Am J Crit Care 2001 Nov;10(6):373-4
Publication Types:
PMID: 11688603, UI: 21543566
Clin Infect Dis 2002 Feb 5;34(6)
Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, CH?8091 Zurich, Switzerland.
[Record supplied by publisher]
We investigated an outbreak of Serratia marcescens in the neonatal intensive care unit (NICU) of the University Hospital of Zurich. S. marcescens infection was detected in 4 children transferred from the NICU to the University Children's Hospital (Zurich). All isolates showed identical banding patterns by pulsed?field gel electrophoresis (PFGE). In a prevalence survey, 11 of 20 neonates were found to be colonized. S. marcescens was isolated from bottles of liquid theophylline. Despite replacement of these bottles, S. marcescens colonization was detected in additional patients. Prospective collection of stool and gastric aspirate specimens revealed that colonization occurred in some babies within 24 hours after delivery. These isolates showed a different genotype. Cultures of milk from used milk bottles yielded S. marcescens. These isolates showed a third genotype. The method of reprocessing bottles was changed to thermal disinfection. In follow?up prevalence studies, 0 of 29 neonates were found to be colonized by S. marcescens. In summary, 3 consecutive outbreaks caused by 3 genetically unrelated clones of S. marcescens could be documented. Contaminated milk could be identified as the source of at least the third outbreak.
PMID: 11830800
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Crit Care Med 2001 Dec;29(12):2387-8
PMID: 11801857, UI: 21659464
J Hosp Infect 2002 Jan;50(1):36-41
Department of Public Health, Istanbul University, Istanbul, Turkey
[Medline record in process]
As most nosocomial infections are thought to be transmitted by the hands of healthcare workers, handwashing is considered the single most important intervention to prevent nosocomial infections. However, previous studies have shown that handwashing practices are poor, especially among medical personnel.The objective of this study was to assess the rate of handwashing among intensive care unit (ICU) healthcare personnel, and then to propose realistic suggestions so that hand hygiene' could be performed at an optimal level. To achieve this, each healthcare worker in the ICU of Istanbul Medical Faculty was observed directly, and, a comprehensive microbiological investigation was carried out among personnel and of the inanimate environment.The frequency of handwashing was low; 12.9% among medical personnel. Moreover, there was a widespread contamination in the ICU and 28.1% of the healthcare workers were carriers for methicillin-resistant Staphylococcus aureus (MRSA). The factors that contributed to low compliance of handwashing protocols were: a low staff to patient ratio, excessive use of gloves and deficiencies in the infra-structure of ICU. In heavy workload conditions, alcoholic handrub solutions for quick hand decontamination can be considered as an alternative to handwashing. Copyright 2001 The Hospital Infection Society.
PMID: 11825050, UI: 21683707
Respir Care 2002 Jan;47(1):61-8
Department of Respiratory Therapy, The University of Chicago Hospitals, 5841 S Maryland Avenue, MC0981, Chicago IL 60637, USA. smorgan@uchospitals.edu
INTRODUCTION: The unique electromagnetic environment of the magnetic resonance imaging (MRI) scanner presents particular problems for critically ill patients requiring mechanical ventilation during MRI. Most currently available MRI-compatible ventilators are limited in scope and function and thus may not be suitable for patients requiring high peak inspiratory pressure or flow. METHODS: To determine whether a standard critical care ventilator could be used under MRI conditions, we modified a Siemens Servo 900C by replacing the standard oxygen blender with an MRI-compatible blender. We then calibrated the ventilator and tested it on a mechanical lung during active MRI scanning at magnetic fields up to 1.5 tesla. After verifying adequate function, we used the ventilator to support 21 critically ill patients requiring mechanical ventilation during MRI. RESULTS: In all cases we found no alterations in ventilator performance resulting from the electromagnetic interference typical of an MRI scan. We also found no abnormalities in the alarm systems for fraction of inspired oxygen, high inspiratory pressure, or minute volume. Finally, we found no degradation of MRI image quality resulting from ventilator operation during test scanning. CONCLUSIONS: We conclude that with minor modifications the Siemens 900C ventilator can safely ventilate critically ill patients during MRI.
PMID: 11749688, UI: 21625168
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