John M Boyce

..Substantial variations were found in the amount of time spent cleaning high-touch surfaces, in the number of disinfectant wipes used in each room, and in the level of cleanliness achieved by housekeepers...

..The available evidence supports more routine use of antimicrobial lock solutions as an HD-CLABSI prevention measure in hemodialysis units...

..This article summarizes the expert panel's deliberations, conclusions, and recommendations...

..To compare fluorescent markers with aerobic colony counts (ACCs) and an adenosine triphosphate (ATP) bioluminescence assay system for assessing terminal cleaning practices...

..We conclude that gastrointestinal colonization with MRSA may serve as an unrecognized reservoir from which transmission of MRSA may occur in health care facilities...

..To determine whether there is an association between the increasing use of alcohol-based hand rubs (ABHRs) and the increased incidence of Clostridium difficile-associated disease (CDAD)...

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..Compared with the CHROMagar MRSA assay, PCR had sensitivity, specificity, positive predictive value, and negative predictive values of 100%, 98.6%, 95.8%, and 100%, respectively. The mean PCR turnaround time was 14.5 h...

..To evaluate the usefulness of an adenosine triphosphate (ATP) bioluminescence assay for assessing the efficacy of daily hospital cleaning practices...

..Observational surveys of hand hygiene compliance are time consuming. Measuring the use of a hand hygiene product is a less time-consuming method of monitoring the frequency of hand hygiene performance...

..We investigated the frequency of environmental contamination in the rooms of patients with diarrheal stools and heavy gastrointestinal colonization with MRSA...

..To determine whether hydrogen peroxide vapor (HPV) decontamination can reduce environmental contamination with and nosocomial transmission of Clostridium difficile...

..Because MRSA is transmitted primarily on the hands of healthcare workers, greater emphasis should be given to improving hand hygiene practices among health personnel. For patients infected with MRSA, vancomycin remains a drug of choice...

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..To determine the ability of a mobile UV light unit to reduce bacterial contamination of environmental surfaces in patient rooms...

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..Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included...

..Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included...

..Twenty-one (21%) of 98 patients were no longer colonized and were removed from contact precautions...

..We found that the equipment was not being disinfected as per protocol and that education and feedback to nursing are warranted to improve disinfection of medical equipment...

..Preliminary studies suggest that hydrogen peroxide vapour technology deserves further evaluation as a method for decontamination of the environment in healthcare settings...

..aureus may cause nosocomial antibiotic-associated diarrhea. Greater recognition of this disease should result in more rapid and appropriate treatment of affected patients...

..In 2007, a multidisciplinary task force revised policies outlining staff responsibilities for cleaning in-patient nursing care units and chose a monitoring system using a specialized adenosine triphosphate bioluminescence test...

..The recovery of MRSA was greater on the CMRSAII agar. Screening of stool samples can identify patients who were previously unknown carriers of MRSA...

..To review evidence regarding the effectiveness of control measures in reducing transmission of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals...

..Herein we describe a patient in whom methicillin-resistant Staphylococcus aureus with reduced susceptibility to daptomycin was responsible for bacteremia and progressive vertebral osteomyelitis during daptomycin therapy...

..To compare the microbiological efficacy of hydrogen peroxide vapor (HPV) and ultraviolet radiation (UVC) for room decontamination...

..None of the 798 responding facilities using ABHRs reported a dispenser-related fire; 766 facilities had accrued an estimated 1,430 hospital-years of ABHR use...

..Clearly, further research is needed to develop efficient, reliable, and reproducible methods for monitoring hand hygiene compliance...

..Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included...

..Additional studies of this issue need to include surveillance for mupirocin-resistant strains...

..After cleaning, 99% of surfaces yielded less than 2.5 colony-forming units/cm(2), 75% yielded no growth, and 70% yielded adenosine triphosphate counts of less than 250 relative light units. The new disinfectant was highly effective...

..CONCLUSION: Active surveillance cultures are essential to identify the reservoir for spread of MRSA and VRE infections and make control possible using the CDC's long-recommended contact precautions...

..The empirical use of vancomycin for suspected community-acquired infections is seldom warranted...

..The sensitivity of RT-PCR, compared with culture, was 92.5%, and the specificity was 51.4%. Because of poor specificity, the RT-PCR kit tested is not suitable for the detection of MRSA on hospital surfaces...

..CONCLUSION: Evaluation of alcohol-based handrubs should consider not only product characteristics, user acceptability, skin tolerance, and cost but also the design and function of the dispensers that will ultimately be installed...

..We review the evidence supporting each of these steps and propose a dynamic model for hand hygiene research and education strategies, together with corresponding indications for hand hygiene during patient care...