Infection control and hospital epidemiology · 2008
Infection control experience in a cooperative care center for transplant patients.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Nusair Ahmad, Jourdan Dawn, Medcalf Sharon, Marion Nedra, Iwen Peter C, Fey Paul D, Reed Elizabeth, Langnas Alan, Rupp Mark E
Аннотация
OBJECTIVE: To characterize infection control experience during a 6.5-year period in a cooperative care center for transplant patients.
DESIGN: Descriptive analysis.
SETTING: A cooperative care center for transplanted patients, in which patients and care partners are housed in a homelike environment, and care partners assume responsibility for patient care duties.
PATIENTS: Nine hundred ninety one transplant patients.
METHODS: Infection control definitions from the Centers for Disease Control and Prevention were used to ascertain infection rates. Environmental cultures were used to detect methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), Clostridium difficile, and fungi during the first 18 months. Surveillance cultures were performed for a subset of patients and care partners.
RESULTS: From June 1999 through December 2005, there were 19,365 patient-days observed. The most common healthcare-associated infection encountered was intravascular catheter-related bloodstream infection, with infection rates of 5.74 and 4.94 cases per 1,000 patient-days for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) patients, respectively. C. difficile-associated diarrhea was observed more frequently in HSCT patients than in SOT patients (3.97 vs 0.57 cases per 1,000 patient-days; P < .0001). There was no evidence of environmental contamination with MRSA, VRE, or C. difficile. Acquisition of MRSA was not observed. Acquisition of VRE was documented.
CONCLUSION: This study documented that cooperative care was associated with some risk of healthcare-associated infection, most notably intravascular catheter-associated bloodstream infection and C. difficile-associated diarrhea, it appears the incidences of these infections were roughly commensurate with those in other care settings.
DESIGN: Descriptive analysis.
SETTING: A cooperative care center for transplanted patients, in which patients and care partners are housed in a homelike environment, and care partners assume responsibility for patient care duties.
PATIENTS: Nine hundred ninety one transplant patients.
METHODS: Infection control definitions from the Centers for Disease Control and Prevention were used to ascertain infection rates. Environmental cultures were used to detect methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), Clostridium difficile, and fungi during the first 18 months. Surveillance cultures were performed for a subset of patients and care partners.
RESULTS: From June 1999 through December 2005, there were 19,365 patient-days observed. The most common healthcare-associated infection encountered was intravascular catheter-related bloodstream infection, with infection rates of 5.74 and 4.94 cases per 1,000 patient-days for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) patients, respectively. C. difficile-associated diarrhea was observed more frequently in HSCT patients than in SOT patients (3.97 vs 0.57 cases per 1,000 patient-days; P < .0001). There was no evidence of environmental contamination with MRSA, VRE, or C. difficile. Acquisition of MRSA was not observed. Acquisition of VRE was documented.
CONCLUSION: This study documented that cooperative care was associated with some risk of healthcare-associated infection, most notably intravascular catheter-associated bloodstream infection and C. difficile-associated diarrhea, it appears the incidences of these infections were roughly commensurate with those in other care settings.