Gary A Noskin

..We evaluated historical trends in the Staphylococcus aureus infection rate, economic burden, and mortality in US hospitals from 1998 through 2003...

..A number of studies have demonstrated that patients infected with either methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) are at higher risk for mortality and medical resource expenditures...

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..Previous studies have investigated the impact of Staphylococcus aureus infections on individual hospitals, but to date, no study using nationally representative data has estimated this burden...

..5) The APIC and the SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts...

..006). Therefore, inaccurate detection and reporting of LIRVRE by disk diffusion and Etest is associated with increased patient morbidity and resource use...

..aureus...

..Inactive antimicrobial therapy in the first 24 h did not significantly impact average outcomes for GNBI among hospitalized patients but may have caused harm to specific individuals...

..5) APIC and SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts...

..Hand hygiene (HH) compliance among health care workers (HCWs) has been historically low and hampered by poor surveillance methods. This study evaluated the use of an electronic device to measure and impact HH compliance...

..This mechanism is indicated by the recovery of identical Acinetobacter baumannii isolates from gloves and from the clinical cultures of a patient with invasive infection...

..To evaluate the impact of postprescription review of broad-spectrum antimicrobial (study-ABX) agents on rates of antimicrobial use...

..We studied key clinical characteristics and outcomes associated with pSAB to better define the epidemiological features of this increasingly recognized clinical entity...

..Limiting the effects of a large-scale bioterrorist anthrax attack will require rapid and accurate detection of the earliest victims. We undertook this study to improve physicians' ability to rapidly detect inhalational anthrax victims...

..Twenty (95%) isolates contained the Staphylococcus cassette chromosome mec type IV gene; this suggests that the increase is due to community-acquired methicillin-resistant S. aureus...

..Lower VRE bacteremia rates and a more polyclonal population, representing less horizontal transmission, may result from routine screening of patients who are at risk for VRE and prompt contact isolation of colonized individuals...

..Future studies should evaluate these findings in vivo...

..9 to 72.4% (P < 0.001). Both the percentage of E. faecium among the enterococci and the proportion of vancomycin-resistant E. faecium increased significantly over this 10-year period...

..To better understand these issues on a regional level, the CDPH and the Evanston Department of Health and Human Services (EDHHS; Evanston, Illinois) began an investigation...

..Education-based interventions can reduce the incidence of catheter-associated bloodstream infection. The generalizability of findings from single-center studies is limited...

..The literature describing complications of S. aureus bacteremia and the bacteriology of prostatic abscesses is reviewed. This was found to be the first report of a patient with persistent MRSA bacteremia maintained by a prostatic focus...

..However, non-E. faecalis, non-E. faecium species are not associated with any differences in mortality...

..This study was designed to determine risk factors and potential harm associated with medication errors at hospital admission...

..There were no positive umbilical samples...

..To determine the prevalence and epidemiological characteristics of rotavirus among adults admitted to the hospital with diarrhea that have bacterial stool cultures sent...

..Mortality among these patients was high, due to serious underlying disease...

..We sought to determine the cost-effectiveness of Antimicrobial Stewardship Teams (ASTs) on the reduction of morbidity and mortality associated with nosocomial bacteraemia...

..We evaluated the use of automated inpatient diagnosis codes and pharmacy data to identify SSIs after arthroplasty...

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..To describe the peritoneal fluid penetration of tigecycline...

..This case-based review will highlight 8 antibiotics that have emerging clinical indications in treating these multidrug-resistant (MDR) pathogens...

..Infection control programs, staff and patient education, and use of optimal antisepsis agents or prepackaged kits are useful toward this end...

..Upholstery, walls, and flooring may enhance bacterial survival, providing infectious reservoirs...

..The possibility of increased serum vancomycin concentrations as a method to optimize current treatment outcomes is also explored...

..Implications and recommendations for message development are discussed...

..000006). In our hospital, the percentage of patients with nosocomial infections is 43% below the U.S. rate. Our typing laboratory costs approximately $400,000 per year, a savings of $5.00 for each dollar spent...

..However, the role of routine inpatient surveillance for ESBL colonization in predicting related infection is unclear...

..faecalis isolates was associated with a guanine to uracil transversion at bp 2576, while the one E. faecium isolate for which the MIC was 16 microg/ml contained a guanine to adenine transition at bp 2505...

..Pediatric rotavirus vaccination correlated with a relative decline of almost 50% in rotavirus identified from adult BSC during the peak rotavirus season, suggesting that pediatric rotavirus vaccination protects adults from rotavirus...

..Guided antibiotic adjustment for the treatment of multidrug-resistant, gram-negative pathogens is explored...

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..An increased number of hand-washing sinks, as a sole measure, did not increase hand-hygiene compliance...

..To report pharmacokinetic alterations and optimal dosing of piperacillin/tazobactam in an obese patient...

..In summary, linezolid appears to be a promising new antimicrobial agent for the treatment of gram-positive infections...

..ICT performance needs to be assessed in a real-world clinical setting. This study aims to describe the incidence and clinical impact of ICT false-positivity in a hospital setting over a 19-month period...

..The impact of community-based rotavirus vaccination on the substantial burden of hospital-acquired (HA) rotavirus has not been documented...

..Thus, those in the laboratory should recognize that many surfaces may be contaminated by resistant organisms during routine processing of patient specimens...

..This pseudobacteremia outbreak highlights the importance of adhering to well-established methods for blood culture collection and ongoing infection control surveillance...

..We hypothesized that it would be possible to design a method to conduct real time active surveillance and conducted a pilot study to identify adverse events and medical errors...

..A larger study is needed for MDRE, as only 4 of 43 surfaces were MDRE positive. The Rodac imprint technique successfully recovered VRE from environmental surfaces...

..Environmental surfaces such as chairs may serve as a potential reservoir for nosocomial transmission of VRE, and an easily cleanable, nonporous material is the preferred upholstery in hospitals...

..PERSPECTIVE: Scheduled dosing of opioids in an inpatient medical population improves analgesia, theoretically by overcoming barriers to drug administration, as well as providing more stable plasma levels of the opioid...

..These data suggest that the RiboPrinter is not reliable for VRE investigation...

..The patient responded to surgical debridement and prolonged antimicrobial therapy with intravenous ceftriaxone...

..To assess current infection control practices of interventional radiologists (IRs) in the context of recommendations by the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration...

..8-78.1) compared with community-acquired pneumonia, and 95.6% specific (90.0-98.5) compared with influenza-like illness. Our findings represent preliminary efforts toward identifying clinical predictors of inhalational anthrax...

..Adverse drug events (ADEs) are the most common cause of injury to hospitalized patients and are often preventable. Medication errors resulting in preventable ADEs most commonly occur at the prescribing stage...

..Investigating reasons for the prescribing of alternative antimicrobial agents outside of these guidelines is crucial for modifying practices that may adversely impact institutional antimicrobial goals...

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..We describe historical landmarks about hospital design, modern facility design, and specific designs to prevent acquisition and spread of infections such as tuberculosis and aspergillosis...

..Routine surveillance cultures can substantially improve prevalence and incidence estimates, and assessing the range of improvement across diverse units is important...

..Statistical methods applied to clinical microbiology laboratory information system data efficiently supplement infection control efforts for outbreak detection...

..CONCLUSIONS: Infectious morbidity can occur after endoscopy despite negative surveillance cultures. The practice of routine endoscope cultures does not prevent device-related infectious morbidity...

..This screening method was efficient, readily standardized, and suitable for most hospitals...