) by multivariate analysis.

Early- and late-onset pneumonia: is this still a useful classification?

The choice of empirical treatment of nosocomial pneumonia in the intensive-care unit (ICU) used to rely on the interval after the start of mechanical ventilation. Nowadays, however, the question of whether in fact there is a difference in the distribution of causative pathogens is under debate. Data from 308 ICUs from the German National Nosocomial Infection Surveillance System, including information on relevant pathogens isolated in 11,285 cases of nosocomial pneumonia from 1997 to 2004, were used for our evaluation.

Surveillance with successful reduction of central line-associated bloodstream infections among neutropenic patients with hematologic or oncologic malignancies.

To determine nosocomial catheter-associated bloodstream infections (CA-BSIs) and to improve the prevention measures, we performed a prospective surveillance in our hematopoietic stem cell transplantation unit at our university hospital. During the 36-month study period all patients with at least two consecutive neutropenic days (NDs) were included. After the first 18 months the recorded data were analyzed and compared with reference data and were then presented to the clinical staff.

Ten years of KISS: the most important requirements for success.

Ten years ago, in January 1997, data collection for the German national nosocomial infection surveillance system was established, which is known by the acronym KISS (Krankenhaus-Infektions-Surveillance-System). Meanwhile KISS was able to demonstrate a beneficial effect from ongoing surveillance activities and appropriate feedback to the users in combination with reference data for ventilator associated pneumonia, primary bloodstream infections and surgical site infections. Significant reductions of infection rates between 20-30% over 3 years periods in the components for intensive care units, operative departments and neonatal intensive care units were demonstrated.

Mortality attributable to hospital-acquired infections among surgical patients.

We performed a multicenter prospective matched cohort study to evaluate the mortality attributable to hospital-acquired infections among 12,791 patients admitted to surgical departments. We were able to match 731 patients with 1 or more hospital-acquired infections (ie, case patients) with 731 patients without a hospital-acquired infection (ie, control patients) at a 1:1 ratio. Of the 731 case patients, 42 (5.