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Infection Control (infection + control)
Terms modified by Infection Control Selected AbstractsINFECTION CONTROL IN LONG-TERM CARE FACILITIES: THE NEED FOR ENGAGEMENTJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2009Denise R. Flinn MD No abstract is available for this article. [source] NURSES' KNOWLEDGE AND PRACTICE OF VASCULAR ACCESS INFECTION CONTROL IN HAEMODIALYSIS PATIENTS IN THE REPUBLIC OF IRELANDJOURNAL OF RENAL CARE, Issue 2 2008DipNS, Margaret Higgins RN SUMMARY Vascular access hygiene is an integral component of haemodialysis care. Ensuring nurses possess sufficient knowledge and utilise recommended guidelines on infection control is essential for safe practice and patient safety. The study aimed to investigate nurses' knowledge and practice of vascular access infection control among adult haemodialysis patients in the Republic of Ireland. A confidential self-completion questionnaire was sent to all 190 qualified nurses employed in nine haemodialysis units in the Republic of Ireland, which assessed knowledge and behaviour in infection control. Although 92% of respondents reported that policies had been developed by their units and 47% had received infection control education in the previous year, knowledge and adherence to best practice demonstrated significant scope for improvement. The study recommended the development of standard guidelines and regular reviews and updates of policies. Systems should also be developed to ensure a high level of compliance. [source] Automated high-level disinfection of nonchanneled flexible endoscopes: Duty cycles and endoscope repair,,§THE LARYNGOSCOPE, Issue 10 2010Melissa McCarty Statham MD Abstract Purpose: Guidelines issued by the Association of Operating Room Nurses and the Association of Professionals in Infection Control and Epidemiology recommend high-level disinfection (HLD) for semicritical instruments, such as flexible endoscopes. We aim to examine the durability of endoscopes to continued use and automated HLD. We report the number of duty cycles a flexible endoscope can withstand before repairs should be anticipated. Methods: Retrospective review. Results: A total of 4,336 endoscopic exams and subsequent disinfection cycles were performed with 60 flexible endoscopes in an outpatient tertiary pediatric otolaryngology practice from 2005 to 2009. All endoscopes were systemically cleaned with mechanical cleansing followed by leak testing, enzymatic cleaning, and exposure to Orthophthaldehyde (0.55%) for 5 minutes at a temperature of at least 25°C, followed by rinsing for 3 minutes. A total of 77 repairs were performed, 48 major (average cost $3,815.97), and 29 minor (average cost $326.85). On average, the 2.2-mm flexible endoscopes were utilized for 61.9 examinations before major repair was needed, whereas the 3.6 mm endoscopes were utilized for 154.5 exams before needing minor repairs. No major repairs have been needed to date on the 3.6-mm endoscopes. Conclusions: Automated endoscope reprocessor use for HLD is an effective means to disinfect and process flexible endoscopes. This minimizes variability in the processing of the endoscopes and maximizes the rate of successful HLD. Even when utilizing standardized, automated HLD and limiting the number of personnel processing the endoscopes, smaller fiberoptic endoscopes demonstrate a shortened time interval between repairs than that seen with the larger endoscopes. Laryngoscope, 2010 [source] Ultrasound screening for internal jugular vein thrombosis aids the detection of central venous catheter-related infections in patients with haemato-oncological diseases: a prospective observational studyBRITISH JOURNAL OF HAEMATOLOGY, Issue 6 2003Florian Lordick Summary. To prove the hypothesis that central venous catheter-related thrombosis and infection are associated, 43 haemato-oncological patients with an internal jugular vein catheter underwent ultrasound screening for thrombosis every 4 d. Catheter-related thrombosis was detected in 13/43 patients (30%). Catheter-related infection, as defined by the U.S. Hospital Infection Control Practices Advisory Committee, was found in 14/43 patients (33%) with colonization of the catheter in two patients, exit site infection in eight patients and catheter-related bloodstream infection in four patients. Catheter-related thrombosis and catheter-related infection coincided in 12 patients and were significantly correlated (Fisher's exact test, P < 0·0001). Detection of thrombosis indicated a catheter-related infection with a superior sensitivity (86%vs 57%) and an equivalent specificity (97%) compared with the presence of clinical signs (erythema, tenderness, warmth or swelling). Neutropenia, which occurred in 32 patients, was found in 13/14 patients (93%) with a catheter-related infection and, therefore, seemed to be an important covariate for the development of a catheter-related infection. This study showed a close correlation between catheter-related thrombosis and infection. Ultrasound screening for thrombosis was helpful for detecting catheter-related infection. These findings could be clinically useful for the handling of central venous catheters in patients with an elevated risk of infectious complications. [source] Infection control in wound care: a study of fatalism in community nursingJOURNAL OF CLINICAL NURSING, Issue 1 2000BNurs, Christine E. Hallett PhD, DNCert, HVCert ,,As part of a study of community nurses' perceptions of quality in nursing care, the author conducted in-depth qualitative interviews with seven community-based nurses. ,,As part of the study, nurses were asked to describe episodes of wound care and to discuss the factors which could affect the quality of such care. ,,One of the most interesting themes to emerge from the data was the apparent ambivalence of the nurses' attitudes towards infection control in wound care. ,,Nurses discussed the concept of ,aseptic technique' in fatalistic terms and seemed uncertain about what could be achieved in terms of infection control. ,,Although their policy guidelines referred to ,aseptic technique', their educational experience appeared to have made them feel uncertain about the implementation of the measures involved. ,,With the proviso that this was a small scale qualitative study, the author concludes by suggesting that there is a need for greater clarity, both in what is taught and in what is included in practice policy with regard to infection control in wound care. [source] National guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus,what do they tell us?CLINICAL MICROBIOLOGY AND INFECTION, Issue 9 2007H. HumphreysArticle first published online: 30 JUN 200 Abstract Guidelines to control and prevent methicillin-resistant Staphylococcus aureus (MRSA) infection are available in many countries. Infection control and prevention teams determine local strategies using such national guidelines, but not all guidelines involve a rigorous assessment of the literature to determine the strength of the recommendations. Available guidelines drafted by national agencies or prominent professional organisations in Germany, New Zealand, North America, The Netherlands, Ireland and the UK were reviewed. Significant literature reviews were a component of guidelines from the UK and North America. Recommendations were not graded on the strength of the evidence in guidelines from New Zealand and The Netherlands. The Netherlands, a country with a very low prevalence of MRSA, had the simplest set of guidelines. Few of the recommendations in any of the guidelines achieved the highest grading, i.e., based on well-designed, experimental, clinical or epidemiological studies, even though the logic of the proposed measures is clear. The onset of community-acquired MRSA is reflected in the recent publication of guidelines from North America. New developments, such as rapid testing and mathematical modelling, are of importance in helping to control MRSA in settings of both low and high endemicity. National guidelines are increasingly evidence-based, although good scientific studies concerning some aspects of MRSA control are lacking. However, general principles, e.g., early detection and isolation, are recommended by all guidelines. There is still a role for consensus and the opinion of experts in devising national guidelines. [source] Periodontal infection control: current clinical conceptsENDODONTIC TOPICS, Issue 1 2006JAN L. WENNSTRÖM The main objective of the treatment of patients with periodontitis is to establish adequate infection control in the dentogingival area. Pocket/root instrumentation (scaling and root planing), combined with effective self-performed supragingival plaque control measures, constitute the basic treatment modalities, but also locally applied antiseptics and antibiotics may be utilized. The purpose of this article is to give an overview of current clinical concepts on periodontal infection control. [source] Methods of filling root canals: principles and practicesENDODONTIC TOPICS, Issue 1 2005JOHN WHITWORTH Contemporary research points to infection control as the key determinant of endodontic success. While epidemiological surveys indicate that success is most likely in teeth which have been densely root-filled to within 2 mm of root-end, it is unclear whether the root canal filling itself is a key determinant of outcome. It is also unclear how different materials and methods employed in achieving a ,satisfactory' root filling may impact on outcome. This article provides an overview of current principles and practices in root canal filling and strives to untangle the limited and often contradictory research of relevance to clinical practice and performance. [source] Description and evaluation of an education and communication skills training course in HIV and AIDS for dental consultantsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2000D. A. Lewis A 2-day course was organised for dental hospital consultants as part of a project on raising awareness of dental staff about HIV and AIDS. The course comprised an information update, practical experience in the diagnosis of oral conditions and a ,hands-on' exercise in infection control. The 2nd day of the course consisted of experiential communication skills training using rôle-play with actors and video feedback. Evaluation of the course showed that the consultants perceived the course to be valuable. There was a general improvement in dentists' confidence in their knowledge, ability to communicate with HIV-positive patients and in talking to staff who are unwilling to provide treatment. These changes are statistically significant and these skills are still being utilized and maintained 2 years later. Information and training packs prepared by multidisciplinary groups using a variety of teaching methods should be made available to those involved in training dental staff. [source] Prevention of cancer through immunization: Prospects and challenges for the 21st centuryEUROPEAN JOURNAL OF IMMUNOLOGY, Issue S1 2007Abstract Persistent infection by several microbial agents is responsible for at least 15% of cancer globally, including most cancers of the liver, stomach, and cervix. The recent development of vaccines that can prevent infection and premalignant disease caused by human papillomaviruses (HPV), which cause virtually all cases of cervical cancer as well as some other cancers, has focused renewed attention on infection control as a means of reducing the global cancer burden. For vaccines to prevent cancer-causing infection with hepatitis C virus, Helicobacter pylori, or Epstein Barr virus, new vaccine technologies to induce more effective protective responses are required. For the two available cancer control vaccines, designed to prevent infection with HPV and hepatitis B virus, the major challenge is to promote effective vaccine deployment through education programs and increased affordability/accessibility for underserved populations, particularly in the developing world, where the cancer burden attributable to infection by these two viruses is greatest. [source] Pandemic influenza communication: views from a deliberative forumHEALTH EXPECTATIONS, Issue 3 2009Wendy A. Rogers BA (Hons) BM.BS PhD MRCGP FRACGP Abstract Objective, To use a deliberative forum to elicit community perspectives on communication about pandemic influenza planning, and to compare these findings with the current Australian national communication strategy. Design, Deliberative forum of 12 persons randomly selected from urban South Australia. Forum members were briefed by experts in infection control, virology, ethics and public policy before deliberating on four key questions: what, how and when should the community be told about pandemic influenza and by whom? Results, The forum recommended provision of detailed and comprehensive information by credible experts, rather than politicians, using a variety of media including television and internet. Recommendations included cumulative communication to build expertise in the community, and specific strategies to include groups such as young people, people with physical or mental disabilities, and rural and remote communities. Information provided should be practical, accurate, and timely, with no ,holding back' about the seriousness of a pandemic. The forum expressed confidence in the expert witnesses, despite the acknowledged uncertainty of many of the predictions. Discussion and Conclusion, The deliberative forum's recommendations were largely consistent with the Australian national pandemic influenza communication strategy and the relevant literature. However, the forum recommended: release of more detailed information than currently proposed in the national strategy; use of non-political spokespersons; and use of novel communication methods. Their acceptance of uncertainty suggests that policy makers should be open about the limits of knowledge in potentially threatening situations. Our findings show that deliberative forums can provide community perspectives on topics such as communication about pandemic influenza. [source] Outcomes of a patient-to-patient outbreak of genotype 3a hepatitis C,HEPATOLOGY, Issue 2 2009Mark E. Mailliard Between March 2000 and July 2001, at least 99 persons acquired a hepatitis C virus genotype 3a (HCV-3a) infection in an oncology clinic. This nosocomial HCV outbreak provided an opportunity to examine the subsequent clinical course in a well-defined cohort. This was a retrospective/prospective observational study of the short-term significant health outcomes of a large, single-source, patient-to-patient HCV-3a outbreak. Outbreak patients or their legal representatives consenting to study were enrolled between September 2002 and December 2007. We measured history and physical examinations, medical records, HCV serology, HCV RNA and genotype, liver enzymes, histology, response to antiviral therapy, and liver-related morbidity and mortality. Sixty-four of the 99 known HCV-3a outbreak patients participated. During a 6-year period, six patients developed life-threatening complications from liver disease, three died, one received a liver transplant, and two were stable after esophageal variceal banding or diuretic therapy of ascites. Thirty-three patients underwent antiviral therapy, with 28 achieving a sustained viral remission. One patient acquired HCV-3a infection sexually from an outbreak patient and was successfully treated. Eleven study patients died of malignancy, including two that had achieved a sustained viral remission after antiviral therapy. Conclusion: Our patient cohort had a nosocomial source and an oncologic or hematologic comorbidity. Compared with previous HCV outcome studies, a patient-to-patient HCV outbreak in an oncology clinic exhibited significant morbidity and mortality. Attention is needed to the public health risk of nosocomial HCV transmission, emphasizing infection control, early diagnosis, and therapy. (HEPATOLOGY 2009.) [source] Decubitus ulcers: A review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2005Cheryl Bansal BA Decubitus ulcers are a worldwide health care concern affecting tens of thousands of patients and costing over a billion dollars a year. Susceptibility to pressure ulcers comes from a combination of external factors (pressure, friction, shear force, and moisture), and internal factors (e.g. fever, malnutrition, anaemia, and endothelial dysfunction). Often, enough damage is done to create the basis for a decubitus ulcer after as little as 2 h of immobility, a situation which may be difficult to avoid if the patient must undergo prolonged surgery or remain bedridden. Damage owing to pressure may also occur hours before the patient receives medical attention, especially if the patient falls or becomes immobilized owing to a vascular event. Several classification systems for decubitus ulcers have been described, based on where injury first occurs. The histologic progression of decubitus ulcers is a dynamic process involving several stages, each having characteristic histologic features. A team-focused approach integrating all aspects of care, including pressure relief, infection control, nutrition, and surgery, may improve healing rates. With accurate risk assessment and preventative care, we can hope to minimize complications and mortality owing to decubitus ulcers. [source] Perfusion, oxygenation and warmingINTERNATIONAL WOUND JOURNAL, Issue 2007David Leaper Abstract Perfusion, oxygenation and warming are three elements which have a significant effect on wound healing both with respect to speed and quality of healing. The effects include infection control, increased blood flow and improved quality of granulation tissue. The importance of these elements are outlined and discussed to provide and introduce the importance of oxygen in the healing process. [source] A review of hand-washing techniques in primary care and community settingsJOURNAL OF CLINICAL NURSING, Issue 6 2009Sheree MS Smith Aim., This review seeks to identify the most effective hand-washing and hand-cleansing practice that could be used in primary care. Background., Healthcare associated infection is a major problem in the UK causing 5000 deaths every year. Current guidelines indicate expert opinion is the level of evidence for hand washing as an activity to reduce infection. Design., Systematic review. Method., Publications on hand-washing, hand-cleansing studies, policy and practice-based documents were sought by searching several databases. Terms used included hand washing, hand cleansing, hand hygiene, hand decontamination, infection control and primary care. Results., Few articles described the hand-washing technique in detail and some publications simply referred to either the European and British Standards or the Centre for Disease Control statement on hand washing. Major discrepancies in hand position and water flow direction were found. Several methodological problems were also identified and few studies were undertaken in primary care. Conclusion., This review has found a lack of evidence for hand-washing techniques being undertaken in practice today. Findings from hand-washing technique studies were inconclusive and methodological issues exist resulting in sparse reliable evidence. There is an urgent need to undertake methodologically sound studies of hand-washing techniques for use in the ever expanding scope of primary care practice. Relevance to clinical practice., Evidence for hand-washing and hand-cleansing techniques will inform healthcare professional practice, and contribute to the overall management of infection control in primary care. [source] An evaluation of nursing practice models in the context of the severe acute respiratory syndrome epidemic in Hong Kong: a preliminary studyJOURNAL OF CLINICAL NURSING, Issue 6 2006Engle Angela Chan PhD Aim and objective., Like other health-care workers, Hong Kong nurses had their professional knowledge and skills seriously challenged during the SARS outbreak. Could current nursing practices support the care of SARS or SARS-like patients in the future? If not, alternative practices would be needed. Providing a preliminary understanding, this paper compares the conventional with different nursing delivery models in a simulated SARS ward and focuses on nurses' efficiency, infection control practices and views of the two models. Design and methods., This study was conducted in three phases. First, a baseline understanding of nursing practices was achieved through four workflow observations. In an eight-hour day, four research assistants observed nursing activities in the medical and fever wards. These data were used in the second phase to construct two sets of clinical vignettes, pertaining to SARS patient care in both conventional and alternative practice models. These scripts were discussed with nine nurses of various ranks from the hospital under study for their expert validation and input. In the third phase, nurse participants and patient actors enacted the vignettes in a simulated setting. Video-taped observations and four nurse participant interviews were employed. Observational data were analysed through descriptive statistics and independent t -tests. Textual data were coded and categorized for common meanings. Results., Conventional practice from the findings consisted of cubicle and named nurse nursing. While the former reflected modified team and functional nursing, it did not confine patient care within a cubicle as suggested by its name. The latter depicted a modified primary nursing approach in a team, with delegation of care. Preliminary findings concerning infection control and nurse satisfaction revealed that the alternative model had an advantage over the conventional. Relevance to clinical practice., This study findings lay the foundation for clinical trials, which would evaluate the significance of patient-care quality, cost-effectiveness and better human resource management by restructuring current nursing practices. [source] Infection control in wound care: a study of fatalism in community nursingJOURNAL OF CLINICAL NURSING, Issue 1 2000BNurs, Christine E. Hallett PhD, DNCert, HVCert ,,As part of a study of community nurses' perceptions of quality in nursing care, the author conducted in-depth qualitative interviews with seven community-based nurses. ,,As part of the study, nurses were asked to describe episodes of wound care and to discuss the factors which could affect the quality of such care. ,,One of the most interesting themes to emerge from the data was the apparent ambivalence of the nurses' attitudes towards infection control in wound care. ,,Nurses discussed the concept of ,aseptic technique' in fatalistic terms and seemed uncertain about what could be achieved in terms of infection control. ,,Although their policy guidelines referred to ,aseptic technique', their educational experience appeared to have made them feel uncertain about the implementation of the measures involved. ,,With the proviso that this was a small scale qualitative study, the author concludes by suggesting that there is a need for greater clarity, both in what is taught and in what is included in practice policy with regard to infection control in wound care. [source] Tissue reactions to sutures in the presence and absence of anti-infective therapyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2005Knut N. Leknes Abstract Background: In the oral cavity, sutures are placed within tissues of high vascularity in a moist environment with infectious potential. The objective of this study was to evaluate tissue reactions at silk and expanded polytetrafluoroethylene (ePTFE) sutures in the presence and absence of anti-infective therapy (AT). Methods: Thirty-six sutures were placed within the mandibular keratinized gingiva in six Beagle dogs. Each animal received one braided silk (4-0) and one ePTFE (CV-5) suture in contra-lateral jaw quadrants at 14, 7, and 3 days prior to biopsy. Three animals received daily AT including topical 2% chlorhexidine solution and a systemic broad-spectrum antibiotic. Biopsy specimens allowed histometric analysis of tissue reactions along the central part of the suture loop including the area of perisutural epithelium, ratio inflammatory cells (ICs)/epithelial cells and IC/fibroblasts, and presence/absence of bacterial plaque in the suture track. Results: A perisutural epithelial sheath was forming within 3 days. The cross-sectional area of the epithelium increased with time for both suture materials (p=0.003) but was particularly pronounced for the silk sutures in the absence of AT. Clusters of IC were present in the perisutural connective tissue and epithelium. Over time, a more prominent increase in IC/fibroblasts was evident for the silk sutures in the absence of AT. The pooled material revealed a significantly higher IC/fibroblast ratio for silk compared with ePTFE sutures (p=0.017). Bacterial plaque influx was detected in 6/9 silk and 0/9 ePTFE suture channels in the presence, and 6/6 and 3/6 suture channels, respectively, in the absence of AT. Conclusions: AT may reduce biofilm formation and inflammation along the suture track. Braided silk, however, elicits more severe tissue reactions than ePTFE regardless of infection control. [source] Nosocomial infections and infection control in regional anesthesiaACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2009R. L. R. Videira No abstract is available for this article. [source] Infection control nurse: a national surveyJOURNAL OF NURSING MANAGEMENT, Issue 5 2004R. Quattrin MD Aim, To study presence and activity of Infection Control Nurses (ICN) in Italian National Health System (NHS) hospitals. Background, Infection Control Nurses play an essential and evidence-based role for optimal infrastructure and essential activities of infection control and epidemiology programmes in hospitals. Methods, A survey of all Italian NHS hospitals (N = 529). Hospital health directors were asked to complete a questionnaire with a specific section on ICN presence, activities and roles played. Response rate was 87.5% (463 of 529). Results, More than 50% of hospitals (250 of 463) have an ICN: 25% (116 of 463) have at least one part-time employed ICN and 23.3% (108 of 250) have at least one ICN employed full-time. Infection Control Nurses are more common in hospitals with >250 beds (P < 0.01). Infection Control Nurses working in hospitals with >250 beds are highly active in surveillance activities, personnel education and management of study groups (P < 0.01). Conclusions, In Italian NHS hospitals ICNs have yet to become pillar figures in hospital infection control. [source] Preparedness for Influenza Pandemic in Hong Kong Nursing UnitsJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2006Agnes Tiwari Background: To present preparedness planning for an influenza pandemic for two nursing subunits: nursing services in hospitals and schools of nursing in universities. Discussion: The preparedness plan is modeled on a modified Haddon matrix, a logical approach to identify measures appropriate for the pre-event, event, and postevent phases of an influenza pandemic. For the pre-event phase, the objective is to ensure preparedness for the potential pandemic outbreak through training, communication, surveillance, infection control, and vaccination. Once the pandemic outbreak is declared, the aim is to implement effective measures to ensure a rapid and appropriate response. For the postevent phase, the plan is focused on the restoration of core functions, vigilance for a second or possibly more waves of the pandemic, and psychosocial support to staff and students. Conclusion: Measures required to prepare for, respond to, and manage the consequences of influenza pandemic are identified. This planning indicates the need to balance a logical approach with contextual perspectives and the importance for nursing leaders to develop plans for subunits of larger entities. [source] Implant treatment in periodontitis-susceptible patients: a systematic reviewJOURNAL OF ORAL REHABILITATION, Issue 2008S. SCHOU summary, Implant treatment in individuals with periodontitis-associated tooth loss is frequently debated. The objective of the present systematic review was to assess the principles and outcome of implant treatment in periodontitis-susceptible patients. Studies considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand-searched. The search was restricted to studies published in English from 1980 to 2006. Prospective and retrospective cohort studies assessing implant treatment in partially and totally edentulous individuals with a history of periodontitis-associated tooth loss were included when the follow-up period was >1 year, when more than five patients were included in the study, and when the treatment involved titanium implants. The outcome measures were loss of suprastructures, loss of implants, loss of teeth, health status of peri-implant tissues and health status of periodontal tissues. Screening of eligible studies and data extraction were conducted by the reviewer. A total of 23 studies were identified. The survival rates of suprastructures and implants were high in individuals with a history of periodontitis-associated tooth loss. Therefore, implant treatment in periodontitis-susceptible patients is not contraindicated provided adequate infection control and an individualized maintenance programme. However, the higher incidence of peri-implantitis may jeopardize the longevity of the implant treatment. Consequently, further long-term prospective studies of sufficient numbers of well-characterized patients are needed before definitive conclusions can be drawn about the long-term outcome of implant treatment in periodontitis-susceptible patients. [source] NURSES' KNOWLEDGE AND PRACTICE OF VASCULAR ACCESS INFECTION CONTROL IN HAEMODIALYSIS PATIENTS IN THE REPUBLIC OF IRELANDJOURNAL OF RENAL CARE, Issue 2 2008DipNS, Margaret Higgins RN SUMMARY Vascular access hygiene is an integral component of haemodialysis care. Ensuring nurses possess sufficient knowledge and utilise recommended guidelines on infection control is essential for safe practice and patient safety. The study aimed to investigate nurses' knowledge and practice of vascular access infection control among adult haemodialysis patients in the Republic of Ireland. A confidential self-completion questionnaire was sent to all 190 qualified nurses employed in nine haemodialysis units in the Republic of Ireland, which assessed knowledge and behaviour in infection control. Although 92% of respondents reported that policies had been developed by their units and 47% had received infection control education in the previous year, knowledge and adherence to best practice demonstrated significant scope for improvement. The study recommended the development of standard guidelines and regular reviews and updates of policies. Systems should also be developed to ensure a high level of compliance. [source] Lack of de novo hepatitis C virus infections and absence of nosocomial transmissions of GB virus C in a large cohort of German haemodialysis patientsJOURNAL OF VIRAL HEPATITIS, Issue 4 2009R. S. Ross Summary., To determine the prevalence and incidence of hepatitis C virus (HCV) infections among haemodialysis patients, a large prospective multicentre trial was conducted in the German Federal State of North Rhine-Westphalia. Sera obtained from the recruited patients in two separate sampling rounds run 1 year apart were analysed for both anti-HCV antibodies and HCV RNA. HCV RNA positive samples were also genotyped by direct sequencing of an HCV core fragment. In the first and second rounds, 150 (5.2%) of 2909 and 114 (5.4%) of 2100 patients were anti-HCV positive, respectively, and 4% of individuals were viraemic. Evaluation of potential risk factors in a case,control study indicated that the factors ,foreign country of birth', ,blood transfusions given before 1991' and ,duration of treatment on haemodialysis' were associated with the risk of HCV infection. Among the 2100 patients of whom ,paired' serum samples from both rounds were available for testing, not a single ,de novo' HCV infection could be recorded. The fact that in a subset of about 20% of these patients no nosocomial GB virus C (GBV-C) transmission occurred during the observational period suggests that the lack of HCV seroconversions was not only attributable to the isolation of HCV-infected patients but also to the strict adherence to so-called universal hygienic precautions for infection control maintained in the participating dialysis centres. [source] Increasing the uptake of hepatitis C virus testing among injecting drug users in specialist drug treatment and prison settings by using dried blood spots for diagnostic testing: a cluster randomized controlled trialJOURNAL OF VIRAL HEPATITIS, Issue 4 2008M. Hickman Summary., The objective of this study was to assess whether introducing dried blood spot testing can increase hepatitis C virus (HCV) diagnostic testing. A cluster randomized controlled trial was conducted. Sites were matched into pairs, with one site in each pair randomly allocated to receive the intervention (training and use of dried blood spot). Data were collected from all sites for 6 months before and 6 months after the start of the intervention. The participants were 22 specialist drug clinics and six prisons in England and Wales. The main outcome measure of this study was percentage point difference in individuals tested for HCV (the difference between the percentage of patients tested 6 months after and 6 months before the introduction of dried blood spot tests). Before the trial, 8% of patients at control and intervention sites had been tested for HCV, with 16 sites testing less than 5% of their caseload. The average percentage point difference between intervention and control sites was 14.5% (95% CI 1.3,28%, paired t -test, P = 0.03); with 13 of the 14 pairs contributing to the positive effect of the intervention (Wilcoxon matched-pairs signed-rank-test, P = 0.002). The size of the difference between intervention and control sites varied considerably. The study provides preliminary supporting evidence that dried blood spot testing may increase the uptake of HCV diagnostic testing, by increasing the opportunity for patients to be offered testing. Additional trials with a larger number of sites are justified, ideally in the context of drug and treatment policies that gave clearer priority (and targets) to infection control and testing. [source] Molecular identification and characterization of rifampicin-resistant Mycobacterium tuberculosis isolates by line probe assay: an approach for rapid diagnosis of multidrug-resistant tuberculosisLETTERS IN APPLIED MICROBIOLOGY, Issue 3 2008C. Bicmen Abstract Aim:, Early identification and characterization of rifampicin-resistant (Rr) Mycobacterium tuberculosis isolates recovered from the samples of tuberculosis (TB) patients in the Aegean (West Anatolian) Region was intended. Methods and Results:, Sixty isolates [47 (78·3%) multidrug-resistant (MDR)], which were identified as M. tuberculosis complex and phenotypically resistant to rifampicin by both BACTEC mycobacteria growth indicator tube (MGIT) 960 and 460 systems were analysed by a commercial line probe assay (INNO-LiPA Rif TB). The concordance of LiPA with the in vitro susceptibility test was found as 98·3%. Among the isolates, S531L (R5 pattern; 46·7%) and L511P/R, S512T, Q513L/K (,S1 pattern; 11·7%) were the most frequent mutation patterns. As compared with the BACTEC systems and conventional techniques for cultivation, identification and in vitro susceptibility testing, INNO-LiPA Rif TB after cultivation in BACTEC MGIT 960 system provided an average of 20 days early diagnosis of RrM. tuberculosis isolates. Conclusions:, Rapid molecular identification and characterization of RrM. tuberculosis isolates after BACTEC MGIT 960 cultivation would be useful for faster diagnosis, infection control and planning of accurate treatment in MDR-TB patients. Significance and Impact of the Study:, Patients with MDR-TB need a specified treatment and efficient follow-up strategies. Rapid and practical methodologies to diagnose and follow these patients should be applied in routine use. [source] Review article: Hepatitis B and dialysisNEPHROLOGY, Issue 2 2010MATTHEW EDEY ABSTRACT: The incidence of hepatitis B virus (HBV) infection in dialysis populations has declined over recent decades, largely because of improvements in infection control and widespread implementation of HBV vaccination. Regardless, outbreaks of infection continue to occur in dialysis units, and prevalence rates remain unacceptably high. For a variety of reasons, dialysis patients are at increased risk of acquiring HBV. They also demonstrate different disease manifestations compared with healthy individuals and are more likely to progress to chronic carriage. This paper will review the epidemiology, modes of transmission and diagnosis of HBV in this population. Prevention and treatment will be discussed, with a specific focus on strategies to improve vaccination response, new therapeutic options and selection of patients for therapy. [source] Hepatitis infection in haemodialysis patientsNEPHROLOGY, Issue 3 2002Chiu-Ching HUANG SUMMARY: Known hepatitis infections among haemodialysis patients include hepatitis B, hepatitis C, hepatitis G and TT virus. Haemodialysis patients with hepatitis B and/or hepatitis C infection may progress to develop significant morbidity, such as cirrhosis, hepatitic failure or hepatocellular carcinoma. Hepatitis B infection may be treated with ,-interferon or lamivudine. Hepatitis C infection may be treated with ,-interferon, but frequent severe adverse effects were observed, while ribavirin is contraindicated for patients with renal failure. Treatment for hepatitis B and/or hepatitis C are costly, and the risk of post-transplant reactivation of hepatitis has been reported. Prevention of nosocomial transmission of hepatitis infection with strict infection control and universal precautions is more important. Accumulating evidence suggests that both hepatitis G virus and TT virus (TTV) are not significant causes of liver disease. Routine screening for hepatitis G or TTV viraemia in haemodialysis patients is not indicated at present. [source] Keeping the lid on infection: infection control practices of a regional Queensland hospital 1930,50NURSING INQUIRY, Issue 2 2000Wendy Madsen Keeping the lid on infection: infection control practices of a regional Queensland hospital 1930,50 Nurses have played an important role in infection control practices throughout the past century. However, the desire for minimisation of cross infection has not always been the basis for many of the activities undertaken by nurses within the general ward. This paper is a historical analysis of those practices that formed the basis of infection control within the medical and surgical wards of the Rockhampton Hospital between 1930 and 1950. In particular, those activities dealing with the disposal of body fluids, ward cleaning, aseptic techniques and associated sterilisation of instruments and articles, the nurses' personal cleanliness and isolation nursing have been addressed. This study has identified economic factors, professional image and local traditions as being influential in the origins and persistence of many activities which may be loosely grouped as infection control measures. [source] Anesthesia in HIV-infected childrenPEDIATRIC ANESTHESIA, Issue 6 2007RUENREONG LEELANUKROM Summary In 2005, it was estimated that 2.3 million children below15 years of age were living with human immunodeficiency virus (HIV)/AIDS and 570 000 children below 15 years died. Maternal-infant or vertical transmission is the most common mode of HIV infection in children. As transplacental passage of maternal anti-HIV antibodies, diagnosis of HIV infection in young infants relies on virologic assays. Infants older than 18 months of age can be diagnosed by serology alone. Pediatric HIV infections are classified according to Center for Disease Control and Prevention 1994 revised classification system. The understanding of viral pathogenesis, the development of highly active antiretroviral therapy, and the ability to quantitate viral burden have led to significant reduction in disease progression and morbidity in HIV-infected children. As survival improves, these children will require anesthesia care and pain treatment during the course of their illness. Considerations for the anesthesiologist include: possible involvement of multiple organ systems, adverse reactions and drug interactions of antiretroviral agents and adequate infection control to prevent HIV transmission in hospital and other infections to the immunocompromized patients. Finally, care should be taken not to violate confidentiality. [source] | |||||||||||||||||||||||||||||||