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Health care-associated infections (HAIs) have traditionally been viewed with a certain air of epidemiological inevitability, seen in many cases as the unpreventable result of keeping very sick patients alive via invasive devices and other medical interventions.
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It may seem intuitive, even obvious to experienced ICPs, but acquiring an infection during hospitalization is about as bad as it gets for a patient. Even patients with a host of maladies that compromise their recovery fared significantly better in outcomes than patients who acquired infections.
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Having worked with a "physician champion" and greatly lowered infection rates by adopting an industrial process model, an infection control professional has joined the chorus that say infections are not an inevitable byproduct of medical care.
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Empowering nurses and other clinicians to speak up when they perceive a patient safety problem may be the most important component of emerging new programs designed to drive infection rates to zero, emphasizes Sara Cosgrove, MD, hospital epidemiologist at John Hopkins in Baltimore.
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Sandiumenge and colleagues evaluated the effects of three strategies of antibiotic prescribing in a 14-bed ICU. The strategies were applied serially, beginning with an initial 10-month period during which patients with suspected ventilator-associated pneumonia received "patient-specific therapy" in which multiple antibiotic regimens, chosen on the basis of length-of-stay and recent antibiotic exposure, were used.
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Infection control practices and other "hospital factors" specific to individual institutions appear to be a greater influence on infection risk than a patient's severity of illness, researchers found.
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The program developed at Johns Hopkins University Hospital in Baltimore that pushed catheter-related bloodstream infection rates to zero in some intensive care units is based on the following four overriding principles. Sara Cosgrove, MD, hospital epidemiologist, comments on each one as follows:
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The World Health Organization/International Union Against Tuberculosis and Lung Disease Global Project on Anti-tuberculosis Drug Resistance began collecting its data in 1994 on drug resistance in 90 countries.
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This article originally appeared in the August 2006 issue of Travel Medicine Advisor. It was edited by Frank Bia, MD, MPH, and peer reviewed by Philip R. Fischer, MD, DTM&H. Dr. Fishcer is Professor of Pediatrics, Divsion of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN. Dr. Fishcer reports no financial relationships relevant to this field of study.
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HIV antiretroviral therapy treatment soon will become a whole lot simpler than most antibiotic regimens when the FDA approves the combination pill of efavirenz/emtricitabine/ tenofovir (Truvada/Sustiva).
